Can a building and its technologies be a “practitioner of medicine”? Can they bridge the political, personal, cultural, economic, and distance divide that has contributed to the isolation of Indian and Native peoples from modern medical care? The recently opened Nighthorse Campbell Native Health Building attempts to answer those questions.

Prominently located at the center of the campus master plan of the new University of Colorado Health Sciences Center (UCHSC), the new building provides a variety of services important to this population: It houses the Division of American Indian and Alaska Native Programs (DAIANP), the Programs for Public Psychiatry, and the Center for Native American TeleHealth and TeleEducation (CNATT).

The DAIANP directs the work of seven national centers that provide research capabilities to assist American Indians in evaluating their health concerns and developing effective health promotion programs in areas such as mental and physical health, alcohol and substance abuse, and elder care.

The CNATT program bridges the healthcare distance gap by coordinating access to telecommunication technologies and transferring relevant technical knowledge and skills to American Indian communities. The Distance Education Program of CNATT provides up-to-date and culturally relevant educational opportunities to healthcare providers, planners, and administrators in American Indian communities on a local, regional, and national basis. The clinical care component of CNATT provides weekly clinics focused on medication management, case management, and ongoing group/individual psychotherapy for veterans with post-traumatic stress syndrome.

Building Details

The building's technical and communication capabilities allow long-distance individual medical consultation for the first time. The physician, therapist, or consultant at this facility is able to observe and monitor individuals at remote rural sites and perform patient consultations and evaluations. This technology also allows the real-time dissemination of important research and information. Even though the simplest of modern technologies may be lacking in many Native households, this facility and the programs it supports bring the latest in healthcare opportunities to the Native Americans in rural America.

It was imperative to understand and integrate Indian culture and beliefs into the development of a relevant, participatory healthcare program, housed in a special facility that would communicate this understanding in terms of design, space, and environment. When respect for Native culture is coupled with medical technologies, public health knowledge, and interventions, a type of synergy is achieved, and modern medicine becomes more congruent with the spiritual and cultural backdrop of Native lives. This project was the perfect opportunity to incorporate this meaning into a building's design and construction.

UCHSC felt it was critical for the university to demonstrate an outreach capacity from its new campus to underrepresented communities and, specifically, to American Indian communities. Because of the work of the Native American TeleHealth program, the University of Colorado has the most Native American PhDs of any university in the country. Recognizing the important role that the UCHSC could play in the success of enhancing healthcare opportunities for Native Americans, the Nighthorse Campbell Native Health Building was designated specifically to be in the first phase (Early Development Phase 0 to 5 years) of three campus-development phases, to bring services online as soon as possible. The building site was intentionally located on the historic “symbolic gateway” to the campus, not buried within the much larger campus of buildings. This building is the only facility on the campus allowed to vary from the strict campus architectural guidelines, allowing for a special and singular identity in building form, detail, and meaning.

It was important to embody in some tangible way some of the key elements of the Native American culture and way of life: respect for the earth, influence of earth and sky, traditions, ceremonies, and diverse architectural traditions. The built forms of the building and landscape needed to reflect the spiritual, aesthetic, and cultural integrity of the people the facility is intended to serve.

In the attempt to bridge the cultural and geographic diversity within Native American cultures, the architectural firm, M+O+A Architectural Partnership, chose to highlight in the design the architectural heritage of three predominant regional Native American groups. The building massing, window shapes, and other detailing recall the Southwest building tradition; the Rotunda and fabric elements reflect the Plains tribal culture; and the exterior/interior log elements represent the Northwest and Alaska Native tradition.

The main design element influencing the interior and exterior space is derived from the Native American belief that the circle represents the dwelling place created by the Great Spirit of all people, connecting all life in balance and harmony. The design incorporates three major, complete circular spaces, forming the building's public spaces: the Council Ring, the Rotunda, and the Auditorium. All are aligned on axis with the sunrise of the winter solstice.

The first major circular space is the Council Ring, greeting visitors outside the east main entry of the building; it is reminiscent of a council ring from the Northern Plains culture, symbolizing connection to earth. This exterior space is defined by log posts and framing that create a circular arbor, and it has a permanent, nonlandscaped floor opening of sacred earth at its core. It was at this location, prior to construction, that the site was blessed in Native American tradition. There was no groundbreaking ceremony, as the idea of “breaking” the earth is contrary to Native American beliefs and tradition. Rather, there was a “ground blessing” ceremony. Prior to occupancy, the building was blessed again, in a ceremony in which soil from four Native American nations was sprinkled into the earth of the Council Ring. The soil was from cardinal points in the United States: Nome, Alaska; the Miccosukee Reservation, Florida; the Passamaquoddy area in Maine; and Feather River, California.

The second major circular space is the Rotunda, a great hall for ceremonial and programmed events, and the horizontal and vertical axis of public traffic through the building. The main building entry feeds directly into the Rotunda, facing east in Native American tradition, and aligns with the winter solstice to allow the rising sun to shine axially into the Rotunda on the shortest day of the year. Representing a tipi form in shape and supported by seven steel columns wrapped by large Douglas fir logs representing lodge poles, the Rotunda soars more than 53 feet to a skylight, creating a three-story atrium and connecting the interior of the building to light, sky, and earth. The space between the seven poles consists of 28 divisions. Seven is a number of special meaning for many Plains Native Americans, symbolizing love, honor, courage, respect, honesty, reciprocity, and family. Twenty-eight is the number of divisions in the Native American medicine wheel.

The skylight of the Rotunda, surrounded by a tipi form on the roof that is made of fabric on a steel frame, becomes a large element visible on the exterior of the building. It is uplit and glowing at night, as if there were fires burning within, symbolizing the Native American spirit high on a mesa. This element also gives a greater presence and identity to this small building surrounded by a campus of larger buildings. The center of the Rotunda floor is paved with hand-selected colored stones native to North America and formed in the shape of the medicine wheel. The colors of the stone—black, white, red, and yellow—are important to the representation of the medicine wheel. Inset along the perimeter of the Rotunda floor are the blessing stones used in the ground blessing ceremony.

The Auditorium, reminiscent of a kiva (a sacred gathering place in Southwest native cultures), is the third major circular element on the west side of the building. With its sandstone veneer echoing the appearance of cliff dwellings located in southwest Colorado, it has a rooftop terrace for special events, with views of the Fitzsimons Campus and the Rocky Mountain Front Range. Inside, the Auditorium space provides seating for 100 and offers state-of-the-art communication technologies, enabling multiple distant parties to meet through real-time, interactive videoconferencing, as well as wireless telecommunication that provides a laptop computer connection at every seat.

Near the Council Ring, a large, hand-picked granite boulder was core-drilled to accommodate a hidden water pump that supplies water from below, representing an endless stream of life-sustaining water delivered by the earth. The water feature and seating areas express the concept of a broken circle, saying, “Indeed, nothing is perfect.”

Each of the three floors houses offices, clinical studios, “smart” classrooms, a multimedia production suite with sound and video recording studios, and a video control room.

The building design includes irregularly shaped windows, with eight corners instead of four. The windows were detailed and installed to be visually “mullion-less” from the exterior, recalling the Southwest native building tradition. The windows are large, to enhance interior daylighting and provide views and a connection to nature along the building perimeter. Light-sensitive spaces, such as the media production laboratories, are located in the center of the floorplate.

Display areas for Native American art are provided throughout the facility.

A video wall is planned in the Rotunda, intended to educate and communicate to all staff and visitors, in a high-tech visual presentation, the mission of the facility: to provide access to healthcare for all Native Americans. HD