The nicest houses in town

On March 4, 2013, in health human resources, Rwanada, by Karen Grepin

Butaro, Rwanda

At first I thought I was looking at a picture of a new eco-design hotel somewhere in Africa, but before I was able to pin it to my “places I want to go” board on Pinterest, I realized that that was not at all what I was looking at. No, in fact, what I was looking at was the new doctors’ residences in Butaro, Rwanda built as part of the new Partners in Health led redesign of the health delivery system in Northern Rwanda.

Attracting health workers to rural areas has always been a big challenge (not just in developing countries, but everywhere). In Sub-Saharan Africa the problem is more acute and even basic shelters are sometimes not available. The lack of housing for health workers is believed to contribute to the low density, migration, and even absenteeism of health workers.

Enter MASS, a design firm from Massachusetts who somehow got involved with the PIH project and exit these beautiful little houses that I think most people would agree constitute pretty nice digs. From an article in the Architectural Record:

The two-bedroom houses—roughly 1,300 square feet each—mimic the hospital buildings’ low-slung forms with clay-tile roofs. While they spill down a steep hill, they cluster together in plan. As Dushimimana explained by e-mail: “Courtyards and backyards are important to Rwandan houses. They are where the family and close friends gather.” The houses were constructed with reinforced-concrete frames to make them seismically sound, and with a total of 29,000 compressed stabilized earth blocks (CSEBs) made by local workers with soil from the site. The CSEB walls are covered with plaster and white paint. Some have a second layer of local volcanic stone. Inside, whitewashed walls contrast with muvura-wood roof trusses, cypress and pine furniture, and metal light fixtures—all made by local artisans. The project cost $400,000, a figure that includes the construction of a road, extensive pedestrian paths, and infrastructure to bring water and electricity to the site.

Although I am not quite sure what to make of this project, and my perpetual internal critic of aid projects is already rambling off a list of potential problems with this approach, I am going to turn all of that off for a few moments to just admire these houses. Clearly this experiment with the redesign of the health delivery system is not a standard approach nor is it something that would have ever happened had PIH not been involved, it will be interesting to see if any of it makes any difference (not that they will be able to measure it…argh, stop it critic) and if it doesn’t, well maybe it will be good for tourism. Pin.

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2 Responses to “The nicest houses in town”

  1. Lucy Stevens says:

    And I note that these houses have electricity – which implies that the hospital has electricity. Our new research and publication shows just how important energy access (both electricity and cooking / heating fuels) is for delivering adequate standards of health care. It matters both for the health services that can be offered, and for the ability to retain qualified staff (as you are pointing out with this housing). Take a look at Just launched today!
    Thanks, Lucy

  2. April Harding says:

    I know what you mean Karen. I often feel…somewhat envious of people who feel drawn to, and take satisfaction from, humanitarian action – such as those of PiH. On one level, efforts such as this are admirable; they certainly achieve real benefits. But like you, when I observe them, I am never fully successful in drowning out the voices of the little demons in my head chanting “sustainability” “cost effectiveness” “trade-offs” and the like.

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