Architecture Delivery to Rwanda

After hearing Paul Farmer speak about Rwanda’s lack of hospitals in 2007, Michael Murphy, then a first year M.Arch at Harvard’s Graduate School of Design, was so inspired that he marched up to Farmer to discuss the intersection of healthcare and architecture. One year and a prestigious Hart Howerton Fellowship later, Murphy was invited by Paul Farmer to help with the design a new hospital in the Burera District of Rwanda. And so, the seeds of MASS Design Group were sewn.

“You can try to distribute massive amounts of drugs, but there is no way that the pipeline can work unless the shelter and physical infrastructure is in place,” explains Murphy. “It’s part of the role of a designer to seek out problems that we didn’t know we had to solve.” Tuberculosis, for instance, is a .4-micron-sized bacteria nearly eradicated in richer countries, but still runs rampant in developing nations, infecting over 2 billion people and killing over 1.7 million each year. Both inadequate drug distribution and poor design of facilities have resulted in the emergence of highly drug-resistant strands that plague these communities, with little hope for relief without infrastructural channels.

As the inaugural hospital of the entire district, Butaro Hospital lies two hours north of Kigali, covers an area of 6000 square meters, and serves over 400,000 people. It is a joint venture between Partners In Health, the Clinton Health Access Initiative, and The Ministry of Health of Rwanda.

In the recently launched Department of Architecture at the Kigali Institute of Science and Technology, two members of MASS lecture in the Faculty of Architecture, and they envision MASS to become a collaborative ‘bauhaus of Rwanda.’ One of them is Sierra Bainbridge, who formerly worked at Field Operations as a project manager of the Highline, and is MASS’s Lead Designer and Country Director in Rwanda.

Taking cues from infection control experiences of PIH and the World Health Organization, they employed creative architectural strategies to combat airborne diseases. Their first move was to transform all hallways into exterior circulation and redistribute the hospital program onto three adjacent hilltops.

The hospital also introduces natural cross-ventilation through clerestories, secluded patient wards around courtyards, rainwater collection for irrigation, and an effective spatial triage system (separating patients based on their condition). Construction began in the fall of 2008, using many local materials -- especially volcanic rock from the nearby Virunga Mountains that are quarried, sized, and shaped by hand by masons.

Here, the workers (there are a total of 200, all local) are laying the foundation for the covered outdoor veranda. According to Ebbe Strathairn, a designer who recently moved to Rwanda in the summer of 2009, "Multiple times our on-site guy has been asked by the laborers who this hospital is for. They think it is too nice to be for them."

With five people on the ground in Rwanda and ten members in Cambridge, Massachusetts, Murphy and his team hold lofty goals even beyond building self-sustaining healthcare infrastructure. Currently armed with an array of pro bono projects, MASS Design Group wants to start an architectural rumble for social change through Africa -- inciting more public discourse surrounding design, and building a local community of designers from the ground up.

In the recently launched Department of Architecture at the Kigali Institute of Science and Technology, two members of MASS lecture in the Faculty of Architecture, and they envision MASS becoming a collaborative ‘bauhaus of Rwanda.’ One of them is Sierra Bainbridge, who formerly worked at James Corner's Field Operations as a project manager of the Highline, and is MASS’s Lead Designer and Country Director in Rwanda.

“There’s a dearth of design thinking where places need it the most. There are 35,000 architects in Africa -- 25,000 of which are in Egypt. We as architects have a role to play in creating social value through design,” --Michael Murphy, co-founder

"As a brief reality check, 800,000 people were killed in the 100 days of genocide in Rwanda. That's 5.5 a minute.." --Ebbe Strathairn, designer

In addition, some of the other projects on the horizon include a 200-unit housing development in the eastern area of Rwinkwavu in Rwanda, the Girubuntu School in Kigali, a bike shop, and a new book on medical infrastructure in resource limited settings.

When I asked Murphy whether he pictures himself in Rwanda after he graduates, a nostalgic smile danced across his face. “Definitely. This is my life. We had eleven people on the ground this summer -- one day we were designing plans, and the next day, people were building it. We train with and accompany the community to seek a better built environment; it’s amazing. Why aren’t more architects doing this around the world?”