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 | Construction management

Sector

Hospitals

Dimensions

9,693 square meters
72 beds, 3 operating rooms

Construction technique

terra pisé, metal carpentry

An earthen hospital

Emergency's new hospital is located in Entebbe, on the shores of Lake Victoria, about 35 km from Kampala. It is among the most important centers of excellence in Sub-Saharan Africa.
Designed by arch. Renzo Piano with TAMassociati, it offers free specialized care to children in need of surgery with advanced techniques and highly qualified staff. Earth from the excavations was used as raw material for the construction of load-bearing masonry, following the construction tradition of terra pisé.

An earthen hospital

Between earth and sky

A project "between earth and sky" that proposes a mediation between the massive character of the thick rammed earth masonry and the light steel members that support the roof. The architecture thus insinuates itself between the red clay earth and the blue sky of the Ugandan plateau, using the earth of the site as raw material to construct the building and the energy of the sky to make it work.
Following the orography of the terrain, the load-bearing walls of the complex determine the terraces from which the hospital volume rises. The park and lake become the dominant and privileged landscape of the healthcare facility, and the masonry itself becomes an integral part of the natural space.
The goal was to combine the practical needs of a pediatric surgery hospital in Africa with the desire to create a model architecture: rational, sustainable, concrete, modern, beautiful, but firmly rooted in tradition.

A point of reference for pediatric surgery

Opening in April 2021, the Center aims to triple Uganda's surgical-pediatric treatment capacity and become a benchmark for pediatric surgery in a country where more than half the population is under 15 years old and the under-5 mortality rate is 43 deaths per 1,000 births.
The hospital provides treatment and care for patients with elective surgical problems mainly involving the abdominal, urological and gynecological systems. It is also a training center for local doctors, nurses and staff, who will help raise the level of pediatric care in their country.
The facility includes an operating plate with three rooms, a sterilization room, 72 beds, 6 intensive care and 16 sub-intensive care beds, 6 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 and their companions. There is a play area for young patients.

The terra pisé technique

Natural earth extracted from foundation excavations was used raw material to make the main structures.
Raw earth is a technique used by man since his earliest experiences in construction. Repurposing it for the construction of the load-bearing walls of the Emergency Hospital in Uganda was a challenge that required continuous research, testing and subsequent improvements, with excellent results in terms of strength and sustainability.
The challenge was to design and build a hospital built from natural earth, made to last and withstand all aggressions, both man-made and weather, and built in a geographic area where rains within minutes make unpaved roads impassable.
This experience proved to be an opportunity to start, without conditioning or preconceived notions, a program for perfecting the technologies that are applied in soil improvement when it is necessary to implement their mechanical characteristics. BUROMILAN was able to develop the right formula and technique to start the project with due confidence, achieving high levels of precision and reliability.

Our work began with the spirit of one who must rediscover ancient techniques whose traces had been lost, thus trying to understand how in Sub-Saharan Africa, specifically in Mali, mosques have been built and repaired in the earth since ancient times.
It continued by learning and delving into the best formulas for qualifying technology and methods for turning natural earth into a good building material from scholars at CRAterre-a research center near Lyon.
In the European standards for construction, the Eurocodes, there is no treatment of unfired earth; therefore, special directives applied in other countries around the world, in this case New Zealand, were researched; having refined the design and determined the "behavior" codes, the construction technique was fine-tuned.
To improve its strength characteristics, polypropylene fibers were added to the excavated earth. Compaction of the raw earth inside the formwork achieved a compressive strength of 14.5 N/mm, characteristic of a medium-quality concrete.

The building finds energy to function in the sun. In fact, the roof is a suspended lattice structure with about 10,000 m2 of photovoltaic panels that not only provide the energy needed to cover part of the hospital's needs, but also serve the function of shading and sheltering indoor and outdoor spaces from rain.
As in EMERGENCY's other hospitals, there is also a garden with 350 trees: greenery is an important element in the recovery and healing of patients.

Photovoltaic roof and covering Emergency Pediatric Surgery Hospital in Entebbe Uganda — © Davide Preti

The idea for the project came from a 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, disciplines seemingly far apart: the result of this union is the so-called healing architecture.
This current sees beauty not only as an aesthetic factor, but as an integral part of care: it is able to impact both the physical and psychological aspects of patients, cooperating with the role of medicine. The idea of creating a hospital that was not only functional and efficient from a medical point of view but also "outrageously beautiful" was one of the guiding principles of the project.