by Jerry ElengicalJan 09, 2023
In May 2016, the Japanese 'Nagoya Journal of Medical Science' published an article titled Healthcare in Myanmar, which outlined the status of healthcare in Myanmar vis-à-vis its transition to a civilian government, since March 2011. The paper distinguishes problems in maternal and child health, nutrition, infectious disease controls, tobacco controls, access to healthcare facilities, and quality of services; concluding that—with a contribution that amounts to a mere 5.2 per cent of the GDP towards healthcare—contributions by a network of international donors via NOGs is vital to upgrading the current status of healthcare architecture in Myanmar. Project Burma Hospital is an instance of the contribution of Projekt Burma e.V. founded by Marion Mück in Filderstadt near Stuttgart, in 2009.
Designed by Stuttgart-based a+r Architekten, the hospital design is one of several projects realised by Projekt Burma in collaboration with local partners in areas of education, health, water, hygiene, and disaster prevention. At the opening of the high school in Thazin, a previous collaboration between the architect and the NGO, the association was approached by the mayor and two community members of the Magyizin village, who explained the dilapidated and inadequate state of medical care in the village and its vicinity—where the nearest hospital was a three-hour long moped ride.
The site for the new hospital is located on a hill next to the village, serving as a refuge during tropical storms and tsunamis owing to its elevated location. The hospital, which opened in 2020 with 20 beds, an operating theatre, a delivery room, and a laboratory, serves 20 communities and 20,000 people as a central hospital.
In the absence of a construction company, the building is primarily built by the villagers under the guidance of a carpenter and exemplifies traditional architecture methods—both in planning as well as in materiality. The site is composed of two buildings, connected via a canopied pathway. The main building is designed as a courtyard house, with a central communal space and a traditional pitched roof, while the side wing is a linear block, distinguishable by its mono-pitch roof.
In the main building, patient rooms, treatment and staff rooms, and the dispensary confront the central communal space—a double height atrium which is accommodated within an all-round gable top roof. A central basin in the courtyard—landscaped with rocks and a sapling planted by the villagers—allows patients to lounge around its periphery. Lined with stones collected from the beach, the basin drains the water in a controlled manner through its surface.
A skeletal structure with an exposed brick infill imitates the traditional brick-nogging construction method—replacing a wooden frame with a reinforced concrete one, to warrant greater stability as well as to protect against insect infestation. The walls, both external and internal (facing the atrium) are punctured with openings that accommodate awning windows, made of wooden slats. A row of vertical wooden slats placed above the windows provides additional ventilation, as their elevated placement allows hot air to be expelled outside.
Below, a timber construction in the form of the gable roof's truss on the underside of the ceiling along with woven bamboo mats create a lattice. This ventilation system of awning windows, bamboo lattice, and folding shutters combine with ventilation louvres at the ridge of the gable, to enable air to permeate upwards and provide constant ventilation. The deep eaves of the gable roof also ensure that while a pleasant draught is circulated throughout the space, the tropical rain does not enter the interiors.
The ancillary block is accessed from the main block via a pergola and contains an isolation ward, additional rooms for infectious patients, storage rooms, washrooms, and sanitary facilities. It also houses a self-catering kitchen—a common practice in Myanmar. In opposition to the main block, spaces in the side wing are accessed via a verandah, placed along the long exterior wall. A wooden railing of cross-bracing elements constrains the verandah as a narrow buffer between the exterior and the interior. The structural composition replicates that of the main building, of brick infills within a reinforced concrete frame, and wooden slats (placed horizontally, in this case) for ventilation. The distinguishing element of this healthcare design is the roof, which showcases a single pitch instead of the four that furnish the roof of the main wing.
Project Burma Hospital is now a central hospital and has facilitated the village of Magyizin into a health centre for the entire region. Awarded the first prize at the AIT award in the health/nursing category, in addition to providing healthcare to the region, the hospital has also served as a source of income by providing employment to the villagers, through its building stages.
As expressed by the jury of the AIT Awards, "This small hospital combines pragmatic and spatial programmatic aspects with local culture in a remarkable way. Its character impresses with noble appropriateness and the consideration of regional construction techniques. What is very remarkable, here, is that non-local planners have demonstrated the conceptual and socio-political empathy that in similar projects in Asia or Africa often degenerates into folkloristic attitudes.”