tangram’s healthcare expertise in facility radiation protection and nuclear medicine department designs were paramount in our commission to this project to provide new nationwide facilities to promote the highest level of cancer care services, for the Government of Algeria’s healthcare facility reform programme. We were appointed design consultants for the Cancer Care Centre at the Cheraga Women and Children’s Hospital, in Algiers.
The design of this central facility offers a state-of-the-art Centre that will contain Radiotherapy services along with the Departments’ first Medical Cyclotron Facility to provide for a Nuclear Medicine department to detect, plan and treat an array of cancers, for Women and Children.
The Centre will contain varied, and technology led departments incorporating bunker design to allow for the production, containment, and usage of medical radiation, in the first of its kind complex and incorporates far more advanced technology than that which is currently available in any facility in Algeria to date. Including, an array of Linear Accelerators, along with chemotherapy unit, Paediatric inpatient facilities, Out Patient Department and a Day Hospital, along with the first Children’s Stem Cell Transplant Unit in the country.
The programme is in its infancy, and the sharing of UK knowledge, skills and expertise is being advocated and strongly supported by the UK Government through many leading figures, who are liaising through tangramGulf to bring in expertise from some of the world’s leading research and treatment centres in UK hospitals who offer a similar size and content units.
tangram have been tasked to bring a timely exchange of UK best practice and understanding to bring benefits not only to this project, but to the wider delivery of the whole national programme. And aid in the understanding of the wider patient care experience beyond the treatment facilities that this Centre will offer, but of a cancer care service that can offer much earlier detection rates, a fuller patient care pathway, along with much improved education and research needs, than is currently experienced.
This expertise is being supplemented with current best sustainable practices to achieve a development that will positively influence not only the medical community, but the environmental design challenges that this Mediterranean setting brings.
Tremendous benefit can be made of the considerable rainfall and shoreline winds that are experienced locally, and alternative renewable energy sources and surface water recycling can be utilised to benefit both the facility and the environment. No sustainable construction standards exist within the building codes, though the Government is committed to reducing hydrocarbons by 30% of the country’s power generation by 2030, and already photovoltaic and wind farms are in use to the north of the country, again the client is looking to tangram’s experience to make considered contributions to the design in this respect.
The Centre proposed for Algiers is located in Cheraga as part of a new build Women and Children’s Hospital, at the lowest point on an undulating site. Tangram identified strong axis points with the proposed new hospital, the adjacent access roads and the hospital main entrance that allowed an east / west orientation of the new unit and aligned the above ground inpatient blocks to form a visual link to the hospital main entrance and provided a public entrance and drop off areas on this axis within a circular glazed podium level.
This level forms a pivot for the upper floors to be pinned to the lower level, partially below ground where heavy and radiation shielded, double storey bunker containment is located, and visually allows for the lighter upper levels to appear to float above the ground. Acting as an iceberg, with most of the accommodation unseen from the kerbside, the main public entrance route, and the adjacent hospital. And separating Outpatients using the lower levels and inpatients above. A Roof top technical level is provided for, shaded by the long sloping roofs to each of the inpatient blocks.
We approach the planning of any health facility by working with the service providers and the end users, in assessing the design layout in terms of function, departmental relationships and adjacencies, patient, goods, staff and service logistics flows and environmental quality.
Contemporary cancer care facilities are designed to empower patients to have more control over their own treatment pathways, where and how their care is provided and how it is delivered.
The plaza formed at entrance level is landscaped to help direct clear pedestrian and vehicle access and forms the viewing corridor from the Centers’ ground and upper levels to the main hospital entrance in the distance, across landscaped grounds.
An atrium is carved out of the main entrance hall to bring in natural light to the public waiting spaces below ground level, which are accessed via escalators or lifts, whilst 2/3 of the lower two levels benefit from the sloping site and have external glazing. At the lowest level of this bunker containment lower ground level access and back of house entrance and egress for staff, goods and services, all out of public view and circulation.
The undulating site layout allows for ground level (albeit sloping) roadway around the development, and the departmental layouts allow for crane access for the medical cyclotron to be hoisted into position from above.
Bunkers, high velocity equipment, energy centres and workshops are tucked well into the ground, in floating encasements treated to baffle noise transfer and prevent vibration spreading throughout the building.
Colours, textures and interior decoration supports ease of wayfinding to the departments for patients and visitors, and infection control solutions incorporate UV management systems and advanced air filtration technology. The internal environment is designed to reflect contemporary healthcare delivery models, with the concept of healthy living supporting the shift from an illness-based healthcare model to a wellness based one.
The emphasis on increased physical and lifestyle changes at home, at work and within the public spaces that form parts of our communities needs following through by designers, facility owners and operators alike, to ensure that well designed health facilities incorporate well designed and sustainable architectural forms, interior and external finishes, furnishings, artworks, way finding and signage. Sustainable landscaping of gardens, courtyards, and plazas with local, native plant types are essential, to allow our external environment to thrive. To promote a healing environment, the exterior should be integrated within the building or viewed from it, to form an essential extension to the patient and staff accommodation, waiting or sub-waiting spaces. For stem-cell transplant patients during their long and extended inpatient stay, views of and during later stages of recovery, access to nature is critical to enhance the recovery period. At Cheraga, like many areas in the north of the country habitats are surrounded by local forests; to bring in this natural amenity, to offer views and access to a familiar natural environment, we introduced a winter garden so that patients, visitors, and staff can explore the textures, shading and smells. Direct and protected routes through are designed specifically for those patients with immune-deficiencies, so patients with longer stays, and perhaps greater need to benefit from the accelerated healing process that green and therapeutic landscapes can bring, are able to enter and enjoy from sanitised and contained pods, dotted around the garden.
Within the site extremities of this project, enormous opportunity exists to develop site contained renewable resource harvesting and energy production, we coupled this with a more sustainable consumption rate for energy demand and usage, utilised to improve both design and end-user practices that tested conventions and innovate are incorporated. Offering the supply of a continuous source of clean energy, resulting in less pollution and Green House Gas (GHG) emissions which contribute to climate change. As the largest country in Africa, 80% of Algeria’s 2.38 million km2 is desert that enjoys between 2,000-6,000 Wh/m2 of sunshine each year; enough to power the world 10 times over. Algeria currently uses 0.003% of its solar potential and capturing even a fraction of this solar trap, so developing proposals that address and take responsibility for improvements to this, we consciously set out to exemplify what is achievable within the rich resource capacity that the site offered.
This project forms the first facility in the newly established, nationwide cancer care programme. It provides the Government’s first medical cyclotron facility and the first stem cell transplant unit in the country, and despite the complexities involved in designing notoriously energy and water demanding building typologies such as this, we were able to demonstrate the possibilities for the future in both healthcare delivery and environmental sustainability.