Mapping New Healthcare Infrastructure After Genocide

In July 1994, the Great Lakes region in Central Africa was in tatters as mass genocide marred the land. “No people, no nation” was a common call; the Tutsis who represent 14% of the region’s population were deemed worthy of death by the government.

Of survivors, widows and orphans were traumatized. Repatriates and refugees became disoriented. As for the nation’s civic infrastructure, there were no markets, no food, no hospitals, and no schools.

From the days of horrific tragedies to the present, pieces of the broken country had to be rebuilt by this shattered, vulnerable society.

As a result, epidemics in the form of HIV/AIDS, meningitis, tuberculosis, measles, malaria, and malnutrition, among others, led to decades of unimaginably high child mortality rates and low life expectancies throughout the region. Inadequate healthcare coverage and poor health system performance resulted in the deaths of nearly 9 million children under the age of five each year.

The most devastating, yet at the same time promising, fact is that the primary causes of these diseases and deaths are now preventable. The World Health Organization (WHO) stated that even though the health resource base has been steadily climbing for decades, mainly in developed areas of the world, “The health sector remains massively under-resourced in far too many countries.”

For instance, for every 1,000 people living in Central Africa, there is one doctor. Despite ample resources in the developing world, the WHO calls the international response to struggling nations “inadequate and naïve,” not to mention “too little, too late” or “too much in the wrong place.”

Last year, both the Healthcare Initiative in The Design School and the College of Nursing and Health Innovation at Arizona State University had the incredible opportunity to offer students a traveling design studio experience focused on addressing some of the critical health and wellness issues facing people in the Great Lakes region of Central Africa, specifically child mortality.

Led by professors James Shraiky and Gerri Lamb, this traveling studio utilized the skills and expertise of an eager, multidisciplinary team of 12 students from architecture, landscape architecture, healthcare innovation, social sciences, and design research.

During fieldwork in Rwanda, as well as back on campus in Tempe, Arizona, students worked tirelessly to propose the design of a new multifunctional clinical facility, plan a healthcare campus, develop a comprehensive site plan template, create a suitable and sustainable landscape program, and conceptualize an effective and efficient healthcare delivery model.
 

The team
As the program for this research experience is highly uncommon in today’s academia, so, too, was it unique and exciting for all participants. The unusual class structure united students from varied academic disciplines to collaborate in an effort to solve a healthcare problem from a design research perspective while under the direction of two professors with distinct backgrounds: one a nurse scientist and the other a design researcher.

Team members arrived to the first day of class worlds apart in perspective and focus. The following represents the diverse ways of thinking, processing, and understanding that they brought to this project.
 

Healthcare innovation and nursing
Arriving in a design studio for the first time, the healthcare and nursing students did not know what to expect. In accordance with traditional healthcare environments, they anticipated structured schedules; pre-set, incremental semester plan rollouts; and innovative uses of technology, not only for all presentations and renderings, but also in the documentation of the healthcare system design.

Online collaboration and discovery is the natural mode of study for this group of students. They assumed that classwork and teamwork would be performed during daylight hours. A patient-centered, holistic focus is foundational to this group.