Reconstruction of maternity ward and a new building for private ward

This week after we have both submitted applications for a building permit and finished the drawings for the construction document and the contract was signed for the construction of the emergency department, we Sandra and Emelie, have been able to spend all our time with the main topic of our master thesis - a design of an extension and reconstruction of the maternity ward and a design for a new building for the private ward at Kolandoto Hospital.

Entrance to maternity ward

Currently the private ward and the maternity ward are in the same building and our intension is to move out the private ward to a new building. Today the private ward provides income to the hospital, since patients who are able to stay here, pay a higher fee than other patients to get higher standard – staying in single patient rooms or sharing ward room with a maximum of 4 patients instead of 20 - as it is in the other open inpatient wards at the hospital. With a new building with even higher standard in terms of sanitary facilities and indoor environment, the hospital can charge more per bed – and in turn it can provide a higher level of income for the hospital, which can be used to finance future investments in the development of the hospital.

The building today

The other big motivation to move out the private ward and extend and reorganize the maternity ward, is the current overcrowded situation at the maternity ward, partly due to the reason that this service of care, is now provided for free at the hospital. So at the moment there is not enough beds and space and no flows are separated, they lack proper waiting room and nursing station. Women are almost sharing beds sometimes, and the doctor told us that they sometimes have up to five births at the same time but only two delivery beds – which put them in situations where they need to be “creative” he told us – meaning they give birth a little here and there if it's urgent. Also the 7 pre-delivery beds and the 9 post-delivery beds where the mothers keeping their newborn babies, almost shares the same room today, which poses a high risk of transmission of diseases and infections between patients and to the newborns.

This is the pediatric ward - but it was the only empty ward suitable for a photo

 

Examination room/ observation room sometimes a delivery room

So there is a lot of things to work with here. We have used participatory design with a lot of workshops with the staff to get a good picture of what is needed and to understand the work flows etc. Very interesting!

 

Coming from Sweden with our background, you sometimes get a bit uncomfortable of what you see - even if everyone seems happy and everyone is really doing their best. The biggest difference we think is the integrity and privacy. Everything is done open here and sometimes when you're on guided tour at the hospital, they try to pull you into the delivery room just in the middle of a childbirth - and inside, already 10 people are watching a mother giving birth – many is of course students from the college but it still feels very strange for us. Or when people want to take photos with us and them - posing in the front of patients. Similar situations also happened at the study trip to Mkula Hospital 3 hours north of Kolandoto, where they guided us through the surgery theatre in the middle of a surgery. But even if you see a bit uncomfortable things here, everything is super interesting and very exciting. You get another perspective on things and this work feels very rewarding and meaningful for us.

Fantastic outdoor waiting room at Mkula hospital