GHESKIO Cholera Treatment Center

Site plan of the Cholera Treatment Center
The Cholera Treatment Center at dusk
Interior of CTC before opening
Interior of CTC in use
Transportation of locally made hospital furniture to CTC
Axon of the CTC
Sections of the CTC
Street view of CTC
Creation of metal façade by Haitian artisans
Creation of metal façade by Haitian artisans
Side view of CTC
Aerial view of CTC and Haitian coast

Primary Authors

  • Michael Murphy/MASS Design Group
  • Alan Ricks/MASS Design Group
  • Adam Saltzman/MASS Design Group
  • David Saladik/MASS Design Group

Contributing Authors

  • Christopher Scovel/MASS Design Group (Project Architect)
  • Sierra Bainbridge/MASS Design Group (Landscape Architect)
  • Nathan King/Virginia Tech Center for Design Research, MASS Design Group (Project Team Member)
  • Matt Sisul/ YCF Group (Structural Engineering)
  • Arash Guity/ Mazzetti (MEP)
  • Fall Creek Engineering, Inc (Civil Engineering )

Author

  • Les Centres GHESKIO: The Haitian Group for the Study of Kaposi

Photographers

  • Iwan Baan

Objectives

The CTC is a one-of-a-kind space for diagnosing, triaging, and treating cholera patients. The facility treats Haitians suffering from cholera, and then uses its wastewater treatment system to remove the waterborne disease pathogens generated by these patients’ waste to ensure that there is no re-contamination of groundwater. This process cuts the cycle of urban infection, while attending to patients’ immediate needs. As the Haitian climate is humid, high roof peaks on the CTC provide efficient natural ventilation of hot air and allow for clerestory daylighting. A rainwater catchment system collects and filters water to be used within the facility. On the interior, a drop ceiling provides a thermal break to cool the space. The building is made from compressed stabilized earth blocks that reduce CO2 emissions, and a 1.5m perimeter access corridor around the building allows for expedited movement. The CTC’s handcrafted metal shade screen façade is incredibly unique. Each perforation in the façade is adjusted to maximize airflow, reduce heat, and maintain patient privacy. Most importantly, however, the façade was designed to leverage local Haitian expertise in craft. The screens were fabricated entirely by metal workers and artisans in Croix des Bouquets, Haiti. This locally fabricated approach is essential to MASS’s process. We advocate for the investment in long term, locally created, economically stimulating, and beautiful buildings that dignify and strengthen communities in a way that a prefabricated and easily broken down structures never could.

Context

MASS Design Group began working in Haiti with Les Centres GHESKIO—a Haitian leader in healthcare—in early 2011 after the 2010 earthquake hit and unveiled the vulnerability of impoverished Haitian communities. Cholera, a curable, preventable disease that had not existed before in Haiti, emerged and ran rampant through the tent cities of Port-au-Prince and surrounding hillsides, enabled by Haiti’s dearth of sanitation and public infrastructure, overcrowded housing, and weakened population. Cholera patients were treated in temporary tents, which were hot in the Haitian climate, difficult to keep sanitary, and incapable of ensuring long term prevention from infection. The urgency for investment in health was incontestable: Haiti ranked lowest in Latin America and 119/137 globally in achieving the Millennium Development Goals that establish targets for improvements in nutrition, education, sanitation, gender equality, and maternal and infant mortality. But investments in public infrastructure were severely lacking. GHESKIO, the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections and the first institution in the world dedicated to the fight against HIV/AIDS, came up with an intervention solution. With MASS Design Group as a partner, they would build a permanent treatment, prevention, and educational center that could be replicated throughout throughout the country and have both an immediate and long term effect on the nation’s battle against poverty and disease.

Performance

The CTC was designed to impact the community and perform over the long-term. This was successfully achieved with three strategies. First, the center’s interior and exterior were created to improve staff performance, increase facility of treatment, reduce length of stay, and increase efficiency. The 1.5m perimeter access corridor around the building allows for expedited movement of beds and staff, nurse stations were designed to be placed in every patient bay to increase direct observation, and equipment and furniture was designed to be easy to clean. The second strategy was to leverage the building process to employ as many Haitian workers as possible, showcasing the value of Haitian skills while stimulating the local economy. A total of 300 jobs were created during the construction process, in addition to 10 artisans who were hired for the façade fabrication, 20 furniture creators hired to produce one-of-a-kind pieces for the CTC, and 20 individuals brought on for millwork (10 of whom were former victims of gender-based violence). The third strategy was to impact the community by improving health. The CTC achieves this by treating on average 100 patients a day and ensuring that none of their toxic waste enters the groundwater. Cholera is transmitted when a healthy individual ingests food or water contaminated with a sick individual’s feces. Treating patients daily allows for the entire community to be at a lower risk of contracting cholera. The CTC demonstrates, then, that architecture can and should be leveraged to resist epidemics.

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Site plan of the Cholera Treatment Center