There is no doubt that architecture can help support the overall health of a populace—at least as far as MASS Design Group (MASS) is concerned: the five-year-old Boston-based practice has a growing body of humanitarian work. Most recently, the firm completed the Cholera Treatment Center (CTC) in Port-au-Prince, Haiti—an airy, welcoming medical pavilion designed to be a benchmark for the treatment of waterborne diarrheal diseases.

Located on the campus of GHESKIO, a leading Haitian health-care and research facility, the CTC was conceived by the organization's founder and director, Dr. Jean Pape, an infectious-disease specialist and professor of clinical medicine at Weill Cornell Medical College in New York. Dr. Pape had been collaborating with MASS on the replacement of a tuberculosis hospital that collapsed during Haiti's January 2010 earthquake. Then a cholera epidemic broke out. While emergency medical crews, including one at GHESKIO, established tent stations to immediately aid the victims, Dr. Pape asked the architects to work with him on the development of a permanent clinic to provide care for patients with cholera or with acute diarrhea due to other organisms. In addition, it would serve as a training ground for future generations of health-care workers.

“There were no piped toilets or wastewater decontamination in the tents,” says Michael Murphy, MASS cofounder and executive director, “and the method of dealing with the crisis (i.e., privatized collection and removal) was not happening appropriately.” For the CTC to quell cholera, the design team needed to devise off-grid water-treatment systems, independent of the city's unstable infrastructure. This would be their first priority.

Bordering a landfill settlement along the coast, the new 7,500-square-foot reinforced-concrete and steel structure is earthquake- and hurricane-resistant and sits on a slab raised more than 3 feet above grade. This not only thwarts potential flooding but also provides room for a cistern under the building that captures rainwater from a gutter on the steel roof. The rainwater is treated and purified for nursing and cleaning. To prevent contamination of the groundwater (only about 6 inches below grade), the architects worked with San Francisco–based Fall Creek Engineering to develop a wastewater decontamination system. This efficient anaerobic biodigester with four chambers (instead of the more typical three) introduces chlorine at the third stage.

MASS engaged local craftspeople and construction crews to build a comfortable, distinguished environment to aid the healing process. In designing the elevated pavilion, the architects created a large rectangular platform on which they placed a series of concrete columns with concrete shear walls, lateral steel bracing, and customized steel roof trusses. A vented, folded steel roof with clerestories optimizes daylight and airflow—as does the perforated steel facade, digitally plotted with smaller apertures along the bottom to give the patients privacy.

Indoors, large overhead fans boost cross breezes within an open room plan divided by low walls made of locally produced compressed stabilized earth blocks. Patient chairs and beds, specially designed by MASS with Herman Miller, are arranged for views of the out- doors or flora-filled central planters.

The $700,000 project was funded with money raised by both GHESKIO and MASS, 30 percent of which was MASS-donated time. Open since May, the CTC may be the first facility of its kind to incorporate waste treatment into the building. “It is a unique situation,” notes Dr. Pape, referring to his collaboration with MASS. “They were not afraid to deal with issues. In fact,” he adds, “they were happy to tackle them and provide solutions.”


Client: Les Centres GHESKIO

Owner: Les Centres GHESKIO

MASS Design Group
334 Bolyston Street
Suite 400
Boston, MA 02116

Personnel in architect's firm who should receive special credit:
Design Principals: Michael P. Murphy, Jr., and Alan Ricks
Project Architect: Christopher Scovel, RA
Project Manager: Adam Saltzman
Project Team: Michael Murphy; Alan Ricks; Christopher Scovel; Adam Saltzman; David Saladik; Amie Shao; Kyle Digby; Robertho Jean Noel; Alix Joseph; Benjamin Hartigan; Nathan King; and Sierra Bainbridge.

Architect of record: MASS Design Group

Structural: Matt Sisul, YCF Group s.a., Port-au-Prince
MEP: Arash Guity, Mazzetti
Civil: Fall Creek Engineering, Inc

Landscape:  Sierra Bainbridge, MASS Design Group
Lighting:  Kera Lagios, LAM Partners

General contractor: TECINA s.a., Port-au-Prince

Iwan Baan

Philanthropic Partnerships
Barr Foundation
Karen and Brian Conway
Deutsche Bank Americas Foundation
Kimelman Family Foundation
Pershing Square Foundation
Shirley + Donald Rubin Foundation
American Red Cross

In-Kind Support
MASS Design Group
Big Ass Solutions
Fall Creek Engineering
Clinton Global Initiative
Herman Miller
MFM Building Products Corp.
ALSA Insurance
Phifer, Inc.


7,500 square feet

Construction Cost:


Project Cost:


Completion Date:

March 2015



Structural system: CIP concrete columns with lateral steel bracing and customized steel roof trusses.

Steel Roof Trusses: YCF Group s.a., Port-au-Prince

Façade System
Strategy: Center for Design Research, Virginia Tech School of Architecture + Design, with Nathan King of MASS Design Group
Optimization: Computational design workflow by Jonathan Grinham of SOAS
Construction: Mackenzy Vil

Membrane: MFM Peel & Seal
Metal: ACRA Industries

Drwall: Majic s.a.

Sliding glass windows: Atlantic Door & Windows

Doors: custom metal doors by MASS

Interior finishes
Cabinetwork and custom woodwork: Atelier 83 - GHESKIO
Floor Finish: Rust-Oleum Epoxyshield Professional Floor Coating / Installed by ProGroup s.a.

Cholera Chairs and Beds:
Design - MASS Design Group
Fabrication - HAFCO s.a., Port-au-Prince
Fabric – Phifer
Metal Finish – Absolute Coating, POR-15

Fans: Big Ass Solutions

Other unique products that contribute to sustainability:
MASS worked with local contractors and hired exclusively local labor to build the cholera treatment center, including providing job training to many. MASS also prioritized local materials and used them whenever possible, including for the building’s façade system (see below).

Add any additional building components or special equipment that made a significant contribution to this project:
Especially unique to the design process are the handcrafted steel shade-screens of the façades, which optimize privacy, daylighting, and ventilation. Designed by MASS through research conducted at the Harvard GSD and Virginia Tech CDR, the screens were then fabricated by metal workers in Croix des Bouquets, Haiti. Because individual façade elements are specified for enhanced environmental performance including daylighting, ventilation, and glare reduction, they create a comfortable, well-ventilated atmosphere without compromising patient privacy (especially important for such an undignified disease). This high-tech, locally fabricated approach enabled us to leverage local expertise and labor in a sophisticated design that responds to multiple performance criteria.