The Paimio Sanatorium 1933

from STUDY AND COMPARISON OF TWENTIETH-CENTURY AND POSTWAR HOSPITAL DESIGN

Architecture, health and modernism

Case study: The Paimio Sanatorium 1933

Finland was part of the Kingdom of Sweden for centuries but in 1809 it became part of the Russian empire as an autonomous Grand Duchy. A great sense of nationalism raised among the Finnish population during the 19th Century. Finnish Architecture until this period was dominated by architects from the Swedish-speaking part of the country ,where the prestigious schools were, while Finnish architects had to go abroad to receive their education (Quantrill, 1983). This proceeded until the 1890s when the Finnish National Romantic movement took the stage. The pioneers of this movement were the painter Akseli Gallen-Kallela and the architect Lars Sonck, who was the winner of 1894 architectural competition for the Church of Saint Michael in Turku. With his designs, Sonck set the principles of Finnish architecture. The beginning of the 20th century saw an incrrease in Finnish architecture’ s confident, as demonstrated by the fact that Finland started producing its own architectural critical journal, Arkitekten. Following the rise of the architectural journal, architects were starting to look beyond the imposition of the Russian empire and Finnish architecture was now being recognised globally through the National Romanticism. At the beginning of 1920s, young Finnish architects labelled National Romanticism as regressive and they became influenced by Neo-classicism. However, by the end of this century, thanks also to the independence from the Russian Empire gained in 1917, Modernism and Functionalism became the biggest influences in Finnish Architecture. (Miller,1982) In 1898, in Kuortane, a small town in Finland, something that will change the future considerations of Finnish architecture happened. Indeed, during this year one of the most influent Finnish architect and designer was born, Hugo Alvar Henrik Aalto. He dominated Finnish architecture for almost half a century and had the merit to make Finland visible and highlighted in the Architecture map. (Quantrill, 1983). As mentioned earlier, Finnish people developed a strong sense of nationalism and attachment to their folklore, which could be a cause of mind closure towards the rest of the world. In Alto’s case, it could have limited his horizons in architectural studies and research but, being raised in a westward – looking environment of a Swedish speaking family helped him avoiding this risk. His background gave him the possibility of having his own personal view of Finnish architecture in the much broader European architectural context, and international influences helped him understanding and admiring more Finnish traditions and creating an indestructible bond between him and the National Romantic movement (Quantrill, 1983).

Case study: The Paimio Sanatorium 1933

Indeed, in Aalto’s early work is clear his attempt to extend symbolic design attitude from the National Romantic movement and Neo-Classicism in his individual interpretation of modern architecture. His ability to modify and mix these traditions with international influences is what makes Aalto’s work unique. His designs presented familiar elements in both original and new forms and this was how he anticipated modern reactions to functionalism. His first work as functionalist happened in October 1927, in his three designs for the Viipuri Library competition. His designs looked over the ninetieth century Greek model of neoclassicism developed by German architects, implementing a new humanistic approach in which people’s needs and people’s interactions with his architecture were the focal points of the project. This was a completely new approach, an evolution from the rationalistic architecture of his contemporaries(Curtis, 1996). Aalto expressed architecture as a living organism that must be experienced and enjoyed and not just a box for accommodating functions. He made this concept visible in his design of the Paimio tuberculosis Sanatorium in 1929-1933. (Colomina, 2019) Even though this building stands in Aalto’s modernist period and was designed accordingly to Le Corbusier’s pioneering ideas for modernism, like roof terraces and ribbon windows, it also shows a preview of Aalto’s later move to a more synthetic approach. (Aalto, Reed, 2002) The Sanatorium is a seven storeys building, remotely situated about 29km from Turku in a thick pine forest that offered outstanding panoramic views for the patients. It is informally planned, the wings radiate from the centre at different angles, based on the direction of sunlight and views. (Richards, 1978) The complex comprised three main wings, in wing “A” patients’ rooms and rest halls were situated, a corridor linked this area to wing “B”, where communal areas, treatment, and therapy rooms were placed, while wing “C” consisted of technical and service rooms. (Fleig, 1990) The outstanding feature of the building was its asymmetrical sun terrace system cantilevering from a single concrete reinforced spine column. This system offered a large sun terrace in each storey of the east wing of the building, which was slightly angled in order to face south and gain as much sunlight as possible. This because the only available treatment for tuberculosis at the period was long exposition to the sun and fresh air. The schedule of accommodation of the building comprised meeting rooms, public spaces, staff housing, a double-height cafeteria and walking path through the surrounding forest for encouraging self-sufficient patients to go for walks (Fleig, 1990).

13. Top plan of the Paimio Sanatorium.(1933)

Case study: The Paimio Sanatorium 1933

The purpose of these walks was to connect patients with the surrounding nature causing a consequent feeling of relaxation in them, as well as improving their physical condition. The patients’ rooms received particular attention, but before explaining them, a little introduction must be made. When Aalto took the planning, he was ill himself and he had the chance to experience the disease on his skin and to understand the human aspects involved. He understood that rooms were designed for people who spend their day in a vertical position and not for those who have to spend their days in bed. In particular, he noticed that his eyes were constantly irritated by the electrics light. The recovery from tuberculosis was very long, and not successful in many cases. Spending all this time confined in the bed of a Sanatorium room can be tremendously depressing for the patient and, to worsen the situation, the conventional hospital was not designed in order to accommodate the needs of a person constantly laying horizontally. Aalto’s view of the sanatorium experience was different, he recognised the needs of the patients as what should have driven his design and his architecture had to be connected with sorrounding nature and work as a medical instrument instead of being architecture in service of medicine (Colomina,2019). In his design for patients’ bedrooms stood out his accurate search for a harmonious connection between service and quiet zones, a sort of complete peace. One of his first decision was to design two-beds bedrooms instead of the more used three-beds rooms, which could have provided more flexibility in the accommodation of the patients but less privacy and quietness. (Fleig, 1990) As mentioned earlier, Aalto understood by his personal experience that light fixtures could not remain in the ceiling, as they would strain patients eyes all day and indeed light sources were moved away from patients’ field of view. The ceiling suddenly became a crucial component of a patient’s daily life, it became a sort of new façade. The colour of the ceiling had to be dark and indeed blue was chosen, as it stimulates quietness and relaxes, and the walls were in lighter shades. All the patient’s rooms were oriented towards the forest and the view from the window had to be calculated taking in considerations the point of view of the reclining patient. (Fleig, 1990) Even in the terrace, the low parapet allowed for a breath-taking view for a horizontal person. Elevators were placed at the end of the corridor, so they would not be a source of disturbing noise for patients in the rooms, and they were encased in glass in order to provide a horizontal view of the landscape beyond sanatorium’s walls for

15. Sketches of patients rooms by Alvar Aalto.(1933)

16. Picture of a patient room in Paimio Sanatorium. (1933)

Case study: The Paimio Sanatorium 1933

travelling patients moving in bed or in wheels (Colomina, 2019). The heating was directed to patient’s feet, and not their head as usual, and windows were constructed in a way that allowed cold from outside to enter only diagonally (Fleig, 1990) Mechanical ventilation was present only in the main kitchen because, as Aalto said during a lecture in Italy describing Paimio, ‘natural ventilation with fresh, ozone-rich air is of the utmost importance in the healing process’. (Schildt, 1995). Patients bedrooms did not have any ornaments, because they could have caused accumulation of dust and, for the same reason, the intersection between wall and floor was curved in the proximity of the windows. (Mccarter,2014) Last, but not least, was the top terrace located seven stories above the pine forest, where patients were brought to take their daily doses of sun and fresh air. Sadly, due to the numerous suicides, it had to be closed off. (Colomina,2019) Aalto’s holistic approach is not confined to the patient experience of the building, but it expands also to that of workers. Indeed, the colours of the different areas of the building were not casual, as for example the reception space, the staircase and the corridors presented a Bright Canary Yellow who evoked happiness even in the cloudy days and all the rooms have been meticulously placed to offer different views and shade of lights to all users. (Mccarter, 2014). Aino Alto, Alto’s wife, and Alto himself designed furniture and sanitary fittings of the bedroom, as sinks that avoided splashing and chairs designed in order to facilitate breathing, as the iconic Paimio Chair which was the physical representation of Aalto’s humanistic approach to design. This chair, firstly seen as a specialized piece of furniture then became everybody’s chair and today it is still in production. (Colomina,2019) Nowadays the Paimio Sanatorium does not work as a tuberculosis sanatorium anymore, but its healing environment is still in use as a health facility (Woodman, 2016).