Designing the building with an East-West orientation and providing centralised courtyard landscapes are some ways to optimise building energy consumption, says Rahul Kadri
While economic growth may be an important indicator of development, the quality of a country’s public healthcare system better demonstrates the standard of living enjoyed by a wider spectrum of the population. The Covid-19 pandemic has served a stark reminder that economies can be brought to a grinding halt if public healthcare systems are inadequate, clearly demonstrating the need for increased investment in the sector.
It is therefore essential to not rely on private health care or PPP modes only and invest in government run public healthcare facilities through advanced and sustainable construction technology to ensure services remain affordable. Good design reduces lifecycle cost of buildings and facilitates faster healing, while also enabling the retention of medical professionals by providing a better working environment.
Owing to rapid urbanisation in recent decades, India faces a development paradox that is widely prevalent among the fast-growing global economies; basic necessities are either unavailable or unaffordable to the vast majority of urban dwellers. Secondly, there is tremendous strain on public infrastructure as an increasing number of people chase a diminishing parcel of public goods.
While India requires 15 doctors and 20 hospital beds per 10,000 people, we currently only have about half of that number. This translates to 700 million people underserved by the system. There’s also a huge disparity between urban and rural areas in terms of access to specialised care. We urgently need to address this shortfall. Public expenditure on health needs to increase manifold, so we can build a well-equipped and self-sufficient network of medical facilities quickly across our tier II cities, towns, and villages, which will help reduce the burgeoning load on metropolitan healthcare infrastructure.
However, there are significant challenges. Achieving the build quality and maintenance standards of private healthcare projects is still an uphill challenge for government-funded healthcare buildings. A few common issues that plague current hospitals are inadequate day-lighting, poor ventilation systems leading to cross-infection, greater building widths leading to doubly-loaded corridors with no connection to the outside, high energy costs and maintenance problems.
One solution to address these issues could be to design interactive facilities that draw from the ideas of biophilia: an innate human tendency to seek connections with nature and other forms of life. Such interventions place patient experience and wellbeing at the core, leading to swifter healing, while also reducing construction and building lifecycle costs.
With the current strain on the public healthcare system in the congested metros, the first step would be adding a layer of primary healthcare fabric in urban slums and rural areas, which endorses health awareness and offers preliminary remedial assistance, can help distribute the burden across the public healthcare infrastructure and enable affordability.
Primary healthcare centres are smaller, more cost-effective to set up and can act as an initial shield for more serious health issues in such areas, eventually branching out to medical sub-centres in each village. There also exists a need for well-equipped speciality hospitals in every district, which would cater to the rural population from each of the district’s talukas. Biophilic and interactive design interventions will help in improving the standards of public healthcare, while regulating construction costs. Adopting simple processes to prioritise critical healthcare services and conceptualising design solutions, keeping all stakeholders such as patients, doctors, nurses and staff etc. in mind, can ensure public healthcare facilities have low maintenance costs and are affordable to the communities they serve.
Cross-infection and contamination can be tackled through design changes such as naturally-ventilated spaces that increase the rate of natural air exchange, segregation of different functions by creating general, semi-sterile and sterile zones (for example, waiting areas to OPDs to ICUs) and creating buffer zones in between.
Designing the building with an East-West orientation to improve daylight, providing centralised courtyard landscapes to provide passive evaporative cooling, and adding solar panels to reduce dependency on conventional forms of electricity, are some ways to optimise building energy consumption and improve efficiency. Also, designing decentralised micro-service zones that run parallel to various departments can help make regular servicing and maintenance easier and quicker.
Today, as our understanding of health and wellbeing evolves, new construction technologies provide limitless possibilities in this sector. Building Information Modeling (BIM), for example, which can help determine the optimal geometry of buildings in response to certain parameters, can aid in pre-empting problems and shortening the time of construction to save costs, while ‘temporary and transformable’ architecture has enabled emergency mitigation like never before. Imbibing such innovations within healthcare design holds the key to streamlining our systems for better performance- from accessibility of essential public services and improved patient care to the wellbeing of our economy.
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