Rural health care is a widely diffused issue in developed and developing countries, but the situation is more critical and complicated in the developing world. Rural and remote villages in sub-Saharan Africa suffer from a severe lack of primary healthcare as services are present mainly in cities and because of the difficult access to the services, that represent a barrier that encourages people in rural areas to neglect health aspects and rely more on alternative (traditional) medicine. Let's also not forget the exciting, long-lasting problems, such as infectious diseases, malnutrition, and maternal mortality, that all fall under the word care, and make the situation even more complicated in African villages. In this research, it has been relevant to observe and reflect on the non-architectural (general) solutions that have been already tested, such as using the Information and Communication Technologies- ICT approach, improving the retention of health workers in rural areas by encouraging them to live and work there, and medical conveys and missions. Architectural contributions to rural healthcare in the Sudan-Sahelian region, which extends from East to West between the great Sahara and the tropical part of Africa, are based on collective efforts involving different players, from architects and organizations to municipal governments and even local communities, working together to create an overall experience rather than a final product. The research takes place in the Sudan Sahelian region, Sub-Saharan Africa, which is considered a transformation zone from the Sahara Desert in the North to the more tropical part of Africa in the south. The final site is going to be in one of the villages of Bara city, which is in the North Kordofan region in Sudan. The study goal is to propose a solution for rural healthcare in the region and specifically in the selected villages, setting the baselines of a solution that can be extended to all the regions of Kordofan. Different research methods were used, such as Literature review, interviews, recorded data from reliable sources, and case studies for health projects along the Sudan-Sahelian region, studying the composition, materials, construction techniques, sustainability aspects, and community engagement. The project proposes guidelines based on the user, economic, environmental, flexibility, societal, and cultural factors that will help inform any interventions in that context. After observing the trend in solutions for rural healthcare problems, medical missions and conveys comes to be the most reasonable choice that has been provided, by different institutions (Educational, governmental, and non-governmental) in Sudan. Along with the outcomes and guidelines learned from the case studies, architecture is a powerful tool of change that could be a catalyst for non-architectural solutions to drive change in the miserable reality of rural healthcare. The final research output was a general urban strategy and a design of a rural healthcare unit that would support this strategy, which is based on circulating the professional health workers from the city to the rural villages. Taking advantage of this scarcity of doctors and bringing primary healthcare to rural communities would break up all the access barriers. The proposed health unit reflects the impermanence of the function and would be a flexible module that has a certain level of adjustability to be adapted for different uses and to reflect what is more than a healthcare structure. Creating a strong connection with the community would break the social and cultural barriers and contribute to solving the issue of health buildings in rural areas.
L'assistenza sanitaria rurale è un tema ampiamente diffuso nei Paesi sviluppati e in quelli in via di sviluppo, ma la situazione è più critica e complicata nei Paesi in via di sviluppo. I villaggi rurali e remoti dell'Africa sub-sahariana soffrono di una grave mancanza di assistenza sanitaria di base, poiché i servizi sono presenti soprattutto nelle città e a causa del difficile accesso ai servizi, che rappresenta una barriera che incoraggia le persone nelle aree rurali a trascurare gli aspetti sanitari e ad affidarsi maggiormente alla medicina alternativa (tradizionale). In questa ricerca è stato importante osservare e riflettere sulle soluzioni anche non architettoniche già sperimentate già sperimentate, come l'utilizzo dell'approccio delle tecnologie dell'informazione e della comunicazione (TIC), il miglioramento della permanenza degli operatori sanitari nelle aree rurali, incoraggiandoli a vivere e lavorare in quelle zone, dei viaggi e delle missioni mediche. I contributi architettonici all'assistenza sanitaria rurale nella regione sudanese-saheliana, che si estende da est a ovest tra il grande Sahara e la parte tropicale dell'Africa, si basano su sforzi collettivi che coinvolgono diversi attori, dagli architetti alle organizzazioni, dalle amministrazioni comunali alle comunità locali, che lavorano insieme per creare un'esperienza complessiva piuttosto che un prodotto finale. La ricerca si svolge nella regione saheliana del Sudan, nell'Africa subsahariana, considerata una zona di trasformazione dal deserto del Sahara a nord alla parte più tropicale dell'Africa a sud. Il sito finale sarà in uno dei villaggi della città di Bara, nella regione del Kordofan settentrionale, in Sudan. L'obiettivo dello studio è proporre una soluzione per l'assistenza sanitaria rurale nella regione, stabilendo le basi di una soluzione che può essere estesa a tutte le regioni del Kordofan. La ricerca si è sviluppata tramite una varietà di strumenti metodologici: dallo studio della letteratura, alle interviste, all’analisi di dati registrati da fonti autorevoli, fino allo studio di buone pratiche di progetti sanitari nella regione sudanese-saheliana, analizzandone la composizione, i materiali, le tecniche di costruzione, gli aspetti della sostenibilità e il coinvolgimento della comunità. La tesi propone linee guida di intervento basate sulla specificità dei fattori economici, ambientali, sociali, culturali e di flessibilità. Dopo aver osservato il funzionamento dei progetti esistenti e i problemi di assistenza sanitaria nelle zone rurali, le missioni e i trasporti medici risultano essere la scelta più ragionevole già fornita da diverse istituzioni (educative, governative e non governative) in Sudan. L’architettura risulta essere un potente strumento per il cambiamento ponendosi come un catalizzatore di soluzioni anche non architettoniche che consentano il miglioramento della misera realtà dell'assistenza sanitaria rurale sudanese. Infine, la ricerca ha dato vita ad una possibile strategia urbana correlata da un'unità sanitaria rurale. Infatti, vista la scarsità di medici, la strategia si è basata sulla circolazione degli operatori sanitari professionali dalla città ai villaggi rurali, portando l'assistenza sanitaria primaria alle comunità rurali ed eliminando così molte delle difficoltà di accesso. L'unità sanitaria proposta riflette la mobilità della funzione proponendo un modulo con un un buon livello di flessibilità che possa essere adattato a diversi usi per poter diventare un riferimento per la comunità con la quale crea un forte legame, contribuendo anche ad abbattere le barriere sociali e culturali e a risolvere il problema dei servizi sanitari nelle aree rurali.
More than a health center : reimagining rural healthcare system in North Kordofan region, Sudan
Saeed, Aymen Ahmed Musa
2021/2022
Abstract
Rural health care is a widely diffused issue in developed and developing countries, but the situation is more critical and complicated in the developing world. Rural and remote villages in sub-Saharan Africa suffer from a severe lack of primary healthcare as services are present mainly in cities and because of the difficult access to the services, that represent a barrier that encourages people in rural areas to neglect health aspects and rely more on alternative (traditional) medicine. Let's also not forget the exciting, long-lasting problems, such as infectious diseases, malnutrition, and maternal mortality, that all fall under the word care, and make the situation even more complicated in African villages. In this research, it has been relevant to observe and reflect on the non-architectural (general) solutions that have been already tested, such as using the Information and Communication Technologies- ICT approach, improving the retention of health workers in rural areas by encouraging them to live and work there, and medical conveys and missions. Architectural contributions to rural healthcare in the Sudan-Sahelian region, which extends from East to West between the great Sahara and the tropical part of Africa, are based on collective efforts involving different players, from architects and organizations to municipal governments and even local communities, working together to create an overall experience rather than a final product. The research takes place in the Sudan Sahelian region, Sub-Saharan Africa, which is considered a transformation zone from the Sahara Desert in the North to the more tropical part of Africa in the south. The final site is going to be in one of the villages of Bara city, which is in the North Kordofan region in Sudan. The study goal is to propose a solution for rural healthcare in the region and specifically in the selected villages, setting the baselines of a solution that can be extended to all the regions of Kordofan. Different research methods were used, such as Literature review, interviews, recorded data from reliable sources, and case studies for health projects along the Sudan-Sahelian region, studying the composition, materials, construction techniques, sustainability aspects, and community engagement. The project proposes guidelines based on the user, economic, environmental, flexibility, societal, and cultural factors that will help inform any interventions in that context. After observing the trend in solutions for rural healthcare problems, medical missions and conveys comes to be the most reasonable choice that has been provided, by different institutions (Educational, governmental, and non-governmental) in Sudan. Along with the outcomes and guidelines learned from the case studies, architecture is a powerful tool of change that could be a catalyst for non-architectural solutions to drive change in the miserable reality of rural healthcare. The final research output was a general urban strategy and a design of a rural healthcare unit that would support this strategy, which is based on circulating the professional health workers from the city to the rural villages. Taking advantage of this scarcity of doctors and bringing primary healthcare to rural communities would break up all the access barriers. The proposed health unit reflects the impermanence of the function and would be a flexible module that has a certain level of adjustability to be adapted for different uses and to reflect what is more than a healthcare structure. Creating a strong connection with the community would break the social and cultural barriers and contribute to solving the issue of health buildings in rural areas.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/196858