April 15, 2015
Dan Luhrs, AIA; and Sheba Ross, AICP, LEED AP, Intl AIA, CDT

What if you had relatively no access to healthcare? And what if ‘relatively’ actually means 60 miles for a catchment area of over 1 million people?What if we have to ‘unlearn’ everything we know about healthcare, just to understand and overcome the societal norms of a culture that believes - "If I go to the hospital, I will die. Hospitals are places where you die."

How do you respond to the fact that lack of healthcare means no prenatal care?  Absence of prenatal care means that women who face complications after giving birth rarely survive long enough to be transported by an ambulance to the hospital. Those who do, seldom receive adequate post-natal attention.

How do you serve a population with an emphatic social hierarchy, where the affluent and the underprivileged are not familiar with co-existence?

How do you get the word out that clinics and medical care are coming for such a large population that inherently distrusts the system of healthcare lauded by a government that questionably promises "We are here for you?"

These are the main questions we faced in planning a Maternal & Children’s Center and Adult Hospital in Akwa Ibom state, in the southern region of Nigeria’s Niger Delta. The Thompson and Grace Medical City is a project launched by a private investment company to address Nigeria’s severely inadequate health services, shortage of qualified health professionals and absence of a medical research infrastructure. According to the World Bank, this region ranks 7th highest in infant mortality among the world’s nations, and life expectancy in Nigeria is 52 years, 17th lowest in the world.  HKS was awarded the contract after a preliminary master plan was outlined by Texas A & M University Landscape Architecture students. Nestled in Afaha Obong, Akwa Ibom, Nigeria, the project site is located on a 116-acres Greenfield site characterized by heavy rains, strong winds and undulating terrains.

Responding to these unique questions, we followed a three-tiered approach:

Engage | Reformulate | Integrate


We held community meetings to demystify healthcare as a preventative and treatment solution. We planned a response to address emergent care at the ‘door’. We crafted a strategy to work with the community to accept preemptive and prenatal care along with the local EMS, to be honest about what care can be and how it should be used. We designed pamphlets and created visuals to communicate the details of an approach that is people-centric. When completed, this project will host Nigeria’s first children’s hospital, which is an incredible opportunity and honor for the HKS team.



We used the mass perception that water is a negative entity and altered the stigma by building our entire concept around the healing benefits of moving water. The design is catalyzed by a physical expression of the development plan that resonates with the dynamics of water and its stewardship.



We were charged to create two distinct hospitals on a small site:  a 200-bed Maternal and Child Care Hospital and a 200-bed Adult General Hospital with shared logistic support and capability to expand to double or triple the size. Our design response was to set-up signature front doors for both hospitals during the first construction phase that will retain their image through the course of future development. We created a communal public plaza as an extended outdoor space for family waiting and public gatherings. Shared logistic support was offered at the lower level to gain operation efficiency and taking advantage of the site terrain, we concealed parking and differentiated the arrival of wealthy car owners from pedestrian traffic.


The buildings are being designed to grow from the ground so that the line between the terrain and the facade is diminished. We are taking notes from Nature and History in order to sculpt spaces that are environmentally adept and intricately efficient.



This project, when it moves forward, will not be just rooted in design, but rather in how we as designers can raise a societal awareness, through our client's strong commitment to create something impactful. Design (as in, our skills), is not the focus. This project is all about establishing a dialog that transforms preconceptions and introduces a new way of life, improved outcomes, and equal access to healthcare. It redefines what care is, to a community that does not yet realize that everyone is truly worth it.

And hence the project signature: Healing (in) the Heart of Africa


How would you do it?

Posted in Health