This book is the third in a series of publications of the University of Tennessee, College of Architecture and Design, highlighting the work produced by the Spring 2013 Haiti Studio. Designed, written, and edited by Alyssa Nealon and Christian Powers. We are grateful for the support of John McRae, David Matthews, and Diane Fox with their assistance in completing this publication. Š 2014 The University of Tennessee, Knoxville, College of Architecture and Design. This publication was printed by Graphic Arts Service at the University of Tennessee. Publication: E01-2710-008-004-15
Voices to be Heard a narrative of the design process unique to the Spring 2013 Haiti Design Studio at the University of Tennessee, Knoxville, College of Architecture and Design
above: Étang de Miragoâne, lake on route from Port-au-Prince to Fond-des-Blanc 2
Preface John McRae
The College of Architecture and Design is actively engaged in design work in remote areas of Haiti, an effort which began in Fall 2010, following the earthquake. As dean of the college, I made initial contact with a longtime friend and colleague, Jean Thomas, to inquire of ways the college could be of assistance. Jean and Joy Thomas, of Fond des Blancs, had been providing service outreach programs for their community for 30 years through the Haiti Christian Development Fund. Jean Thomas asked the college if they could design a secondary school in a short time frame. I, along with several faculty and students, traveled to Fond des Blancs in September, 2010. The class accepted this daunting task and finished the design the following spring studio. The first phase of the school was completed and opened in Fall 2012. Subsequent to the school project, the Haiti studio undertook the design of fourteen faculty houses for the Fond des Blancs community the following year.
This past semester, the Haiti studio continued what has become a vibrant collaboration with the College of Nursing, developing designs for a medical clinic in the town of Fort LibertÊ, Haiti. These designs were completed under the auspices of the Friends of Ft. LibertÊ, a support group involved in various projects within the community. These ongoing partnerships amongst various colleges at the University of Tennessee and organizations abroad have shaped the learning environment for the students at the College of Architecture and Design. To promote student work and raise awareness, in-class practices and solutions were shared on the project website (haitiproject.utk.edu). Our objective, as faculty, is to aid the students’ design development in a way that ideas and solutions are transferable into similar global conversations.
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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 an 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 LibertÊ. We had the privilege to write the following publication, which represents a narrative on the process of our studio and how we engaged other disciplines with design. Our goal was to display the thoughts and perspectives of the students, faculty, and professionals who participated in the 2013 spring semester Haiti Studio. 4
The Voices‌
7 | to honor culture, country, and community
19 | to build upon distinct minds working together
31 | to narrate personal perspectives from students
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Voices to Honor kilti | culture: (noun) the characteristic features of everyday existence, as a way of life, shared by people in a place or time
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Haiti
“Haiti” is derived from the Arawak Indian word meaning mountainous country. The Arawak Indians inhabited the island before the European colonization led by Christopher Columbus. After centuries of turmoil and enduring multiple political leaders, Haiti declared their independence in 1804 and officially adopted its name. This event made Haiti the first independently black-ruled nation in the world. Due to the country’s unique history, nationalism is very strong throughout the country; the population identifies themselves as Haitian with immense pride. Despite its misfortunes in the past few years, Haiti, as a country, has continued to build upon its strengths. Haiti is more than a country; it is a tight-knit community of
hard-working, family-oriented people. Unlike American cultures, Haitians live simpler lives, and in some ways, a more peaceful lifestyle. They have strengths in communicating through art and music. The population as a whole is self-sufficient; they live within their means and cherish what they have. Through this, they understand the fragility of life. By first respecting the dignity of the Haitian people, we were able to better help them; we understood the unique environment and embraced the challenges of designing within it. While we did not have the opportunity to visit Haiti, we gained knowledge through research and others’ experiences. With this, we focused on rehabilitating their medical culture in the country.
section cover: Locals of Torbeck, Haiti; above right: Map and context; below right: Data & timeline infographic 8
HAITI DOMINICAN REPUBLIC
786,000 healthcare focused educational programs conducted throughout Haiti.
7.9% of Haiti’s GDP is spent on Health; the US spends over twice as much
3,500,000 people affected 220,000 people died
Positive HIV tests are down to 3.8%
8,231 total people died from cholera
19% of children are underweight
Fall 2012: UTK-CoAD’s L’Exode Secondary School opens in Fond des Blancs October 2010: cholera outbreaks January 12, 2010 at 2:53pm: 7.0 magnitude earthquake occurs 16 miles outside of Port-au-Prince
During 2012: medical data was collected by the Ministry of Health of Haiti
As of mid-2013: 69 NGOs focused on healthcare are currently in Haiti
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left: Map of Baie de Fort LibertĂŠ, Fort LibertĂŠ, and its surrounding villages 10
Fort Liberté
The historic city of Fort Liberté lies within a natural harbor on the northeast coast of Haiti, within the Nord-Est department. The city has physical ties to its history within the ruins of the original Fort-Dauphin built by the French, and emotional ties by being the place of Haiti’s independence. As a class, we were met by one of the biggest challenges of this city — accessibility. Fort Liberté is nearly 300 kilometers (or 185 miles) from Haiti’s International airport in Port-au-Prince. Due to the lacking infrastructure, it would take a full day’s travel to arrive in Fort Liberté. Accessibility also plays a role in the resources used in building construction. Fort Liberté’s department borders the Dominican Republic. Contrary to Haiti, the
Dominican Republic’s forests have yet to be diminished by deforestation. Material availability such as this was critical in determining the types of materials for our projects. Currently, there is only one hospital in the city, and the Eben-Ezer clinic supplements this hospital by taking care of patients with less critical healthcare needs. A unique aspect of the Eben-Ezer clinic is that it performs regional outreach through educational programs. With planned expansion to the building, it hopes to broaden outreach in its community. In addition to these programs, the clinic has a special relationship with Friends of Fort Liberté, a non-profit organization that often sponsors visiting healthcare professionals and mission trips.
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Medical Culture Susan Speraw
When thinking of healthcare in Haiti, what comes first to mind are the faces of the people we serve. In the fifteen years of my interface with the Caribbean nation, history has brought times of peace, periods of political upheaval and violence, and occasions of wrenching tragedy. While these seasons of human experience come and go in predictable cycles, what remains constant for me are memories of little girls in hair ribbons and ruffles, boys in immaculate white shirts, some whose eyes are hollow and haunting, with bony arms and bellies distended by hunger and disease. I remember the faces of mothers in bright colors, nursing babies at their breasts, and the countenances of the old, weathered and lined by time and hardship, as they wait in long lines, hoping for a medicine or tonic that will allow them more years of life. Young or aged, Haitian life has taught them to wait. I also recall overwhelming need, poverty that holds people back, and scarcity of care that too often leads to death. The deep irony is that the catastrophes of the 2010 earthquake
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and subsequent cholera outbreak, which took hundreds of thousands of lives, have also brought greater access to healthcare than the country has known in at any time in its recent history. Non-governmental organizations (or NGOs) have brought medicines and new facilities, opening their resources to the poor, eliminating poverty as a barrier to access to food and medical care. Many communities, where malnutrition was previously widespread, have seen their children restored to vigor. With this influx of resources has also come danger. NGOs and their free care have lured patients who could otherwise have paid for services away from local Haitian doctors and local hospitals, robbing them of their meager livelihood. As a result, many doctors have left the small towns they once called home, relocating to larger cities or emigrating out of Haiti altogether; some hospitals have shut their doors. In the short term, these losses have not been acutely felt, but as the four year anniversary of disaster approaches, and as new calamities strike around the globe, NGOs are withdrawing. The risk is
that the precarious well-being of the Haitian people is about to be undermined, and that with the NGOs gone, and Haitian doctors driven out of business, the need will soon be greater than ever. To be sure, progress on many fronts has been made. Tent cities, constant reminders of disaster, are gradually disappearing. Politically, peace holds. Industry is growing. But health is a fragile thing, and in Haiti it must be safeguarded 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.
above: LÊogâne nutrition clinic; below: Rural Haiti nutritional education 13
“The needs are still very great, but many are helped, one at a time… And so we press on, building on friendships that have been forged in this partnership across the years.” Friends of Fort Liberté
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Friends of Fort Liberté
In 1973, a minister from St. Albans, West Virginia, Dr. S. Robert Weaver, went on a mission tour of Haiti. He and his wife were hosted by Pastor André and Madame Justine. Dr. Weaver was so impressed with the young Haitian couple that he committed to helping their church construct a new building for their rapidly growing congregation. When he returned to the United States, Dr. Weaver contacted an architect in his congregation and asked if he could help. J.D. King went to Fort Liberté to design the new church and met Pastor André. The friendship that was established with these two men is now strengthened between volunteers from Haiti and the U.S. After J.D.’s death in 1989, the child sponsorship program kept friends in the U.S. connected to
the congregation in Haiti, through all the political upheaval and change. In 1993, a group of J.D.’s friends and family officially formed the Friends of Fort Liberté. Since its inception, the group has completed many projects in the town, including: the Jerusalem Baptist Church, the Eben-Ezer School and Medical Clinic, the King Orphanage, and a farmhouse and farm development, all of which are located in Fort Liberté and its neighboring areas. Each person who visits pays their own way, and the funding for the programs comes from friends telling friends. Friends of Fort Liberté mission trip programs grow every year, as friends in the U.S. visit Haiti and share the stories of the great needs with their friends and congregations.
above left: View from Rue Sainte-Jean; above right: Construction efforts for the King Orphanage; below: Existing Eben-Ezer Clinic 15
Connections Christopher King
right: Christopher King shares travel sketches with Haitian children 16
I came to the class having facilitated designs for other parts of Haiti, but this was my first opportunity to connect the university with the town I love deeply — Fort LibertÊ. One of the greatest challenge with students was to help them understand the cultural context in a short time. I have spent twenty years learning about Haiti and Haitians and still feel I am just beginning to comprehend the complexities of the culture. In addition, every Haiti project involves two sets of clients — the Americans involved in funding it, and their Haitian partners who will use it. The interests of the two groups are often in concert, but differences of opinion arise. We taught the students how to navigate this mine field while interacting with their first clients. Subsequently, we also guided the students into the mind set of the people they are serving, in turn, seeing the building from the point of view of the user and builder. The most important thing we can do is educate the contractors already building, and train a new generation of architects that will rebuild their homeland.
Sa ou pa konnin pi gran pase ou! To know, you have to learn.
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Voices to Build Upon kolaborasyon | collaboration: (noun) the act of working jointly with others or together especially in an intellectual endeavor
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Design Thinking David Matthews
My travels to Haiti and the incredible opportunities to instruct design studios at the University of Tennessee have offered extraordinary opportunities for people to think and work differently. A major goal is to engage the breadth of creative possibilities in the Haiti studio. My engagement in design thinking techniques, recently learned at the Luma Institute, were implemented via transdisciplinary collaboration with the university’s Nursing Program and were incorporated in the studio experience. These approaches were provided to foster success through relationship and practicing deeper sense of empathy when making decisions. Design thinking includes and reaches beyond the traditions of visual and spatial design associated with the building arts. I have become deeply committed to design thinking as a universal process of creating original ideas, objects, spaces, or experiences with meaning, imagination, and integrity. It includes the design of tangible aspects of the environment, such as buildings, furniture
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or landscapes, and the design of intangible aspects of human experience such as government policy or health care procedures. The best design thinking synthesizes these tangible and intangible aspects of the world into new holistic human experiences. It is an inclusive process with emphasis on empathy and collaboration — putting others needs ahead of ones own while working for an outcome bigger than any individual can imagine. Methods of design thinking engage collaboration and independent processes in a manner that displaces self-indulgence and self-promotion with the concerns of others. Design thinking relies on the deep traditions in visual design, such as engaging non-linear problem solving, cyclical explorations, and iterative prototyping with the goal to make the future better. One of the most significant outcomes of implementing design thinking in this studio is how it engages and creates design roles for both design and nursing students.
“Often a native builder couldn’t tell you why they built their roof in that form, but they know it works. ” Christopher King
section cover: Group brainstorming; above: Precedent study critique; below left: In-class discussion; below right: Cross-discipline in-class presentation 21
Nursing Collaboration Moriah McArthur
The devastation inflicted by the 2010 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 infrastructure. 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 healthcare, as well as the typical services and operations of rural clinics. 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
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promotion. However, it was not long before we realized how much we had to learn from our creative counterparts. Through interaction with College of Architecture and Design (CoAD) 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 CoAD enhanced our understanding of yet another layer of human experience that impacts wellness. From vibrantly colored murals to light filled vaulted ceilings to landscaping, 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 treatment in clinical settings could potentially influence a range of
behaviors and phenomena including patient satisfaction, education, and willingness to return to the clinic in the future; all of which improve health outcomes and help ensure nurses provide the best care possible. The CoAD 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 in the design process. Throughout the semester, nursing students reflected on the challenges and ultimate benefits of working so closely with another discipline including: learning a common language to transcend discipline specific jargon, embracing a new way of thinking about health, and overcoming logistical or technological challenges to ensure all voices were heard, despite the rapid pace and tight deadlines of the project. These skills are necessary and transferable to many aspects of life, and this unique project exemplified the power of collaboration for interdisciplinary education and practice.
above: Tent clinic outside Léogâne
“Little as we know about the way in which we are affected by form, by colour, and light, we do know this, that they have an actual physical effect.” Florence Nightingale
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Sterilization: sanitation must be a simple and effective process for the patient and provider. Waste Disposal: cross-contamination and exposure to hazardous material is dangerous and should be handled with care. Stability: safety restraints should be used to prevent movement that can cause further injury or hinder medical process. Durability: the vehicle or transport must be able to withstand the elements and resist degradation.
IMPORTANCE P R A C
Representation: signage and color should be utilized on the vehicle or transport so it is recognizable.
Quick and Easy Set-Up: minimizing the time-consuming process of site preparation is critical. Spacial Efficiency: limited space requires a high degree of efficiency in the storage and transport of supplies. Reaching Distance: the space should be designed to allow for rapid access to materials and minimum reaching distance. Flexibility: the space should be designed so it can be simply transformed for various events and situations. Equipped: the vehicle or transport must be able to handle various terrains with speed and utility. 24
D F UT DIFFICULTY
Development Process
Our process began with collaborative work in a set of three to four students — consisting in backgrounds of interior design, architecture, and nursing. Our primary task was to deliver a concept that would generate a product idea for diabetic children; these solutions were to encourage the children to monitor their blood glucose levels. During this project, we were removed from our comfort of designing space to begin learning how to think as industrial designers. As we developed various solutions, we focused on the functionality and feasibility of each design aspect, and we were introduced to the notion of heuristics. A heuristic is a concept that drives a design. We created a list of ten elements derived from our group’s concept
and charted a comparison of the importance and difficulty of each heuristic (project example located on the opposite page). This chart shaped the way we approached design for the two remaining studio projects and has become a useful tool in creating hierarchy in decision making. After determining a focused direction, we would then collaborate with nursing students to determine the realities of our proposed design possibilities. What was beneficial about this opportunity was that we were able to consult with those who have medical knowledge and those who would eventually utilize our designs. This collaborative effort was essential. It allowed us to be more confident and intentional in our designs.
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Mobile Medical Unit
We continued to build on the principles from the first project and apply them to our Mobile Medical Unit. Our goal was to design a medical object or structure that would serve rural Haiti in the case of a natural disaster, emergency, or healthcare epidemic. Not only did we focus on the audience and user of a mobile medical unit, but more importantly, we concentrated on the utilitarian aspects of the project. As a start, we researched some of the essentials for medical treatments in the event of catastrophe. We presented precedents of both innovative techniques and mobile units, and began pulling ideas from the passive systems, local materials, military equipment, and vehicles relevant to the Haitian culture. Some of these typologies were then applied to the resulting group’s medical center projects.
Again, we based our projects on ten heuristics. Although every heuristic list was similar, each group’s design was influenced by different factors. Three common themes across the projects were as follows: mobilization of the unit to serve all rural areas of Haiti; efficiency of the compartmentalized space; and the ease of the product’s assembly. Even with the very technical aspects of the design, the projects revolved around the culture. The solutions were created with a hope of ensuring the acceptance and continual use of the unit long after “foreign” medical staff have departed. Though in different forms, these projects each conveyed the ideas, design processes, and collaborative efforts of the students — design and nursing alike.
above left: Exploded axonometric (SawyerSherborne-Wetherington); above right: User perspective (Hall-Nealon); below: Assembly diagram (Hogue-Powers) 26
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Eben-Ezer Clinic
Our final project was a comprehensive project focusing on the insights learned from the previous projects, as well as the focus on the balance of design through functionality, feasibility, and beauty. The current Eben-Ezer Medical Clinic was designed in the 1970’s without the Haitian context in mind. The existing building plan was inefficient and did not utilize passive systems necessary due to the lack of resources in Haiti. Friends of Fort Liberté requested designs for an addition to the existing clinic, however an expansion came with many challenges. The use of passive systems were imperative to lessen its energy needs; and yet another hurdle was to create a clear plan for visitors unfamiliar with medical practices. In addition to increasing the number of examination rooms, specialized rooms for dental and eye exams and an observation room would allow more visiting specialists to provide care to the community. The clinic needed space for its educational outreach with the Empower and Advance organization. Empower and Advance is a local non-profit organization
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that educates local communities on medical basics which can improve the future health and wellness of Fort Liberté. Another project objective was to create functional spaces for any situation. Due to unreliable energy sources, ample natural lighting was needed to ensure staff could diagnose patients. Because air-conditioning units and exhaust fans are rare, passive ventilation was necessary to deter the spread of infectious diseases and cool the interior spaces. Where privacy was important, the locally molded vent-block or fabric panels were used. Many decisions were derived from the vernacular architecture in the community. It was clear that in our projects, that there needed to be a focus on clear way-finding, passive system design for lighting and ventilation, and ways to accommodate not only the patient but the family at large. With the heuristics to guide our design decisions, our final designs were meant to positively influence, respect, and build off the strengths of Fort Liberté and the Haitian culture.
Min anpil, chaj pa lou. Having many hands, the load is not heavy.
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Voices to Narrate refleksyon | reflection: (noun) a thought, idea, or opinion formed or a remark made as a result of meditation
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In preparation to write the publication, we asked our fellow students various questions, pulling specifically from their experiences and reflections of the Haiti studio. Each individual has a unique perspective on what they have learned from the class; we gathered three parallel motifs from their dialogue. The following section represents synopsis of the students’ views and design solutions, each influenced by varying educational backgrounds. Though these perspectives span across university programs, the students shared similar thoughts on the significance of collaborating with partners, learning from the client and culture, and building upon others’ strengths.
section cover: Courtyard and waiting area (SawyerSherborne-Wetherington); above: Waiting area (Metts); opposite left: Laboratory (Culbertson); opposite middle: Artisan bowls; opposite right: Local guinep tree 32
Nursing Perspective Deborah Beaver
Collaborating with architecture students throughout the process of designing a health clinic for rural Haiti was both a demanding and enlightening experience. It was not challenging from the stand-point that I had difficulty trying to understand all of the architecture lingo but the contrary. I had a great working relationship with the students, and they broke things down for me and explained the parts I needed to know. I believe I was able to do the same when relaying medical
information. The difficulty was the project itself — how do you develop an efficient and sustainable medical clinic in a rural setting in a country who has very little infrastructure and resources? 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.
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Collaboration
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 entire class felt the 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
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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 an educated individual giving their all to this project” (Sawyer, undergraduate architecture). It was clear from the first day of class that there was excitement in working together, especially with individuals of differing backgrounds. “It enhanced my group’s design and gave me a broader view of the architecture side of design that I would not have received in another studio” (Brelsford, interior design). The collaboration pushed beyond the borders 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 ideas lacked practicality and may even be detrimental to medical practices. Just as the nursing students and faculty guided our decisions, we taught them how to visualize space and to apply characteristics to spaces. From these collaborative experiences, we were able to provide not only more grounded and established ideas, but we also were able to build positive relationships and interact with others.
above: Waiting area (Hall-Nealon); below left: Vegetated screen wall (Metts); below right: Model photograph (Metts) 35
“I hope we pioneered a bit showing that disciplines, like cultures, can easily work together despite differences. Because together, those differences added valuable knowledge, insight, and perspectives that made the final product so much better.� Stasia Ruskie
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Design Perspective
above left: Pharmacy (Culbertson); above right: Central courtyard (Culbertson); below: Entryway (Coker)
For Haitians, comfort is established with a sense of familiarity. Research was key to understanding familiar construction types and accepted building practices. In this way, we rid ourselves of many preconceived notions of developing countries or how to design medical facilities. We instead, began pulling from the local cultural norms from our first project for the Haitian people. “By beginning with the mobile medical unit, we immediately recognized the necessity of this unit and our clinic design to fit into the existing culture” (Brown, undergraduate architecture). In studying the local people, several differences between the Haitian and American cultures emerged. One in particular, the closeness and importance of family. Family, immediate and extended, plays a large role in the lives of Haitians. We had to learn how to shape the spaces that would accommodate family members that are accompanying and visiting patients. Nearly every students’ building site plan revolved around an interior, secure courtyard. “This allows an outdoor
space for children to play while waiting with their parents” (Brown). “By using the native culture, architecture, and language, this provides the necessary comfort and familiarity for the people of Haiti” (Brelsford, interior design). In the case of a visitor’s illiteracy, the new clinic expansion must create inherent wayfinding and organization, which the clinic lacks currently. As many of our fellow students felt their clinics were designed “to allow the patient to leave with something more than they came — with new found knowledge” (Metts, graduate architecture). We found the original clinic design was not reflective of the environment in which it was built, and understanding the culture and climate was the key to the success of design. Design decisions were made after studying every aspect of the users’ lives — all to determine how they use their current medical buildings and what are best solutions for the Fort Liberté community.
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Vernacular Architecture
Vernacular architecture is solely concerned with the domestic and functional. It is in our nature to solve problems by our experiences, but this can be detrimental to success when working in such a different environment. With the Haitian culture and its people, respect is key. After the earthquake, humanitarian efforts in the architectural spectrum were disconnected from the cultural norms due to lack of understanding of the Haitian people. In disregarding the context and culture, such decisions have a negative impact in local architecture. We learned to focus on not only the aesthetics but also the fundamentals and economics of the project. The way we build in the wealthy countries is not the global norm. Strong, durable, and cheap, reinforced concrete meets the requirements of the developing world. As a relatively modern construction technique, it requires the seamless cooperation of steel and concrete, and without proper engineering, it is easy to incorrectly assemble these construction methods. “Due to the limited amount of materials and difficulties encountered when
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importing certain materials into Haiti, we as responsible architects, had to consider utilizing familiar local materials and methods of construction when designing” (Brown, undergraduate architecture). Because Haiti is in a tropical climate with limited power supply, it was a necessity for the design of this medical clinic to “accept and implement passive strategies with natural day lighting and natural ventilation” (Metts, graduate architecture). In response to natural lighting, some students achieved this with private outdoor courtyards for examination, while others utilized reflection and clerestory windows; both strategies are successful solutions. Instead of air conditioning units, passive ventilation was necessary to deter the spread of infectious diseases and cool the interior spaces. We found that the acceptance of a building typology relies on an understanding of the indigenous materials and local building practices, while offering improved techniques. Due to the limited amount of materials and difficulties encountered when importing them
to Haiti, we need to utilize local materials and methods of construction. Vernacular architecture is important as it allows the current tenants to feel comfortable in the places they will reside and interact. Using indigenous materials and practices allow the residents easy access and understanding for future repair. In addition, it allows an inherent knowledge of building construction. “By utilizing and improving upon the vernacular architecture, a responsible architect will ultimately provide a safe, recognizable, and sustainable structure� (Brown, undergraduate architecture). Being more attentive to the choices we make, made us more considerate of our actions and how it would affect others.
above: Exam room (BradyOiler-Olsen); below left: Passive systems diagram (Hall-Nealon); below right: Wooden canopy
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Nursing Perspective Stasia Ruskie
I know implicitly that health falls across many disciplines. Having a decent home is a health issue, so I was excited to be a partner in the Haiti project. I thought I understood a little about architecture, but I was surprised at how the processes and sometimes freeform, “blast out ideas” can quickly consolidate strengths and weaknesses within those ideas. I found this fascinating and extremely productive; it minimized criticism and allowed for ‘critique’. I learned about the process of designing and working towards a final product. What helped the most in the collaboration was the students’ immediate acceptance of us nurses, complete openness to our healthrelated input, and their sharing of architectural concepts with us. While neither group was a 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
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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. After this class, I think about buildings in ways I never thought before. It is a more ‘holistic’ way, the way nursing approaches health, of all the many ways a building functions, and is designed for. It expanded my mind about designing for air flow, heat reduction, use of ambient light, and use of locally-obtained materials. These are all aspects that medicine also needs to consider when they work in low resource settings. I was very reassured that there are people out there thinking this way, because many medical solutions in the U.S. do not take the situations of the patients into full consideration, but take the perspective of the provider, which tends to be very privileged. In this way, the Haiti project was very practical and realistic in designing something applicable to Haiti.
Min ale, min vini fe zanmi dure. If you consent yourself to only receive, without giving, you will lose friends.
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The Future John McRae
The College of Architecture and Design is continuing its work in Haiti through a number of strategies. One important dimension is development of the LIFEHOUSE — a bilingual user construction manual developed for use by the Haitian people in designing and building their own homes. This project has been funded through the University of Tennessee Office of Research. Next steps include a “test house” and vetting the document prior to release in both the United States and Haiti. The College will also continue its collaboration with the College of Nursing and College of Engineering with additional studio projects in Fond des Blancs and other locations. The College has greatly valued its involvement in Haiti. This has proved to be a tremendous learning and growing experience for both the students and faculty alike. We are excited to continue our collaborative efforts in meeting the needs of various Haitian communities.
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above left: Rural mountain road near Fondwa; above right: University faculty sharing sketches; below: Private nutritional counseling session 43
Graduate Nursing
Undergraduate Interior Design
Undergraduate Architecture
Student Participants
Graduate Architecture
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Deborah Beaver Stasia Ruskie Emily Stewart Alvinia Ziegenfuss Erin Brelsford Tiffiny Hall Michelle Hogue Caroline McDonald Deanna Olson Alicia Wetherington Bevin Brady Aaron Brown Emmie Corgan Alyssa Nealon Morgan Oiler Christian Powers Wilson Sawyer Laura Sherborne Mitzi Coker Ben Culbertson Lauren Metts Stephen Shepherd Jennifer Stewart
Individuals
Special Thanks
Organizations
Joleen Darragh George Dodds Diane Fox Florence Graves Christopher King Annette King Crislip David Matthews Moriah McArthur John McRae Scott Poole Kiki Roeder Susan Speraw Jean & Joy Thomas Scott Wall College of Architecture and Design College of Nursing Friends of Fort LibertĂŠ Parkwest Medical Center Ready for the World 45
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At Home With the Poor by Jean L. Thomas Empower and Advance: www.empowerandadvance.org Friends of Fort LibertĂŠ website: www.haitifriends.com
References
Haiti: After the Earthquake by Paul Farmer Ministry of Health in Haiti: mspp.gouv.ht
Notes on Nursing by Florence Nightingale Spring 2013 Haiti Studio website: haitiproject.utk.edu Photographs courtesy of Friends of Fort LibertĂŠ, Mary Michael Forrester, David Matthews, and Dan Speraw. The photographs are from their travels from Haiti. Model photographs by Alyssa Nealon. All photographs used and edited with permission. 48