HEALING ARCHITECTURE - the 3rd place by joey harb

University of the Holy Spirit of Kaslik Faculty of Fine Arts Department: Architecture Semester: Fall 2017/2018 Course: ARCH 670, Senior Project I Instructor: Robert Karam

Joey Harb 201101984

H E A L I N G

A R C H I T E C T U R E

The 3

place

TABLE OF CONTENTS I. I n t r o d u c t i o n I. Intro II. Statement of the problem III.Research question IV.Aim and objective

II.T h e o r e t i c a l

Basis

I. C a n c e r I. Introduction II. Cancer patient III. Cancer and stress IV. Cancer in Lebanon V. The cancer center and the concept of healing architecture

II. H e a l t h c a r e III.H e a l i n g

a r c h i t e c t u r e

I. Introduction II. Architecture elements III. Design factors

IV.T h e

t h i r d

p l a c e

I. I n t r o d u c t i o n II. M a g g i e â&#x20AC;&#x2122; s III. C a s e

c a n c e r

c a r i n g

s t u d y

IV. c o n c l u s i o n

III.S i t e I. Site Location II. Context Analysis III.Urban Section IV.Site Atmosphere V. Climate VI.Conclusion

IV.P r o g r a m I. Program summary II. Area chart III.Function diagram IV.Vision V. Conclusion

V.A r c h i t e c t u r a l

concept

I. D e s i g n

s t r a t e g y

II. D e s i g n

g u i d e l i n e s

III.C o n c e p t IV.M a s t e r V. P l a n

p l a n

l a y o u t

VI.V o l u m e

c e n t e r s

INTRO

INTRODUCTION

One of the moments where life suddenly gets very serious is when you get cancer. No matter how the course of the illness evolves, it is inevitably the start of a new phase in oneâ&#x20AC;&#x2122;s life as well as for those close to you. More than 12 million people are affected by cancer worldwide. Therefore, it is important to have quality counselling facilities both for the patient and their relatives. Fighting and bringing down cancer diseases has been on the global agenda for a long time in terms of medicinal treatment, but the idea of architecture, specifically targeted to care for people with cancer, is a relatively new typology emerged from the United Kingdom.

Lead by architectural theorist, Charles Jencks, and his late wife Maggie Jencks, the concept used in Maggieâ&#x20AC;&#x2122;s centers have been carried out architecturally by prominent architects such as Rem Koolhaas, Zaha Hadid and Frank Gehry. This fact may partially take claim for the rising public interest.

STATEM ENT OF THE PROBLEM S TAT E M E N T

THE

PROBLEM

According to the National Cancer Registry activity in Lebanon, about 8868 cancer cases were diagnosed in Lebanon in 2007.

Which is increasing in its incidence yearly providing high rates of cancer cases year by year.

One of the main problems that have been faced the last several years by the patients during their course of treatment is the psychological side and how it affected them and so their treatment plan and this was clearly reflected on the outcome of treatment and their health, and so then many researches proved that the psychological insult have an important role during treatment providing new protocols of therapy.

STATEM ENT OF THE PROBLEM S TAT E M E N T PROBLEM

THE

The presence of multiple kinds and activities in the hospital is a new concept of therapy is now used and have proven its efficacy, it would help patients in performing their daily activities and reducing their negative energy and depression episodes during the course of treatment especially post-chemotherapy or surgeries.

In Lebanon there are 28 facilities (clinics and hospitals) which provide treatment for all people suffering from cancer.

RE SEA RCH QUESTION RESEARCH

QUESTION

Healing in psychology, medicine and even in the spiritual sense involves a process where the patient or the recipient receives a physically external antidote in order to help them heal. It is then up to the patient to take the inward step of acceptance and retrospection in order to progress the healing. However, if we ignore the qualities of physical context it could involuntarily slow the healing process.

How then, can the architecture have an active role in the healing process of cancer patients?

A IM AND OBJE CTIVE

Cancer patients suffer from psychological and physical conditions, such as stress, depression, fatigue and pain. This worsens their quality of life and has negative impacts on their recovery. Is seems evident that the patients will benefit from a cancer center as a supplement to the hospital treatment.

Here the environment will relax and stimulate the senses positively, and counselling, therapy, courses, creative and physical activities will be offered focusing on rebalancing the patient and the relatives in order to help them deal with the disease and maintain quality of life. Cancer brings psychological as well as physical side effects. Healing architecture can affect these, which may affect the cancer disease positively.

C ANCE R

INTRODUCTION

Cancer is a disease caused by an uncontrolled division of abnormal cells on a part of the body, a growth or tumor resulting from an uncontrolled division of cells. More than 12 million people are affected by cancer worldwide. Cancer is the second leading cause of death with 13% of worldwide mortalities.

C ANCE R PATIE NTS THE

PAT I E N T

EXPERIENCE

An overview of the patient experience in both physical and psychosocial capacities.

C ANC ER PATIENTS CHEMO

EFFECT

Comparing Schedules and Anxiety Levels: Chemo Patient vs. Healthy Person

Cancer and Stress STRESS

Stress is provoked both through inner psychological stressors, which can be caused by the cancer patientsâ&#x20AC;&#x2122; fear concerning future treatments, possible pain, possible complications and external physical stressors caused by sensory perceptions from hospital environment in which the patient suddenly finds itself.

Stress can cause damage to the immune system due to a release of stress hormones adrenalin and noradrenalin.

So stress have an effect on the healing process of cancer patients.

Cancer in Le banon CANCER

INCIDENCE

PROJECTION

MALES

2020

8868 cancer cases were diagnosed in Lebanon in 2007. Which is increasing yearly.

Cancer in Le banon CANCER

INCIDENCE

PROJECTION

FEMALES

2020

In Lebanon there are 28 facilities (clinics and hospitals) which provide treatment for cancer, but there is only one center that dedicated to fighting cancer and it is for children.

The cancer center and the concept of healing architecture CANCER

CENTER

HEA LTHCA RE A RCHITE C TURE High rise hospitals pavilions

Nature hospitals Urban hospitals Public hospitals Civil hospitals Institute Pacheco Belgium 1826

1800

asylum

Mega hospitals

Research center Hospital xifre Spain 1844

Specialist hospitals

Asylum Austria 1848

Hopital lariboisiere France 1900

1900

Specialist hospitals

Academisch medisch Netherlands 1983

Eramus hospital San Francisco hospital Rotterdam 1975 USA 1946

Maggieâ&#x20AC;&#x2122;s Dundee UK 2003

2000

HEA LING A RCHITE C TURE INTRODUCTION

The environment and the architecture have a great effect on human wellbeing, and that it in relation to health care and hospital design can have an important effect on the healing and health of the patients.

The human body has an ability to “self-heal” when put into positive healing environments. This healing is enabled by responding to the spaces around them.

Healing architecture implicates not only the wellbeing of the patients, but also their relatives and the staff around them.

One of the body’s most effective ways of healing is through means of releasing chemicals in the brain such as endorphins (dopamine) which have the ability to reduce pain and swelling, lead to feelings of euphoria, modulate appetite, and enhance the immune response.

The concept does not conclude that the architecture heals on its own, but it suggests that the architectural design through elements such as daylight quality, atmosphere, coloring, sound, privacy, sociality and safety can improve the healing of a patient, physiologically as well as psychologically.

Certain elements in environments such as color, light, and natural landscapes can contribute to the body’s ability to self-heal.

HE ALING A RCHITECTURE ARCHITECTURE

ELEMENTS

A diagrammatic overview of presented parameters showing the interrelation between the architectural framework and the physiological effects.

HEA LING A RCHITEC TURE DESIGN

FA C T O R S

VIEWS

Views and access to relieves stress and pain.

nature

LIGHT

MOVEMENT

Good daylight quality, min. 500 lux, creates a good working environment.

Clear plan, visible entrance and good overview makes the place inviting and manageable, reducing stress and anxiety.

High intensity light, 2500 lux for 2 hours, relives depression and fatigue.

HEA LING A RCHITEC TURE DESIGN

FA C T O R S

P R I VA C Y

SOUND

Private space improves confidentiality and relieves stress and anxiety.

Low internal noise level improves confidentiality and private spaces, reducing stress.

Social space improves social interactions among patients, families and staff, relieving stress, anxiety and depression.

Low noise levels from exterior sources reduces stress and anxiety.

THE THIRD PLAC E

INTRODUCTION

It is like a house which is not a home, a collective institution,

hospital

which

not

a church which is not religious, and an art gallery which is not a museum.

THE THIRD PLAC E

MAGGIE’S

CANCER

CARING

CENTERS

Maggie’s Cancer Caring Centers, originating from the United Kingdom, was invented by architect Charles Jencks and his cancer-stricken wife Maggie Jencks in 1996. Maggie’s centers interpret the relaxing and casual mood of the home in their designs. It is important to make users feel safe and that nothing is expected of them. The third place, is not initially meant for recovering the physically ill or exhausted - to do that the home or the hospital is required.

The third place, the place in between home and workplace, has in this regard an important role to play in terms of healing and is conventionally places like cafés, bookstores and other hangouts at the heart of communities. They tend to serve the people with an openminded environment that offers social equality. In the third place, the main conversation between individuals.

activity

THE THIRD PLAC E

MAGGIE’S

CANCER

CARING

CENTERS

As in the case of Maggie’s centers it is the feeling of community, of belonging, that positively affects the individual. The ideas behind the third place shares a lot of similarities with the atmosphere and architecture associated with Maggie’s Cancer Maggie's Cancer Caring Center Caring Centers. Zaha Hadid

Maggie's Lanarkshire Rem Koolhaas

Maggie's Cancer Caring Center Snøhetta

Maggie's Lanarkshire Reiach and Hall Architects

This concept involves warmth in atmosphere, social activity, and sense of belonging to a community. The home-like and relaxed physical nature of the spaces are important in order to develop these qualities.

THE THIRD PLAC E

MAGGIE’S

CANCER

Maggie’s Cancer Caring Centre West London, RSH+P

CARING

CENTERS

Maggie’s Cancer Caring Centre Dundee, Frank Gehry

Maggie’s Cancer Caring Centre Glasgow, OMA (Rem Koolhass)

C ASE STUDY

LIVSRUM

ROSKILDE,

ADEPT

This center is located in a residential neighborhood and is broken down into three volumes to scale down the building. The entrance is located in the corner between two volumes, which leads directly into the common space where one is distributed out to the other functions that has different room heights. The administration is facing the road in two levels thus the arriving guests can be observed. Private functions are located away from the road towards the private outdoor spaces, which has the character of a villa garden.

Livsrum Roskilde, exterior

Livsrum Roskilde, common space

C ASE STUDY

LIVSRUM

ODENSE,

WIENBERG

ARCHITECTS

The building is a faceted volume with an inviting entrance between two bulges of the volume. One enters the hall where the common space is located further inside the building. Both the exterior and interior consists mainly of concrete and wood implemented in horizontal bands. The common space distributes flow to the rest of the building using only few hallway square meters. The outdoor area towards south is closely connected to the common space providing a fluid transition between the two

Livsrum Odense, entrance

Livsrum Odense, common space

C ASE STUDY

LIVSRUM

AALBORG,

P O LY F O R M

The building consists of five mono-pitched volumes of recycled brick with a roof structure that span the gap between them. The entrance is between two of these volumes. One enters a large common space, with many different functions. The heart is located further in the center and from here, other functions can be reached. The building is located in a residential neighborhood and the tile mimics the surrounding materiality. Roads encircle the center, and as a consequence hereof, private functions are oriented towards the roads. However, the small windows ensure the desired privacy, they also reduce views.

Livsrum Aalborg, exterior

Livsrum Aalborg, common space

C ASE STUDY

CONCLUSION

The analysis of the different Cancer Health Care Centers illustrate different ways of creating a relaxing and soothing environment for cancer patients and their relatives focusing on the parameters that influence the experience and atmosphere of a room. However, the architecture contains many of the same values as evidence based design, why the case studies provide valuable knowledge of positive parameters in terms of the factors and architectural settings defined through evidence based design.

From the analysis the evidence based design parameters are elaborated in relation to the experiences gained from the centers. An important parameter in the case of the Cancer Health Care Centre is to consider the scale.

SITE SITE

LO C ATI O N

The project is to be situated on a site in Byblos, Lebanon. The site is located next to the Notre Dame de Secours Hospital.

The site is located relatively far from the downtown section, but still in close relation to the hospital itself.

Symmetrical layout with greenery around and in between. The project will be situated on a site bordered by a green areas on all sides, and bordered by three roads. It is thus surrounded by vegetated areas, residential and urban

Away from the noise and stress of the city, but still at midpoint, Byblos is an ideal site.

SITE C I R C U L ATI O N

National highway Primary road Secondary road Sea road Pedestrian road Railway

SITE ZONING

Residential zone Agricultural zone Commercial zone Mixed zone

SITE URBAN

FA B R I C

Commercial unit Residential unit State unit Medical unit Service unit Cultural unit Sports unit Educational unit

SITE N ATU R A L

S PA C E S

Green spaces Agricultural green spaces Natural green spaces Sands and beaches Bare rocks

SITE SITE

LO C ATI O N

SITE CONTEXT

A N A LY S I S

DISTRICT Residential neighborhoods characterize the area around Our Lady of the Succors hospital to the west and south. Green areas, are situated close and all around the hospital.

Monastery of Our Lady of the Succors is facing the hospital from the west side and laying on a hill over Byblos.

SITE CONTEXT

A N A LY S I S

INFRASTRUCTURE The main road is on the west from the hospital. Two other roads frames the hospital.

In addition to this, there are smaller roads, which are only used by the residents themselves or people visiting the Monastery of Our Lady of the Succors. The Green areas related to the Monastery contains several agricultural fields.

SITE CONTEXT

A N A LY S I S

A R R I VA L Arriving to the site by car by one main entrance. Or can be from the hospital entrance directly The parking spaces can be accessed from the main entrance or from a different entrance from the main road.

SITE CONTEXT

A N A LY S I S

Monastery of Our Lady of the Succors The Monastery of Our Lady of Succour (Saydet alMaounat) at Byblos stands 150 meters up on a hill overlooking the Byblos coastline. The monastery one sees now was built over ancient Phoenician ruins. The Order was given it in 1770

Shortly before World War I (1914-1918), the monastery was restored and a church was built. During the war, a great number of disaster victims and dis placed persons found refuge there.

SITE CONTEXT

A N A LY S I S

Monastery of Our Lady of the SuccorsÂ Â In 1947, the Order undertook the construction of a hospital in the town of Byblos, which in 1977 was transferred to a great complex of buildings on a hill near the monastery, being provided with modern material and the services of doctors highly reputed in their profession. At present it has a capacity of three hundred

In 1981 the Order set up a school for nurses. The monks who have assumed its administration have done their best to make the hospital comparable to the leading university hospitals of the country, according to the Order's mission of love, expressed by serving the sick and the needy.

SITE CONTEXT

A N A LY S I S

The Centre Hospitalier Universitaire Notre Dame de Secours is a Lebanese medical center located in Byblos, Lebanon. It is a private hospital owned by the Lebanese Maronite Order and Monastery of Our Lady of the Succour.

The hospital is affiliated with the Holy Spirit University of Kaslik Faculty of Medicine and Medical Sciences and the Higher Institute of Nursing Sciences. The hospital was founded in 1978.

SITE URBAN

SECTION

3 21

SITE URBAN

SECTION

SITE SITE

ATM O S P H E R E

The Hospital takes on the urban landscape by providing a breathing space in the border of the city. The nature and curvature of the surrounding, gently slopes towards its own center. The introvert shaping of the landscape and the composition of trees surrounding the area hinders noise and visually isolates the green space from the rest of the city.

One feel stung by peace by walking around the hospital or walking to the monastery facing the hospital on the other side and it acts as a refuge in the otherwise hectic context. Patients or staff from the hospital who need a break from the hectic daily life in the hospital also use the green spaces surrounding the hospital.

SITE SITE

C L I M ATE

AV E R A G E T E M P E R AT U R E S A N D P R E C I P I TAT I O N

C L O U D Y, S U N N Y A N D P R E C I P I TAT I O N D AY S

WIND ROSE

SITE SITE

C L I M ATE

VIEWS

S U N PAT H

N AT U R E C O N N E C T I O N

SITE CONCLUSION

3 main poles in the site

Medical pole

The green circle is the nature surrounding presenting the natural pole

Spiritual pole Natural pole

The blue circle is the hospital presenting the medical pole The red circle is the monastery presenting the spiritual pole

SITE CONCLUSION

HEALING

PROGRAM PROGAM

SUMMARY

Fu n c t i o n

m2 total

Pe rc e n t a g e %

Administration

500

12.5

900

22.5

Patients housing

1,100

27.5

Complementary therapies

1,500

37.5

To t a l

4,000

100

Cancer Counselling Centre

- The 3rd place

PROGRAM AREA

CHART

Fu n c t i o n

Quantity

m 2 / ro o m

m2 total

Entrance hall

100

Wa i t i n g a re a

120

O ffi c e s

150

M e e t i n g ro o m

D i re c t o r o ffi c e

S e c re t a r y o ffi c e

Ad m i n i s t r a t i o n

To t a l

500

PROGRAM AREA

CHART

Fu n c t i o n

Quantity

Cancer Counselling Centre

The 3rd place

m 2 / ro o m

m2 total

1- common area Entrance hall

Common space

Kitchen

Multipurpose

Lo u n g e

Info

Library

PROGRAM AREA

CHART

Fu n c t i o n Cancer Counselling Centre

Quantity -

m 2 / ro o m

m2 total

The 3rd place

1- common area C h i l d re n a n d y o u t h space Wo r k s t a t i o n

G ro u p ro o m

C o n v e r s a t i o n ro o m

Open conversation space

Reflective space

Wo r k s h o p

PROGRAM AREA

CHART

Fu n c t i o n Cancer Counselling Centre

Quantity -

m 2 / ro o m

m2 total

The 3rd place

2- activity area E xe rc i s e ro o m

We l l n e s s a re a

E x a m i n a t i o n ro o m

O ffi c e s

100

S t a ff ro o m

3- staff area

PROGRAM AREA

CHART

Fu n c t i o n Cancer Counselling Centre

Quantity -

m 2 / ro o m

m2 total

The 3rd place

3- staff area Storage

Shower & toilets

Wa rd ro b e

storage

To i l e t s

4- additional spaces

PROGRAM AREA

CHART

Fu n c t i o n Cancer Counselling Centre

Quantity -

m 2 / ro o m

m2 total

The 3rd place

4- additional spaces C h a n g i n g ro o m s

Te c h n i c a l ro o m

5- outdoor facilities T h e r a p y g a rd e n s

Terraces Fa m i l y a re a

Total

900

PROGRAM AREA

CHART

Fu n c t i o n

Quantity

m 2 / ro o m

m2 total

General beds

360

C h i l d re n

120

Semi private

150

Pr i v a t e

480

To t a l

Pa t i e n t h o u s i n g

1,110

PROGRAM AREA

CHART

Fu n c t i o n

Quantity

m 2 / ro o m

m2 total

Complementary therapies

A l t e rn a t i v e m e d i c i n e therapy Physical therapy

500

600

M i n d -B o d y t h e r a p y

400

To t a l

1500

PROGRAM AREA

CHART

Fu n c t i o n

Quantity

Complementary therapies

Tre a t m e n t Ro o m

4 1

Storage

O ffi c e

O ffi c e To t a l

m2 total A l t e rn a t i v e m e d i c i n e

P h a rm a c y / Pre p S p a c e

M u s i c T h e r a p y ro o m

m 2 / ro o m

1 1 500

PROGRAM AREA

CHART

Fu n c t i o n

Quantity

Complementary therapies

m2 total Physical therapy

Gym

Yo g a S t u d i o

C h a n g e Ro o m s

Storage

T h e r a p i s t o ffi c e

To t a l

m 2 / ro o m

600

PROGRAM AREA

CHART

Fu n c t i o n

Quantity

Complementary therapies

m2 total M i n d -B o d y therapy

M e d i t a t i o n Ro o m

G ro u p C o u n s e l Ro o m

I n d i v i d u a l C o u n s e l Ro o m s

Pr a y e r ro o m

To t a l

m 2 / ro o m

400

PROGRAM PROGAM

SUMMARY

Fu n c t i o n

m2 total

Administration

500

Cancer Counselling Centre

- The 3rd place

Pe rc e n t a g e %

900

Patients housing Complementary therapies

To t a l

900

100

V ISIO N THE

CENTER

The aim is to implement healing

The qualities of the surrounding

It is desired to design a building that

architecture through the cooperation

landscape must contribute to this

addresses the various functions and

correlation

explores

between context and architecture, and architecture and user.

outside

between

through

inside

integration

and of

the

complex

tensions

between contradictions.

natural. Consequently, the unity between

center

that

has

architectural

center and outdoor through the

The building must be open and

familiarity of a house, yet not a

gardens

must

holistic

inviting, but still embrace the user to

home; one that allows spirituality

image

center

create a sphere of intimacy with

without resembling religiousness; a

spatial potentials and well-defined

specific place to recover that defies

logistics of functions.

the institutional character. All of

create

cancer

communicating life and hope. By

purposeful

architecture

variation,

should

address

the a

sensible place for happiness and hope, as well as sorrow and despair.

which

must

confronted

with

technical aspects in an integrated design solution.

V ISIO N THE

CENTER

Cancer brings psychological as well as physical side effects. Healing architecture can affect these, which may affect the cancer disease positively.

The evidence based design factors of light, acoustics, flow, relation to nature as well as personal and social space will be integrated in the design process of the Cancer Centre.

V ISIO N THE

CENTER

The Cancer Centre should contrast the hospital and not resemble an institution. However, the connection to the hospital should be considered.

The Cancer Centre should relate to the green area surrounding it as well as the monastery facing it.

PROGRAM C ONCLUSION THE

CANCER

CENTER

the cancer patients receive their medical treatment at ‘’Notre Dame de Secours Hospital – Byblos’’ , which is a typical, insensitive hospital environment.

The cancer center will be a retreat from this and be a place for the cancer patients to go before, after or in between treatments, why a uplifting, inspiring environment that can relax and sooth the patients and reduce and relieve their stress, anxiety and depression seems to be a relevant and important aspect in their overall course of recovery.