Engatonye Maternity Centre

Brent Kokonya
Jomo Kenyatta University of Agriculture and Technology, School of Architecture and Building Sciences, Department of Architecture

Idea projektu

The inspiration for this study is a developing phenomenon in Kenya where county governments with a high Maasai demographic in their respective counties like Laikipia and Kajiado are constructing traditional structures in hospitals for maternity purposes as part of the facilities provided.

This is because the Maasai feel that modern maternity facilities do not respect or allow for them to practise the traditions they adhere to during a woman's nativity and post-partum period.
These traditions include:
1. antenatal seclusion, a period in which the pregnant mother leaves her homestead with a midwife, usually her mother in law or an old female relation and retreats to a special manyatta, where the midwife in this case takes care of her by carrying out chores on her, food preparation as well as dispensing
advice related to maternity
2. celebration of a child's birth in a goat eating ceremony
3. maternal leave in which the mother generally abstained from sexual relations with her husband for a 3 month period for the mother to heal and bond with her baby

According to research conducted by 360 village health, 95% of women in Maasailand give birth at home.

The facility aims to reduce maternal mortality by providing a safe space for women who are strong adherents to Maa culture to give birth while observing cultural rites but under the supervision of professional medical staff.
This would lure women who prefer giving birth in the outback due to cultural practices to come and give birth in the facility reducing cases of women dying during childbirth, a statistic that stands at 500 deaths for every 100,000 live births.

Popis projektu

The project's plan is abstracted from a traditional Maasai homestead.
The centre is comprised of:
1. administration department which is constituted of the clinical officer’s office, nutritionist’s office, public health officer’s office and the finance and account department
2. clinical support facilities which consist of an ambulance loading zone, clean utility room, pharmacy, sluice room and sterile processing department
3. diagnosis and treatment facilities which include an operating suite, pathology lab and a radiology department comprised of MRI and ultrasound
4. main entrance and reception Ambulance liaison officer’s office, concourse, forecourt, interview room and reception desk.
5. non clinical support like a kitchen for the staff, pantry and washrooms for the assisted and semi ambulant
6. outpatient department made of consulting rooms, triage and a vaccination room,
The clinical support, diagnosis and treatment facilities are located at the epicentre as one main clinical centre to make it easier for everyone to easily access them.

The wards are positioned close to the boundary along a circular arrangement similar to how maasai manyattas are laid out in homesteads.
The manyatta wards serve as a waiting area for pregnant women waiting to deliver who as well as a space for them to give birth and recuperate after delivery.

The manyatta wards serve the following purposes:
1. act as a sexual deterrent which stops the man from engaging the pregnant mother in intercourse.
2. provide for the privacy needs of the inhabitants
3. The earthy tones of the wards would enhance the chromo-therapeutic properties of the structure by inspiring primal strength in the mother as she gives birth and recovers.
4. provide for comfort of the users giving a sense of homeliness since they all have a similar design language

Technické informace

The main clinical centre employs the following design strategies:
1. Has acrylic roofing
to allow natural light to filter into hospital spaces enhances convalescence and reduces contraction of nosocomial diseases
This is because natural lighting enhances the circadian rhythm of patients.
2. Has a bobinette/scrim ceiling
This gauze cloth is used as a ceiling fabric to allow for natural light to filter into the space.
The gauze fabric would filter light at varying intensities depending on which spaces it would cover by varying the sizes of the pores
3. Has a pathway which surrounds the main clinical centre
The single loaded pathway follows the same circulation path Maasais use in a traditional homestead albeit connecting the manyatta wards to the clinical
support facilities of the health centre.
The pathway is covered by a mesh which mirrors the folds of the Maasai kilt
with its rectilinear shapes borrowed from the tartan pattern of the kilt.
The pathway performs ta similar function to the kilt as an item of clothing
although in this case, the mesh obscures the manyatta wards from the
celebratory space acting as a transition space between the public celebration
space and the private manyatta wards.

The manyatta wards are adapted to their function through the following ways:
1. Chromo-therapy
Travertine floor tiles and sand faced plaster interior wall finish are used because they have earthy tones with brown, rust and beige hues.
These are colours identified by the local Maasai as invoking primal strength which is fundamental for the mother in the process of childbirth and convalescence.
The red oxide floor finish is seen as a colour of warmth by the local maasai continues the traditional perception of the manyatta as being a place of warmth
2. Privacy
Windows louvres are installed along an axis to enhance privacy, one of the factors Maasai women are keen on during child birth.
The window louvres allow for constant ventilation flow throughout
3. Natural lighting
The wards use recycled PET bottles containing a mixture of water and bleach to diffuse natural light into the space.
The PET bottles are installed on the roof.
This also cuts down the costs incurred due to electricity
4. Scale
The structure is low in height to emphasise a humanistic scale and by extension depict a homely ideal which the mothers look for in place of birth.
This way the mothers feel they are at a home away from home.
The small scale also ensures that the manyattas meld with their environment as much as possible

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