Open Architecture Network

As it seems the text we submitted in the 'Edit' option is the main required text. No text files like .doc or .txt were not required I think.
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Actually we took a snapshot of the entries at the time of the deadline. So, you can go ahead an update your entries after the jurying, but any changes made prior to the announcement of the winning entries would be a violation of the competition rules and you may be disqualified.

cheers,

Kate Stohr
Open Architecture Network Staff

we use a stone and concrete septic tank at the clinic. compost toilets are fine too, although i'm not familiar with any in the area.

from our end, there is no problem! we're creative commons kind of folks. use all the photos and other materials from our wiki etc. as you like.
-nyaya health

these are provided onsite at the clinic. however, there is flexibility here; if you find an interesting way to incorporate an x-ray room into the center, by all means... ultrasound, on the other hand, is done by a portable machine a t the patient's bedside so no need for a separate room.
-nyaya health

thank you for your queries. we do apologize for the confusion. the main issue here is that there are two potential sites to build on-- A and B. in the clarifying brief document, it describes both sites:
http://www.nyayahealth.org/Library/OAN_AMD_Nyaya_Health_ClarifyingBrief....

also on the picassa page there are two distinct gallery for each site:
http://picasaweb.google.com/nyayahealth

a)site A is indeed agricultural land but it is being offered to nyaya for development.
b)site B is on the hill to the south
c)correct, just historical.
d)this is clarified in the design brief.
e)just one proposal, you choose which site.
f)it is on the hill to the east of the site B.

thanks!

You are correct. We provide the telecommunications details only to give you a more complete sense of the overall project. You are expected only to provide designs for the main building.

Thanks for the insightful post. This is certainly along the lines that we were thinking, as you rightly point out that in our area local access is so critical. The central telemdicine unit designed for the competition would be a hub for planning, experimentation, and training purposes. It would also be the focus of receiving outside consultations. The issue with a truly "mobile unit" is that most villages are acccessible by very poor dirt roads. But perhaps you are more interested it in small, permanent structures. These units could certainly be part of our intra-district strategy, which relies on local community healthworkers to, as you suggest, perform diagnosis, triage, and treatment in the field. In the beginning a huge step would be doing VOIP (using a zero-usage-cost intranet system) to enable the CHW to communicate with the central medical team. I know this sounds overly simple, but this is likely to be one of our more exciting and effective applications of telemedicine. In the beginning, we were imagining incorporating this into existing pharmacies and health posts, since in that instance it is more about the technology than the design. Even for using our internet as ISP, the computers could be located at schools etc. That is not to say there are not advantages of having independent structures for this, and there would of course be opportunities to pursue designing these, and we of course would welcome them, but I think for the competition purposes it is probably best to focus on the central unit. The basic technology and their costs are described briefly in the clarifying brief. Note also that in these areas there always will be district hospitals or otherwise "referral clinics" that benefit from having a larger telemedicine center to coordinate activities. So I would say the concept of a telemedicine center located near to a district clinic or hospital center is appropriate and scalable. Hope this helps.

I am sorry for the confusion. We are trying to allow for as much flexibility as possible. As discussed in the clarifying brief, those counselling rooms would mostly be for one-on-one counselling on education or microfinance projects. There would be a possibility of clinical interactions in these counseling rooms, but it is unlikely that that would happen. We are trying to leave things open-ended to provide you with some flexibility in design and us long-term with flexibility in programming. We were also trying to stay as consistent with the original brief, which had labelled two counseling rooms.

Dear Duncan Maru,

I am always trying to approach your work with empathy, and I can guess how difficult your work is, however I have to ask for the same empathy from you, since, continuous changes about the competition is devastating for us, most of the designers here I believe have other works than this challenge, and we can spare our limited time for this, but when even the smallest change is made in the brief, whole design entails complete reviews. I approve dynamic design inputs, open-endedness, process rather than position, but in order to make proposals we need tangible and constant inputs at least for a limited time, after the challenge there will already be a process with the winning proposal naturally. Please do not be offended but with all my respect I am asking to have a final design input, or let us know that this pdf is the final one.

The design brief as it currently stands is the final one.

We definitely empathize with you all and are so appreciative of the creative energy and solidarity you are all putting into the project. Our reason for putting the updated design brief was to help you all design something more realistic. It was intended as an "update" with more site specifics. Unfortunately some of those updates changed a lot about how you all were planning on designing, and we apologize for the wasted time and energy. The most recent PDF was an attempt to allow more flexibility and to be more consistent with the original design brief. We again apologize for having been quite unprepared initially to understand what this project would entail, but we have made some strides over the last few months and are excited about the project's prospects.
Thank you all again for your patience and dedication.

Reading the clarifying brief for the competition, it's stated that both sites are available on the sketchup site. Besides the Clinic model and the incinerator/ burial plat, there's only one site, which I assume is site B, on the hill.

- Will site A be available on the sketchup site?

Dear all,

Thank you for your patience.
We have just uploaded the pictures and the new sketchup file and made a note of it on the FAQ page.
http://sketchup.google.com/3dwarehouse/search?uq=13801887529798628529
http://picasaweb.google.com/nyayahealth

I'm sure that we will have to address further concerns over the next few months from the design teams, and we look forward to that dialogue. Let us know if you have any questions, concerns, ideas, and we'll get to it promptly.

Best,
Duncan

Apologies again for our lack of clarity. We will attempt to address your excellent questions. We have also updated the brief with these clarifications for re-download if you would like for reference:
http://www.nyayahealth.org/Library/OAN_AMD_Nyaya_Health_Telecomm_Center....

1. This would be for permanent staff to live there.
2. The fundamnetal difference is that patients won't be seen there. Hence we are calling it a telecomm center rather than a telemedicine center. This made sense for a few reasons.

Location-- when we had written the grant, we were thinking that the telemedicine center would be located at the badelgata hospital, but for political reasons that became impossible. As such, we had to do it at the clinic site. The land adjacent to the clinic site is arable farmland that we certainly could buy out at a huge sum, but I don't think that would be appropriate for the community.
Scalability-- ability to incorporate the design into existing clinics and hospitals. In most cases in Nepal, the shortage is not of hospital beds or spaces for patients but rather for staff trained and willing to work there. We felt that there wouldn't be much benefit of having a single "telemedicine center" that had patient. Also, the telecomm center that you design would work for large hospitals or smaller clinics, since the basic functionality of community space and housing of the server/ISP is the similar.
Logistics-- in our context, where the clinic is relatively small, designing a telemedicine center where patients would actually be seen but where community activities would also take place seemed to present issues in patient comfort and confidentiality without much benefit. Since it costs so little to get the connectivity from the clinic (just a little cords or Wi-Fi), it didnt seem like there was much of a benefit to actually seeing patients at the center.
Functionality-- having some distance from the clinic allows the community and ourselves to better achieve multiple functions for the space by relieving the constraints of being built into a clinic/hospital.
Applications-- Designing a true "telemedicine center" might make sense if we were doing high-end applications, like real-time videoconferencing of surgery cases. The design of such facilities really needs to be unique. For us, however, we are merely doing voice and store-and-forward applications, both of which really don't fundamentally change how the clinician interacts with the patient.

3. There is no community space at the clinic. There isn't any similar space in Sanfe or elsewhere in the area, although admittedly most activities take place outside. There are schools with decent-sized halls. I think for trainings this space will be particularly important. We are especially excited to have a training center for community health workers; this currently takes place at the clinic, but it would be nice to have a larger, designated space.

4. Good catch. That is actually an electrical pole. There is no telephone lines in Sanfe, though we are lobbying on it with Nepal Telecom. Deep apologies for the careless mistake on our part.

I had already posted these questions in other threads, but it's hard to find out when those get updated.

- the sketchup model shows concrete stairs on the Western boundary of the site, and what appears to be water (colored blue in model). Can you clarify if these are actual stairs, or maybe just a footpath?

- It seems this revised site is significantly smaller than the original near the clinic. Can you please confirm that the site has an area of ~2000 sq.m? It was mentioned in a previous thread that the new site is approximately 1 acre, but 2000 sq.m. = 21,500 sq.ft., about 1/2 acre.

- what is the preferred unit of measure in Nepal - inch or cm?

thanks.

We apologize that we hadn't adequately addressed your other threads.

Re: those stairs.
You are correct. Just a footpath. Apologies for our poor sketchup skills.

Re: size of the site.
Indeed, the entire plot of land available for this at the new site is about 1/2 acre. There is approximately 1/2 acre additional land to expand to on that particular plot. The space next to the clinic is indeed much larger, but that is very arable farmland that is better to be left to its current purpose. There was a misunderstanding that that land was to be developed. Nepalis are familiar with both metric and american, although metric is more commonly used.

Hi Theoryshaw,
We do plan on added RSS in the near future. This is our first competition using the system so there are kinks along the way.

I believe the latest "Information Technology and Telecommunications Strategy for Nyaya Health in Acham, Nepal" brief (dated Dec. 27th, 2007) supercedes the Sinclair email titled "Visiting Nyaya Health", dated Jan. 7th, 2008.

The discrepancy is due to the fact that Sinclair visited the other OAN/AMD competition sites as well.

It has been stated by Nyaya Health that their strategy changed after the site visit by Sinclair.

Of course, I would appreciate direct confirmation by Nyaya Health on this issue as well.

That is correct, our document supercedes his. We apologize for the confusion. The issue is that yes the former grain storage is our clinic, but the telecomm site is not directly adjacent to the clinic. Those new photos are old photos that one of our members came across. The new photos will be uploaded tomorrow evening 1/11 EST, weather and politics permitting. They will be clearly labeled and organized.

Given the lateness in the finalizing of the site (they are very close together) we will be accepting designs for any of the sites. The focus should be on the scope of the project, integration of technology and response to need.

For some reason we did not get the latest information on the site until after we left Nepal.

The joys of working these environments!

Cheers
Cameron

Thank you for this insightful post. We will ask around in Achham about bamboo construction to better understand the issues as to why it is not more widely used in our area, and whether there are any examples of its successful application.

We feel it is a feasible material but the climate may not be totally beneficial to producing large quantities.

What crops are grown on the land surrounding the clinic?

Almost exclusively wheat.
A few plots grow leafy vegetables.

Re: Bamboo. People used it to build temporary houses and also in the beginning of contruction (to place the bricks and proceed in the vertical). They have not found it useful for constructing more permanent structures.

We are trying to get you more photos of the site, for now the best photos are around:
http://picasaweb.google.com/nyayahealth/AMDOANSiteVisit/photo#5151385966...
http://picasaweb.google.com/nyayahealth/AMDOANSiteVisit/photo#5151385987...
Within in a week we will have many, many more!

All entries are to uploaded digitally to the project that is started when you sign up. If you some reason you have having alot of problems uploading (ie. internet connection is difficult) please let us know.

By "board" I understand a physical printout, mounted on a stiff backing of some sort.

Is this to be digital file only?

I think the original poster was inquiring about dimensions of board (width X height). If digital only is required, then maybe a minimum resolution (pixels) would be helpful.

Can you please clarify?