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GHESKIO Cholera Treatment Center

MASS Design Group

Port-au-Prince, Haiti

March 2015

PRIMARY AUTHOR

Michael Murphy/MASS Design Group Alan Ricks/MASS Design Group Adam Saltzman/MASS Design Group David Saladik/MASS Design Group

CONTRIBUTING AUTHOR

Christopher Scovel/MASS Design Group (Project Architect) Sierra Bainbridge/MASS Design Group (Landscape Architect) Nathan King/Virginia Tech Center for Design Research, MASS Design Group (Project Team Member) Matt Sisul/ YCF Group (Structural Engineering) Arash Guity/ Mazzetti (MEP) Fall Creek Engineering, Inc (Civil Engineering )

AUTHOR

Les Centres GHESKIO: The Haitian Group for the Study of Kaposi

PHOTOGRAPHER

Iwan Baan

OBJECTIVE

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CONTEXT

MASS Design Group began working in Haiti with Les Centres GHESKIO—a Haitian leader in healthcare—in early 2011 after the 2010 earthquake hit and unveiled the vulnerability of impoverished Haitian communities. Cholera, a curable, preventable disease that had not existed before in Haiti, emerged and ran rampant through the tent cities of Port-au-Prince and surrounding hillsides, enabled by Haiti’s dearth of sanitation and public infrastructure, overcrowded housing, and weakened population. Cholera patients were treated in temporary tents, which were hot in the Haitian climate, difficult to keep sanitary, and incapable of ensuring long term prevention from infection. The urgency for investment in health was incontestable: Haiti ranked lowest in Latin America and 119/137 globally in achieving the Millennium Development Goals that establish targets for improvements in nutrition, education, sanitation, gender equality, and maternal and infant mortality. But investments in public infrastructure were severely lacking. GHESKIO, the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections and the first institution in the world dedicated to the fight against HIV/AIDS, came up with an intervention solution. With MASS Design Group as a partner, they would build a permanent treatment, prevention, and educational center that could be replicated throughout throughout the country and have both an immediate and long term effect on the nation’s battle against poverty and disease.

PERFORMANCE

The CTC was designed to impact the community and perform over the long-term. This was successfully achieved with three strategies. First, the center’s interior and exterior were created to improve staff performance, increase facility of treatment, reduce length of stay, and increase efficiency. The 1.5m perimeter access corridor around the building allows for expedited movement of beds and staff, nurse stations were designed to be placed in every patient bay to increase direct observation, and equipment and furniture was designed to be easy to clean. The second strategy was to leverage the building process to employ as many Haitian workers as possible, showcasing the value of Haitian skills while stimulating the local economy. A total of 300 jobs were created during the construction process, in addition to 10 artisans who were hired for the façade fabrication, 20 furniture creators hired to produce one-of-a-kind pieces for the CTC, and 20 individuals brought on for millwork (10 of whom were former victims of gender-based violence). The third strategy was to impact the community by improving health. The CTC achieves this by treating on average 100 patients a day and ensuring that none of their toxic waste enters the groundwater. Cholera is transmitted when a healthy individual ingests food or water contaminated with a sick individual’s feces. Treating patients daily allows for the entire community to be at a lower risk of contracting cholera. The CTC demonstrates, then, that architecture can and should be leveraged to resist epidemics.