How Can Interdisciplinary Collaboration Best Serve the Growing Healthcare Needs of Africa?

With the second-largest population in the world – at more than 1.3 billion people – and a higher growth rate than any other continent, Africa presents a unique challenge to healthcare professionals, designers, and architects alike.

By the year 2050, the continent will require more than 100,000 new hospitals and countless health centers to serve its exploding population. Beyond the construction there are still a variety of issues that need to be addressed, such as utilizing Africa’s limited financial and environmental resources. While abundant medical research is ongoing, rarely does it consider the relationship of health and the built environment. Jefferson is addressing this problem through the interdisciplinary collaboration between clinicians, industrial designers, engineers and architects to create health infrastructure specifically tailored to serve the growing needs of the African continent.

Chris Harnish, MArch, associate professor of architecture in the College of Architecture and the Built Environment, is the driving force behind Jefferson’s mission in Africa. Professor Harnish joined Jefferson in 2009 and brings with him years of experience with humanitarian architecture and the healthcare climate in Africa. Find out more about Professor Harnish’s research and the questions he’s trying to answer.

Q: What is your research focus?

A: This research is focused on health infrastructure in low-to-middle-income countries (LMIC), humanitarian architecture (architecture that seeks to improve a humanitarian issue) and global urbanization and development. Historically, there’s been a disconnect between the medical and design professions. Architects don’t research and evaluate their design work in the way required for efficient medical evaluation. Meanwhile, medical professionals tend to not contemplate the built environment when they consider patient outcomes or quality of care – particularly in low-resource settings. My work is aimed at bridging that gap.

Q: What’s one question you’re investigating?

A: I’m currently collaborating with OBGYN faculty at Thomas Jefferson University and the Kamuzu University of Health Sciences to study the Queen Elizabeth Central Hospital Maternity Ward, where more than 28 mothers deliver each day in “open-ward” settings. I want to know which architectural factors contribute to patient dignity and healing in high-risk maternity wards in Malawi. In these contexts of limited privacy and limited human resources, architecture can significantly contribute to the maternal birthing experience while improving staff satisfaction and performance.

We aim to link medical literature to architectural design in an evidence-based design methodology. We’ve also conducted design evaluations of Health Centres and Health Posts for the Ministry of Health, and are currently working with them on the design guidelines for Infectious Disease Units in their rapid response to COVID-19.

Q: What first sparked your interest in your area of research?

A: I approach humanitarian architecture from a personal, human-centered environmental ethic. After moving through smaller scale, one-off projects in the humanitarian sector, I came to believe health infrastructure is the most impactful place to apply my skills and passions. Strengthening the health sector and architecture profession in Malawi is the overarching goal of this work, and I strongly believe working within systems is key to equitable humanitarian work.

Q: What’s an interesting fact about your study subject?

A:  There are many. First of all, in Malawi, designers have to worry about the cold as much as the heat, which surprises people from the north. And there aren’t lions walking around downtown Blantyre. There are some interesting aspects of Africa that most people probably don’t realize. For example, Africa has the fastest growing population on earth, and is the most rapidly urbanizing continent on earth. In fact, more than half of global population growth up to 2050 will happen in Africa. By that time, Africa will have 2.5 billion people on the continent. According to my researcher friends at MASS Design Group that means Africa will need to build:

• 700,000,000 housing units
• 300,000 schools
• 100,000 health centers

Every single day that translates to building:

• 7 health centers
• 25 schools
• 60,000 housing units

And let’s not forget that Malawi’s population is currently 18 million with growth projections ranging wildly between 60-100 million by 2100. If Malawi is going to maintain its goal of one health centre per 10,000 people, you’re looking at needing more than 350 health centers in the next decade, just to keep pace. These aren’t easy numbers to achieve. And these projections should serve as reminders that public health and urbanization – amid resource scarcity – are the greatest challenges of this century.

Q: Many researchers have superstitions. Things they’ve done to cosmically help their research work succeed. What are yours?

A:  Speak the local language. Eat the local food. Choose a local soccer team to be your favorite, and keep track of how they’re playing.

Q: What’s the best part of your job?

A: Being an academic who gets to build stuff. I’m principles-driven. This job lets me focus on doing meaningful and impactful work. For me, humanitarian architecture in the health sector is about as impactful as architecture gets.

Q: What’s something people would be surprised to find out about you?

I’m extremely picky about certain things, like cooking, stereo equipment, and choosing the right music for the right time. I collect street art. I love birds.  I can operate heavy machinery. I can tune a chainsaw. I have no fear of being at the top of very high ladders.

Q: Wow, that sounds dangerous! Does that ever come in handy for your work?

A: Sure, it makes people think you’re not a nerdy architect who knows nothing about the way things operate.