The 140-bed hospital complex stops time, like a long-lost friend you run into where you’d least expect to. In such a surprise occurrence, past and future appear to come to a standstill.
Here, just outside Rwanda’s capital of Kigali, it’s impossible to ignore that the site once held a police outpost in the whirlwind of mass murder.
Kaleidoscopic images of those days in 1994 bring forth anguish and terror as if they were happening today. At the same time, in this stillness, one can’t help but rejoice at the sight of the new hospital building and the national, multi-ethnic renaissance it embodies.
And there’s something more captured in this freeze frame: a dignity among the people and staff, pride in the accomplishment. Now that sustainability and organic shape have formed a kind of orthodoxy in architectural academia, is the building-in of dignity the next disruptive idea? Here at the hospital, it would seem this way: dignity for patients, for staff, for tradespeople, for the natural world.
But how is this made, how is this done? With a client list that includes Paul Farmer’s Partners in Health and Bryan Stevenson’s Equal Justice Initiative, among others, Boston’s MASS Design Group has been in a unique position to design for dignity and its timeless qualities and at the same time design for action, creating buildings that help carry out the healing mission on a day-to-day basis.
The Butaro District Hospital just outside Kigali went up in 2011, an award-winning project shared by Paul Farmer’s Partners In Health, the Rwandan Government, and a group of intrepid, idealistic students from Harvard’s Graduate School of Design, now a well-established studio of sixteen staffers and dozens of fellows and volunteers.
The story goes that, in a moment of doubt concerning the whole meaning of architecture, co-founders Michael Murphy and Alan Ricks happened to take in a 2010 lecture by Farmer, Boston’s world-renowned doctor of the dispossessed. Farmer called for Third World clinics that helped heal people, not make them sicker. With drug-resistant tuberculosis increasingly prevalent, why, for example, were waiting rooms almost uniformly unventilated?
Murphy and Ricks approached Farmer afterward and asked him who his architect was. “We don’t use architects, I just sort of sketch something,” said Farmer. “Well, you have an architect now,” said Murphy. Murphy, who was still a student, was soon winging it to Kigali to build the hospital. When a bulldozer was too expensive an option for leveling the site, there was some nail-biting, but not for long. A local engineer obtained local labor to dig by hand, for half the cost, and within half the time_ as bulldozing. Ultimately, 4,000 villagers worked on building the hospital.
As for the problem of drug-resistant TB spreading around while people waited to see a doctor, MASS Design addressed that with a design tweak that meant a lot: they located the waiting rooms on the outside of the clinic.
They also put a half-wall down the middle of the ward. Now, rather than staring at each other across the room, patients have their heads to the half-wall and face their own window—with all the privacy and dignity such a realignment affords.
In the same serendipitous manner, Murphy and Ricks created a second partnership, this time with Bryan Stevenson, the lawyer, civil rights champion, founder of The Equal Justice Initiative, and author of the best-seller Just Mercy. Stevenson, Murphy read, had a vision to create a memorial to the thousands of blacks who had been lynched in the South. After all, he reasoned, there were hundreds of markers honoring the Confederate dead, but very few to commemorate the victims of white supremacy. There were monuments to Holocaust victims from Kigali to Phnom Penh, and from Berlin to Washington, D.C., but not much about this American era of terror.
Inspired, Murphy dashed off an email to Stevenson, blindly addressed to firstname.lastname@example.org. Stephenson invited Murphy down for a tour of Montgomery, Alabama, the next day and now, thanks to a ten million dollar gift from the Stryker siblings in Michigan, the MASS-designed memorial is slated to open next year. The design is dignified and calm as well as harrowing—a paradoxical play of conflicting feelings.
You enter a forest of columns hanging at various levels from the ceiling. The ground drops as you proceed as if you were the victim dropped through gallows. But then, as you walk up on a hill at slightly above eye level with the columns, something else happens. Call it a feeling of connection, contemplation, a still, forever kind of moment in a violent world.
Many other projects have followed MASS Design’s first, the Butaro Hospital in Kigali, including a tech hub and TB Hospital in Haiti; a social services center in Poughkeepsie, New York; a vocational training center in Ethiopia; and a Maternity Waiting Village in Malawi. Their website images all make us give pause, take us out of the world of “realistic” challenges, solutions and billable hours, out of ordinary time, and yet all are very much in it. After all, says Christian Benimana, the architect in charge of MASS Design in Africa, the continent is exploding. With 400 million people now, there’s projected to be 1.2 billion in 2050, mainly in the cities.
So how to help shape this new world in a way that is both timeless and timely? There have been more than enough missteps in aiding Third World countries: imposing solutions, infrastructure projects that go nowhere but to an impossible indebtedness to Western firms, training and hiring few. Shame, not dignity, can often be the sorry outcome.
One key to getting it right, at least for MASS Design, is the practice of BIM-powered “Lo-Fab” design, which seeks to go beyond a simple checklist of sustainable practices: solar panels, check, renewable materials, check, rain garden, check. “Lo-Fab” (Locally Fabricated) speaks to MASS Design Group’s approach to the design and building process. “On every project, we highlight and scale local innovation and ideas, hire local labor, and use local materials. Let’s do this together.”
At his eight-person Kigali headquarters, before being pulled away for dinner after a long day, Benimana enlarges on Lo-Fab: “A building must be more than a building. It needs to help fulfill the clients’ mission. In that sense, it can’t be neutral. A building either helps or it hurts. Given the construction boom in African cities, time is of the essence.”
Trained as an architect Shanghai’s Tongji University, Benimana had to learn Mandarin in a year. Over his eight years of study, he marveled at the enormous, transformative changes going on throughout China “And yet, there was so much pollution, so much displacement with all that growth,” he says. “And now you can see the same things going on in Africa. Here in Kigali, the building boom is already displacing more and more people, often to unsafe earthquake zones.”
That’s why one of Benimana’s next undertakings is an African Design Centre with campuses in Kigali, in the South African capital of Cape Town, and in Ghana’s capital, Accra, to train more architects. While Italy, with 153,000 licensed architects, has an oversupply according to the Architects’ Council of Europe, Benimana points out that Africa has very few. The idea is to meet the needs of a burgeoning Africa, heading off the worst effects of rapid growth. “The question is,” he says, “can our cities be equitable, healthy, good places to live or not?” Applications to the African Design Centre’s fellowship program http://trueafrica.co/article/africa-design-centre-looking-architects-take-next-step-career-rwanda are due June 29.
Built-in dignity will surely be on the curriculum. Marika Shioiri-Clark, one of MASS Design’s founders who took a year off from the GSD for the Butaro hospital, offered an epiphany on how this dignity can work itself into the construction.
The volcanic rock surfacing the hospital is a nuisance to farmers. There are piles of it pushed to the edges of the road. Local masons use the stone, but with lots of mortar, a technique Shioiri-Clark thought could be improved upon when cladding Butaro’s walls. There was a necessary learning curve, getting the rocks right. As the masons went around the building, they became expert at making a virtually mortarless facade. Finally, they came around to the front where they began. Seeing it was not quite perfect, they insisted on redoing the whole thing at no charge. Shioiri-Clark came to deeply understand how the beauty of a building springs from the pride involved in construction, the dignity of work itself.
MASS Design gets that for work to be dignified it must also be just. The masonry trade was men only. Then Anne-Marie Nyiranshimiyimana, better known as Kankwanzi. Before long, Kankwanzi was teaching other women the trade. Now, if you visit, you can see a dozen women chipping away, fashioning the stone, all dressed in stunning colors: emerald headdresses, and spotless blue and gold dashikis.
Their pride is evident like their blues and golds flashing in the sun, supporting families on an equal par with their men, building new homes, sending children to school. Such dignity and equality bestow beauty to the building, a beauty that for a new generation of architects may equal or surpass the sculptural beauty of form for form’s sake.
For these students and young professionals, a luxe hotel’s aeronautical curves may look sleek, like Brancusi’s Bird in Space and yet feel empty of meaning. Even if that hotel is LEED certified and greener than green. Rather, they may indeed find a way beyond sustainability, which indeed sounds like an oxymoron, and beyond the sculptural beauty of form, which sounds like another. No matter, they will want to know how their buildings confer dignity, with a big D on the people as well as the planet, a dignity that helps heal old wounds while fostering health and equity going forward.
♣ For more on MASS Design, go to co-founder Michael Murphy’s keynote address at AIA's Conference on Architecture 2017 in Orlando, April 27.
by Louis Postel for Graphisoft USA