A sustainable future for Healthcare design
TThe COVID- 19 crisis has brought to the forefront the shortcomings of India’s current healthcare system. While we need 15 doctors and 20 hospital beds per 10,000 people, we only have about half of those numbers, which means that over 70 crore people are underserved by the system. There’s also a huge disparity between urban and rural areas in terms of access to specialised care. These gaps need to be bridged urgently.
REINFORCING THE SYSTEM
The initial course of action should be to reinforce the primary layer of healthcare in urban slums and rural areas, and offer preliminary remedial assistance. Smaller, cost- effective primary healthcare centres and medical sub- centres can be set up as an initial shield in every village, branching out to well- equipped speciality hospitals in every district to cater to the rural population from each of the district’s talukas. Such a system would help relieve the strain on healthcare infrastructure in cities and make it affordable to the masses.
The design of the current stock of healthcare facilities also needs to be looked at through the lens of disease control–– and changes made accordingly. Several studies over the past few months have shown that the spread of COVID- 19 within closed- off, compact and poorly- ventilated spaces is higher than in open spaces. But most hospital campuses today exist as hermeticallysealed, integrated units with deep floor- plates, which results in poorly- lit and poorly- ventilated indoor spaces connected via shared circulation elements like lobbies, double- loaded corridors, and elevator banks. Additionally, dependency on air conditioning has increased so much that 90 percent of the air is recirculated within the building and only 5 percent fresh air is brought in. This increases the possibility of cross infection and contamination significantly, while simultaneously inducing high operational energy costs and maintenance problems.
The better design alternative would be to segregate functions into multiple, separate building wings with reduced widths, and to add buffer zones in between. This would aid natural cross ventilation within indoor spaces, reducing the risk of infection by increasing the rate of air exchange. It’d also avoid interference of services and maintenance areas with procedure areas, allowing for greater isolation of diseases. Independent buildings would need to be zoned responsibly too, and functions segregated within sections or floors by creating general, semisterile and sterile zones ( for example, waiting areas to OPDs to ICUs). In order to dilute and remove contaminated indoor air, air conditioning systems will need to be upgraded to incorporate a three- stage filtration process with UV treatment in the AHU ( Air Handling Unit) or ducts. Integrating automation through technological solutions will also be crucial to limit physical interaction and aid safe distancing.