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Sunday, 4 November 2018

How beautiful buildings can heal the sick – and make us all feel better

Designing buildings which actually help people get better is surely an obvious thing to do:
Futures Forum: Therapeutic garden at Sidmouth Victoria Hospital >>> "a remarkable transformation to an inviting courtyard"
Futures Forum: The Maggie's Centres: creating 'spaces of calm and light to help support patients and their families'
Futures Forum: The UK’s first ‘garden hospital’
Futures Forum: Design for Wellbeing

An exhibition looks at how this can happen:
Living with Buildings | Wellcome Collection

As previewed here last month:
Futures Forum: 'Living with Buildings' > how architecture affects our lives, our health, our wellbeing

And with a very insightful overview from the i newspaper:

How beautiful buildings can heal the sick – and make us all feel better

Living with Buildings, a new exhibition at the Wellcome Collection, explores how architecture can support and shape human health


Paimio Sanatorium in Finland (Photo: Ben Gilbert /Wellcome Collection) Provided by E.Philippou@wellcome.ac.uk
Tuesday October 2nd 2018

The best architecture can lift the human spirit and has an impact on our health. So how can new structures be designed help improve modern life? Matilda Battersby finds out at a new exhibition

The elegant staircases connecting the seven storeys of the Paimio Sanatorium are an arresting custard yellow. This is no whim or the result of a questionable interior design trend. The bright linoleum, installed in 1933 when the building was constructed in south-west Finland, was chosen by architect Alvar Aalto “to bring sunshine indoors”.

This is just one example of the ways that the sanatorium, now a famous piece of Functionalist architecture, was designed with its patients in mind. When it was built, a TB epidemic was at its height in Finland and the only treatment was exposure to clean air and sunlight. The building was the treatment, the only possible cure, with a top-floor balcony where patients were wheeled out to breathe the air for two-hour intervals, three times a day.

Fast-forward 85 years and TB has been eradicated in Finland. The sanatorium has fallen into disuse – it was put up for sale earlier this year – but it remains a striking example of how architecture can promote healing.

It is one of the main examples going on show as part of Living with Buildings, a new exhibition at the Wellcome Collection in London about how architecture can support and shape human health.


Paimio Sanatorium, Finland (Photo: Ben Gilbert/Wellcome Collection)

Letting the light in


“Buildings can have a powerful influence on feelings of wellbeing,” says Emily Sargent, curator of the show, which opens on Thursday. “Historically, much ill health has been about lack of access to light and clean air.

“If architecture itself can improve those things – through better ventilation, access to outside space and so on – then the building itself becomes a kind of cure.”

The idea of medical facilities as healing spaces filled with light and air became fashionable during the late Victorian era, supported by visionaries such as the nurse Florence Nightingale.

In her Notes on Hospitals, published in 1863, she wrote: “Artificial ventilation may be necessary, [but] it never can compensate for the want of the open window … Second only to fresh air, however, I should … rank light in importance for the sick … Quite perceptible in promoting recovery is being able to see out of a window, instead of looking at a dead wall.”



Florence Nightingale (Photo: Hulton Archive/Getty Images)

Bringing the outside world inside

Her principles were first put into practice in the building of St Thomas’ Hospital in London, from 1861–65, and they continue to be influential, for example in the redesign of Alder Hey Children’s Health Park in Liverpool. Today, it’s a 60,000 metre squared futuristic construction: a three-fingered structure covered by an undulating grass roof overlooking Springfield Park.

According to Benedict Zucchi, principal architect at BDP, the firm that designed the building, the Alder Hey was designed to look like a hill in the park, in contrast to the Victorian behemoth of a hospital that came before.

“The idea for the new hospital was to capitalise on the park, and give children and staff a chance to look out of their windows at a tree or landscape,” says Zucchi. “To provide a positive distraction, to also allow natural light in and create a more positive environment.”

In this way, he sees it as a modern echo of Paimio. “At Alder Hey, patients can go outside and play on the balconies or staff can push the beds out. We wanted to remove that feeling of isolation from the outside world a hospital can give you.”




St Thomas’s hospital in London (Photo: Jack Taylor/Getty Images)

Humanising hospitals

Over the past 100 years, our ideas of what constitutes a medical building have shifted. In the 18th century, European hospital architecture was dominated by the “pavilion plan” – wards arranged in narrow rectangles linked by long connecting corridors.

By the 1960s, there was a shift towards a “patient-centred” approach, which tried to do away with endless corridors. The idea was to “normalise” hospitals: to make them less austere and dated, and more like shopping centres.

This brought its own problems – chiefly that modern hospitals tend to have multiple wings, high-rise buildings, elevator systems, “streets” of shops, a school and places of worship. However well-intentioned, the sheer scale of buildings can overwhelm patients.

Since the 1980s, the emphasis has moved towards “humanising” hospitals. In 2005, the South Tees Acute Hospitals NHS Trust argued that transforming the “inhospitable hospital [could be done] in a range of ways, including providing a sense of control [to patients], external views, positive acoustics, natural light, pleasant fragrances, bodily comfort, varied colour and private space”.


A healthy environment

Understanding and designing for how humans interact with and experience a medical space is something that Aalto had hit upon more than 80 years ago: Paimo’s curved white façade is offset by green-and-orange awnings, a deliberate choice by the architect to reflect the colours of the surrounding pine forest. Inside, every detail was intended to promote a silent, healthy environment.

The humanised approach to designing medical buildings is particularly clear in Maggie’s Centres. These are designed to provide practical and emotional support for people living with cancer. Now dotted across the UK, China and Japan, and with others under construction in Norway, Spain and the Netherlands, they are the brainchild of Maggie Keswick Jencks, who was told in 1993 that her breast cancer had returned and she only had three months to live.

“After leaving the oncologist’s office, she felt she had nowhere to go. She could see a need for a domestic-scale building, a place where cancer patients could go for therapy, or just to sit and think,” says Sargent.




Maggie’s Centre at the Victoria Hospital in Kirkcaldy (Photo: J Mitchell/Getty Images)

‘They feel the building is cuddling and supporting them’

The first Maggie’s Centre opened in Edinburgh in 1996, a year after Jencks’ death.


“All our centres are designed by different architects but they retain the essence of Maggie’s vision; they are warm and welcoming, have a kitchen table at their heart and feel removed from the hospital grounds in which they are situated,” says Diego Alejandro Teixeira Seisdedos, Maggie’s Centre in-house architect.

“People say a weight lifts off their shoulders just walking over the threshold. They feel the building is cuddling and supporting them.”

Jencks’ vision was a direct response to the nature of modern hospitals, which can be cold, unwieldy places, built for practicality and clinical need. These priorities, understandably, can overlook the human experience of being inside such an institution. But, as studies have shown, a positive environment can benefit patient recovery.

In 2018, light, air, beauty and comfort aren’t just considerations for those who are creating hospitals but a major trend in architecture generally.




Paimio Sanatorium, Finland Photo: (Ben Gilbert/Wellcome Collection)

An end to ‘sick buildings’

Designers now work to avoid the problems of “sick buildings” – mould, damp, polluted or contaminated air – while at the same time, cultivating working and living environments that are sustainable for human health, minimising the risk of stress and even loneliness.

This summer the second part of the Well Building Standard was published, a system for scoring a building based on its access to “air, water, nourishment, light, fitness, comfort and mind”.

The first part of this certification, out in 2014, has so far ­encouraged architects of 1,000 office buildings to consider the health of potential workers and ­install biophilic living walls, access to natural light and fresh air, or “circadian lighting”, which are thought to helps boost the body’s immunity and encourage better sleep patterns.




Inside Paimio Sanatorium, Finland (Photo: Ben Gilbert for Wellcome Collection)

Healthy homes

According to the Global Wellness Institute’s Build Well to Live Well report, the next frontier will be a focus on “healthy homes” – those with “natural lighting, air quality, acoustics, proximity to green spaces and exercise facilities, as well as non-toxic paints and finishes”.

These are already in high demand, and the dedicated sector of the global property industry is expected to soar from $134bn (£103bn) to $180bn by 2022.

At the Lakehouse apartment complex – the first building in Colorado to follow the Well Building Standard, set to open in 2019 – air is filtered, black-out shades aid sleep and, in addition to a wellness centre, there’ll be a “harvest room” with a juicing station, designed to encourage sharing of organic vegetables.

Ivan Harbour, a senior design partner at Rogers Stirk Harbour + Partners architects, designed the Cancer Centre at Guy’s Hospital in London as well as Maggie’s West London, which won the 2009 Riba Stirling Prize. He is currently designing a mobile clinic for the charity Doctors of the World.


Uplifting architecture

“The best architecture should be uplifting,” he says. “If the people inside it feel the influence of the building in a negative sense, then you, the architect, haven’t delivered. As a designer, you should consciously and subconsciously feel the effects of the building on the human spirit.

“Designing for health is really about making sure that patients feel positive, whether through things that appeal to the senses, such as light, colour and materials. Or by being able to easily navigate and understand your location within a building.”


It seems that the rules for instigating a therapeutic environment remain true regardless of whether the resident is sick, or simply wishes to remain healthy.

‘Living with Buildings’ runs from 4 October to 3 March 2019, admission free, Wellcome Collection, 183 Euston Road, London NW1 2BE



Paimio Sanatorium, Finland (Photo: Ben Gilbert/ Wellcome Collection)


The perfect building?

The walls inside Finland’s Paimio Sanatorium are rounded, as it was believed germs collected on corners. The sink in each TB sufferer’s private room resembles a urinal, as they were designed to be noiseless by the architect, Alvar Aalto. He even went so far as to design specialist spittoons for TB patients to produce phlegm into, and to invent door handles that wouldn’t catch on nurses’ sleeves.

The windows in Paimio’s recreation room are three metres tall and the ceiling is painted in green lacquer to reflect the pine forest, so that as patients reclined in chairs designed by Aalto and angled optimally for inhalation, they would have seen the shapes of trees dancing above them. Patients may have spent years inside the sanatorium, so Aalto brought the outside in for them.

Not all of Aalto’s designs went down well with the patients at Paimio. Death loomed large over its inhabits (it is estimated around half of patients died), who took issue with the white, curved wardrobes installed in each private room. They looked alarmingly like tombs.


Read more in Long Reads



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