PMMT uses its 'fluid hospital' methodology to design an innovative healthcare center in ecuador

design firm PMMT, based in barcelona and madrid, recently completed the new manta hospital, located on the coast of ecuador. as the firm’s third healthcare center in the country, the new manta hospital covers over 24,000 sqm and offers services to 200,000 inhabitants of the city of manta. the project has become landmark within the city and a benchmark for future healthcare developments due to its three main features.

PMMT designed the hospital with three features that make it one of the most innovative hospitals internationally. its universal accessibility measures, that make it absolutely inclusive; the hyperflexibility achieved by its parametric design system; and the earthquake-resistant structure and façade. in 2016, the province of manabí suffered a devastating earthquake that completely destroyed the former manta hospital. given this context, the construction of the new equipment was needed as soon as possible. 

it was decided to build a new health center following the parameters of a ‘fluid hospital’, a methodology created and developed by PMMT architecture. the ‘fluid hospital’ typology created by PMMT whose conceptualization and design are the result of a standardized method that starts with an in-depth analysis of the metric that defines the building, enabling an important time reduction fort the design, construction, equipment and commissioning processes. previously, PMMT had already designed and built two other hospitals in ecuador in the cities of machala (2016) and puyo (2013). both buildings were also a response to the need of being built in record time – less than a year from the beginning to the end of construction – and with a tight budget. 

such working methodology consists in defining those parameters which, correctly combined, guarantee the good functioning of the healthcare building as well as its adaptation to future changes. this involves parametrizing the organization and location of the corridors according to their use (public, private, maintenance, supplies, etc), the metrics of the layout and blocks, the modulation of the façade, the strategies for future extension, vehicular access, the location of the installation galleries and other regulations that are vital for the beginning of the construction works. 

the manta hospital incorporates a structure capable of resisting earthquakes with standards that exceed the public regulations. the façade was designed to minimize damages that can hurt people or stop the functioning of the hospital. an articular system was implemented so that all the efforts that occur in the structure are not transmitted to the façade nor the carpentry, and are absorbed in a spring system that guarantees flexibility between the different elements. 

also, the use of polycarbonate resulted in a light and high-performance façade, able to withstand an earthquake through joint technology on a formal level. the white color that defines the skin of the entire building stands out contrasting with the colorful local architecture. in addition, the orthogonal image of the plot inherently organizes the spaces on the floor as the hospital is distributed in wide general circulation corridors and open waiting areas. 

the different accesses allow the position of the four facades oriented towards the cartesian points. the building, shaped like a large horizontal prism perforated by patios, is a modular, extroverted, moldable, fluid, flexible, interchangeable, polycentric, sectorized and functional. 

the hospital is made of single 7x7m basic modules, articulated according to the level of access to the different services. the modules are placed from bottom to top the most restricted areas, the ambivalent areas, and the public ones. these areas are connected perpendicularly by wide ‘covered streets’. likewise, there is a large exterior promenade which runs perpendicularly to the north entrance that picks up staff/patients from their respective car parks. the rest of the site is landscaped using the same scheme as the built area.

the design is ‘extroverted’ due to its openings to light through large windows and interior patios. the façades are treated as a barrier to the hostile conditions of the surroundings (roads and climate), closed to east and west, and opened to the more favorable north and south, allowing optimum ventilation. PMMT designed the hospital to be manageable and open within itself. the corridors gain width in order to form the waiting areas, passage areas, connection areas and patios. these extra-wide corridors blur the division between circulation areas and working areas.

the extreme parameterization of all the hospital parts and systems goes one step further in creating a highly flexible building. the distribution of the different areas can be turned or inverted, and most of the areas can even be swapped. this versatility enables to expand the hospital through new pavilions or buildings in the future. 

by placing the entries at the ends of the modules, these do not interfere with future redistributions or extensions, creating an interchangeable project. the simple and effective scheme of the project facilitates an easy extension of the building towards the south, so that any necessary modules can be added.

the spaces have no hierarchy, creating a multi-nodal and polycentric hospital. the project boasts empty spaces such as waiting areas, corridors, patios, as well as filled spaces like rooms and pavilions. the building dialogues with the environment, being protected from the outside views and possible interferences through the differentiation of the pavement, the vegetation, and other elements. the hospital is also sectorized, open to different schedules and functions, and with differentiated entrances: to the east, the main entrance; to the west, emergencies and provisioning, for example.

the hospital’s distribution is based on transparent criteria, enabling easy accessibility and an immediate relationship with the areas of attention and consultation. all the areas that have direct access for the users are placed in the west side of the building (consultations, cabinets, administrative areas, direction and user support) and the spaces with double access – public and technical – are located in the central area of the hospital (radiology, hospitalizations). the most restricted areas that have an alternative access from the outside, are located at the west side (surgical block, emergencies, warehouses, kitchen, pharmacy…). finally, the parking lot is situated next to the general access and on the side road.

due to the innovative methodology of the ‘fluid hospital’, the manta hospital has recently been awarded with a mention at the bbconstrumat 2019, among other recognitions. the award is a recognition of PMMT’s commitment to innovative constructive parameters always thought to be at the service of people.

project info:

architecture: PMMT

project name: new manta hospital

location: ecuador

designboom has received this project from our ‘DIY submissions‘ feature, where we welcome our readers to submit their own work for publication. see more project submissions from our readers here.

edited by: cristina gomez | designboom