Energency NGO Started the site construction activities of the Centre of Excellence in Paediatric Surgery in Uganda

1. EMERGENCY e Renzo Piano Building Workshop
Centre of Excellence for Paediatric Surgery
Uganda

2. 2 3
Centre of Excellence
for Paediatric Surgery
Millions of children die every year simply because they have no
access to health care. Lack of resources? Lack of interest for
the sufferings of many? Lack of social responsibility from the
Governments? Or all of the above?
Whatever the reason, the question remains: shall we continue
to tolerate this scandal, or shall we make every effort to save or
improve the life of millions of fellow human beings?
We are all part of the human community, we are “equal in dignity
and rights”, as stated in the Universal Declaration of Human
Rights. If and when the “right to life” is violated, no matter who
is the victim, it’s a piece of humanity that gets lost, forever. This
humiliated and suffering humanity needs an answer now. They
cannot wait further for health care to become “high quality and
free of charge for all”.
EMERGENCY builds and runs hospitals. Hospitable places
where all those in need can be treated, looked after without any
discrimination and free of charge, with quality and respect.
EMERGENCY’s experience testifies that establishing centres
of medical and surgical excellence is feasible even in the most
difficult and deprived situations, and I hope we will find support
in continuing and expanding this practice of medical science and
social responsibility.
The next big challenge is to establish a Centre of Excellence in
Paediatric Surgery in Uganda, on the Victoria Lake. Children will
come from all over Africa, children from different Countries and
with different problems.
Just as patients with heart problems did come from 26 Countries
to the Salam Centre for Cardiac Surgery, on the outskirts of
Khartoum, Sudan, opened by EMERGENCY in 2007.
They deserve a beautiful hospital, a place full of joy and love,
something to give back a bit of hope, a possible future.
The hospital will also be the perfect setting for qualified training
of young doctors and nurses from Uganda and beyond. We want
to establish a facility that will effectively contribute to build local
capacity and have a long term impact.
When my friend Renzo accepted the offer to imagine, design,
realize this hospital, when he got deeply involved in this project, I
felt happy and relieved. He will make it, we will make it together:
“Renzo Piano for EMERGENCY”. Grazie, thank you Renzo.
Gino Strada
EMERGENCY
When Gino Strada asked me to participate in this new challenge,
I didn’t think twice and immediately said: Yes!
One of the reasons is that it is almost impossible to resist Gino’s
proposals. But the truth is that I do like to think of Africa as a
workshop for the future not just as the scene where sufferings
and forgotten wars take place.
This new children’s hospital in the heart of Africa will be a model
of medical excellence, environmental sustainability, energetic
independence and harmonious space distribution: we want
to utilize the resources of the earth, water and sun, the best
achievements of modernity, the real one.
The hospital will be built in a healthy location, on Lake Victoria,
surrounded by nature and trees. The greenery will be the close
horizon of the little guests: the trees as a metaphor for their
healing process.
A hospital featured with the best equipment and the best doctors,
with special attention dedicated to areas for living, for playing and
for teaching and training the local staff.
Gino always asked me to design a “scandalously beautiful”
building. He talks about the scandal of beauty because for
selfish people it is a scandal to offer beauty and excellence to all,
particularly to the disadvantaged and marginalized ones.
On the other hand, it is well known, that in all African dialects,
the idea of beauty goes always with the idea of good: there is no
beauty without good.
The strength of EMERGENCY is based on this focus on beauty
as well as on the practice of medical excellence, the sense of
justice, the rejection of war and the pursuit of harmony.
Renzo Piano
RPBW
Health, beauty and respect
for human rights

3. 4 5
Index
WHO WE ARE
Emergency NGO
The RPBW company's history
Emergency and RPBW
company's timelines
THE HUMANITARIAN PROJECT
A cultural opportunity
The needs
The ANME
The aims of the project
The facility
Not only Uganda
Why excellence is a tool
The human resources
A teaching hospital
On the children's side
THE ARCHITECTURAL PROJECT
Between land and water
Energy autonomy
A building born out of the ground
Wall termal inertia
The sun for a ceiling
A terrace on the lake
Healing greenery
A machine to provide health care
Colours and materials
Imagining light
Timing and budget

4. 6 7
Who we are
EMERGENCY is a neutral and
indipendent organization, founded in 1994
to provide free, high quality medical and
surgical treatment to the victims of war,
landmines and poverty and to promote
a culture of peace and human rights.
In these first 21 years, EMERGENCY
has treated more than 6 million patients.
One every 2 minutes.
Over 80% of the funds raised
by EMERGENCY comes from private
individuals, businesses, foundations.
The other 20% comes from international
agencies and governments
of the countries where we work, who have
decided to support our intervention.
EMERGENCY employs over 90%
of the funds raised to achieve its statutory
purposes: to provide free medical care
to those in need and promote a culture
of peace and respect for human rights.
What we do
Where we are
How we use the funds
Manifestofor a human rights based medicine
After the International Workshop “Building Medicine in Africa. Principles and Strategies”
Venice, Italy, May 2008 and in accordance with the spirit and the principles
of the Universal Declaration of Human Rights, stating that:
“All human beings are born free and equal in dignity and rights”
“Everyone has the right…to medical care”
“The recognition of the inherent dignity and of the equal and inalienable rights of all members
of the human family is the foundation of freedom, justice and peace in the world”
Social responsibility
Governments must have
the health and well being
of their citizens as their priority,
and allocate adequate
human and financial resources.
The services provided by health
systems and humanitarian
projects in the health sector
must be accessible to and free
of charge for all.
we hereby declare
the “Right to be Cured” as a basic and inalienable right belonging to each
and every member of the human community.
we therefore advocate
the implementation of health systems and projects solely devoted to preserve,
extend and improve the life of the people in need and based on the following principles:
Equality
Every human being has
the right to be cured regardless
his economic and social
condition, gender, race,
language, religion and opinions.
Standards of health care,
set by the progress of medical
knowledge, must be delivered
equally and without
discrimination to all patients.
Quality
High quality health systems
must be based
on community’s needs,
up to date
with the achievements
of medical science,
and not oriented, shaped
or determined by lobbies
and corporations involved
in the health industry.
we recognize
EQS (Equality, Quality, Social responsibility) based health systems and projects
as respectful of human rights, appropriate to develop medical science
and effective in promoting health by strengthening and generating human,
scientific and material resources.
we commit
To plan and develop EQS based policies, health systems and projects.
To cooperate among us to identify common needs in the health sector
and design joint programmes.
we appeal
To other Health Authorities and Humanitarian Organisations to sign this Manifesto
and to join in promoting an EQS based medicine.
To donors and to the international aid community to support, fund and participate
in designing and implementing EQS based programmes.
Italy
Clinic for migrants and people in need, Palermo
Clinic for migrants and people in need, Marghera (VE)
Clinic for migrants and people in need, Polistena (RC)
Clinic for migrants and people in need, Castel Volturno (CE)
5 Mobile clinics
1 Information desk for health and social orientation, Sassari
Sierra Leone
Paediatric Centre, Goderich
Surgical Centre, Goderich
Central African Republic
Paediatric Centre, Bangui
Intervention of a surgical team at the Complexe Pédiatrique, Bangui
Sudan
Paediatric Centre, IDP Camp in Mayo Khartoum
Salam Centre for cardiac surgery, Soba, Khartoum
Paediatric Centre, Port Sudan, Red Sea State
Iraq
Rehabilitation and Social Reintegration Centre, Sulaimaniya
Professional and Training courses
323 Cooperatives for disabled persons
5 Health centres in refugees and IDPS camps
Afghanistan
Medical and Surgical Centre, Anabah
Maternity Centre, Anabah
Surgical Centre for war victims, Kabul
Surgical Centre for war victims, Lashkar-gah
40 First Aid Posts and Health Centres
We build and run hospitals open
to everyone in need
without any discrimination.
We send surgical teams in emergency
situation.
We train national staff thoroughly,
with the intent of handing over
all the health facilities to the local health
authorities as soon as self-sustainability
can be achieved.
EMERGENCY

5. 8 9
From 1994 to the present day, EMERGENCY has worked in 16
countries, building hospitals, Surgical Centres, Rehabilitation
Centres, Paediatric Clinics, First Aid Posts, Primary Health Clinics,
a Maternity Centre and a Centre for Cardiac Surgery.
Since 1994, EMERGENCY teams have provided assistance to over
6 million people.
Surgical Centre
Opened: November 2001
Activities: Emergency and General
Surgery, Orthopaedic and Reconstructive
Surgery, Trauma Surgery.
Facilities: Emergency Department,
Outpatient Department, 3 Operating
Theatres, Sterilization, Intensive Care
Unit, Patient Wards, Physiotherapy,
Radiology, Laboratory and Blood Bank,
Pharmacy, Classrooms, Playroom,
Auxiliary Facilities, Guesthouse for
patients and their parents.
Number of beds: 85
Salam Centre for Cardiac Surgery
Opened: April 2007
Activities: Paediatric Cardiac Surgery,
Adult Cardiac Surgery, Interventional
Cardiology.
Facilities: 3 Operating Theatres,
Sterilization, 15 beds Intensive Care
Unit, Sub-intensive Care Unit, 3 Surgical
Wards, Outpatient Department,
Catheterization Laboratory, Radiology,
Ultra Sound, TC, Laboratory and Blood
Bank, Physiotherapy, Pharmacy, Technical
and Auxiliary Facilities, Guesthouse
for foreign patients.
Number of beds: 63
All EMERGENCY facilities are
designed, built and run by specialized
international personnel, who provide
training for local staff.
EMERGENCY ngo hospitals
Medical-surgical Centre
Opened: December 1999
Activities: Surgery for war and landmine
victims, Emergency Surgery, General
Surgery, Trauma Surgery, Internal Medicine,
Paediatrics.
Facilities: Emergency Department,
Outpatient Department, 2 Operating
Theatres, Sterilization Room, Intensive
Care Unit, Surgical-Medical Wards,
Physiotherapy, Radiology, Laboratory
and Blood Bank, Pharmacy, Classrooms,
Playroom, Auxiliary Facilities, Maintenance
Department
Number of beds: 56
Afghanistan, Anabah, Valle Panshir
Maternity centre
Opened: June 2003
Activities: Obstetrics, Gynaecology,
Neonatology.
Facilities: Emergency Department,
Outpatient Department, 1 Operating
Theatre, Intensive Care Unit, Wards,
Nursery, Ultrasound Room, Delivery Room,
Diagnostics, Technical and Auxiliary
Facilities shared with the Medical-Surgical
Centre.
Number of beds: 39
Afghanistan, Anabah, Valle Panshir
Surgical Centre for war victims
Opened: September 2004
Activities: Surgery for war and landmine
victims.
Facilities: Emergency Department,
Outpatient Department, 2 Operating
Theatres, Intensive Care Unit, Surgical
Wards, Physiotherapy, Radiology,
Laboratory and Blood Bank, Pharmacy,
Classrooms, Playroom, Auxiliary Facilities,
Maintenance Department.
Number of beds: 90
Afghanistan, Lashkar-gah
Sierra Leone, Goderich
Sudan, Khartoum
Afghanistan, Kabul
Surgical Centre for war victims
Opened: April 2001
Activities: Surgery for war and landmine
victims.
Facilities: Emergency Department,
Outpatient Department, 3 Operating
Theatres, Sterilization, Intensive Care
Unit, Sub-intensive Care Unit, Surgical
Wards, Physiotherapy, CT Scan, Radiology,
Laboratory and Blood Bank, Pharmacy,
Classrooms, Playroom, Auxiliary Facilities,
Maintenance Department.
Number of beds: 95
EMERGENCY builds and run:
– hospitals specifically dedicated to war victims and surgical emergencies;
– physical and social rehabilitation centres;
– first aid posts for emergency treatment and referral of patients to our surgical centres;
– healthcare centres for primary medical assistance;
– paediatric clinics;
– maternity centres;
– outpatient clinics and mobile clinics for migrants and people in need;
– centres of medical excellence.

6. 10 11
The Renzo Piano Building Workshop
(RPBW) is an international architectural
practice with offices in Paris, Genoa and
New York City.
The Workshop is led by 14 partners,
including founder and Pritzker Prize
laureate, architect Renzo Piano. The
company permanently employs nearly 130
people. Our 90-plus architects are from all
around the world, each selected for their
experience, enthusiasm and calibre.
The company’s staff has the expertise to
provide full architectural design services,
from concept design stage to construction
supervision. Our design skills also include
interior design, town planning and urban
design, landscape design and exhibition
design services.
Since its formation in 1981, RPBW has
successfully undertaken and completed
over 120 projects across Europe, North
America, Australasia and East Asia.
Among its best known works are: the Menil
Collection in Houston, Texas; the Kansai
International Airport Terminal Building in
Osaka; the Kanak Cultural Center in New
Caledonia; the Beyeler Foundation in
Basel; the Rome Auditorium; the Maison
Hermès in Tokyo; the Morgan Library
and the New York Times Building in New
York City; and the California Academy
of Sciences in San Francisco. Recently
completed works include the Isabella
Stewart Gardner Museum extension in
Boston, the Shard in London, and the
Astrup Fearnley Museum in Oslo.
The quality of RPBW’s work has been
recognised by over 70 design awards,
including major awards from the American
Institute of Architects (AIA) and the Royal
Institute of British Architects (RIBA).
In all our work we aim to address the
specific features and potential of a
particular situation, embracing them
into the project while responding to the
requirements of the program. We continue
to push the limits of building technology –
innovating, refining and experimenting – to
come up with the very best solution for
each situation. Our method of working is
highly participatory, with clients, engineers
and specialist consultants all contributing
from the beginning of a project and
throughout the design process.
Our approach to design is not strictly
conventional and involves the use of
physical models and one-to-one scale
mock-ups to help test and develop our
proposed design concepts. We also believe
that the design process is not linear and
that it requires architects to think and
draw on different scales at the same time,
considering each finished detail in the
development of the overall design.
Many awards including:
2013
Named a Senator for Life by the Italian
president, Giorgio Napolitano.
2010
Raffaello Prize - Eccellenze del Made in
Italy,Palazzo Produttori, Fermo, Italy
2000
Officier, Ordre National de la Légion
d’Honneur, Paris, France Leone d’Oro for
the career, Venice, Italy (name: Golden
Lion for Lifetime Achievement, Venice,
Italy) Premio Leonardo, Palazzo del
Quirinale, Rome, Italy
1998
The Pritzker Architecture Prize, The White
House, Washington, U.S.A.
1994
Goodwill Ambassador of Unesco for
Architecture
“... this translates into an idea
common to nearly all my projects
of a collective nature:
to raise the specialised functions
or foundations eight or ten metres above
the ground, setting aside the ground floor
as a comunal area
where people can come together
and mix...
Architecture is the art of responding to real needs,
but it's also the art of answering people's dreams...
If the moral element is missing, then the part
that responds to people's needs is a betrayal”...
“What convinces me to accept a specific project
is the possibility it offers to create architecture
that is above all a public place...
...a meeting point not only for people but also for a wide range
of disciplines that, for different reasons and in different ways,
tackle the issues of knowledge and diffusion.”
Renzo Piano Building Workshop
...a hybrid realm that encourages dialogue
and conversation
between the various occupants
of the building, and between them
and the city all around.”
Renzo Piano
Architecture and Design
Awards

7. 12 13
2011
2009
2017 2017
2013
2008
2007
2010
2012
2006
1999
1994
1995
2002
2001
2003
2004
2014
Missions of war surgery and obstetrics in Kigali, Ruanda
CAMPAIGN AGAINST THE LANDMINES
1996/2005 Surgical Centre of Sulaimaniya, Iraq
Rehabilitation Centre of Sulaimanaiya, Iraq
1998/2005 Surgical Center of Erbil, Nord Iraq
Surgical Centre of Battambang, Cambodia
Paediatric Centre in Goderich, Sierra Leone
CAMPAIGN “CEASE FIRE” 2003
Support at Al-Kindi hospital in Bagdad and Kerbala, Iraq
Maternity Centre of Anabah, Afghanistan
2003/2004 Centre Prosthesis and Rehabilitation
in Medea, Algeria
Centre Prosthesis and Rehabilitation in Dohuk,
Nord Iraq
2003/2004 Renovation of health Centres in Benguela, Angola
Mission of surgery to the public hospital in Jenin, Palestina
Delivery of drugs to the Casa de la mujer, Nicaragua
Support for widows and destitute women of the Panjshir Valley,
Afghanistan
Surgical and medical Centre, Afghanistan
Mission of war surgery in Asmara, Eritrea 2000
Jovanovic Zmaj Jova support the orphanage
in Belgrado, Serbia
CAMPAIGN “A SHRED OF PEACE”
2001/2002 Centre Prosthesis and Rehabilitation to Diana, Iraq
Aid program for war widows in Panshir, Afghanistan
2001 Surgical Centre of Goderich, Sierra Leone
2002 CAMPAIGN “ITALY OUT OF THE WAR”
2003/2012 Online newspaper PeaceReporter
Surgical Centre of Lashkar-gah, Afghanistan
Start of preventive medicine activities in Port Sudan, Sudan
Aid to the people of Falluja, Iraq 2004
Start of emergency surgery courses, Afghanistan
Reconstruction of the department of emergency
surgery in Al Fashir hospital in North Darfur, Sudan 2004/2005
Start of project for the prevention of sexually transmitted diseases
in sex workers, Italy
Support the hospital in Kalutara, Sri-Lanka 2005
Opening of FAP in Tagab, Afghanistan
Start of blood bank project, Central African Republic
Opening of FAP in Arbat camp, Iraq, for Syrian refugees
Opening of FAP in Andar, Afghanistan
Opening of Ebola Treatment Centre in Lakka, Sierra Leone
Opening of second health centre in Arbat camp, Iraq,
for Iraq refugees
Paediatric Centre of Bangui, Central African Republic
Start of mobile clinics, Italy
Mission of war surgery in Misurata, Libia
CAMPAIGN “IT CAN ONLY BE ABOLISHED”
Paediatric Centre of Port Sudan, Sudan
2011 MANIFESTO “THE WORLD WE WANT”
Salam Centre for Cardiac Surgery in Khartoum, Sudan
Clinic in Marghera, Italy
Paediatric Centre of Nyala, Darfur 2010/2011
MANIFESTO “I STAY WITH EMERGENCY” 2010
New First Aid Posts (FAP), Afghanistan
Information desk for social and health orientation
in Sassari, Italy
2005
Paediatric Centre of Mayo, Sudan
2005/2007 Assistance to inmates
Rebibbia New Complex Roma, Italy
2005/2008 Reconstruction of houses in the village
of Punochchimunai, Sri-Lanka
Clinic in Palermo, Italy
MANIFESTO FOR A HUMAN RIGHTS BASED MEDICINE
Information desk for social and health orientation in Sicily, Italy
Opening a Clinic in Polistena, Italy
Launching of 2 new mobile clinics in Italy
Opening 4 new FAPS in Afghanistan
Opening of FAP in Sheikhabad, Afghanistan
Politruck, Italy
Opening of FAP in Waterloo, Sierra Leone
Opening of Ebola Treatment Centre in Goderich, Sierra Leone
Mission of war and emergency surgery in Bangui,
Central African Republic
Centre of Excellence for
Paediatric Surgery, Entebbe, Uganda
Centre of Excellence for
Paediatric Surgery, Entebbe, Uganda
1971-1977
Centre Georges Pompidou,
Paris, France
1983-1986
IBM Travelling Pavillion,
Roma, Italy
1979
Otranto Urban Regeneration Workshop,
Otranto, Italy
1982-1986
The Menil Collection,
Houston, U.S.A.
Lingotto Factory Conversion,
Torino, Italy
1983-2002
1992-1997
Beyeler Foundation Museum,
Riehen, Switzerland
1988-1994
Kansai International Airport Terminal,
Osaka, Japan
1991-1998Jean-Marie Tjibaou Cultural Center,
Noumea, New Caledonia
1992-2000
Potsdamer Platz,
Berlin, Germany
1999-2005
Zentrum Paul Klee,
Bern, Switzerland
Parco della Musica Auditorium,
Roma, Italy
1994-2002
1998-2006
Maison Hermès,
Tokyo, Japan
1999-2005
High Museum Expansion,
Atlanta, U.S.A.
2000-2008
California Academy of Sciences,
San Francisco, U.S.A.
2000-2006 Renovation and Expansion of the Morgan Library,
New York, U.S.A.
2000-2007
The New York Times Building,
New York, U.S.A.
2002-2010
Central St. Giles Court Mixed-use Development
London, United Kingdom
2005-2012 Renovation and expansion
of the Isabella Stewart Gardner Museum, Boston, U.S.A.
2006-2011
Ronchamp Gatehouse and Monastery,
Ronchamp, France
2000-2012
London Bridge Tower,
London, United Kingdom
2006-2012
Astrup Fearnley Museum of Modern Art,
Oslo, Norway
Whitney Museum of American Art, New York
2007-2013
Kimbell Art Museum Expansion,
Fort Worth, U.S.A.
2002-2013
MUSE Museo delle Scienze,
Trento, Italy2010-2012
Auditorium del Parco,
L'Aquila, Italy
2007-2015
Renzo Piano Building Workshop
Surgical Centre in Kabul, Afghanistan
EMERGENCY

8. 14 15
Our vision of Africa has recently undergone a slow but steady
development, from neglected continent to the new frontier of an
evolving world.
The challenge of this new project of EMERGENCY NGO is
to combine the practical requirements of a paediatric surgery
hospital in Africa with the desire to create a model piece of
architecture: rational, tangible, modern, beautiful, but firmly linked
to tradition. It will be more than a mere hospital: it will be the first
architectural work in Africa designed by Renzo Piano who, over
the past decades, has actually written the story of architecture.
This project is a sign of extreme symbolic importance for the
promotion of health care and culture in Uganda and in the whole
of Africa.
A cultural opportunity

9. 16 17
The needs
What if children can’t get the surgery they need
As stated by World Bank President Jim Kim, “Surgery is an
indivisible, indispensable part of health care”. The burden of non
communicable diseases and injuries is increasing at an ominous
pace, making integration of surgery and anaesthesia care critical
to achieving the newly evolving Sustainable Development Goals
(SDGs). Without immediate attention and scale-up, absence of
surgical care will not only continue to result in preventable death
and disability for millions, but is also estimated to reduce the
gross domestic product of low and middle income countries by
as much as 20% by 2030 (The Lancet Global Health, April 2015,
special issue on Global Surgery).
In particular, many surgical conditions of childhood are amenable
to simple surgical intervention, but if left untreated, complications,
lifelong disability or death can ensue.
It has been estimated that 85% of children in low-income
countries are likely to require treatment for a surgical condition
by the age of 15 years (WHO Bullettin, Paediatric surgery and
anaesthesia in south-western Uganda: a cross-sectional survey,
2010).
Uganda, a low-income country, faces considerable challenges
in the provision of paediatric surgical care. Of its rapidly-growing
population of 37.6 million, 48% is under 15 years of age.
Uganda's population demographics, expenditure on health care
and health-care outcomes are typical of low-income countries in
sub-Saharan Africa.
Postgraduate training opportunities for physicians are limited;
only 10 trainees complete postgraduate training in surgery in the
country each year.
The Under-5 mortality was estimated as 138 per 1,000 live births; WHO Country Health System Fact Sheet 2006
a WHO evaluation of the trends in child mortality reduction clearly
indicates that the Millennium Development Goal concerning child
mortality (MDG4) will be highly unattended.
Ensuring proper surgical paediatric care is a high priority to
contribute to an accelerated reduction of child mortality in Uganda
and in its neighbouring countries.
The ANME
Building an African Network
of Medical Excellence
The need of paediatric surgery in Uganda and neighbouring
countries has been identified by the African Ministries of Health to
develop an African Network of Medical Excellence (ANME).
The ANME is a multi-national health project designed by the
International NGO Emergency with the Ministers of Health of:
Central African Republic, Chad, Democratic Republic of Congo,
Djibouti, Egypt, Eritrea, Ethiopia, Rwanda, Sierra Leone, Somalia,
South Sudan, Sudan, Uganda.
The aim of the ANME is to promote the construction of medical
centres of excellence on the African continent, following the
model of the Salam Centre for Cardiac Surgery, the first centre of
excellence opened by EMERGENCY in 2007 in Sudan.
As stated in the “Manifesto for a Human Rights based Medicine”,
signed by all participating Countries, the right to healthcare is a
basic and unalienable right belonging to each and every member
of the human community. Therefore health projects should be
developed on the following principles: Equality, Quality and Social
Responsibility (EQS).
In practical terms, this means that standards of health care, set
by the progress of medical knowledge, must be accessible and
delivered equally and without discrimination to all patients.
The aims of the project
Health care and training programmes
The Centre of Excellence for Paediatric Surgery in Uganda
will treat free of charge the main paediatric surgical conditions,
contributing to the reduction of the paediatric mortality rate of
Ugandan and African children.
As for all EMERGENCY NGO’s structures, the hospital will also
run training programmes for the local medical staff to promote
the development of knowledge and competences until the
achievement of a complete professional autonomy.
The facility
A hospital for the children
The hospital compound will be around 140,000 sqm and the main
hospital building will have a surface of approximately 10,000 sq m.
The hospital will have a capacity of 80 beds, 8 of which will be in
the intensive care unit (including neonatal intensive care).
The Hospital facility will include the following components:
- Emergency department – open 24 hours a day, 7 days a week
- Outpatients department (OPD) – open from 8am to 4pm, 6 days
a week
- Diagnostic department – open 24 hours a day, 7 days a week
- Laboratory and blood bank
- Operating Block – including 3 Operating Theatres and
Sterilization
Progres towards MDG Under-5 Mortality target in Uganda
"We’ve always worked to mantain high standard of care and professionalism in our projects, to use all the necessary technology,
compatible with our resources and the expertise of the local staff. We have done it, aware of the enormous (and frustrating)
inadequacy of our resources in front of the extent of the problems, of the innate limitation of any of our interventions.
But we’ve decided to help everybody, without any discrimination, to help them at our best, and for free.
We do not want to map the world with different colours: countries with the only right to antibiotics and painkillers and countries
where to build state of the art and highly specialized hospitals".
Gino Strada

10. 18 19
- Intensive Care Unit (ICU)
- Inpatient Wards
- Pharmacy
- Administration
- Technical department
- Ancillary and domestic services (laundry, maintenance, etc.)
- Guesthouse for regional patients and relatives
Not only Uganda
The regional calling
The catchment area for emergencies is central Uganda, whose
population is estimated to be over 6,500,000 people. In addition,
through the referral system, the catchment area for elective
patients will include the whole Uganda and other African countries
joining the ANME project.
In the past 7 years, the Salam centre for cardiac surgery, the
first Excellence Centre of the ANME, has become the point of
reference for thousands of sick people coming from 26 countries
in Africa and Asia.
Why excellence is a tool
The positive returns on the National
Health System
In the past decade the international donor community has
devoted significant resources to the health sector, paying
particular attention to responding both to man-made and natural
disasters, and to increasing effective disease prevention and
primary health care delivery.
Despite these efforts and the relevance of the resources
allocated, the overall impact of this approach in “strengthening
National Health Systems” in Africa is still unsatisfactory, as
demonstrated by the major health indicators: as reported by
the GHO (Global Health Observatory) of the WHO “For African
countries the rate of decline in maternal and child mortality in the
past 20 years is still largely off-track”.
Actually, improving the health of the populations, particularly
of the most vulnerable groups, depends on the capacity of the
National Health Systems to deliver an effective, qualified and
comprehensive medical care, together with the capacity of
develop competences of the medical staff.
According to recent studies, 5 billion people lack access to
safe, affordable surgical and anaesthesia care, while 33 million
individuals face catastrophic health expenditure due to payment
for surgery each year (The Lancet, April 2015).
Prevention and basic health care are of fundamental importance
but the scale up of high quality care is the key to achieve health,
scientific and economic development.
The Centre of Excellence for Paediatric Surgery will generate
resources: it will set models to design and manage effective
health projects, promote medical knowledge, allow qualified
teraning and attract committed staff.
The Human resorces
Who will work in the the Centre of Excellence
for Paediatric Surgery
EMERGENCY will guarantee the international staff required
to meet high clinical standards and proper training of national
medical and non medical personnel.
Particular attention will be paid to improve the management skills
of administrative and ancillary personnel that ensure the smooth
running of the hospital activities.
As in all EMERGENCY’s facilities, priority will be given whenever
possible to vulnerable social groups. All national staff work will be
organised in full respect of national labour laws.
An International team of approximately 20, including medical
and non-medical staff, will be based in Entebbe. EMERGENCY
aims at gradually reducing the number of international staff
continuously present on mission, while increasing the level of
responsibility of local staff.
The requested professional figures are: surgeons, paediatricians,
anaesthetists, nurses, laboratory and x-ray technicians,
physiotherapists, biomedical engineers, administrators,
logisticians.
EMERGENCY aims at gradually reducing the number of
international staff continuously present on mission, while
increasing the level of responsibility of local staff.
The requested professional figures are: surgeons, paediatricians,
anaesthetists, nurses, laboratory and x-ray technicians,
biomedical engineers, administrators, logisticians.

11. 20 21
A teaching hospital
A hospital, but also
a permanent training centre
Thanks to the large areas dedicated to
teaching, the hospital will also become
a regional training centre for health
professionals. It will be a meeting
point between the knowledge of the
EMERGENCY personnel and the young
Africans who will therefore have access,
in their own continent, to top quality
specialised training, without having to
resort to expensive study periods in
foreign countries. The aim is to promote
training processes to encourage young
African doctors to stay in their own
country and raise the national health
standards, without the need to satisfy their
professional ambitions abroad.
The hospital's layout has been designed to
clearly identify areas and functions.
The public areas on the south wing and the
private ones on the north are connected
Energy consumption has been driving
the architectural design, clearly expressed in the roof.
The generous photovoltaic surface provides
sunshading while producing energy for the hospital uses.
by the operational theatre, the most technical
area of the hospital.
All the areas are visually connected by the
internal garden.

12. 22 23
On the children’s side
Large play areas, for the children’s well-being
Considerable space will be dedicated to play areas, both
outside and inside the hospital. Play is intended as a healing
factor, a fundamental element on the road to recovery, a way of
making the children’s stay in hospital as relaxing and cheerful
as possible. The hospital itself will be designed as a place that
amazes, thanks to ever-changing glimpses and openings. A way
of making the facilities welcoming and friendly, to calm the fears
of the young patients.
The courtyard with the big trees
in the centre acts as the meeting point for
the kids and their families.

13. 24 25
Imagery ©2013 NASA, TerraMetrics, Map data ©2013 Google, MapLink, ORION-ME -
To see all the details that are visible on the
screen, use the Print link next to the map.
Pagina 1 di 1Google Maps
21/02/2013aps.google.it/maps?hl=en&q=uganda&bav=on.2,or.r_gc.r_pw.r_qf.&bvm=b...
Between land and water
A hospital on the banks of Lake Victoria
The plot of land where the Centre of Excellence for Paediatric
Surgery will be built is located to the north of Entebbe, in Wakiso
District, about 35km south-west of Kampala. A city situated on
the northern shore of Lake Victoria and which, in 2009, had
around 115,000 inhabitants. The capital of the British protectorate
of Uganda until the time of national independence (1962),
nowadays it’s home to various government institutions including
the President’s residence, the largest Ugandan airport - Entebbe
International Airport - and the National Botanical Gardens, laid out
in 1898.
Energy autonomy
A building that is fully autonomous
from the energy point of view, exploiting the local
natural resources: sun, water and air
The new Centre of Excellence for Paediatric Surgery in Kampala
will be equipped with systems that can create a comfortable
environment both for workers and patients, while respecting low
environmental impact standards.
Accordingly with these issues, buildings are made in “Terra Pisè”,
a local construction technique based on using “terra cruda” that
provides buildings thermal inertia, through a simple but functional
installation, keeping temperatures and humidity constant all over
the year.
There are two main principles regulating the energy production
systems and its distribution:
- There are functions and activities that cannot be interrupted;
- There should be the best comfort, balanced with the maximum
level of energy savings.
With respect to the first principle, the operating rooms, surgeries,
recovery rooms and intensive care spaces cannot be subject to
interruptions in their activities, and thus will be protected through
absolute continuity systems, mainly in terms of electricity; two
accumulators with inverters will provide electricity at the required
tension, without being affected by interruptions in the network
supply.
In the meantime generators will be activated in order to keep
energy supply even in the case of longer black-outs.

14. 26 27
To comply with the willingness to exploit sustainable energy
sources, two ways have been explored:
- Using all renewable sources; 10.000 mq of solar panels to
produce 700 kW/h of electricity, representing the maximum power
needed by the entire hospital, thermal solar panels to heat water
for toilets, water supply from wells both to be made drinkable and
to cool down heat pumps condensers, used for air conditioning,
both in winter and summer, in turn powered by solar panels.
- Implementing low-energy-consumption systems, reaching high
performance and reusing all wastes. For example. Hot water
coming from generators will be addressed to the heat absorber
that will maintain air conditioning in the operating and emergency
rooms even in external supply blocks conditions, and to services
and kitchens usage.
The exceeding electrical production, due to strong isolation, can
be put in the network and used, in part, to heat water and spaces
in winter or to accumulate cool air in summer.
consumptions if compared with common filament or fluorescent
lamps, are able to maintain their functional trait lasting ten times
more with almost the same purchasing costs.
The water treatment plant will provide irrigation to the park.
Organic externalities coming from kitchens will be transformed in
compost or thinly crushed to be directed to the treatment plant.
An automatic and easily managed system, BMS, allows to
address independently energy according to the different needs,
taking into account the importance hierarchies and real needs,
respecting the principles of non-stop of primary tasks and
constantly looking for solutions to improve renewable energy
sources usage instead of traditional ones.
Another important issue, is the one of using low-consumption
systems such as LED illumination tools that in addition to offer
good lighting with the right color temperatures and extremely low
The concept design is clearly identified in the sketch.
The photovoltaic roof and the red module of the operational theatre
flying on the ground provide the basic shelter
around which the hospital can be built.

15. 28 29

16. 30 31
A building
born out of the ground
Excavated earth used to build
the load-bearing walls
Earth is the raw material used to build the
homes of the poorest people in most parts
of the world.
It’s a simple, cheap building technique but
one which, in Africa, is associated by most
people with a past of poverty that needs to
be forgotten.
We were fascinated by the idea of giving
back some dignity to this technique,
using the excavated land to build the
load-bearing walls with the rammed earth
technique.
The rammed earth technique is an ancient
building method involving a mixture of
earth, sand, gravel, binding agents and
a little water, compressed in wooden
or metal frames or moulds. The great
advantage is that the material is available
locally, and there’s no need for cement or
highly specialized workers.
An eye on sustainability, right from the
construction phase.
In the last months, we’ve opened a
construction site in Entebbe to test the
building of the load-bearing walls with the
local earth. We’ve done it in collaboration
with Craterre Ensag, our partner in the
project: the test, which has been very
positive, has also allowed to experiment
the collaboration with the local workforce
who will be employed in the building.
Rammed earth has been used for centuries
as a construction material.
The main structures built with the local earth
will be like something deeply belonging to the site.

17. 32 33
- 10 -
A building born out of the ground
Excavated earth used to build the load-bearing walls.
Earth is the raw material used to build the homes of the poorest people in most parts of the world. It’s a simple, cheap build-
ing technique but one which, in Africa, is associated by most people with a past of poverty that needs to be forgotten. We
were fascinated by the idea of giving back some dignity to this technique, using the excavated land to build the load-bearing
walls with the rammed earth technique.
The rammed earth technique is an ancient building method involving a mixture of earth, sand, gravel, binding agents and a
little water, compressed in wooden or metal frames or moulds. The great advantage is that the material is available locally,
and there’s no need for cement or highly specialised workers . An eye on sustainability, right from the construction phase.
World heritage sites
Earth-built areas
Wall thermal Inertia:
Rammed Earth
In hot climates, rammed-earth walls are
particularly indicated because of their
capability to attenuate thermal mass.
Thermal trasmitance of a rammed earth
wall is extremely variable and influenced
by its composition (content of straw, earth
characteristic, volume) which can vary
from 0.4 to 0.9 W/mK.
Rammed earth generates following
benefits:
- extremely low embodied energy
- renewable energy
- no environmental impact in terms of
dismissal and recycling.

18. 34 35
The sun for a ceiling
9,800 square metres of photovoltaic panels
to provide the hospital’s electricity supply
This building, born from the earth, will get its energy from the
sun. The roof will be made from a suspended trellis structure
supporting 9,800 square metres of photovoltaic panels (equal
to the surface of a football pitch). This system will ensure that
the hospital has an autonomous electricity supply during the
day. It will also be connected to the main line, to provide energy
to the surrounding area at times when consumption is low. The
photovoltaic roof, “floating” above the building, will also guarantee
shade for the hospital and all the uncovered walkways.

19. 36 37
SOLAR POWER SUPPLY with active
shield system
THERMAL INERTIA due to using rammed
earth for construction
NATURAL VENTILATION OF THE
BUILDING both daily and overnight

20. 38 39
Hospital in Uganda for Emergency Wood frame option
Renzo Piano Building Workshop e TAMassociati
PHOTOVOLTAIC PANELS 3SUN
PANEL DIMENSIONS 1001mm x 1402mm
FRAME DIMENSIONS 1100mm x 1500mm
PHOTOVOLTAIC PANELS 3SUN
PANEL DIMENSIONS 1001mm x 1402mm
FRAME DIMENSIONS 1100mm x 1500mm
MAINTENANCE PATH
AND PHOTOVOLTAIC ELECTRICAL
DISTRIBUTION
MAINTENANCE PATH
AND PHOTOVOLTAIC ELECTRICAL
DISTRIBUTION
PRIMARYAND SECONDARY WOODEN
STRUCTURE
PRIMARYAND SECONDARY WOODEN
STRUCTURE
SKYLIGHTAND VENTILATION
SKYLIGHTAND VENTILATION
STANDING SEAM METAL ROOF
STANDING SEAM METAL ROOF
RAINWATER DRAINAGE SYSTEM
RAINWATER DRAINAGE SYSTEM

21. 40 41
A terrace on the lake
Not a building, but walls that echo
the geography of the place
The building will follow the curves that slope down to the lake.
By following the course of the land, the hospital walls and the
boundaries of its outdoor pathways will form terraces on which
the hospital itself will stand, in a spatial continuum between
interior and exterior, above and below. The stacked walls will
break the distinction between the various zones, creating a unity
between the lake, the park and the internal hospital environment.

22. 42 43
Healing greenery
A big botanical garden providing
psychological care
In this hospital, patients will have the chance to enjoy the
reassuring strength of nature - an extra healing factor. The cool
areas of shade in the botanical park, inspired by the botanical
gardens of Entebbe, will give the sick child a feeling of physical
and mental well-being; a bright, pulsing green that will become an
essential part of the architecture.
Each room will have a large, floor-to-ceiling window so that
the beauty of the park and the surrounding nature can be fully
enjoyed.
The aim of the greenery project is to free patients from the anxiety
of their day-to-day situation; the first step towards recovery.
The transparency of the west elevation
provides long views towards the lake
and the surrounding nature.
The north and south elevations are conceived
as structural rammed earth walls
providing protection to the patients
and local identity to the building itself.

23. 44 45
Trees around,
metaphor of healing
Renzo Piano

24. 46 47
A machine to provide
health care
An operating block exploiting
the best technology available
An operating block has to be a
technologically perfect machine, with
very specific working features. Yet it also
has to include a range of environmental
characteristics that help the patient
find some psychological comfort. The
operating theatres, technologicaly
advanced departments, will stand out from
the rest of the hospital with a calaured
metal covering.
The use of colour, light and other spatial
expedients ensures the well being of the
young patients of the hospital while they
are being treated.
The operational
theatre is the most
delicate area
of the building
where the care
and attention have
direct effect
on people's life.
It is the real machine
exported from abroad
with the best
possible
technologies.
Air Circulation system diagram
within the operational theatre.

25. 48 49
A building born out of the ground
Excavated earth used to build the load-bearing walls.
Earth is the raw material used to build the homes of the poorest people in most parts of the world. It’s a simpl
ing technique but one which, in Africa, is associated by most people with a past of poverty that needs to be
were fascinated by the idea of giving back some dignity to this technique, using the excavated land to build th
walls with the rammed earth technique.
The rammed earth technique is an ancient building method involving a mixture of earth, sand, gravel, bindin
little water, compressed in wooden or metal frames or moulds. The great advantage is that the material is av
and there’s no need for cement or highly specialised workers . An eye on sustainability, right from the const
Colour and materials
Colour: psychological comfort during an illness
A hospital has to be a “welcoming” place. It has to convey a
feeling of serenity and safety. Colour has an unquestionable
psychological impact on how we see a place, producing a very
positive effect on the human psyche (especially in children) when
it’s well-used. A spectrum of colours based on the tints of nature
will be used for the exterior rammed earth walls, making the
interior areas more welcoming for our young guest. Colour will
become an excellent tool for determining the psychological as
well as the dimensional aspects of the clinical areas.
Welded steel plates
Metal frame
Rammed earth
Operable shading panel
Window
Handrail
Water pipe
Skylight
Metal cladding
Insulated panels
Window with hidden frame
Suspended ceiling
Steel structure
Courtyard pavement
Concrete slab
Steel structure

26. 50 51
Imagining light
Natural light,
to give the hospital
a homely feel
Light will be the prevailing element of
the project, favouring natural solutions
wherever possible. The inpatient ward
and the outpatient department will be
lit with large windows looking out onto
the surrounding greenery, with the in-
between spaces using natural overhead
illumination. At the front of the building,
there will be winter gardens where people
can relax, play, study, enjoy the panoramic
views towards the lake and admire
endless plays of light and shadow.
The international compound is dedicated
to the foreign staff.
The small apartments are distributed along
a pedestrian path and are divided in two blocks
focusing on the canteen and the piazza.

27. 52 53
EMERGENCY ONG ONLUS
via Gerolamo Vida 11
20127 MILANO
T +39 02 863161
F +39 02 86316336
info@emergency.it
via dell’Arco del Monte 99/A
00186 ROMA
T +39 06 688151
F +39 06 68815230
roma@emergency.it
Isola della Giudecca 212,
30133 VENEZIA
infovenice@emergency.it
www.emergency.it
EMERGENCY BELGIUM www.emergencybe.org
EMERGENCY HONG KONG www.emergencyhkg.org
EMERGENCY JAPAN www.emergency-japan.org
EMERGENCY SWITZERLAND FOUNDATION www.emergency.ch
EMERGENCY UK www.emergencyuk.org
EMERGENCY USA www.emergencyusa.org
Structural engineer
Milaningegneria
Via Thaon di Revel, 21
20159 Milano Italy
T +39 02.36798890
F +39 02.36798892
@ www.buromilan.com
Mep engineer
Milaningegneria
Via Thaon di Revel, 21
20159 Milano Italy
T +39 02.36798890
F +39 02.36798892
@ www.buromilan.com
Consultant
CRATerre-ENSAG
Cultures constructives
et développement durable
38092 Villefontaine Cedex-France
@ www.craterre.org
Architects
Renzo Piano Building Workshop
Via P. Paolo Rubens 29
16158 Genova - Italy
T +39 010 61711
F +39 010 6171350
@ www.rpbw.com
studiotamassociati
2731 Dorsoduro
30123, Venezia - Italy
T. +39 041 5226974
@ www.tamassociati.org
OrigonieSteiner
EMERGENCY
TIMING
Project Implementation Timeframe
The estimated time needed to design and build the
hospital is 30 months, including 6 months for the
definition of construction and permit procedure and
collect actual quotations, and 24 additional months
to complete the construction of the building and
its full equipment. Time estimates are subjected to
variations due to national or international factors.
TOTAL
€ 5.364.000
€ 940.000
€ 710.000
€ 1.800.000
€ 1.270.000
€ 22.869.000
* A Contingency of +/- 10% in cost variation must be considered
* EMERGENCY ngo will contribute to the overall budget with 3.000.000 of Euros already funded and
will guarantee most of the running cost with its own financing
* The running cost has been evaluated in 4.720.000 Euros/Years
€ 12.785.000STRUCTURE AND FINISHING
MEP SYSTEMS
EXTERNAL AREAS
SHIPMENTS, GEOTECHNICAL TESTS, UTILITIES
FURNITURE AND EQUIPMENTS
HUMAN RESOURCES AND GENERAL COSTS
TOT
COSTS
Provisional Budget
EMERGENCY is an independent organization,
funded mainly by individuals, companies, foundations
and the contributions of the government of the
countries where it is working.
The provisional budget for the Centre of Excellence
for Paediatric Surgery in Uganda has been estimated
for the Hospital Compound in 16.000.000. The
average running costs are expected to be about
4.720.000 per year.
The Government of Uganda is committed to
contribute financially with the 20% of the total
building and equipment costs.
EMERGENCY and the Government of Uganda will
work together to promote the project to major donors
in order to secure the adeguate funds for a smooth
running of the hospital.
The appropriate allocation and rational use of
resources will constantly be monitored.
Financial procedures that satisfy best international
practices will be applied to ensure transparent and
effective use of funds.
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SYSTEMS
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28. “We are going to build
a Centre of Excellence
in Paediatric Surgery in Uganda.
Children will come from all over Africa to receive
high quality treatment,
free of charge.
They deserve a beautiful hospital,
a place fill of joy and love,
something to give back a bit of hope,
a possible future”.
Gino Strada
GraficaOrigoniSteiner
EMERGENCY