Mirebalais National Teaching Hospital, Regional Reference Lab, Haiti

Mirebalais National Teaching Hospital, Regional Reference Lab, Haiti

Budget: $1.875 million

Size: 15,700 sfLDN_NewProjects_RegionalReferenceLabx500

Project team: Shepley Bulfinch (architect); JML Engineering (structural engineer); Mazzetti (MEP engineer); Build Health International (GC).

Description: Designed for Partners In Health, the new home for Haiti’s National Pathology and Microbiology Reference Lab provides high-level lab space for clinical pathology and microbiology, including BSL-2 and BSL-3 labs, and addresses the critical need to diagnose and treat disease in Haiti. To provide sophisticated lab space in a resource-limited environment, the design strategically zones “high-tech” environmentally controlled spaces and “low-tech” naturally ventilated spaces, while providing flexibility and capacity for future change and expansion.

Located across from the main hospital, the Reference Laboratory occupies two floors within a simple linear structure, organized “anatomically” into three sections: at the “head”, the main entrance serves as patient intake for testing and triage of test samples, with lab offices and conference/classroom above. Within the “torso” is a long flexible space with open bays for diagnostic labs, which include modular benches, zoned to support chemistry, hematology, immunology and virology testing and equipment. On one side of the lab are a series of rooms for anatomic pathology and microbiology. Along with regularly spaced alcoves for fume hoods, these are clustered and stacked on each floor to concentrate necessary exhaust fans. At the “tail” are located support functions, including a break room, staff lockers and showers, waste handling and storage at the ground floor, with a specialized BSL-3 lab above. The building organization allows for naturally ventilated spaces to be concentrated at the head and tail of the building, with conditioned space concentrated in the torso. A linear open air circulation gallery, shady and north facing, provides an outdoor respite area for lab technicians and staff. The most technically demanding lab space, located on the top floor, benefits from a high-bay roof that lets natural daylight penetrate deep into the interior spaces. Deep roof overhangs provide shelter from direct sunlight and driving rain.

Completion date: January 2016

Contact: Gerard Georges, Project Manager, Shepley Bulfinch, ggeorges@shepleybulfinch.com

Originally published by Laboratory Design Newsletter:  http://www.labdesignnews.com/news/2015/10/mirebalais-national-teaching-hospital-regional-reference-lab-haiti


University Hospital Changes Haitian Health Care

University Hospital Haiti A collaboration between Partners in Health and the Haitian Ministry of Health has lead to a turning point in the history of Haitian health care. Last month, a patient received the first ever surgery in Mirebalais’ newly opened University Hospital. It was the first of many surgeries in the new, fully equipped public hospital with a state-of-the-art operating room. JML Engineering was proud to help make this hospital possible.

“We’re thrilled that construction of Hôpital Universitaire de Mirebalais, in Mirebalais, Haiti, is complete. The 205,000-square foot, 300-bed facility—called HUM for short—will fill a huge void, locally and nationally, for people who previously had limited access to quality health care,” said physicians for PIH/Zanmi Lasante and members of the executive leadership team of Mirebalais National Teaching Hospital.

Haiti Hospital Uses Solar PowerHaiti’s first ever teaching hospital, University Hospital is also expected to be the largest solar powered hospital in the world that creates over 100% of it’s energy during daylight hours. Energy is expensive in Haiti and this solar roof is estimated to save the hospital’s operating costs $379,000 a year. “The challenge was in the design and engineering, and getting the solar power produced to mesh with the often unstable grids and the backup generators,” said Jim Ansara, University Hospital’s director of design and construction. “At each step of the way, we were attempting things that had never before been done in Haiti.” John Looney and JML Engineering were an integral part of the project and building the hospital. There were construction obstacles while building the hospital, Looney says the hospital’s 24-ft to 28-ft spans and load-bearing walls are unlike the 10-ft by 10-ft un-reinforced modules that typically are found in Haiti.

Article Sources and Images from Partners in Health:

Two Hospitals in Haiti Tell Very Different Stories

Mirebalais’ new world-class facility contrasts sharply with Port-au-Prince’s crumbling General Hospital.

Jean Pharés Jérôme | December 28, 2012 06:15

MIREBALAIS, Haiti — Under the leadership of the American NGO Partners In Health, led by Dr. Paul Farmer, the largest post-earthquake health project has finally materialized: the construction of the University Hospital of Mirebalais (HUM).

The Haitian government and its international partners, however, are still struggling to begin reconstruction of the Hospital of the State University of Haiti (HUEH) — the main hospital in Port-au-Prince — about three years after the earthquake of January 12, 2010.

The rebuilding of HUEH, commonly known as the General Hospital, was one of the first projects to be approved by the now-defunct Interim Commission for the Reconstruction of Haiti (IHRC). Created after the earthquake, the IHRC was co-chaired by former US President Bill Clinton and the Haitian prime minister, but it disappeared before the start of the hospital’s reconstruction.

Three years after the disaster, HUEH continues to function in buildings that were badly damaged. Buildings that represent a real danger to the hospital have been demolished, including pediatrics, laboratory and maternity. All these services are currently housed in tents.

Patients in this public health facility believe that destroying some parts of the building gives hope that construction will begin soon. But nobody knows when that day will come.

“I do not know why the construction has not yet begun,” said Christophia Saint-Jean, general secretary of the Union Employees of HUEH.

After a visit to Washington, DC in early 2012, former Haitian Prime Minister Garry Conille announced the start of construction for the month of May. Seven months later, there has not been any progress. The minister of health, Dr.Florence Duperval Guillaume, cited technical complexities to explain the delay in starting work, while others have reported disagreements between the major donors who fund the project—the US, French, and Haitian governments.

In fact, the causes of blocking the reconstruction of HUEH seem to be deeper than what is currently known. Director general of the Ministry of Health (MSPP), Dr. Marie Guirlène Raymond Charité, declined to be interviewed on the subject, stating, “the reconstruction project at HUEH is a political issue.”

At a press conference last October, the minister of health announced that construction on the hospital would start before the second half of 2013 and would be completed in 2015.

“We know that the work will take three years, but we do not know when they will be launched,” said another member of the board of the union of the hospital. He added, however, that he has had several meetings with members of hospital management regarding the reconstruction project. According to information provided by the Minister Duperval at the press conference, the work will be funded by the French, American and Haitian governments for $82 million. The initial cost of the project was $53.2 million, but the Haitian government agreed to contribute to the total.

“The Haitian government was under pressure from donors and will add the other $30 million,” said an official of the Ministry of Health, on the condition of anonymity.

The other side of the coin

Although the reconstruction of HUEH has been slow to start, the construction of the University Hospital of Mirebalais (HUM), 30 miles north of Port-au-Prince, has had more success. Conceived after the 2010 earthquake, HUM’s construction is already completed. The inauguration ceremony for the hospital, the largest project of post-quake reconstruction to date in the health sector, was held on November 6.

The construction of the new hospital is a sign of hope for the Haitian health system, which has struggled to provide quality services to the Haitian people.

“This hospital is the culmination of a dream dating back a quarter century, and underlines our commitment to the country and people of Haiti, which is stronger than ever after the earthquake,” said Farmer, co-founder of Partners In Health.

HUM is a 205,000-square foot, 300-bed facility. When fully operational, the hospital will be able to serve 500 patients a day. It will provide primary care services to roughly 185,000 people in Mirebalais and two neighboring communities with “30 outpatient consulting rooms and six operating rooms,” according to information provided by HUM.

Approximately $17 million has already been invested in the construction of HUM, and Haitian authorities and their partners plan for it to rise to the rank of a world-class hospital and a national center of education.

Partners to build Haiti hospital — JML is one of those Partners

Partners In Health, the Boston-based global health initiative that has been the face of health care in Haiti after the devastating earthquake six months ago, is building a new teaching hospital there.

The 320-bed, seven-building hospital will rise in Mirebalais in the rural Central Plateau, a 45-minute drive from the outskirts of Port-au-Prince, the hard-hit capital. It will become a national referral center when it opens at the end of next year, seeing as many patients as are seen at the other 12 clinics in Haiti where Partners in Health currently works.

The new hospital will also train doctors, nurses, and other health professionals. Teaching hospitals were among the 60 to 70 percent of health care facilities destroyed by the earthquake.

The project is the biggest in the 23-year history of Partners In Health.

“It’s ambitious,’’ Dr. David Walton, the group’s deputy chief of mission in Haiti and a physician at Brigham and Women’s Hospital in Boston, said by phone yesterday. “We are dealing with a tragedy that is unprecedented, so our response has to be unprecedented. This hospital is really going to be a centerpiece of our earthquake response.’’

Partners In Health had been planning to build a 108-bed hospital in Mirebalais that would bring comprehensive primary and prenatal care to more than 160,000 people in the region, treating people suffering from tuberculosis, HIV, malaria, and malnutrition. But after the earthquake, the Haitian Ministry of Health asked the organization to expand its plan, leading it to add improved diagnostic capabilities, an intensive care unit, and six operating rooms equipped for thoracic surgery.

While private hospitals in Haiti offer such facilities, they are beyond the reach of most Haitians, 80 percent of whom live on less than $2 a day, Walton said. The new hospital, which will cost Partners In Health $15 million to build, will treat all comers. Partners In Health has raised $85 million for Haiti earthquake relief.

Walton, echoing former president Bill Clinton’s words as the United Nations special envoy to Haiti, said the project will “help Haiti build back better.’’

Partners In Health is working with its Haitian sister organization, Zanmi Lasante, on clinical care. On medical education, it has formed alliances with such US medical schools as Duke and Dartmouth, Walton said, in addition to its original relationships with Harvard Medical School and Brigham and Women’s.