Suture and sante : a placemaking procedure

Abstract

The post-apartheid repetition and insertion of an unchanged standard clinic design across South Africa, has resulted in a number of urban and design problems stemming from the architecture of the clinics and their inability to adapt. Designed before the resurgence of the Tuberculosis epidemic, the facilities were not designed for optimal ventilation or air-borne infection prevention . The current healthcare facilities cannot support the ever-increasing urban population, and as a result, patients are forced to wait for long hours before being attended to, in poorly ventilated, unstimulating spaces. Emanating from an understanding of the relationship between architecture, health and the transmission of disease, the dissertation endeavours to create a new healthcare facility that remedies these problems through design. The dissertation identifies Alaska, an informal settlement, as an appropriate site in need of and with a population size to support a new public healthcare facility. Recognising the risks of blind top-down provision of buildings into informal settlements, the dissertation explores the power of a collaborative approach towards design. The design process engages the community in a series of participatory exercises in order to discover and enable grass-roots knowledge and innovation, and to instill a sense of ownership and responsibility for the intervention, after construction is complete. The dissertation studies the traditional healthcare practitioners within the settlement, for spatial clues and an alternate approach to the provision and architecture of healthcare. The Salutogenic (the healthy pole of the health- disease continuum) approach of the traditional healers is merged with the pathogenic design sensibilities of typical western facilities, in order to create a facility which not only focuses on curing disease, but also on instilling preventative habits within the community. The intervention intention to be reflective of and responsive to the dynamic context of Alaska, is realised through the spatial and design intelligences of a top-down provider enabling the innovation and local knowledge of bottom-up approaches through a collaborative design process. The intetnion is expressed through the inclusion and manipulation of local building materials and techniques.