At this elegant new hospital, the doctors were the designers

Tambacounda Hospital in eastern Senegal is an essential public facility. Serving a rural region that spans multiple countries in West Africa, the hospital sees 20,000 patients a year. But with little funding and overstretched resources, the hospital’s buildings struggled to keep up with that demand.

To help improve conditions there, the design-focused Josef and Anni Albers Foundation funded the design and construction of a new maternity and pediatric hospital building. Designed pro bono by Basel-based architect Manuel Herz, the curving brick facility was built by local contractors for just $2 million. It’s a significant upgrade.

“In lieu of incubators, they were using a discarded refrigerator tray with ordinary lightbulbs on top of it for heat,” says Nicholas Fox Weber, executive director of the Josef and Anni Albers Foundation, of the conditions of the hospital before the new building. “You didn’t want a woman in early labor to be right next to a woman in the very late stages of labor who in turn was right next to a woman with a small baby who in turn was next to a woman who had lost her baby. Everybody was packed in like that.”

“One day I just thought, ‘People don’t need to live this way. Can’t we do better?’” Weber says.

He’d been traveling to Senegal for nearly 20 years, and had created a Senegal-focused sister organization to the Josef and Anni Albers Foundation, called Le Korsa, to assist local doctors in the region with funding and medical supplies. When he was visiting the hospital about four years ago, he decided Le Korsa could do much more to help. So the foundation launched a design competition for a new maternity and pediatric building.

One of the designers invited to participate was Manuel Herz, who has worked in Africa for years. “When I started to participate in the competition, I had my doubts, to be frank,” Herz says. “Is it correct for me as an architect based in Basel or any of the other architects participating in this competition to provide a design quote-unquote-solution for a region they had never really been to, for doctors and patients they had never spoken to, for a context that they are very unfamiliar with?”

Instead of proposing a design, Herz proposed a design process. He and Weber traveled to Tambacounda so that Herz could speak directly with the doctors, medical staff, patients, and local officials. After a few weeks of research he returned to his studio. A few months later, he returned to the hospital to present his plans, and the local governor held a meeting with the entire staff to review Herz’s design.

“He asked everybody in the room to issue his or her opinion of the design proposal, and he listened for about two hours to every nurse, every doctor, every janitor,” Herz says. “Some of their comments were incredibly precise and sharp, like move the door here, and this space is not big enough, and we need to change the order of the rooms and so on.” With that feedback, Herz refined the design, and the governor approved the project.

The new facility will officially open May 10. The S-shaped building adds 150 hospital beds and baby cots on two floors, with a narrow, 23-foot-wide footprint that allows passive cooling in the extremely hot climate. In addition to clinical spaces, the corridor includes numerous seating and lingering spaces, where families can wait for patients and doctors can have meetings.

The building was constructed with U-shaped bricks that were cast on-site, using a special design developed by Herz. They’re used on the building’s facade as a perforated screen, allowing cross ventilation inside while also shielding the hospital rooms from rain and sun. To test the design, Herz worked with a local doctor and general contractor to build a prototype. It soon became more than that. “The general contractor built the test facade not on the hospital site as I had suggested, but he built it in a small village 50 kilometers south of Tambacounda. And instead of building a wall, he built four walls and a roof ,and it became the village school,” Herz says.

During the construction of the hospital, Herz got married. He and his wife asked their wedding guests to forego gifts and instead donate money to build a playground in the hospital courtyard—the first playground ever built in the city. “We want people who go to the hospital to remember it as a happy place,” he says.

The project will be displayed at the 2021 Venice Architecture Biennale. Weber says Le Korsa is hoping to expand on this work,and is now raising funds to build housing for the doctors and medical staff.

Herz also designed the homes Le Korsa is hoping to build. He says that even though the budget for these projects is low by international standards, he didn’t want them to look or feel cheap.

“Yes, it’s low-cost, and it’s in a setting that is maybe not ordinary or not everyday, but it needs to have just as good a space and in exactly the same quality of execution just as any other project in my office,” he says.