This question framed the January 30 talk that was given by Sierra Bainbridge of MASS Design Group and hosted by PennPraxis as part of its ongoing Praxis Dialogues series. Since its founding in 2008, MASS Design Group has grown into a renowned social-impact architecture and landscape architecture firm, beginning with the design and construction of the Butaro District Hospital in Rwanda (a project with Partners in Health and the Rwandan Ministry of Health). When the project’s designers first visited other hospitals in Rwanda, they found that the buildings typically featured central double-loaded corridors without adequate exposure to the outdoors. As a result, these hallways were conduits for sick patients and sick air, harming patients rather than healing them, and churning through doctors at an unsustainable rate as Rwandan physicians moved elsewhere to practice in better conditions. These conditions forced a new question for the Butaro project’s architects and landscape architects:
If buildings are making us sick, can they also make us healthier?
The Butaro project was symbolic as a place of healing in more ways than one, as it transformed a former military barracks into a restorative building and landscape. The designers reoriented the patient experience and the hospital’s physical infrastructure, giving each patient bed a view of the surrounding landscape and pushing all circulation to the exterior so that sick air could no longer fester inside the building. On the building site, the project’s landscape architects deployed trees and shrubs to stabilize the hillside, and various seating areas and pathways encouraged patients to linger outside as they recuperate.
How can one construction project support a whole community?
As the project managers mapped out the construction process for the Butaro hospital facility, they adopted Partners in Health’s operational model in order to effect change at the community scale. This meant that the project employed local laborers on a rotational basis, hiring a force of 4,000 people that revolved every 2 weeks (rather than a much smaller, more stable workforce), extending the project’s economic impact as much as possible. The design also made deliberate and exclusive use of regionally sourced materials in order to multiply the economic impact and lighten the environmental impact of the construction process. The facility opened in January 2011, and MASS Design Group subsequently undertook other projects at the site. In their partnership with the Rwandan Ministry of Health, however, the project architects and landscape architects faced another question of scale, as the Ministry sought to replicate the Butaro design principles elsewhere:
How can one individual design make every subsequent design better?
The design of the Butaro hospital project fueled MASS Design Group’s interest in a more holistic, scalable approach to social-impact design, resulting in advocacy, research, and training projects to evaluate and adapt the Butaro approach elsewhere in Rwanda and beyond.
As Sierra Bainbridge concluded in her talk, and MASS Design Group’s Butaro hospital project makes clear: Design is not neutral. Architecture and landscape architecture can have a social impact, and design should uphold dignity for all.
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