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.
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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.
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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.
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This is the pediatric ward - but it was the only empty ward suitable for a photo |
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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.
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Fantastic outdoor waiting room at Mkula hospital |