In the dark corridors and congested waiting rooms of rural hospitals in sub-Saharan Africa, tuberculosis can spread like a rumor in a small town. A patient who comes in with a broken leg might leave with a deadly disease.
Recently, several global health aid groups have been trying not only to contain and treat recalcitrant infectious diseases like tuberculosis, but also to promote new ways of building hospitals in the world’s poorest rural areas.
In July, builders broke ground on a new hospital in Rwanda’s Burera district, near the Uganda border. The design relies on simple features to reduce the spread of airborne disease: outdoor walkways instead of enclosed halls, waiting rooms alfresco and large windows staggered at different levels on opposing walls to keep air circulating.
The hospital’s construction is being overseen by Rwanda’s Ministry of Health; Partners in Health, a nonprofit group based in Massachusetts; and the Clinton Foundation. It was designed by graduate students at Harvard’s design school.
“It’s not revolutionary or difficult,” said Dr. Peter Drobac, a clinical adviser to Partners in Health who has worked at hospitals in various developing countries over the past 10 years, and who is advising the Rwandan government. “But your average hospital in rural Africa would have long, dark hallways and the windows shut.”
A study published last year in the journal PLoS Medicine found that tuberculosis hospitals in Lima, Peru, that had big, open windows and high ceilings had better air exchange than hospitals with high-powered mechanical ventilation systems.
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That's a good idea to ventilate the building, although it might pose a problem if an illness needs to be quarantined. There should still be a separate room for that function.
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