Open Architecture Network

Nyaya Health

Winners First Place Winner: Max Fordham LLP, (Gwilym Still, David Hawkins, Bertie Dixon and Thomas Bailess) + Nick Lawrence, London, UK
Second Place Finalist: Emre Can Yilmaz , Istanbul, Turkey	Third Place Finalist/Founders Award: Studio Wikitecture, Second Life

Fourth Place Finalist: Kathy Bevers, Tatyana Lemon, Gina Livingston-Smith and Cassie Walck Boulder, CO

Fifth Place Finalist: Mas-A Seville, Spain

Honorable Mentions
From Left to Right: ARCHITEKTURKONSULAT: Walter Kräutler and Kilian Mattitsch, Vienna, Austria Souman Barua, Tim Green, Rob Rickey, Graham Hill, Indy Sohel and James Leaman, Devon, UK http://www.openarchitecturenetwork.org/node/1093 Sanjit Roy Architecture: Sanjit Roy and Birinchi Kumar Roy, India/USA http://www.openarchitecturenetwork.org/node/1947 Matthew Bitterman, Luke W Perry and Nicolette Mastrangelo, Berkeley, CA, USA RZS, Zach Olczak, Rob Bratton, Memphis, TN, USA

| Challenge |

Enable families in a remote rural area of Nepal where there is only one doctor for a population of 250,000 to access healthcare from top physicians and medical professionals all over the world by building a tele-medicine center.

Download the Design Brief

| Client |

Client: Nyaya Health

Location: Sanfe Bagar, Achham, Nepal

Client Web Site: http://www.nyayahealth.org/

Client Description: Nyaya Health is a community-based healthcare organization providing maternal and child health services to poor patients in the districts of Achham and Doti, Nepal. It provides free health services to an area of 440,000 people. About 740 out of every 100,000 women die in childbirth in this region. The organization have assembled a group of local community healthcare workers and midwives, who operate under a community-based board of directors, to provide antenatal and obstetrical services to women and children in this area.

The UN Development Program recently recognized the current program as a “model initiative”. In addition, the organization has produced a cross-border alliance with U.S. physicians to provide voluntary specialty services for severe health problems faced by people in this area; They need to establish a tele-medicine center to take advantage of this alliance and provide consistent services.

End-users: The clinic will serve a staff of 10 healthcare workers and 7,700 beneficiaries.

Need: : This community is the poorest location in the poorest country in Asia. Most men are gone for 9 months of the year, because they migrate to work across the border in India (where they often acquire HIV). Women and children, often unsuspectingly infected with HIV, are left to tend to agricultural plots. However, poverty has been increasing in this area because of illnesses among women and children, preventing them from working or being able to attend school. We provide crucial health services to this area. However, our ability to provide services has been limited by (1) the lack of expertise to deal with increasing burdens of complicated infections, which “first world” doctors have the expertise to treat, (2) limited ability to regularly order supplies and pharmaceuticals from international shippers (since Nepal has limited drug manufacturing facilities) because we lack internet access, and (3) limited ability to facilitate training of local healthcare workers, who need internet access to attend online trainings. We have partnered with physicians at Yale School of Medicine, Harvard Medical School and University of California San Francisco, who have agreed to provide voluntary expert consultations and access to Yale’s online medical resources if we develop tele-medicine facilities.

The clinic serves 7,700 patients per year on average. We estimated 20% of that population needs medical consultations via tele-medicine services. There are no other healthcare facilities in the region. In addition, the facility would greatly benefit our staff of 10 healthcare workers, who would receive much greater training to assist them in providing health services.

| Program |

Competitors are challenged to design a tele-medicine/health facility and a community technology center for the local NGO, Nyaya Health. Located in the rural town of Sanfe Bagar in the Achham district of western Nepal, this facility will provide medical services to the town and surrounding villages.

In the region there is one doctor for every 250,000 people, and this tele-medicine center will allow staff from Nyaya Health to provide access to medical expertise from around the globe.

The proposed facility will allow local healthcare workers to:

• provide more accurate diagnosis and treatment via tele-medicine consultations and training sessions with international physicians
• communicate reliably and regularly with U.S. physicians who will provide interpretations of X-rays, laboratories and drug susceptibility assays
• provide internet access to medical databases and training programs to optimize patient care
• access open-source software packages designed to facilitate the rapid procurement of pharmaceuticals and medical supplies
• provide computer training and internet access to the community at-large
• provide a public gathering space for the exchange of health information and other community services

Design Considerations: Participants are challenged to incorporate the needs of the community and to employ sustainable and/or local building material using local labor to realize their design. Designers should also take into account the remote nature of the site and costs associated with transporting materials in developing their designs.

Space Considerations:
Approximately 40% of the building will be open to the public and used as a community computer lab and training facility. The other 60% of the building will be dedicated to the provision of medical services including, obstetric and nursing training; telemedicine exchanges and X-ray interpretation with oversees medical professionals; patient consultation; and offices to manage medical files and order pharmaceutical supplies.

Telemedicine Center
Site area: 2 acres
Total facilities footprint: 175 m2
Total occupancy: 40

Medical Components
• counseling rooms (2)
• administrative office (1)
• multi-purpose meeting room/break room
• server closet
• AV telemedicine consultation/training room
• multi-purpose meeting space for health professionals
• storage/pharmacy

Community Components/Public Space
• community library
• multi-purpose gathering space
• community computer lab

| Site |

Sanfe Bagar is a rural town on the foothills of the Himalayas in Western Nepal

The tele-medicine center would be located near the 'new clinic' (former grain storage) and it is hoped that their will be connectivity on the site of the abandoned hospital to allow future expansion of Nyaya Health.

a few minor details about the site to note as well: - There is a 5 minute walk via footpath from paved road where there is parking space for equipment trucks to unload stuff. - 50 meter from nearest telephone pole - Requires approx. 150 meter of piping from nearest freshwater source - in range of current CDMA signal, but the signal is very weak and allows for only 10 kbps at off-peak hours. -The site is in a fairly wooded area that is isolated from houses. little traffic passs by the footpath but highly accessible from sanfe. -The site is located on a hill about 25 meters above a small stream and about 200 meters from a civil engineers office.

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| Environment |

Climate: Alpine
Temperature: 10-24C
Rainfall: 1250mm.Nepal experiences monsoon rains from June to September
Latitude: 29N
Longitude: 81E

Special Conditions
Earthquakes, epidemics, fires, landslides and debris flow, floods, hailstorms, thunderbolts and windstorms. Every year, mainly during the monsoon, landslides and debris flow cause damage to agricultural land and human settlements.

| Construction Budget |

Total Construction Budget: $32,000 USD