MASS design group: butaro hospital, rwanda MASS design group: butaro hospital, rwanda
apr 23, 2013

MASS design group: butaro hospital, rwanda

the burera district was one of the most under-served parts of rwanda, one of the last two areas in the country lacking a regional hospital. massachusetts-based non profit firm MASS design group pooled its resources and designed ‘butaro hospital’ as part of a program of partners in health and in collaboration with the government of rwanda. bringing together infectious disease specialists as well as brigham and women’s hospital and harvard medical school to effectively mitigate and reduce the transmission of airborne illnesses, the architecture works with the program, using design strategies in plan, patient and staff circulation and natural cross-ventilation.

one of the hospital’s outdoor paths
image © iwan baan (also main image)



the architecture takes advantage of the temperate climate to create a network of outdoor spaces and a ventilation strategy that changes the air in the ward at least a dozen times an hour using a simple stack principle, wherein hot air rises and is ejected from the building. high-vaulted ceilings and slow moving fans also promote the gentle movement of air.  the hilltop campus is a series of terraced gardens, open courtyards and covered verandahs, that serve the dual purpose of creating gathering areas and preventing infection by eliminating enclosed spaces where possible.

the layered envelope is visible during the ribbon cutting ceremony
image © jay cody



additionally, color coded signs are employed to help patients and families navigate the veranda system and prevent cross-contamination between wards. a spatial triage system is designed to assist the most vulnerable and immune-compromised patients. the architects prioritized air quality as a central design problem because tuberculosis is a leading killer along with HIV; many clinics became sites of infection rather than places for finding care. the building solves to create new standards where infection control becomes a design strategy.

the sloped site required circulation solutions that incorporated the surrounding greenery
image © jay cody

outdoor courtyards become gathering spaces
image © iwan baan

the hospital can become a site for disease prevention instead of intended transmission
image © clinton foundation



the 150-bed flagship facility now serves over 400,000 people and saved 2 million dollars in construction fees by implementing a coordinated construction plan that involved a combination of locally sourced materials, local builders and sustainable practices while employing some 3500 members of the community. volcanic rock from the virunga mountain chain creates one layer of the two-tiered building envelope while the sloped site was fitted with a network of walkways, ramps and stairs. low stone walls double as resting and seating areas, while allowing views of the northern rwandan landscape. the stone-clad labs, wards and treatment centers used ‘jigsaw’ joint technique previously unseen in rwanda and created by on-site local masons. the program includes surgical suites, an emergency room, a pediatric ward, intensive care units and an IT room.


wireless internet is available throughout the hospital and laptop computers can be found at every nursing station. they technology serves the double purpose of serving patients and also allowing medical staff access to educational resources or expert consultations for difficult cases. the architecture’s regard for low-tech measures for patient safety and pertinent, technologically advanced systems make the hospital a model of rural healthcare delivery.

locally sourced stone can become landscaped space
image © jay cody

exterior view
image © MASS design group

courtyards combat infection-prone enclosed spaces
image © iwan baan

image © jay cody

covered verandah view
image © jay cody

‘butaro hospital’ by MASS design group, butaro, rwanda
image © iwan baan

view into one of the wards
image © jay cody

one of the architects traverses the ward
image © jay cody

image © iwan baan

examining room
image © jay cody

main courtyard of the hospital shows clear, color-coded signs
image © MASS design group

the sloped site at dusk
image © jay cody


former president bill clinton at the groundbreaking ceremony of butaro hospital
image © MASS design group

construction view of the foundation-building
image © MASS design group

two bird’s eye views of the construction process
image © MASS design group

the building also posited a new model of construction, employing over 3500 community members
image © global health corps

innovative ‘jigsaw’ joinery was used in the masonry
image © MASS design group

masonry views during construction
image © MASS design group

the stonework is particularly distinct
image © MASS design group

the nearly completed hospital
image © MASS design group

image © MASS design group


site plan




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