NEXT STEP Ngaoubela
The hospital of Ngaoubela is located within the central region of Adamoua and provides medical care for patients within a radius of 250 kilometres. After a first successfully realised project, a new building for an operation theatre in 2012, the hospital approached us for some additions. Gathered in one project, we were supposed to find an urgent solution for three different uses:
1) Housing for the patient’s relatives
In the African health system the relatives play a huge role in the daily care of their patients, especially in rural hospitals like in Ngaoubela. Despite of the medical support, the family members have to look after everything else, like cooking, cleaning and feeding, etc.. Therefore the relatives have to stay in the hospital the same time as their medicated family members. Due to a lack of space in the clinic, the relatives originally had to sleep and stay underneath their patient beds or in the hallways. In order to improve this situation it was necessary to create a separate accommodation, where the adjoining family members could stay, sleep, cook and meet the others. Hence, the first task was to create a housing structure for around 70 people with the possibility to extend in the future.
2) Refurbishment of the operation theatre into an emergency and intensive care unit
After the new operation theatre was build, the previous quarter became free and provided space for a new emergency unit as well as an intensive care ward. The transition of the former structure mainly included the internal re-organisation as well as the roof structure by keeping all external walls. Another aim was to improve the climatic as well as the lighting situation within the tract.
3) New reception and entrance building
During the first phase in 2012 it turned out that the situation of orientation, entrance area with reception needed to be considered for further improvement. This was addressed in the project brief. In order to separate the enrolled patients from the others waiting for registration, an additional waiting area was located around a central reception area, close to the entrance of the site.
As the three uses deal with different requirements and surroundings, the building techniques vary according to their demands.
1) Housing for patient relatives
The accommodation provided by the hospital for family members had to meet the common understanding of housing for people from the rural areas. As this part was less of importance for the clinic to keep working, we decided to use clay for the main building material for several reasons.Air dried adobe bricks form the outer shell with a visible structure, subdivided by prefabricated concrete bars after every second course. This building technique is commonly known from rammed earth walls. For the first time this method was incorporated into a visible brick pattern as it prevents the wall from erosion. Because of the possibility of termites affecting the timber construction it was necessary to completely separate these elements from the enclosing walls. Instead the in-build furniture serves as the supporting structure while actings as elements of use within the room. Another advantage of the resulting gap was that it always provides for a good ventilation.
2) Rebuilding of the operation theatre into an emergency and intensive care unit
This was achieved by a straight hallway connecting the entrance area, the reanimation room directly to the operation theatre building. The climatic improvement implemented u-shaped flaps in the existing vertical tin cover to allow the hot air to circulate underneath the roof. Due to sanitary issues it was necessary to stick to conventional building materials like cement blocks for the dividing walls and plywood for build-in furniture and suspended ceilings.
3) New reception and entrance building
The ensemble includes two major courtyards, whereas the new entrance building defines the first to create a clear organized area closed to four sides. The reception building is widely visible and welcomes the arriving patients to one side where as it locates the inpatients to the rear. The anteroom is separated by a perforated wall, to the one side the patients waiting to be registered and on the other side the patients waiting for treatment in the adjoining emergency unit and outpatient department. The initial design of the combined filtered ventilating and fixed glass units of the new operation theatre from 2012 was used in a playful way to create a overall design language for the different building types to architecturally connect these to one ensemble. These elements enrich the reception building as well as the emergency unit and intensive care ward.
Ongoing building site in Cameroon
On this blog you´ll find daily upates on our ongoing building site in Ngaoubela