Architecture is a powerful profession that can have a lasting impact on societies. But how can this impact be turned to the advantage of the world's poorest, i.e. those who generally do not have access to the benefits of architectural services? An exemplary answer springs up when a second-year architecture student designs a hospital for one of the poorest countries in the world, builds it with the help of the local community and funding from an aid organisation, and turns it into a centre for regional development and a successful model for other clinics in the future. This may sound implausible, but it is exactly what happened in Butaro, Rwanda, with Michael Murphy, who graduated from Harvard only half a year after the clinic was opened by the Rwandan State President Paul Kagame.
The project only became reality because Paul Farmer, head of Partners in Health (PIH), had himself been a student at Harvard, at the Faculty of Medicine, when he founded this charitable organisation in 1987. Michael Murphy approached him to ask who was responsible for the architectural design of PIH's clinics, and it was then that Farmer decided to offer Murphy the job. Until 2007 Farmer had designed the structures himself, because there were usually no trained architects available in the regions where he worked. Along with several other architecture students, Murphy founded the pro-bono design office MASS to take on this challenge. They had quite an ambitious programme for a group of students with no experience, with one of their central goals being to use architecture as an engine for economic growth while improving the living conditions of local communities.
![Inaugurated last January,
the hospital operates
in the district of Burera, an
area with 340,000 inhabitants
which had no doctors or health
services until the Partners
In Health humanitarian
organisation arrived in 2007. Inaugurated last January,
the hospital operates
in the district of Burera, an
area with 340,000 inhabitants
which had no doctors or health
services until the Partners
In Health humanitarian
organisation arrived in 2007.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_6961_DO110708014_UPD1.jpg.foto.rmedium.jpg)
![The buildings is partly clad
with locally quarried volcanic
stone. The buildings is partly clad
with locally quarried volcanic
stone.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_7553_DO110708015_UPD1.jpg.foto.rmedium.jpg)
The risk of infections is further reduced by dispensing almost entirely with air-conditioning systems.
![In total, 3,898 people from
the local community worked
on the construction site.
In this way they received
manual training and were
able to acquire new skills. In total, 3,898 people from
the local community worked
on the construction site.
In this way they received
manual training and were
able to acquire new skills.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_2860_DO110708016_UPD1.jpg.foto.rmedium.jpg)
![The project was designed
as a series of pavilions
grouped around a garden, with
all the wards and beds facing
the surrounding landscape. The project was designed
as a series of pavilions
grouped around a garden, with
all the wards and beds facing
the surrounding landscape.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_4014_DO110708012_UPD1.jpg.foto.rmedium.jpg)
—Andres Lepik, art historian and curator
![A important actor in the design process was Paul Farmer, director of Partners In Health who founded this organization in 1987 while studying medicine at Harvard. A important actor in the design process was Paul Farmer, director of Partners In Health who founded this organization in 1987 while studying medicine at Harvard.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_6527_DO110708001_UPD1.jpg.foto.rmedium.jpg)
Project Team: Michael Murphy, Alan Ricks, Sierra Bainbridge, Marika Clark, Ryan Leidner, Garret Gantner, Cody Birkey, Ebbe Strathairn, Maura Rockcastle, Dave Saladik, Alda Ly, Robert Harris, Commode Dushimimana, Nicolas Rutikanga
Structural engineering: ICON
Construction supervision: PIH/IMB, Bruce Nizeye, Felix Ndagijimana
Sewage plant engineering: EcoProtection
Landscape design: Sierra Bainbridge, Maura Rockcastle
Client: Rwandan Ministry of Health, Partners In Health / Inshuti Mu Buzima
Built area: 6,040 m2
Cost:$4.4 Million
![The hospital consists of an emergency room, two operating theaters, a department of internal medicine, maternity, pediatric clinic for infants and an intensive care unit. The hospital consists of an emergency room, two operating theaters, a department of internal medicine, maternity, pediatric clinic for infants and an intensive care unit.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_5303_DO110708002_UPD1.jpg.foto.rmedium.jpg)
![To build the hospital, MASS used the abundant low-cost labor force, readily available due to high unemployment, transforming the building process into an opportunity for training more than 3,800 inhabitants. To build the hospital, MASS used the abundant low-cost labor force, readily available due to high unemployment, transforming the building process into an opportunity for training more than 3,800 inhabitants.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_7567_DO110708003_UPD1.jpg.foto.rmedium.jpg)
![The health center has more the feel of a resort than a hospital, anonymous and isolated. The health center has more the feel of a resort than a hospital, anonymous and isolated.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_9978_DO110708009_UPD1.jpg.foto.rmedium.jpg)
![Doctors at the health center will train 1,500 nurses for the health care system in rural areas. Doctors at the health center will train 1,500 nurses for the health care system in rural areas.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_3708_DO110708005_UPD1.jpg.foto.rmedium.jpg)
![The hospital is located atop a hill, along the valleys of Butaro that stretch north to the border with Uganda and occupies an area previously used by a military base. The hospital is located atop a hill, along the valleys of Butaro that stretch north to the border with Uganda and occupies an area previously used by a military base.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_7921_DO110708007_UPD1.jpg.foto.rmedium.jpg)
![To reduce the risk of infection and energy costs, MASS decided to omit air conditioning almost everywhere. To reduce the risk of infection and energy costs, MASS decided to omit air conditioning almost everywhere.](/content/dam/domusweb/en/architecture/2011/08/26/butaro-hospital-rwanda/big_356375_3563_DO110708010_UPD1.jpg.foto.rmedium.jpg)