This plan is based on the earlier specifications provided by AFH for Nyaya Health.
Nyaya Health’s Tele-medicine and Community Center is a unique architectural and technological proposition by virtue of its humane mission and its inherent
constraints.
This facility addresses the needs of the sick and the poor by providing them a shelter that offers solace, support and relief from pain.
Instead of offering a cramped facility, the facility is thrown open to outdoors. The value of space is most appreciated by those who live in cramped houses and huts.
Also, the majority of the patient population coming for maternal health services need open space to alleviate their symptoms of giddiness, vertigo and nausea. While it may
be slightly expensive to opt for this open design as compared to the closed model, it is well within the budget.
The center layout and plan is minimalist, sustainable and uses local materials for construction. There are no state-of-art structures not to make the patients drop their
jaws in awe. The look and feel of the center should evoke a sense of safety, reliability and of belonging. It makes one feel at home and in knowledgeable and caring
hands.
Ample care has been taken to plan for streamlining of healthcare and educational operations as well as to create an environment conducive to the medical and
paramedical professionals.
The simple brick, tiles and glass combination provides the basic structure as well as the aesthetic appeal. Provisions such as wide corridors, built-in benches, plants,
etc not only helps patients, but also enhances the overall look and feel of the facility. The momentary relaxation offered by the cultivated greenery around is very helpful to people who are used to living in impoverished and cramped dwellings. The extra dose of oxygen at this altitude probably makes a lot of sense.
While the focus is on using the construction materials in an optimal, sustainable and aesthetic manner, it is never forgotten that this abode is for those who have been deprived of basic human rights, such as access to healthcare.
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Specific Details
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Roofing
Tin Alloy sheets can be used for roof. Two sheets of alloy can be riveted to the pillars. The sealed-in air offers insulation against heat and cold. As a practise in cold climes,
two or more thick tin sheets are riveted to the basic structure and are very sturdy, lightweight, and have good insulating properties. The roof structure supports the water
harvesting system by collecting the rainwater and leading it to the storage area. This collecting system runs along the roof. While the roof could have been an excellent
place for solar energy receptors, it is not advisable to mount these expensive structures on the roof in seismically active zones.
Foundation
Stones, which are abundant in hilly climes surrounding Sanfe Bagar, serve as good foundation material, fused together with concrete and mud. The structure can then be
built after the foundation has thoroughly dried and set in. The room areas/ beams/ pillars can be earmarked in the foundation structure and layout.
Basic Structure
Pillars can be made conventionally with concrete gravel and local construction material. Iron pillars could have been used but may be expensive and may interfere with
technical equipment working. The pillars can be sloped outwards so as to not collapse within the building structure.
Walls
The best option, though locally not available, would be to import bricks and build the walls. Bricks are low maintenance weatherproof building material that offer stability,
sustainability and are impermeable. Since most of the buildings are made with mud and stones, this option could also be explored.
Stone walls may not be helpful considering the nature of the project and the facilities it intends to offer. In response to the climatic conditions, the best option is to import
bricks from India. The stones layout used for the foundation can also be raised to support tin walls that can be sealed within.
Windows
All rooms of the Telemedicine Center have windows. The size of the windows is big in comparison to the windows seen in existing Sanfe Bagar healthcare facilities. The
windows let in abundant daylight and fresh air.
The windows open out into the open corridors. The windows, if required, can be converted into window counters for areas such as pharmacy, reception, administration desk,
registration desk, etc. All windows have iron grills in order to avoid break-in, security and theft. These can be procured from the second-hand deals.
Layout and Alignment
The facility should ideally be facing East direction, in order to receive morning sunlight for lighting and disinfecting the clinical facility.
Consultation Rooms
These are the critical and clinical areas of the facility. As opposed to the general idea of having 50sqft for each room, this needs to be increased to a minimum of 100sqft.
Consultation rooms contain the examination table, doctor desk and chair, patient and attendant chairs, washbasin corner, storage space, etc. These rooms are aligned in
East direction to let in daylight as well as facilitate solar mode disinfection.
Telemedicine Room
The room needs to be soundproofed and well lit. The windows may be shielded to prevent the glare while operating the equipment.
The room should also house a movable bed, in case the patient is too sick to ambulate. There should be enough area to move around the bed in order to transmit the best
possible image to the other medical facility.
The telemedicine equipment is mounted on a revolving shelf space. The revolving shelf, when rotated 180 degrees, connects to the community computer lab as well. The
whole shelf can be rotated to provide audio-visual aid to the long distance continued medical education programs to the staff. This revolving shelf , preferably made of iron, is
sturdy enough to ensure the safety of equipment.
The satellite dish antenna that may be required to support Telemdicine facility transmission will be propped on the roof of the toilets area.
Corridors
The corridor runs along the entire facility. All rooms open out into this corridor. The inner corridor is lined with built-in stone/ bamboo benches which are very important for
waiting patients.
Simple bamboo benches can also be made to line along the corridors. In future the external corridor may be lined with glass and solar panels for electricity consumption.
Corridors provide shelter from sun and rain to the waiting patients. Corridors can be used to access the pharmacy, registration and clinical areas.
The corridors are connected to the ramp to facilitate wheel chairs and stretcher movement.
The corridors are provided with bamboo railing along the walls to help the sick, old and the infirm.
Bath, Toilets and Sanitary Areas
The toilets have been separated from the main building for the purpose of easy access, hygiene and usability. By separating out the toilets and sanitary sections, the
floating patient population can access these areas without entering the clinical premises.
The community center can access the toilets without entering the main building. In response to local customs, the toilets are segregated gender wise.
There are many donation options wherein bathroom tiles can be sourced. This may be a one-time high cost activity but has long-term benefits. Healthcare facility needs to
emphasise on sanitation and hygiene, more than anything else.
The terrace of this area is suitable for mounting the satellite or connectivity equipment. This set up should be mounted in such a way that the whole system can be portable
when required, say on a van. The equipment should be riveted on the terrace area and should easily be transferable to any transporation option.
Landscaping and Ground Cover
Hilly climes need trees that prevent soil erosion, act as wind barriers, apart from offering respite from the dry surroundings. The importance of plants in healthcare facilities
can never be under estimated and are essential to the general healing process. While it may be impossible to have tall wind barrier trees, plant them early and let them
grow.
The ground cover is essentially to add the aesthetic sense to the technology facility. Certain plant species are effective in keeping moths, pests and insects away. Having
this kind of round cover that runs along the facility will help in pest control.
Pathway
The purpose of the pathway is to protect the soil and offer clean surroundings. Local stones can be cut and arranged in interlocking manner to provide granite pathway that
runs along the facility. The pathway could also be made of concrete, if cost effective.
Line the pathways with bushes and shrubs that can be maintained by local population or with stones to avoid erosion due to rain/ wind/ mudslides/ etc.
The pathway joins to the main road. This pathway is helpful for transporting pharmacy and warehouse material. There will be signs in local and English signage. Pathway
lights will be solar powered.
Amphitheatre
Since the facility is located on an inclined land, the nature of this plot can facilitate building and amphitheatre like terraced steps, which can be used for community
activities. Ground cover grass can be planted to prevent the soil erosion.
Electrical Provision
Lighting is through the use of CFLs that can generously be donated by many companies in India.
Fans for cooling the rooms. Air conditioner is not required and is economically not viable. Ventilators on high walls is sufficient for air circulation and keeps the area cool.
Electrical switches are placed at shoulder level to prevent kids of operating them.
Storage
The storeroom has built in shelves that can stock up on medical equipment, pharmacy items and other goods. The storage rooms’ window doubles up as a pharmacy
counter for the patient population accessing it from the outer corridor.
Power and Electricity
If the topography supports, wind mills are the best power generations, followed by solar backup mechanism. Generator is always at hand for emergencies in a healthcare
facility.
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The project specifications have been changing so often that it takes double the effort to keep in sync. All the best for your endeavours! There is no greater satisfaction
than to see a sick person healed.
Thanks,
Ishrath
