Institute of Medical Sciences | By AHED Associates – Jacobabad ,Pakistan



Institute of Medical Sciences

Type Educational
Location Jacobabad ,Pakistan
Plot Size 15 Acres
Covered Area 115,000 square feet
No of Beds 135
Design Firm AHED Associates

Oasis for Healing: Jacobabad Institute of Medical Sciences

Hospital Sections Include

  • Emergency services
  • Out-patient department
  • in-patient wards, diagnostics
  • maternal
  • child health department,
  • operation theatres, CCU and ICU
  • Thalassemia treatment clinic.
Jacobabad, an agricultural city in northern Sindh province of Pakistan, is a place that gives clear purpose to architectural design. With mean summer temperature of 98 degrees Fahrenheit (37 degrees Celsius) and low rainfall, first and foremost is the need for architecture to respond to the desert climate: to soften its harshness and to harness the natural resources it makes available. Accordingly, in Ahed Associates’ design for the Jacobabad Institute of Medical Sciences (JIMS) – a new district-level hospital in Jacobabad – climate is the prime determinant for all aspects of architecture.
Established with the support of USAID, the newly constructed 130-bed JIMS will be operated and maintained by the Government of Sindh. As a civil hospital it will provide free primary and tertiary health care to a population of nearly two million from upper Sindh and neighboring parts of Baluchistan. Its objective is to significantly improve standards of institutional healthcare available in the catchment area. However, the larger challenge will be to sustain the standard of the hospital long beyond its inception and into the future. Consequently, for Ahed Associates, architectural and infrastructural sustainability is another critical factor in the design of JIMS.
The site is 15 acres of which the current project will be spread over 8 acres including external development and landscaping. The remaining area will be used for future expansion of medical facilities and essential staff housing. The scope of the current hospital includes emergency services, out-patient department, in-patient wards, diagnostics, maternal and child health department, operation theatres, CCU and ICU, and a Thalassemia treatment clinic. Total area is approximately 115,000 square feet.
Human movement is of paramount importance in any medical facility. Respect for visitors and users of the hospital underpins the architects’ circulation design strategy at JIMS. Their design seeks to create a safe, peaceful, and legible space for pedestrians, unimpeded by vehicles and the sun. Pedestrian and vehicular circulation zones are separated from the start. The front of the hospital is on Jacobabad-Suhbatpur Road, the city’s main vehicular artery, along which most visitors will arrive on public transport. An entrance portal at the boundary along the main road clearly demarcates the drop-off point for wagons, taxis and rickshaws, as well as a pedestrian entry gate. From here a paved path shaded by trees leads towards the hospital building set back 150 feet from the noise and dust of the main road. To the west of this path is a cafeteria for visitors’ daily use as well as respite after a tiring commute to the hospital. Adapting the clients’ original brief to contextual realities, the architects proposed the cafeteria as well as a visitors’ “serai” or hostel as necessary additions to the program. Both these amenities are closest to the main road as part of a layering strategy of spaces proceeding from most public to most private. The pedestrian path continues straight into the hospital building which presents a generous portal to welcome the visitor into its protective heart.
The architects have interpreted the topographical context of Jacobabad as an agricultural landscape of predominant horizontality. They therefore chose to echo this in the proportions of the hospital building form, raising it no more than two floors above ground level. One and two-storey departmental blocks are organized around a square central courtyard as main waiting space with aspect ratio (height to width) of 1:2. The double-storey blocks are placed at the west and south sides of the courtyard to provide shade through building height.
Circulation porticos covered by a roof-top pergola surround this courtyard, tying the blocks together in a unified arrangement of forms. The pergola ensures that human movement between departments always takes place under protection from the strong Jacobabad sun. It overhangs a quarter depth of the courtyard on all sides to create a sheltered outdoor waiting space on ground floor, while opening a central void to the sky for tall trees to grow. In the center of the courtyard is a water fountain to help cool the waiting space. The semi-covered central courtyard surrounded by continuous porticos has a number of advantages. It creates shade and coolness as well as a space for natural vegetation. It facilitates way-finding by serving as a visible reference point for people circumambulating it and by allowing all departments to be visible through its double-height void and open porticos. The visibility of people moving in these porticoes or seated in the courtyard imparts a sense of security and community to the hospital. Smaller courts within and between individual department blocks provide deep shade and privacy into which windows open for fresh air, soft natural light, and views of greenery. Windows are deep recessed for shade and deployed for cross-ventilation in all spaces except ICU and operation theatres which are air-conditioned. In the double-storey ward block a wing-shaped canopy above roof level and windows at both floors work together to create a stack effect, pulling cooler air into the wards. A water cascade in a double-height patio under the canopy further lowers temperature for the wards.
Materials, landscaping and solar devices also contribute to a sustainable hospital building in a desert climate. At JIMS the architects have relied on increased thermal mass of the building envelope to retard heat transfer to keep interiors cool during the day and warm in the chilly desert night. External walls are composed of two layers of concrete masonry with polystyrene insulation in between, and 2 inches of concrete facing as external cladding. Additionally, this external layer makes year-to-year maintenance easy by serving as a durable cover over wall surfaces. Vegetation will work in tandem with architecture to ameliorate the climate inside the building: trees are planted along external walls to protect them from the brunt of the sun’s heat and glare, to filter dust away from interior spaces, and to create pleasant views from windows. In waiting courts trees  accompany benches to lend shade and closeness to benign nature. Date palms line the edges of the site with the city as a contribution to greenery in Jacobabad. The architects selected a variety of vegetation including trees, shrubs and ground cover suited to the local ecosystem. This should serve as a precedent for future planting of vegetation in Jacobabad.
Solar panels to harvest energy from the sun have been placed on the roofs. These provide an installed capacity of 88KW, sufficient to support general lighting at the hospital. Solar heaters will be used to heat water for winter, and solar pumps to run the fountains in the courtyards.
Ahed Associates design for JIMS seeks to create an environment conducive to providing excellent medical care within the economic resource constraints of a developing country. In doing so it responds to the extreme nature of Jacobabad’s local climate in a manner that creates spaces comfortable for human occupation and functioning, and respects the local social context within which medical care is given and received.



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