27. April 2021
In the United Nations Universal Declaration of Human Rights, health is enshrined as a human right. In concrete terms, this means that all people must have access to health care. For our highly developed Western industrialised societies, this is usually the norm. Poor countries like Myanmar, however, are often still far from this reality. With a new hospital building that transforms traditional construction methods into a contemporary design vocabulary, a+r Architekten are doing their bit to ensure that people in Magyizin, a remote village in the Bay of Bengal, have faster and better access to medical care. The project, which is currently also providing medical care to those injured in the recent political unrest, was awarded the AIT Award 2020.
Myanmar, formerly also known as Burma, is the second largest country in Southeast Asia and has a population of around 53 million. After many years of military dictatorship, it remains to be one of the least developed countries in the world. Still in very troubled political waters and often hit by natural disasters such as cyclones, floods or earthquakes, more than a quarter of Myanmar’s population lives in poverty. Medical care is not available throughout the country and standards are very low. For example, Myanmar has a very high maternal and infant mortality rate.
After almost five intensive years of planning, fundraising, material procurement and construction, the hospital was officially opened in February 2020. With 20 beds, a fully equipped operating theatre, a delivery room and a laboratory, it now serves around 20 communities and 20,000 people as a central hospital. The majority of the hospital equipment arrived by container from Germany on the initiative of Projekt Burma e.V., where it had been donated by German institutions and doctors.
A hill on the side of the village facing away from the sea was chosen as the location for the new building. Thanks to its elevated position, the building also serves as a safe refuge during tropical storms and tsunamis. a+r Architekten developed a single-storey atrium house that serves as the main building. The sheltered inner courtyard is the heart of the building; it is both a lounge area and a communal space. Grouped around it are the patient rooms, the treatment and staff rooms and the dispensary. To minimise the transmission of diseases, the waiting area is located outdoors. The linear side wing with its distinctive mono-pitch roof is accessed via a pergola. It houses an isolation ward with additional rooms for infectious patients, kitchens — for self-catering, which is common in Myanmar — along with storage rooms, washrooms and sanitary facilities.
While travelling around the country, the architects had studied the traditional construction methods. As with the high school in Thazin, they designed the hospital according to the country’s typical “brick nogging structure”, using a skeleton construction with brick infill. In the case of the hospital, the supporting skeleton was made of reinforced concrete to achieve greater stability and to protect against insect infestation. Architecturally striking features are the movable shading and rain protection elements made of wooden slats and the roof construction of the atrium house with its all-round gable top. In combination, both also ensure constant ventilation — one of the major issues when building in a tropical climate. The underside of the ceiling structure made of timber trusses was largely covered with weaved bamboo mats. In this way, the air flow circulates through the open windows behind the shading folding shutters, upwards through the bamboo lattice and back out again via ventilation louvres in the ridge of the gable top. “There is a pleasant draught everywhere in the building,” says Julia Raff, the project architect, explaining the simple but effective basic principle of cross-ventilation. Since there are no construction companies in the area, the building was largely erected by villagers under the guidance of a carpenter.
The villagers also actively participated in the construction of the hospital, which is officially called Project Burma Hospital. For example, they collected stones on the beach to line the central basin in the inner courtyard. In case of heavy rainfall, water can be drained off in a controlled manner via this surface. In a few years, a sapling tree in the middle of the basin will provide additional shade. In the course of building the new hospital, the Myanmar government additionally funded a house for doctors and nursing staff. Thus, the village of Magyizin is developing into a health centre for the entire region. During the Corona pandemic, the hospital is also used as an official quarantine centre. Since the outbreak of the recent political unrest in Myanmar, many, mostly young people injured in the protests have been treated at the Burma Hospital.