The remote district of Achham in the hills of Nepal has a doctor-patient ratio 150 times more extreme than the average recommended by the World Health Organization (WHO).
In dire need of a community hospital, the New York-based Sharon Davis Design has completed the transformation of a formerly overrun clinic into a 7.5-acre campus, nearly eight times its original size. Set atop the terraced slopes of the Seti River valley, the Bayalpata Hospital campus includes five medical buildings, an administration block, ten single-family homes serving the hospital’s staff and families, and the first and only dental office in the region.
The hospital was primarily built with locally-sourced rammed earth and stone using low-tech construction methods, with the exception of a reusable, plastic lock-in-place formwork implemented to speed up the construction process. “We see this project as a model of how rammed earth, and other vernacular materials, can be utilized to create modern architecture,” explained Sharon Davis, principal of Sharon Davis Design, in a press statement. “Without local materials, this project may not have been possible because of its incredibly remote location – a 10-hour drive from the nearest regional airport and a three-day drive on narrow, mountainous roads from the nearest manufacturing centers around Kathmandu.”
According to the firm, several sustainable guidelines were met to make the campus as self-sufficient as possible by including its own water supply and storage, wastewater treatment facilities, and a photovoltaic array that generates more energy than the campus can use on an average day. The campus’s implementation of passive cooling—breezeways, clerestory ventilation, and ceiling fans—will prove useful in the summer months given the extreme heat common in the northwest region of Nepal.
The overall design of the campus was intended to maintain a domestic appearance through the use of a low profile and courtyards landscaped with native plants. From a distance, the gabled roofs appear to mimic the rise and fall of the mountain range in the distance, and tall window frames compose views of that mountain range while bringing in enough natural daylight to offset the need for excessive artificial lighting.
The Bayalpata Hospital was funded in a collaboration between the Nepalese government and NGO Possible Health with the expectation that it could provide care to 100,000 people a year on average. The Nepali Times hailed the design as a valuable case study for accessible and affordable care in a remote region of the country, with the hope that similar hospitals will be installed throughout other parts of Nepal.