the natural ventilation and ensuring inward flow to the patient rooms. The team considered how both patients and staff flow through the facility—we designated separate staff areas to ensure protection of the staff while minimising the need for PPE. The team adapted the facility using a WHO guide, planning for both mild and severe patients, addressing ventilation, patient and staff flow, protection of staff, laundry, and medical waste disposal. We feel incredibly fortunate to have had this opportunity - for Mazzetti to be able to invest our time in research of COVID-19 and develop ventilation recommendations for our hospital clients in the US and now globally. We are using this knowledge and our experience in healthcare ventilation to help facilities anywhere, threatened by this virus, including those without the tremendous healthcare infrastructure that we have in the U.S.

Haiti project – June 2020 As reported in the New England Journal of Medicine,1

COVID-19 cases have been

reported in all 10 departments of Haiti. As of 2 June 2020, there were more than 2500 confirmed cases and the doubling time was five days.

Haiti has one of the highest mortality

rates from natural disasters in the world. The same factors that contribute to deaths from natural disasters, make Haiti susceptible to a viral pandemic: poverty, food insecurity, lack of clean water and sanitation, scarce health care resources, low educational attainment, political division, and densely populated slums that are controlled by gangs and inaccessible to public officials. Lessons learned in Haiti will be applicable in other low-income countries with similar vulnerabilities. The second project was catalyzed by the need in Haiti for screening facilities. This project was not site-specific, rather,

focused on the need for designing prefab screening facilities with, per the WHO’s request, the ability to “expand” as needed. Mazzetti partnered with architecture firm TreanorHL. This effort was directly coordinated with the United Nations Humanitarian Response Depot (UNHRD). The team essentially provided guidance

for designing modular screening facilities with the ability to scale to different sizes. In Haiti, specifically, the design guidance was applied to pre-existing modular facilities, remaining from a post-hurricane relief effort. The teams advised that the screening

facility should be a collection of modular units that can be easily site assembled and used individually or combined into larger enclosed and conditioned spaces. The arrangement of these modules serves the flow of patients and a larger overhead


Original maternity facility in Burkina Faso.

shade structure will be provided for unconditioned areas for waiting and to maintain physical distance. The modules may rest on legs and so a

raised walkway or platform may be used to provide a roughly uniform walking surface.

While the modules are designed to

resist wind, methods such as anchors or ballast will be required to hold them down in windy or seismic conditions. While Haiti is prone to both hurricanes and earthquakes, a specific site has not been selected and the building code has not been specified. Therefore, determination of wind or seismic design criteria has not been started. The overhead shade structure could

take the form of a rigid structure using steel, aluminum, or wood, with a hard roof. Alternatively, the shade structure could be composed of a fabric stretched over a tent-like framework. The selected system should balance low initial cost, while being durable (relative to the lifespan of the facility), easy to erect using local manpower, expandable and potentially demountable for reuse at another location.

Knowledge sharing & mentoring Later, Team 1 became an advisor to other international teams (among the 16 formed), with the goals of multiplying the capabilities of WHO staff and sharing experiences to shorten the design process for new teams. The team learned to work with limited

information, communications constrained by time zone, language, and multiple layers between design team and in- country staff. Many of the rules we know from our experience in the US simply do not apply in areas with severely limited

resources, where natural ventilation is the norm and power may not be reliable. As of this publication, IFHE members and partners are mentoring projects in both Brazil and Ethiopia with varying scopes. A full report on the Haiti screening facilities can be viewed at view/00f189f9-09bc-400d-b7af- 106286c5e52b.

Accra ventilation design analysis The IFHE ventilation team, comprised mostly of Team 1 engineers, was also asked to assess the ventilation design of a new tent hospital to be constructed in Accra, Ghana. A computational fluid dynamics (CFD)

assessment was completed to provide illustration and understanding of the airflow movement within the space, with the intent of creating a cleaner environment for medical staff. The patients in this case were patients with mild COVID symptoms. The team assessed the airflows

produced from the air-conditioning systems, as well as air extracted behind the patient beds and recirculated into the space via HEPA filter systems. The team analyzed the air volumes,

velocity, directions, and temperature to help determine any modifications required for better ventilation to the space. Based on this, the team advised on how to redesign the HEPA (high- efficiency particulate air) filter system and reposition the extract grilles to provide better airflow from the patients towards the extract, providing a better distribution of air throughout the space. Using CFD modeling, the team

determined that some simple modifications could improve the

Modular screening facility design for Haiti. IFHE DIGEST 2021

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116