THE HAITI PROJECTBuilding... Health, Safety, & SustainabilityThrough... Radical Collaborative Design Relationships

FORGING THE TEAM

CONTEXT OF THE PROJECT

ENGAGING THE PROCESS

ADDRESSING THE NEEDS

DESIGNING THESOLUTIONS

REALIZING THE RESULTS

FORGING THE TEAM

The studio project for spring 2013 involved the

design of a medical clinic for a community in

Haiti. The project was centered on an active

collaborative practice between the architecture,

interior design and nursing programs. The

nursing program has a very distintive graduate

concentration focusing on disaster response

and mitigation. The nursing faculty have a

thoughtful recongition of the value and role

of architecture and design in contributing to

this program and they approached the design

faculty about collaborating. The partnership

has proven to be a strong and active one, with

positive benefits for both colleges.

The work in Haiti has also proven to be a

natural fit, as the Nursing faculty already had

ongoing programs in the country along with

years of experience in that environment. The

two colleges have now worked together in two

Haiti research seminars, a senior design studio,

and have collaborated on a user construction

manual being developed for Haiti.

The nursing faculty have exellent experience

in areas that are very complementary to

architecture and design. The lead nursing

faculty member is a very experienced

practicing professional with a wealth of

knowledge and an understanding of Haiti.

Likewise, the supporting nursing partner has

infectious disease experience with extensive

experience in developing countries, including

a trip to Haiti with architecture faculty on two

occasions. The students who have worked

on the Haiti Project at various times also

cover a range of disciplines, architecture,

interior design, landscape architecture, civil

engineering, mechanical engineering and

chemical engineering, together with the

graduate students in nursing.

The design proposals communicated in this

document are under review for construction

and selection of one, or a compositie of

designs, is expected in the near future.

“Health is a fragile thing, and in Haiti it must be safe-guarded with extra care. This is one reason why this studio project holds such promise. The work of the College of Architecture and Design, in conjunction

with the College of Nursing, has begun drafting plans to strengthen resources that contribute to the health of generations to come. Our work can help assure that the faces of women, children and the

old will not be denied when health fails; they will not have to wait.”

Susan Speraw, College of Nursing

CONTEXT OF THE PROJECT

The collaborative practice between the

architecture, interior design and the nursing

programs was preceded by other projects

udertaken in Haiti following the earthquake,

all of which led to the forging of this crucial

partnership between the two colleges.

By way of background, a collaboration between

the architecture program and a Haitian based

nonprofit began in fall 2010, following the

January 12th, 2010 earthquake. This relationship

has been focused in a rural community and has

involved design and on-going construction of a

secondary school, along with a neighborhood

master plan and the design of fourteen

homes for faculty, staff, and others. This work

involved architecture, engineering, landscape

architecture, civil engineering and chemical

engineering.

Addressing the health and wellness needs in

Haiti, especially related to health education,

provides a third crucial leg in the priorities for

design by the college Haiti Project. It is believed

that these efforts, in the long run, will lead to

job-creation and a strengthened economy in

the country.

The client included two groups, a non-profit

faith based foundation out of the U.S. and the

local church, which is led under the direction of

a pastor who has been active in the community

as a minister for 50 years. The U.S. non-profit

has been operating in the community, formally,

for 20 years, and informally, an additional 20

years before that. They have focused their

efforts in several areas—child sponsorship, a

primary/secondary school, and the medical

clinic. The nonprofit, as stated in it’s mission,

has a “multi-pronged approach to transform

a single community by facilitating Haitian

initiatives that already exist.”

Both the school and the housing addressed

crucial needs in Haiti. The medical clinic had

a different but equally critical focus, location,

and client. The spring 2013 studio targeted

healthcare through the design of an addition to

a small existing health clinic. The existing clinic

started in an abandoned building in 1993 and

was built as a facility in a community on the

northeastern corner of Haiti.

The work put forth has proved successful—the

school opened on schedule in Septermber

2012. Sale of the home sites and designs is

also moving forward. It is anticipated that all

proceeds from the housing project will go to

support the needs of children in the school.

The entire project is documented on the

internet, a print publication that was developed

for the school, and a similar publication was

developed in summer 2012 for the housing

design. The work of the studio has been

supported in a range of ways including the

generosity a U.S. based non-profit surviving.

The medical clinic was organized similarly to

the previous projects-through the mechanism

of a design studio. The studio this past spring

involved 19 senior undergraduate and graduate

students from architecture, interior design,

along with 4 graduate students in nursing.

ENGAGING THE PROCESS

The studio included architecture and interior

design students from undergraduate and

graduate, along with four graduate student

consultants from Nursing. A concerted effort

was made, from the very beginning of the studio,

to develop an immersive approach to the work.

How can one break free of personal biases and

of a common understanding of processes that

work is done in the U.S.? How can designers

adjust their thinking to reflect a sensitivity to

the culture of Haiti. Initially the plan was for all

of the students to go to Haiti, as had been done

in previous studios, but the plans unfortunately

had to be cancelled at the last minute due to

violence in Haiti. This called for adjustments in

how knowledge would be gained and how we

would simulate what would have been a direct

experience. Fortunately, the faculty were still

permitted to go, to a different location, which

proved very valuable in providing data and

information for the students.

Though the experience was limited to a

vicarious one, there were significant effort on

the part of all in the studio to absorb as much

as possible about the conditions in Haiti and

what might be an appropriate response. The

nursing faculty played a key role in bridging

that need, through their knowledge of health

and conditions, health practices and care in the

country. As might be expected, there is virtually

no model or similar condition in this country,

with which to compare how to approach design

of a medical clinic in Haiti.

The students first participated in “design

thinking” as a way to break free of a

conventional thinking and traditional design

process approaches. The focus was on getting

outside of the norm, and bringing professionals

of entirely different backgrounds together in a

way that might generate new approaches to

problem solving. To culminate the first stage of

the studio, the students worked in teams of all

three disciplines to develop a “mobile medical

pack” that could be taken back in to remote

areas of the country as a “field clinic”. Everyone

was operating outside of their normal comfort

zone and the results were creative and wide

ranging.

“The collaboration of architecture and nursing was essential to work through the design process of this

clinic. Together we created a dynamic team that was able to work through problems and develop a

design that would accommodate the specific needs of the community”

Deborah Beaver, Graduate Nursing Student

ADDRESSING THE NEEDS

Haiti offers extraordinary creative opportunities

for people to think and work differently. In

order to encourage the breadth of creative

opportunity in the Haiti studio, design

thinking techniques were implemented

and transdisciplimary collaboration was

incorporated in the studio experience. These

approaches were provided to foster success

through relationship and practicing a deeper

sense of empathy when making decisions.

Because design thinking is a universal process

of creating original ideas, objects, spaces, or

experiences with meaning, imagination, and

integrity they were able to reach beyond the

traditions of visual/spatial design associated

with the building arts. The best design thinking

merges and synthesizes the tangible and

intangible aspects of the world into new holistic

human experiences. It is an inclusive process

with emphasis on empathy and collaboration.

We all realized that design thinking equally

emphasizes the need to foster deeply creative

ideations to generate many diverging concepts

and superior critical thinking. The team focused

on the concerns of others rather than self-

indulgence and self-promotion.

Design thinking is not practiced as an expertise

mastered by a specialty discipline, but as

a design process applicable to all people

interested in making the future a better

place. By focusing on design processes that

were universal and disciplinary inclusive, the

following were fostered by transdisciplinary

collaboration in the stuidio:

Students were in relationship first.

This became extremely important and

surprised everyone. Designers and nurses

approach their work differently and

placing them together became powerful

in reaching solution. Success is measured

by how well you work and succeed with

others. The quality of design improves

through, not despite, human relationships.

Students were readically inclusive.

Creativity requires thinking different.

One of the best ways to think different

is to work and play with people that are

very different than you. Being radically

inclusive de-emphasizes who had the

good ides, and emphasizes how the good

idea arose and was transformed for the

better by working collaboratively.

Transdisciplinary Collaboration & Design Thinking

“The needs are still very great, but many are helped one at a time... And so we press on, building on friendships that haven been forged in this

partnership across the years.”

Friends of Fort Liberte

ADDRESSING THE NEEDS

Haiti has amazing strengths. The culture is rich

with deep human relationships and community.

Providing health care design solutions for Haiti

is a complex and challenging prospect. First

and foremost was the difficulty of addressing

our own prejudices and stereotypes of the

Haitian culture and the desire to fulfill ones

own personal satisfaction gained from serving

a community in need. Haiti appeared to be an

easy place to rush in and provide a “superman”

solution for a culture in severe crisis. Too often

Haiti is portrayed as a place where one can

be a hero that “knows better” and one can

easily correct obvious failures. By working in a

transdisciplinary and design thinking mode the

emphasis shifted from ones personal objective

and limitation to outcomes that can build a

better future through relationships.

Equipped for Multiple Terrains

Readjustable Space

E�cient Use of Space Reaching Distance Minimized

Quick and Easy Set-Up Durable

Sterilization Quickly and E�ciently

Proper Waste Disposal and Containment

Appropriate Restraints and Stability

Appropriate Markings and Representation

The vehicle or transport must be able to handle various types of terrain. This includes mountainous terrains as well as typical roads. Here, speed and utility are key.

The space should be suitable for sever-al occasions. It should be designed so that it can simply be transformed for each occasion. Each version should be a well-designed as the next.

The limited amount of space requires for a high degree of e�ciency. Each object/person must have necesary space so they can perform without infering with eachother.

The space should be designed so that minimal movement is necesary. This makes it easier for multiple users to operate simultaneously. It also allows for more rapid access to materials.

In the event of an emergency, time is of the essence. Preparation is an import-ant and can be a large time consump-tion. E�orts to minimize this are very important.

The vehicle or transport must be able to withstand the elements as well as resist degradation over time. Durability represents the strength and longevity of our aid and design.

Safety is extremely important; for victim and person providing aid. There-fore, sterilization must be a simple and e�ective process. Sanitation in this climate is critical and often neglected.

Crosscontamination and accidental exposure to old hazardous material is dangerous and should be handled with care. The proper containment and disposal of such material is vital.

Unsteady movement can cause injury as well as hinder medical processes. Safety restraints should be provided for persons and materials.

Appropriate signage and color should be utilized on the vehicle or transport. This is important so that it is easily recognized as aid and so that it can be spotted from a distance.

The first phase of the studio was initiated with

design of a mobile medical unit. This phase

was a four-week design exercise to develop

team communication and rapport, and receive

instruction and practice in design thinking

techniques. Examples of design thinking

techniques such as, affinity clustering, creating

importance difficulty matrixes, creating

concept posters, and developing and evaluating

with heuristics were formally introduced to the

students.

A central design thinking tool initiated and

applied in design process was the use of

heuristics. Student teams developed sets

of criteria that were used to organize key

technical and cultural concerns that were

central to the success of the project and could

be used in critical review and improvement of

the design by all collaborating participants.

The key concerns were organized into a list of

8-10 heuristics that facilitated on focusing and

ideation and critical review of design proposals.

Teams were encouraged to revise and update

the list of heuristic topics as they learned of

new issues and discovered relevancy of topics.

The use of heuristics allowed teams to:

• Develop and evolve agreed upon sets

of issues for project success.

• Facilitate multiple points of views from

different professional perspectives.

• Create divergent ideas and creative

responses to problems.

• Provide focus in the critical review of

the project proposals based on relevant

and significant issues developed by the

teams.

The project in Haiti has unique collaborative

practice and technical challenges. For example,

in the design of the clinic, the structure had

to provide light for diagnosis, ventilation to

maintain healthy fresh air for disease control,

protection from hurricanes, and be organized

for different cultural and familial expectations

for health care. The above concerns had to be

achieved without the use of electrical services.

The use of heuristics and the techniques to

develop, refine, and employ there use were

central in the success of the project.

Use of Heuristics

DESIGNING SOLUTIONS

The nursing program recognizes the

importance of interdisciplinary collaboration in

finding innovtive and sustainable solutions to

the complex problems facing the world’s most

vulnerable populations. Because health and

wellness are shaped largely by socioeconomic

and environmental factors, nursing’s

partnership with architecture was a natural

fit. As nursing faculty, we may have initially

perceived our role in the collaboration as

predominantly informative: Teach architecture

and design students the fundamentals of

infection control and describe how healthcare

workers and patients interact in clinical settings

so that students can design a building suitable

to the purpose of health promotion. However,

it was not long before we realized how much

we had to learn from our creative counterparts.

Through interaction with architecture and

interior design students and faculty, we began

to understand buildings are living organisms in

their own right. They are comprised of dynamic

systems involving space, light, color, and air

that help construct our sense of reality and

perception of the physical world in which we

live out our lives. In healthcare, we are deeply

concerned with the lived experiences of people

suffering from illness and how healthcare

professionals can better support holistic

healing. Working with architecture and Interior

design enhanced our understanding of yet

another layer of human experience that impacts

wellness. From vibrantly colored murals to

light filled vaulted ceilings to landscaping,

architecture and interior design students

showed us the value of design beyond the

traditional, more measurable indicators such

as ventilation or square footage. The sensory

experience of people seeking treatement in

clinical settings could potentially influence a

range of behaviors and phenomena including

patient satisfaction, education, and willingness

to return to the clnic in the future; all of which

improve health outcomes and help ensure

nurses provide the best care possible.

The devastation indicated by the 2010 Haitian

earthquake presented a unique opportunity

for nursing and architecture to unite under

a shared “build back better” philosophy

and contribute to the reconstruction of the

country’s ailing healthcare infrastrudture.

Faculty in both disciplines had prior experience

working in Haiti which we shared with students

to facilitate greater understanding of Haitian

culture and way of life. As nurses, our goal was

to provide insight into the challenges Haitian

people face accessing healtcare as well as the

typical services and operations of rural clinics.

The architecture and interior design students

were extraordinarily perceptive and engaged

us in thoughtful discourse about the needs

of both patients and healthcare providers.

Students also seized the opportunity to

incorporate nursing students into their design

teams and utilized their knowledge base in

the design process. Throughout the semester,

nursing students reflected on the challenges

and ultimate benefits of working so closely with

Nursing Faculty Perspective

DESIGNING SOLUTIONS

another discipline including: learning a common

language to transcend discipline specific

jargon, embracing a new way of thinking about

health, and overcoming logistical/technological

challenges to ensure all voices were heard

despite the rapid pace of tight deadlines of

the project. These skills are necessary and

transferable to many aspects of life, and

this unique project examplified the power of

collaboration for interdisciplinary education

and practice.

The semester was initiated with a three week

design of a mobile medical unit. Student

teams were to propose a system of delivering

health care to rural Haitians in the field

directly following a natural disaster. The

design had to respond to the realities of the

Haitian communications and transportation

infrastructure, cultural expectations of

delivering medical care, and the ergonomic and

human factor issues of transporting supplies.

The intent was to allow students to prepare

for the design of a clinic without disciplinary

ownership, become familiar with the design

process, and develop team cohesion and

rapport. The challenges facing the design teams

with the mobile medical unit further prepared

them for the clinic project by allowing for the

understanding of key health issues facing Haiti,

familiarizing methods of delivering health care

without electricity, developing a sensitivity

of medical waste and environmental impact,

and create unique, creativing responses with

limited physical resources.

Mobile Medical Unit

“What helped the most in the collaboration was the student’s immediate acceptance of us nurses, complete openness to our health-related input, and their sharing of architectural concepts with

us. While neither group was specialist in the other discipline, everyone was treated as an expert and knowledge was readily shared. We eagerly shared

our knowledge so we could understand each others’ expertise and bring the two together to design a

building useful to the client, a Haiti citizen in need of a health care clinic..”

Stasia Ruskie, Graduate Nursing Student

DESIGNING SOLUTIONS

As the first cross-disciplinary and collaborative

experience for many of the students in this

Haiti studio, it not only shaped the way we

approached problems, but also shaped how

we communicated, perceived, and discussed

information with others. Like previously

mentioned, our class consisted of students

in undergraduate and graduate architecture,

interior design, and nursing. The nursing

students and faculty acted as consultants to

our group projects. They brought knowledge

on an unfamiliar topic for the design students,

and became a resource necessary to the design

process. This changed how we, as design

students, engaged others in the development of

our designs. We cooperated within our groups

to overcome the project’s inherent challenges

and to complete a design that would benefit

others.

The class as a whole felt collaboration amongst

disciplines, though not essential, should be

encouraged and facilitated to ensure ideal

development. “Allowing a different viewpoint

into the heart of my design helped me make

imperative changes and allowed us as a class to

switch the focus of our designs on the needs of

the clinic’s user” (Metts, graduate architecture).

Collaborating with students of another

discipline truly broadened the experience of

the class and revitalized our typical learning

atmosphere. The functionality of every design

move was questioned to protect the efficiency

of the clinic’s visitors and employees, as a

whole.

With the aid of a team member or outside

perspective, the project will develop with

renewed enthusiasm. “They brought the

enthusiasm that can only come from and

educated individual giving their all to this

project” (Sawyer, undergraduate architecture).

It was clear from the first day of class that

there was excitement to be working together,

especially with individuals of differing

backgrounds. “It enhanced my group’s

design and gave me a broader view of the

architecture side that I would not have gotten

in another studio” (Brelsford, interior design).

The collaboration pushed beyond the orders

of the design profession. They informed us

about the specifics of nursing and healthcare in

developing countries by explaining from their

personal experiences so we could better cater

to our clients. We found that sometimes our

good design idea lacked practicality and may

even be detrimental to medical practices.

Just as the nursing students and faulty

guided our decisions, we taught them how to

visualize spaces, create relationships, and apply

emotions and characteristics to spaces. From

these collaborative experiences, we were able

as a class to provide not only more grounded

and established ideas, but we were able to

build trust and relationships that will begin

to positively shape the way of how we think,

perceive, and communicate with others.

Studio Perspective

OBSERVATION

OBSERVATION

VIEW INTO OBSERVATION ROOM

SECTION C

SIMPLE EXAM BED SOLUTION

WALL SECTION A

8Ó x 8Ó x 16Ó TYP CMU BLOCK

8Ó X 12Ó REINFORCED CONCRETE BEAM

DASHED LINE FOR IMPLIED REBAR BEYOND INTO BEAM

CAST IN PLACE CONCRETE STRIP FOOTING

PLYWOOD JOINT FOR CMU WALLS

4Ó GRAVEL FILL

6Ó POURED IN PLACE CONCRETE SLAB

CORRUGATED METAL ROOFING TIED IN WITH SCREWS

2Ó X 4Ó PURLINS TO HOLD DOWN ROOF

2Ó X 4Ó WOODEN TRUSS SYSTEM

COMMUNITY

COMFORT

WATER COLLECTION

NATURAL DAYLIGHT

PASSIVE VENTILATION

WOODEN TRUSSES TAKEN APART AND REUSED ON NEW BUILDINGS

CORRUGATED METAL ROOFREUSED ON NEW BUILDINGS

CMU BLOCKTORN DOWN, BROKEN UP AND REUSED AS AGGREGATE FOR CONCRETE AND IN GRAVEL WALKWAYS

EXTERIOR/ INTERIOR DOORSTAKEN DOWN FROM WALL AND REUSED IN UP-STAIRS APARTMENT AND DORMITORY

INTERIOR TILEREMOVED FROM CONCRETE SUBLAYER AND REUSED IN THE NEW OBSERVATION, OR IF TOO DAMAGED, BROKEN DOWN AND USED AS A CONTRAST TO CRUSHED CMU GRAVEL

EXISTING SECOND LEVELFLOOR SLAB AND MOST UPSTAIRS WALLS LEFT UN-TOUCHED. EXTERIOR PORCH BECOMES INTERIOR. RE-USE METAL ROOF FOR NEW SLOPE AND ADJUST EXIST-ING WOODEN TRUSSES TO MONO TRUSS WITH NEW SLOPE. WINDOWS REMAIN IN PLACE.

IRON WORKTAKEN DOWN FROM WALL AND REUSED ON WINDOWS IN NEW BUILDINGS.

EXISTING FURNITUREREMOVED AND REUSED THROUGHOUT REST OF SITE AS NECESSARY.

REUSE OF EXISTING FIRST FLOOR CLINIC

GROUND FLOOR PLANSCALE: 1/8: = 1’0”

HEURISTICS:

A

C

B

REALIZING THE RESULTS

The spring, 2013, studio of 23 students in

architecture, interior design and nursing,

developed a total of 11 different solutions for the

Ft. Liberte Medical Clinic. The projects provided

a siignificant level of creative thinking and idea

generation across a range of considerations.

It is anticipated that a selected project, or

composite, will be built in the fairly near future.

At the conclusion of the spring semester,

a confidential debriefing/dialogue was

conducted with the class by an outside

consultant to determine the value of this

collaborative experience. The results, as of

last year, were overwhelmingly in support of

the partnership of collaborative practitioners.

The team is moving forward to a Haiti Studio

in the spring, 2014, and beyond. The partners

are building their work on several fronts, along

with the studios, including areas of research.

In particular, the construction user manual for

single family homes, entitled LIFEHOUSE, is

scheduled for completion by fall, 2014. It will be

given widespread disribution in Haiti, translated

into both French and Creole.

It is the better of the faculty and students

who have been involved that the work in Haiti

provides a service learning experience that is

life changing. The most crucial aspect of the

collaboration, aside from the obvious benefits

of the team, is related to the intent that all

the work is done with the engagement of the

Haitian people. It is criticially important to

develop a means for connecting to the culture

and context, and investing the people in the

process at each step along the way.

“We found that the acceptance of a building typology relies on an understanding of the

indigenous materials and local buildng practices while offering improved techniques. Due to

the limited amount of materials and difficulties encountered when importing them to Haiti,

responsible architects must consider utilizing local materials and methods of construction

when designing.”

Christian Powers, Fourth Year Undergraduate Architecture Student

“The Haiti Studio was more than a design class, it was an opportunity to

provide amity to fellow members of the human race. The projects were beyond

the typical, theoretical client expected in an educational setting. We had and

actual client with needs to take care of actual visitors. We had the chance

to enter the lives of individuals living a thousand miles away, and to build

on their strengths to better their lives. This challenge of working in a foreign

environment brought another dimension to our designs. The objective of this

class was more than good design. It was about both applying research to

design a functional and feasible medical facility—whether built or mobile—for

Haitian communities, especially Fort Liberte.”

Spring 2013 Haiti Design Studio