Before 2007, people living in the rural Burera district of northern Rwanda had little access to a health-care facility or doctors. Then the nonprofit Partners in Health and the Rwandan Ministry of Health began creating a health-care network in the region, including the 150-bed Butaro Hospital, designed by Boston-based MASS Design Group. The hospital opened in January 2011 and quickly made an impact on the health of the nearly 350,000 people in the area.
Despite its success, the hospital has grappled with a pivotal challenge. How to attract and retain Rwanda's brightest medical professionals, as well as doctors from other countries? A response to that challenge opened this past November: the first phase of permanent doctors' housing, built by MASS about a five-minute walk from the hospital. The project, developed in partnership with Boston's Brigham and Women's Hospital (BWH) and its Global Surgery program, was the brainchild of BWH donor Daniel Ponton. The four houses are the first structures on Umusozi Ukiza—the Healing Hill—which MASS has masterplanned to eventually include more individual dwellings, shared housing for staff without families, a community center, and living quarters for cancer patients and their families. The houses are owned by the Ministry of Health, and the doctors who live there do not pay rent. “This is the first step in trying to instigate the development of the whole area,” says Michael Murphy, founding partner and executive director of MASS.
Murphy and Alan Ricks, along with classmates of theirs, began working on the design of Butaro Hospital as students at the Harvard Graduate School of Design. The two incorporated the nonprofit MASS (Model of Architecture Serving Society) in 2010. The doctors' housing is emblematic of MASS's commitment to a particular metric of success. “We try to calculate value in terms of people affected as opposed to simply the object produced,” says Murphy. The housing was a design-build project that involved training local labor to work with materials at hand. In addition to employing six MASS fellows—including project manager and Kigali native Commode Dushimimana—on the housing project, the firm trained 10 local Rwandans in steel bending and 14 in masonry, and the total construction created many jobs. (Murphy says Dushimimana's nickname on the site was Umujyambere, or “he who will go far,” because of his management and training skills, though Dushimimana modestly insists others were called this, too.)
The two-bedroom houses—roughly 1,300 square feet each—mimic the hospital buildings' low-slung forms with clay-tile roofs. While they spill down a steep hill, they cluster together in plan. As Dushimimana explained by e-mail: “Courtyards and backyards are important to Rwandan houses. They are where the family and close friends gather.” The houses were constructed with reinforced-concrete frames to make them seismically sound, and with a total of 29,000 compressed stabilized earth blocks (CSEBs) made by local workers with soil from the site. The CSEB walls are covered with plaster and white paint. Some have a second layer of local volcanic stone. Inside, whitewashed walls contrast with muvura-wood roof trusses, cypress and pine furniture, and metal light fixtures—all made by local artisans. The project cost $400,000, a figure that includes the construction of a road, extensive pedestrian paths, and infrastructure to bring water and electricity to the site.
In conversation, Murphy stresses the stories of the Rwandans who helped make the housing a reality, which belies the fact that quietly beautiful architecture is at the heart of the project. “Most housing in this area is substandard,” says Murphy, “but it didn't cost us any more to push [a design] agenda. Why do these doctors deserve anything but the best of what's available?”
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Interior finishes Cabinetwork and custom woodwork: Cast in place- dyed concrete sinks, Muvura wood, Cypress wood, Steel, custom design ' locally fabricated
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Floor and wall tile: Mosaic wall tile, Prototype bathroom, custom design ' locally fabricated
Downlights: Steel pipe, steel plate, woven papyrus, custom design ' locally fabricated
Task lighting: Steel pipe, custom design ' locally fabricated
Exterior: Steel plate, custom design ' locally fabricated