Sachibondu - Designing for Health

For the past 10 weeks, we have been working on a project we’re incredibly excited about - the first phase of what will become the new Sachibondu Hospital, delivering a significant upgrade in facilities status with the Zambian Ministry of Health and enabling the provision of better critical health support to tens of thousands of people from remote communities across Zambia, Angola and the Democratic Republic of Congo.

Founded over 45 years ago, Sachibondu was set up as a Rural Health Centre near Mwinilunga, a remote and rural region of North West Zambia on the Democratic Republic of Congo border. Each year thousands of patients come to the Health Centre where they are met by a small team of dedicated nurses and midwives who do all that they can to help.

With few good alternative options, most patients travel remarkably long distances to reach Sachibondu, some up to 10 days from within Zambia or neighbouring Angola and DRC. Many patients from the DRC, where women are often persecuted and have few rights, seek help for issues related to armed violence or pregnancies often caused by rape and abuse.

The Centre provides a wide range of general health care including tuberculosis, malaria and HIV clinics, and also works hard to increase awareness, testing and education in order to reduce the numbers of new infections. Lessons in food nutrition and cookery are also provided to help families overcome malnutrition and improve childcare standards. The original facilities at the Sachibondu Health Centre were of poor quality and limited space, meaning that the Centre struggles to cope with the increasing numbers of patients arriving each day. With a history spanning more than five decades, development and growth of the centre has always been dictated by need, with infrastructure provision being sought locally and with little or no design input.

In remote areas such as this, resources are scarce and buildings are typically inadequately ventilated and suffer from low light levels, even during the middle of the day. These environments can perpetuate the spread of infection and disease, but there are ways that we can change this.

Better design and innovative approaches to basic materials and local building methods can make a huge impact on the health and well-being of patients. By increasing internal air-change rates passively and introducing effective and controllable natural ventilation, we can reduce health risks. Effective day light strategies can also reduce the reliance on electricity, which is often inaccessible, and helps provide more enjoyable and usable spaces.

Working closely with the staff and selected patients at Sachibondu, we have developed a masterplan and development strategy for the Centre, incorporating patient wards, clinical and diagnostic testing facilities, a specialist infectious diseases unit, operating theatre and staff housing. The key aim in redeveloping the Centre has been to achieve an upgrade status with the Ministry of Health to a Hospital (higher level than a ‘Rural Health Centre’). With this, the Government will provide fully trained doctors, more staff and better resources, whilst the facilities themselves with be able to accommodate significantly increased patient numbers and undertake critical surgery and treatments.

Over the past ten weeks, we have made great progress as the building begins to stretch above head height. The project employs around 120 people across construction, brick production and site hospitality, a mix of men and women from a number of local villages.

Given the remote location, some 10 hours drive to the nearest well-stocked hardware store, our design prioritises materials available locally or that can be produced on site. With large volumes of excess soil generated from the construction, as well as large anthills near site which provide a great source of clay-rich soil, we have produced almost 250,000 bricks on site providing local employment whilst minimising material costs. The bricks are made from compressed stabilised earth using Hydraform hydraulic brick machines. We have also re-used large areas of the existing health centre floor slabs, with the demolition rubble adding fill to our foundations and the roof timbers being re-worked for windows and doors.

The first phase is due for completion in October and we will continue to post updates periodically.

We would like to give a special thank you to those who have supported the project so far, including: Drum Property Group, WEIR Group, EDF Energy, Morris & Spottiswood, Mark Beaumont (Africa Solo), StructureMode, HOK International, Jestico + Whiles, Vardy Foundation, Robert Barr Trust, Paul & Paula Yacoubian, Kuenssberg Foundation, Jylag, Cardiff University, Lee Wakemans, Bea Sennewald, iEMERGE, The Orkidstudio Scottish Fundraising Committee.