Bayalpata Hospital in Nepal wins global design award

Nepal’s Bayalpata Hospital has won an international award in the Health Category at the World Architecture Festival held in Amsterdam on Thursday.

The hospital in Nepal’s Achham district is a public-private partnership between the group Nyaya Health and the Nepal government, and is built almost entirely using rammed earth technology using locally available material with an ambitious zero carbon construction.

‘This is an example of when architecture provides more than a building. Although modest in scale and architectural expression is delivers a massive leap in healthcare provision in a region with scarce resources,’ jury members of the Global Architecture Festival said in their citation. ‘A great example of an architect listening closely and responding intelligently to site and situation. The building is rooted in its site through its use of onsite materials and has impeccable zero carbon design credentials.’

Bayalpata was started by visionary Nepali and American public health experts in 2009, and took over a defunct government hospital to show that accessible and free medical care was possible in a rural Nepal district that had the highest maternal and child mortality and lowest lifespan.

Today, the hospital treats 100,000 patients a year from Achham and six surrounding mountain districts. Paid for mostly by crowd-funding, the $4 million three-phase expansion of Bayalpata Hospital with its state-of-the-art architecture was completed earlier this year.

“Our specs were to use local materials as much as possible, keep energy costs low, and respect the local context,” explains Arun Rimal, a Nepali architect with the US-based Office of Structural Design (OSD). “The rammed earth uses local clay and sand from the river. The thick walls give thermal mass for insulation, and the skylights optimise sunlight and ventilation.” 

The reliance on local material turned out to be a huge advantage because the project faced unforeseen logistical problems due to the 2015 earthquake and Blockade. However, the four-year construction was delayed by just six months because it did not rely too much on bricks, steel and other imported material. 

The facility has a rainwater harvesting system, treats its wastewater and has a network of greywater-irrigated terraces and bioswales to control erosion and recharge the acquifer. A 100kw solar array on the roof meets most of the hospital’s electricity needs, even powering the facility’s only air conditioning unit in the surgical ward. 

“It was a deliberate design decision to work with the natural environment as much as possible and also to address the cultural context,” says Tyler Survant from Sharon Davis Design in New York, which also conceptualised the unique Women’s Opportunity Centre in Rwanda. “We had to plan for a different kind of hospital from the West: here you have patients and relatives who have travelled for days on foot to get here.”

Bayalpata has public outdoor spaces and canopied courtyards to serve as comfortable waiting areas, while the operating theatres and wards are recessed. Unlike in the US, staff housing also had to be integrated into the facility since it has fulltime resident doctors, who live with their families.