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HEALTH ESTATE ARCHITECTURE


concerns about preserving the environment, but also to its economic and social merit, and the well-being of users. That it remains a challenge to establish a single definition for the concept of sustainability is a problem faced by scholars of the cultural heritage of health estate.1


There is an


urgent need for studies that could serve as a practical guide to the relationship between historical health estate assets and sustainability to advance the concept of sustainable heritage.


Health architecture and sustainability All buildings where health-related activities are carried out, whether for study, teaching or practical application - in addition to documents, objects and medical instruments among other things - can be considered to be the ‘cultural heritage of health’.4


Sanglard and Costa


consider the ‘cultural heritage of health’ as consists of socially constructed material and symbolic goods, which demarcate and record the development of the evolution of processes related to “individual and collective health in its scientific, historical and cultural”.5 Unlike other buildings, health estate


took a long time to gain prominence in architectural studies. The first dedicated hospitals appeared only at the end of the 18th century and before that healthcare was essentially provided in religious buildings. Even at the beginning of the 20th century, the architectural language of hospitals was still mixed with that of churches and convents.6


That changed


with the advent of Modern architecture with its promotion of form, function and spatial freedoms that initiated a sea- change in hospital design. The conservation of the cultural heritage of health has been gaining increasing importance in international architectural circles in recent years, and it recognises the link between the buildings and the history and values of the communities in which they operate. Under this vision of heritage, hospitals are more than mere functional spaces for the practice of medical activities; they are


Hospital Cassiano Campolina in Entre Rios de Minas was founded in 1904 and declared a heritage site in 2018.


important instruments for the analysis, evaluation and historical knowledge of health and society.4 In Brazil, a heritage site is listed when


it starts to appear in the list of assets recognised for their historical, artistic or cultural importance by a municipal, regional or federal authority. The most common action used as a means of preserving the historic characteristics of buildings is a tombamento. This listing of a cultural asset by the National Historic and Artistic Heritage Institute (IPHAN) aims to ensure respect for the memory of the place and the maintenance of quality of life. Tombamento comes from Torre do Tombo, a public archive in Portugal where important documents are kept and preserved. However, the declaration of buildings as a heritage site alone does not provide full guarantee of preservation of the architectural asset. It is necessary to “join forces with the State, pro-heritage organizations and civil society”, so that actions to preserve historical heritage are successful.7 With regard to hospitals and other health buildings - especially those belonging to the public healthcare


system - there are even greater challenges. In addition to the usual lack of resources for maintenance, conservation and restoration of the facilities and infrastructure of hospital buildings, these are almost always susceptible to other problems. They include the following: l Political disconnection between public and private spheres.7


l The lack of funds for modernisation and technological adaptation.


l The lack of permanent education related to the use and preservation of environments.


l The specific regulations related to health environments, which can hinder the adaptation and revitalisation of health buildings considered heritage sites.


The defence of historical heritage is always more effective if there are integrated and systematic actions to protect, preserve and promote the cultural value of buildings. The conservation of these buildings always depends on the availability of considerable resources. Actions related to sustainability can be implemented focused on purposeful preservation, as opposed to actions that


Furniture, medical instruments and original equipment at Hospital Cassiano Campolina in Entre Rios de Minas. 104 IFHE DIGEST 2021


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