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Proposal and information prepared about the work of the Haiti Project, a multidisciplinary effort of students and faculty of the University of Tennessee, Knoxville.
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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