All in This Together

At the beginning of this year, few of us could have foreseen how quickly our lives, both personal and professional, would be transformed by the COVID-19 crisis. In the midst of the upheaval, the pandemic has forced us to re-think the ways in which we work, and has also led us to surprising and exciting opportunities to collaborate across international borders as designers look for ways to address critical issues of infrastructure and design.

We began with very basic information, including photos of the site, elevations, and floor plans. We developed a long list of questions: what were the funding sources available? What is the standard of care? What construction resources are available? How does the facility currently operate? Conversions between metric and imperial measurements, and from French to English, added layers of complexity on a tight timeframe, but together the team was able to achieve a quick turnaround and viable solutions for the clinic.

Program spaces included treatment areas (mild to moderate, severe, and critical), laundry, restrooms, offices, donning/doffing areas, morgue, incinerator, and circulation. The team used existing information to analyze flow of patients and providers to minimize opportunities for cross-contamination. The design included new strategies such as the addition of double doors for separation of staff and patients and clean/dirty areas. The existing facility relies on natural ventilation; the design proposes a hybrid system with natural ventilation with mechanical exhaust to keep clean air flowing into patient rooms and prevent contaminated air flowing back into corridors. Staff areas are constrained, but the design directs staff, patient, and visitor flow for maximum efficiency and safety as well as strategic use of PPE. Staff can observe patients from a central corridor to reduce donning and doffing needs.

Cultural considerations greatly impacted the decision-making process. While in many countries visitors to COVID-care units are prohibited, the team determined that in Burkina Faso, family members are considered to be critical to recovery and therefore visitors would be strongly encouraged to visit (albeit with PPE, physical distancing and other safety protocols). The design accommodates visitors with dedicated circulation routes in and out of the facility depending on the patient level of acuity.

Our very positive experience with the Burkina Faso project has led to opportunities to mentor other international teams participating in the same process for other facilities in Brazil. As we await updates on our project from the field, we are optimistic that similar efforts by firms working around the globe are having far-reaching positive impacts, one clinic at a time. We are truly all in this together, and our success at navigating the COVID-19 crisis globally will depend upon our willingness to collaborate across borders and explore new avenues for treatment and recovery in diverse locations from next door to half a world away.