Hospitals

Emergency Pediatric Surgery Hospital

PROJECT DETAILS

City
Entebbe
Country
Uganda
Customer
Emergency NGO NGO
Architectural design
RPBW Renzo Piano Building Workshop, TAMassociati
Period
2013 - 2020
Amount of works
17.400.000 €
Services Provided
Structure Design | BIM | Construction Management
Sector
Hospitals
Dimensions
9.693 m2
72 beds, 3 operating rooms
Construction technique
terra pisé, metal carpentry

An earthen hospital

The new Emergency Hospital is located in Entebbe, on the shores of Lake Victoria, about 35 km from the capital Kampala. Designed by architect. Renzo Piano with TAMassociati, it is a pediatric surgery hub of excellence-among the most important in Sub-Saharan Africa-that offers free care with advanced techniques and highly qualified staff. The load-bearing walls were built using excavated earth as raw material, following the building tradition of the pisé land.

An earthen hospital

The new Emergency Hospital is located in Entebbe, on the shores of Lake Victoria, about 35 km from the capital Kampala. Designed by architect. Renzo Piano with TAMassociati, it is a pediatric surgery hub of excellence-among the most important in Sub-Saharan Africa-that offers free care with advanced techniques and highly qualified staff. The load-bearing walls were built using excavated earth as raw material, following the building tradition of the pisé land.

Between earth and sky

The thick rammed-earth masonry and light steel members supporting the roof create an architectural space where the red of the clay soil and the blue of the Ugandan sky dialogue: a hospital 'between earth and sky,' in which the former is the material for construction and the latter provides the energy to run it, thanks to 10,000 square meters of photovoltaic panels. The volume of the hospital rises on soft terraces that pander to the orography of the terrain, while the surrounding park and Lake Victoria, overlooked by Entebbe, represent the dominant landscape in which the health facility is immersed: a complex that is perfectly integrated into the natural context also thanks to the characteristic rammed earth masonry. The project combines the practical needs required of a pediatric surgery hospital in Africa with the creation of a model architecture: rational and sustainable, beautiful and concrete, modern yet anchored in local architectural tradition.

A landmark for the region

Inaugurated in April 2021, the Center's mission is to triple Uganda's surgical-pediatric treatment capacity, in a country where more than half of the population is under 15 years old and the infant mortality rate, under age 5, is 43‰. The hospital is thus destined to become a reference point for the entire region: thanks to it, young patients with elective surgical problems, mainly involving the abdominal, urological and gynecological systems, will find treatment and care.

But the facility is also a training center for local doctors, nurses and staff, who will help raise the level of pediatric care in their home countries. It includes an operating plate with three rooms, a sterilization room, 72 beds, six intensive care units and 16 sub-intensive care units, six outpatient clinics, a radiology department, a laboratory equipped with a blood bank, a CT scan, a pharmacy, and a guest house with about 40 beds to accommodate patients arriving from afar with their companions. For younger patients, there is a play area.

The terra pisé technique

Natural earth extracted from foundation excavations was used as raw material for the main structures. Construction with unfired earth is a very ancient technique, known to man since ancient times: using it to build the load-bearing walls of the hospital was an engineering challenge that required repeated research, experimentation and refinement, until excellent results were achieved in terms of strength and sustainability. Indeed, it involved creating a building that could withstand all man-made and atmospheric aggressions, in a region where rains make unpaved roads impassable within minutes. The experience turned out to be an opportunity to also initiate a program of perfecting technologies for soil improvement in cases where it is necessary to implement the mechanical characteristics: BUROMILAN managed to develop the right formula and technique needed to start the project with due confidence, achieving high levels of precision and reliability.

To tackle the project, we were guided by our curiosity to rediscover ancient techniques whose traces have almost been lost, studying how earthen mosques are still built and repaired in other parts of Sub-Saharan Africa, such as Mali. Work has continued with researchers at CRAterre, a research center near Lyon, on developing the best formulas for qualifying the technology used and methods for turning natural earth into a good building material. In the European standards for construction, the Eurocodes, unfired earth is not among the regulated materials: it was therefore necessary to research special directives that are applied in other countries around the world, such as New Zealand. After refining the design and establishing the structural design codes, we developed the construction technique. The earth from the excavations was then reinforced by adding polypropylene fibers, improving its strength characteristics. Compacting the unfired earth inside the formwork achieved a compressive strength of 14.5 N/mm, similar to that of an average-quality concrete.
The hospital finds part of the energy needed for its operation in the sun. Indeed, about 10,000 m2 of photovoltaic panels are installed on the roof of the building, a suspended lattice structure, which not only provide enough electricity to meet a significant percentage of the needs, but also serve the function of shading and sheltering from rain both the covered spaces and several outdoor areas. Also in Entebbe, as in Emergency's other hospitals, there is a garden with 350 trees, in accordance with the idea that greenery is also an important element in the recovery and healing of patients.
The idea for the pediatric surgery hospital in Entebbe was born from the meeting between Gino Strada, surgeon and founder of EMERGENCY, and architect Renzo Piano. Both shared a desire to combine medicine and surgery with architecture of excellence, two spheres seemingly far apart that nevertheless, by coming together, give birth to "healing architecture," architecture that heals. Beauty, according to this current of thought, is not just an aesthetic factor, but rather an integral part of healing: an element supporting medicine, capable of benefiting patients both physically and psychologically. The idea of creating a hospital that was not only functional and efficient from a medical point of view, but also "outrageously beautiful" in its aesthetic appearance, was one of the principles that guided the project from the beginning.
"An outrageously beautiful hospital."
Gino Strada
Founder of Emergency

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