GHESKIO Cholera Treatment Center, 2015, MASS Design Group. Photo: © Iwan Baan

How Architecture Has Responded to Health Emergencies

Of all the things that architecture must achieve, the most elemental is to keep us alive. In the first half of the 20th century, architectural historian James Marston Fitch conceptualized architecture as the essential intermediate layer that permits human beings to thrive on the planet, so poorly adapted are we to survive without shelter, as most other terrestrial species do. A new exhibition at New York’s Cooper Hewitt, Smithsonian Design Museum, Design and Healing: Creative Responses to Epidemics, explores how architecture and design play key roles in making us whole. After all, as licensed professionals, architects are charged to protect the health, safety, and welfare of the public. 

Design and Healing, which runs until February 20, 2023, was conceived just prior to the outbreak of the pandemic that has shaped our lives for nearly two years now, a shared global event. Design is part of a healthcare net that has saved many, but not all. The exhibition is curated and designed by MASS Design Group, in collaboration with the Cooper Hewitt. Michael Murphy, MASS founding principal and executive director, notes in this exhibition that “breathing is spatial,” which has implications at a variety of scales that the exhibition addresses: the human body, the individual building, the city, the globe. The exhibition demonstrates the simultaneously grand and minute scales at which creative design solutions, both current and historical, help keep us alive: personal protective equipment, medical devices, furniture design, social distancing, mechanical systems, hospital and clinic design, even ambient sound in healthcare environments.

Designed for a tuburculosis sanatorium in Paimio, Finland, completed in 1933, the Aaltos created armchairs with slanted backs that eased the pain patients experienced when they breathed or coughed. The Paimio Chair later became an icon of modern furniture design.


For an architectural audience, some of the most engaging content focuses on how buildings can mediate our well-being and help make us well again. MASS Design Group’s work in healthcare over the past decade is well represented, but there are also historical examples of architectural design’s healing power. One of the best is Alvar and Aino Aalto’s scheme for a tuburculosis (TB) sanatorium in Paimio, Finland, completed in 1933. The focus was on designing places of recuperation with abundant sunlight and fresh air. The Aaltos paid close attention to creating what I would call a comprehensive architecture of human empathy. For example: Sinks were designed with generously curved basins to allow water to flow noiselessly down the surface, so as not to disturb patients nearby. Armchairs with slanted backs eased the pain patients experienced when they breathed or coughed, and the chairs’ curved wood surfaces provided a warmer touch on human skin than tubular steel. Indeed, Aalto’s Paimio Chair became an icon of modern furniture design. 

GHESKIO Tuberculosis Hospital, Port-au-Prince, Ouest Department, Haiti, 2015, MASS Design Group. Photo: Iwan Baan


The empathy of a healing architecture is seen in contemporary examples, such as the GHESKIO Tuberculosis Hospital in Port-au-Prince, Haiti, designed by MASS Design Group after the 2010 earthquake. The island was hit with multidrug-resistant TB, from which patients might take a couple years to recover and remain infectious as treatment commences. The response was to create a place of dignity—a word you typically don’t hear much in healthcare design. There’s emphasis on access to shade, fresh air, and color in the hospital environment. Consultations between patients and healthcare providers happen in open-air spaces to help thwart disease transmission, and they also save energy through passive cooling. 

Another Haiti project by MASS, the GHESKIO Cholera Treatment Center, was developed in the wake of the influx of the disease after the earthquake; cholera hadn’t been present on the island prior to the catastrophe, and so people were being treated in tents. This permanent facility collects rainwater for on-site use and recycling (as much as a quarter-million gallons a year, according to the exhibition), natural ventilation, and durable, infection-resistant materials that can withstand repeated chlorine sanitizing. But this building and the TB hospital are not just machines for treating disease. They are humanistic in their use of natural light and ventilation, along with uplifting forms and materials. That uplift is part of the healing process. 

While many projects, both built and in-process, feature lessons learned in taking new directions in the design of healthcare facilities, the exhibition also includes evidence that novel approaches to creating more healthful environments can happen on mundane levels, in vernacular guises, that may permanently change the way we socially interact. 

The StoDistante piazza in Vicchio, Italy, by Caret Studio (based in nearby Florence), 2020.


A visually engaging example is StoDistante piazza in Vicchio, Italy, by Caret Studio (based in nearby Florence). The project makes visual how we calibrate our social distance, often subconsciously, with a series of squares that graduate in size. It’s a wonderful example of how design can seep into the built environment without fanfare, to which we all respond without even thinking about it. Also exhibited is a series of creative yet anonymous sidewalk graphics that give social distancing cues. 

Architecture for healing can arise from vernacular impulses. Across the globe, jerry-built structures on sidewalks and in parking spaces in front of restaurants and humble eateries are now oases of alfresco dining. Dining shelters—some elaborate, others modest—have transformed how we congregate to share meals and public space. Their openness is a key design response to the need for social distancing, good ventilation, and shelter. I suspect they’re not going to disappear anytime soon. They are a new chapter—along with many others—in architecture for healing.

Featured image: GHESKIO Cholera Treatment Center, 2015, MASS Design Group. Photo by Iwan Baan.


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