Designing Healthcare Environments for Handicapped Children
Architects in India are generally not very interested in barrier-free design and accessibility. The
majority of them would not have even heard these terms used in this context. They are unaware what
good can happen through appropriate design because they don’t really understand the impact of bad
design.
Children know immediately when they are sick. The way in which parents, doctors and healthcare
workers react to a child who is fearful of being ill is of central concern. If the parents and the caregivers
are not given an environment in which they can make the child feel comfortable, then the child can’t
get well. Children get frightened very easily when they get brought into a traditional hospital setting.
They need a different arena of design.
Bruce Komiske talks about the lessons the project team learnt form the construction of the Hasbro
Children’s Hospital:
“ …some of the guiding principles we learnt from our project. First, if you don’t set a vision for the
project that is beyond where you are, all you will create is the same program in a pretty new box, and
nobody can afford to do that…Second, there is the objective of creating an economic advantage in the
new project. The days of just replacing facilities because they are old and antiquated are over. The
third point is that you have to break paradigms in order to be truly successful.”
He goes on to say:
“…thing we tried to do was to celebrate our successes at every step. Very few opportunities in
healthcare allow you to have as much fun as going through a project, and you ought to take advantage
of it.”
I wish the people in the healthcare industry involved in healthcare projects would realize this. We may
be designing a hospital to help heal handicapped children or sick people in general and one would
think what a happy activity to be involved in, but the acrimonious project meetings in which
everybody’s sole aim seems to be to cover their behinds would belie this.
To get back to the issue at hand. Enumerated below are some design imperatives for designing
healing environments for children, handicapped or not.
1. Providing a circulation system that promotes easy orientation and administrative surveillance
of the building and meets accessibility standards.
2. Providing a non-institutional, non-threatening setting that simulates a home environment.
3. Creating distinct territories for different programs that may be housed in the building, each one
having a distinct identity and sense of place.
4. Developing architecture in harmony with its place. (I don’t think Disneyland should be the
design imagery that would be appropriate.)
5. Providing an environment where color, light, acoustics, tactile surfaces and climate control
have been carefully thought out, this will enhance the healing process.
I’m sure there will be other design objectives that will be equally important. Please let me know, my
email address is given at the end of this article.
I am going to conclude with a wonderful quotation about what architects should be doing, from a
lawyer named Roberto Unger, profiled some time back in the Harvard Graduate School of Design
newsletter:
“The architect at his best must make forms enabling people as individuals and as groups to express
themselves by changing their situations. In this manner he becomes like the lover for whom the
fulfillment of the beloved’s life plan is part of his own life project. He lives out his transformative
vocation by assisting someone else’s…”
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