Open Architecture Network

PROJECT DESCRIPTION:

DEFINITION OF TELEMEDICINE
Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred via telephone, the internet or other networks for the purpose of consulting, and sometimes remote medical procedures or examinations.


PURPOSE OF PROJECT
Achham is a rural agricultural district with some of Nepal’s highest poverty, infant mortality, maternal mortality and HIV rates. The mission of the project is to establish essential public health services in one of Nepal’s most underdeveloped areas, but also to develop a model of scaling-up and management of health services in remote areas. Telemedicine here is considered as a tool to improve health services delivery and empower populations in the area to obtain access to vital resources that will serve as platforms for further educational and economic improvement. Staff can improve training, quality assurance and collaborate with specialist colleagues and accustomed health system in the first world.


SITE DESCRIBTION
The stepped site is located a seven minutes walk from an existing clinic in Sanfe Bagar. The small transit town of about 5000 inhabitants is situated in Achham, Nepal at the bottom of the Himalaya. Temperatures vary annually between 3 to 42 degrees (winter-nights 5°, winter days 25°; in the summer up to 42°). The site, which is located in flood plain also, experiences monsoon rains and earthquake landslips.
The building spot was selected because of the nearby existing clinic and its logistical conveniences in transporting supplies (end of paved road); however travelling time is 2-4 hours by foot. Currently there is no access to the internet, not even landline connection is available.


DESIGN CONCEPT
The design intention is for the building to form part of the landscape. Using the given stepped site in its pure form and as guidance for the concept, the building is embedded in the landscape to achieve a union with the beautiful and natural environment of the Himalaya.
The two storey building separates a conference space on the upper floor from a more private staff quarter on the lower ground floor with the benefit of having separate access and reducing the footprint of the building and the cost for the land.
The upper floor includes a spacious conference room, computer working spaces and consultation rooms. The lower ground floor provides sleeping facilities for permanent staff which are connected to communal facilities through an open green courtyard. While the common spaces are very open towards the courtyard, the sleeping quarters allow more intimacy, respecting the individual’s privacy and taking strong reference to the cultural need for sexual separation.
The courtyard itself is a traditional element that symbolises the extension of the landscape into the building and therefore nature being a strong part of daily life. Creating a courtyard in the centre of the building means all rooms benefit from south light and natural ventilation. Narrow slots of recycled opaque glazing make sure the rooms are flooded with light without being overheated.


CONSTRUCTION MATERIALS
Making the building part of the landscape and sustainability being a major factor building materials were carefully considered by the design team. Local materials including mud bricks and gabions are proposed to address the request for a sustainable building that is cost effective.
Mud brick is a cheap environment friendly construction. Virtually all the energy input for mud brick construction is human labour and after a lifetime of use the bricks break down into the earth they came from. It is considered as structural wall on both levels of the building.
Gabions are modular building blocks formed of wire mesh and filled with rock. They can be used as retaining walls to hold back earthworks as well as architectural cladding to give a particular aesthetic to a building. They are very easy to construct on difficult sites and produce a quick-to-assemble and natural wall and posses a very good thermal conductivity. Gabions are considered here as retaining walls as well as cladding elements as rocks seem to appear as local material which makes the construction both sustainable and cost effective. The Gabions for Cladding are tied to the main body of the building. Beside these two natural resources it is considered to use existing glass materials such as old bottles embedded into mud.


SUSTAINIBILITY
Sustainable building materials are only one of many aspects of an environmental friendly building.
External walls and the green roof form excellent thermal mass that absorb the warmth in the warmer period and radiate in the colder months, so extensive heating is not needed as much.
A stove fired with biomass placed in the communal area connects the rooms via pipes and distributes the heat in early morning and evening in winter.
Another aspect is Rainwater which is a good source of water that can be used for washing, flushing toilets and if properly treated even for drinking and other household use. It is collected from the roof and stored in a tank at the rear of the building until needed. Black small tubes are installed on the roof to heat up water circulated by a pump for warm water.
Wind turbines are installed on the site to achieve constant electricity. An antenna for future internet connection needs to be installed in one of the many trees.


AREAS
Areas were carefully discussed in the design team and considered reasonable with the footprint of approximately 260 m² with regards to a two storey building.