FOR ANY patient visiting a hospital it can be a daunting and slightly scary experience. For children, particularly for children with a sight related problem, it can be frightening and intimidating, especially as most hospitals are usually cold and clinical. A notable exception is the Paediatric Ophthalmic Eye Unit at the Richard Morris Hospital (part of the United Bulawayo Hospitals or UBH). It’s a child friendly, welcoming place designed with bright cheerful colours and an interior courtyard filled with sunshine and toys, which is used as an informal waiting room or a place to relax and eat lunch. The staff has their own slightly smaller courtyard where they can have a quiet break and enjoy a breath of fresh air.
All the signage is designed to be large and easy to read to avoid any confusion or difficulties for visually challenged patients. The lower part of the interior walls (or dado) is painted in distinct bright colours so that it easy to see where the plain grey doors or recesses are located – another important and carefully thought out visual aid. Access to the clinic can be either from the main hospital or directly from the open space outside the front entrance. The exterior has been simply landscaped with paved walkways, some green grass and waterwise plants, and a few wild olive trees, all intended to make the clinic seem friendlier and less like a cold institutional building. And there’s even a huge teddy bear at the reception to greet the children.
Although it’s officially a paediatric clinic adults can also receive care and treatment, whether it’s a simple eye test and a pair of prescription spectacles, a cataract operation or more specialised eye surgery. It’s one of only two referral clinics in the southern part of Zimbabwe so UBH services Bulawayo Metropolitan Province, Matabeleland North and South Provinces, Masvingo and Midlands Provinces, as well as patients from across the Southern African region. The Bulawayo United Hospital had an eye department for adults and children, but their operating theatre has been closed for years due to a leaky roof which damaged valuable equipment.
Before the new clinic began operating patients would have had to make the long and costly journey to Harare for evaluations, treatment and checkups. There are a couple of small dormitories or hostels where parents or care-givers can sleep if children need to stay overnight or for a few days in the recovery ward. It’s especially convenient for parents and patients from lower income brackets or for people who have had to travel long distances to the clinic. The whole design ethos is geared towards the practicalities of the procedures carried out and the comfort and convenience of the patients and their caretakers. The majority of the funding for the project.
was provided by the Christian Blind Mission (CBM), an international development organisation based in Germany, committed to improving the quality of life of people with disabilities in the developing world. They are involved in programmes across Africa, as well as in South America and the Caribbean, the Middle East and Asia providing support, care and educational facilities for blind, deaf and physically disabled children. CBM first became active in Zimbabwe in 1974 in co-operation with the local organisation Jairos Jiri Association. In 1982 they started to support the School for Blind Children in Kadoma and in 1983 they set up a partnership with the Lutheran Church of Zimbabwe, supporting their resource centres for children with visual impairments.
The Paediatric Ophthalmic Eye Unit is an ongoing co-operative programme, which includes funding from Christian Blind Mission, the running and of the day to day staffing and administration overseen by the Zimbabwe Council for the Blind, and the Ministry of Local Government, Public Works and National Housing who are the long term custodians and land owners. Although these organisations all brought a wealth of experience to the project it did make the design process extremely involved and a little bit cumbersome as designs and decisions needed to be approved by numerous committees, and the design had to be cost engineered several times in order that the size, layout and specification suited the clients’ budget.
The design process took around five months from the initial brief to the presentation of tender drawings – from May to September 2014. It was further complicated by the fact that all clinics and hospitals have specific requirement for health and safety regulations set down by the Ministry of Health. This meant that all the materials used for flooring, painting, plastering, ceilings and so on needed to meet the specifications laid down. The operating theatres in particular have very specific requirements.
They need to have scrub areas with elbow operated faucets; sluice rooms; autoclave facilities for sterilising instruments; facilities for disposing of ‘sharps’ and other medical waste; vinyl floors with seamless concave skirting selected for their sterile, anti-fungal, anti bacterial and antistatic properties; and appropriate natural and artificial lighting for surgical conditions. In addition the air circulation needs to be germ and dust free so air-conditioning units with High Efficiency Particulate Air (HEPA) filters were fitted in the in the operating theatres. The architect, Geoffrey Fox from the Architectural Planning Studio, also needed to consider the human traffic flow and the surgical waste flows, so that the staff, patients and surgical equipment can maintain the necessary hygiene conditions without compromising the required sterility of the operating theatres.
All of this needed to be accomplished on a limited budget and still look aesthetically appealing and patient friendly. On top of all these limitations the Harare based consultant team and the Ministry team (each consisting of a full array of engineers and quantity surveyors), could only attend site when all of the numerous stakeholders could be in attendance. In hind sight Fox admits that having such a big team, at such a distance, with so much paper work, was ungainly and more frequent site visits, and the ability to make decisions more easily would have been in the project’s interests. The building process took around 11 months until completion in December 2015. The clinic became fully operational in April 2016, so it’s just over a year old.
The clinic is in essence three buildings combined into a single integrated structure of about 616m2. The first section is made up of the out patients department, comprising the reception and patients’ waiting area, consultation rooms, an optometry/ refraction room (for eye tests), as well as offices, storerooms, a duty room with a kitchenette and ablutions for patients and staff. The second section is made up of a patients’ pre-operative preparation room, two operating theatres, a scrub room and a sluice room, a patients’ recovery room, as well as staff changing rooms, a duty room and a storeroom. The third section is made up of the hostel/dormitory section with rooms accommodating up to four beds each for male and female caregivers from out of town, as well as ablutions and basic cooking and laundry facilities.
The majority of the materials were acquired in Bulawayo apart from the ironmongery and the specialised basins, faucets, sluices and related hospital equipment which was imported from SA. The exterior warm, textured, sandy/yellow coloured facebricks were manufactured in Botswana but available in Bulawayo. Geoffrey Fox from Architectural Planning Studio was the Principal Agent for the project – meaning in effect, that as well as design, the architect took responsibility for contract administration, team co-ordination and site supervision, ensuring that the construction was carried out as per detailed drawing documentation and specification, and that every decision right down to the finish, paint colours, signage, and landscaping were individually tailored to the project and the clients particular needs.
However the success of a project like this is dependent on the full involvement and professionalism of the associated team of consultants (Mike Mawire & Jackson Taivavashe from ASMEC, mechanical and electrical engineers, Cyprian Kunaka of Dickie and Kunaka, Structural and Civil Engineers, and Matt Dove of Matt MDA Quantity Surveyors), as well as the guidance and oversight of The Ministry of Local Government, Public Works and National Housing and the team of consultant doctors and nurses at UBH. The main contractor on this demanding and highly detailed project was Tzircalle Brothers (Pvt) Ltd., based in Bulawayo.
The completion and opening of the Paediatric Ophthalmic Eye Unit has meant an invaluable improvement in the lives of many people with visual impairments in Bulawayo and the surrounding region, particularly for the less privileged patients. Hopefully it will continue to offer excellent patient care and world class treatment for many more years.
CONSULTANTS Client Representative – Christian Blind Mission (CBM): Michele Angletti Client Representative – Council for the Blind: Aplos Nyathi Architects- Architectural and Planning Studio: Geoffrey Fox Structural & Civil Engineers – Dickie and Kunaka: Cyprian Kunaka Electrical & Mechanical Engineers – ASMEC: Mike Mawire Main Contractor – Tzircalle Brothers : George Tzircalle Quantity Surveyor – Matt Dove Associates: Matt Dove Electrical & Mechanical Subcontractor – Tzircalle Brothers: Peter Tzircalle MATERIAL SUPPLIERS Reinforcement Steel – Steel Force Steel Windows and Glass – Monarch ( windows ) CH Naake (glass) Shopfitting – Kitchens for Africa: Shayne Clift, (kitchen only) Tzircalle Brothers (suspended ceiling and aluminum doors and windows ) Landscaper – Ceilings& Bulkheads – Tzircalle Brothers: George Tzircalle, Cement – PPC CEMENT Bricks – Buy and Build & Macdonald Bricks Paint – Paint & Allied Painting – Tzircalle Brothers Plumbing – Tzircalle Brothers Waterproofing& Specialist Vinyl Floors – Engineered Waterproofing Systems: Brian Macklin Gutters – Zeus Trading Roof- PG Timbers Byo Doors – Halsteads Lighting – Tzircalle Brothers 3/4 stones – Davies Granite Black concrete plastic sheeting – Halsteads Sand pit and river – Quality Sands Signage – Copper Wares, Bruce Johnson, Wall and Floor tiles – Tzircalle Brothers Pavings – Tzircalle Brothers Lintels – Tzircalle Brothers Backup generator – Tzircalle Brothers Air con Systems – Tzircalle Brothers
Text: Michael Nott
Photos, Plans And Elevations:
