Welcome back to another episode of MedCity FemFwd, a podcast dedicated to exploring the breakthroughs and challenges in women’s health. In this episode, we’re joined by Allison Adamson, an architect at Build Health International.
We discuss Build Health International’s new Maternal Center of Excellence in Sierra Leone, what they hope to achieve and what’s ahead for the organization.
Here is an AI-generated transcript of the episode:
Marissa Plescia: Hi Allison. Thanks so much for joining MedCity FemFwd.
Allison Adamson: Thanks for having me, Marissa. Marissa, happy to be here.
Marissa Plescia: Yeah, of course. Um, maybe just to start, can you just tell us a little bit about yourself and Build Health International?
Allison Adamson: Yep. So, um, my name’s Allison Adamson and I’m an architect at Build Health International.
Allison Adamson: We are a design build nonprofit that delivers high quality, dignified and equitable healthcare solutions, um, to resource constrained settings around the world. Um, we’re based in Massachusetts. So we oppo operate globally, um, and have offices in Haiti at Sierra Leone and um, Rwanda. So we often partner with other nonprofit organizations and local governments to provide the architecture, engineering, construction training and facilities maintenance, anything you need to, to provide a strong healthcare infrastructure and, and systems.
Marissa Plescia: Great. Thank you so much. And going off of that, um, you know, the, what we’re talking about in this episode is the Center of Excellence, the maternal center of excellence that you’re building in Sierra Leone. Um, can you just tell us a little bit about, um, why you decided to create this and why, why you felt it was important?
Allison Adamson: Yeah, so this, um, the, the Center, the Maternal Center of Excellence was born out of our, our partnership with Partners in Health. Um, they’re another US-based nonprofit that provides, um, the care in these resource constraints settings. So we, um. Partnered with their, their Sierra Leone branch, um, to, to build this.
Allison Adamson: We, it was the, the long-term vision of Dr. Paul Farmer, who, um, founded PIH to provide, um, equitable, affordable, and, and high quality care in resource constraints settings. Um, and we know Sierra Leone has. Had a, a number of aspects in, in history that’s affected its healthcare system from Civil War to the Ebola crisis.
Allison Adamson: Um, and, and that’s led to. Some of the highest maternal mortality in the world, um, with 70% of global maternal deaths occurring in the Sub-Saharan region. Um, so both, both organizations saw the need there and, and saw the opportunity to provide, um, you know, higher quality maternal care to, um, provide a lot of impact there.
Marissa Plescia: Yeah. Thank you so much. Um, yeah. And can you tell me a little bit more about, um, what the center looks like? What, what kind of care can women get at the center?
Allison Adamson: Yeah, it’s, it’s, um, supposed to provide everything from, you know, your outpatient care all the way through delivery. Um, it’s a 120 bed facility with antenatal care, postnatal critical care.
Allison Adamson: Uh, there’s a labor delivery ward. Um, dirty bed nicu, two operating rooms and, and about 15 exam rooms, um, for, you know, your antenatal, um, consultations, postnatal consultations, um, early conversations. You know, we talked about the design. Um. Being a, a beacon of hope for an improving healthcare system in the country, um, to convey ideas of dignity and trust.
Allison Adamson: You know, women should come to it and know that they’re welcomed and they’re comfortable to receive care and they, they know they’re gonna res, be respected and provide high quality, um, or receive high quality care there. Um, and, and this shows up in a lot of, you know, design aspects around the site. We, um.
Allison Adamson: I have a mother’s dormitory for mothers who have been discharged from the hospital, um, but might have a baby in the NICU to stay on the campus. Um, many women might come from travel hours to deliver their baby here, so we, we don’t want them to make the, the hard choice of do I travel home to recover while I leave my baby at the hospital in a run both state.
Allison Adamson: So this gives them the option of, you know, stay close. Um, and, and heal there. Um, there’s a number of education spaces. Um, the, the staff there really wanted these waiting areas and courtyards to be a spot where families and visitors gather, where they can also go out on like a Tuesday afternoon and give a, a talk about the importance of antenatal care, um, or the importance of family c plan, family planning.
Allison Adamson: Um, privacy was a big aspect, um, that went into providing high quality and, and care and, and making women feel comfortable and respected. So, you know, there’s, um, separate wards and, and exam rooms kind of off to the side for more sensitive procedures and screening walls around waiting areas, um, especially for some, some younger patients too.
Allison Adamson: Um, and just, you know, creating. Beautiful, clean and effective and efficient spaces. So we have a a EP, um, team that does all the engineering to make sure the spaces are gonna be cool and comfortable and well lit, so that way, you know, the nurses can do their job and the doctors can do their job, and, and women are getting high quality care with the right equipment.
Allison Adamson: That’s, that’s also clean too.
Marissa Plescia: Really interesting. And do you have any similar centers, um, in other parts of the world that you kind of used as a model to create this?
Allison Adamson: Um, yeah, so we, BHI actually started, um, right after the, the 2010 Haiti earthquake. And we built a 300 bed teaching hospital there. Um, and we, we started doing, um.
Allison Adamson: Only work in Haiti for the first couple of years until we’ve, we’ve expanded out and done, um, now worked in, in 70 countries around the world. Um, and we’ve learned a ton along the way. Um, so, you know, every country’s different. So we’re, we’re taking some lessons from Haiti, um, that we did at the university teaching hospital and then applying to Sierra Leone, but also tailoring it to, um.
Allison Adamson: You know, the, the local needs. But we’ve, we’ve learned, you know, um, having pop-up roofs that can provide some airflow and ventilation, having central nurse station, so that way, um, staff can see every patient and, and, um, keep tabs on them since we, we don’t often. Um, use nurse call stations in keeping support spaces, uh, pretty centralized so that way nurses can go back and forth quickly, um, to get what they need and bring back to the patient.
Allison Adamson: So we’ve, we’ve learned a lot from our previous work in Haiti that we’re, we’re taking forward to all future projects, including MCOE.
Marissa Plescia: Yeah. Yeah. Going off that, you mentioned every country is different. How did you go about, um, designing this specifically for Sierra Leone? Um, did you have any input from members of the community?
Marissa Plescia: Um, how did that, how did that work?
Allison Adamson: Yeah. We, we keep the community and the buildings users always at the, the forefront of our design. So we’ve had many conversations with partners in Health, Sierra Leone, who are running the hospital and operating in and working closely with the clinicians. We traveled there a handful of times to present, uh, floor plans and renderings and got feedback on those to know what was working well with them, what wasn’t.
Allison Adamson: Um, you know, weekly Zoom calls where we go over some of these questions of, you know, how big a waiting room needs to be, you know, what’s gonna make, um. You know, a labor and delivery ward feel comfortable and, and private while still allowing the nurses to do their job and what spaces need to be near each other.
Allison Adamson: So it’s, it’s those weekly, um, phone calls and site visits to see how they’re currently operating and how other hospitals are operating in the country to, to learn what’s, what’s gonna work for them. So we make sure it’s what we’re providing is actually gonna be useful.
Marissa Plescia: Yeah, that’s great. Um, and can you tell me a little bit more about, um, uh, partners in Health’s role in this partnership?
Allison Adamson: Yep. So they are, they operating Coia Government Hospital. It’s on the eastern side of the country. Um, and the MCOE is a part of this. So they are also run that facility, um, providing the clinicians, um, monitoring patient data and, and providing the training program. So they’re the, they’re the ones providing the actual care at the hospital and, and we’re our partners in, um, building this together.
Marissa Plescia: Right. Yeah. And you, you mentioned that, um, build Health International is a US-based nonprofit. Med City News is, um, audience is mainly American. So, um, why is it important for the American healthcare system to be aware of these efforts?
Allison Adamson: Uh, that’s a, that’s a great question. Um. One. You know, we focus on, um, the infrastructure and we, we know how important that is to providing, um, high quality care.
Allison Adamson: Um, and I know just from me growing up in the US taking a lot of things like clean water, the equipment and medicine that’s needed to make me feel better, may take. I might take for granted, but it’s not always available in, in some of the regions we work. So, um, we know that, you know, to provide the right care and, and high quality care, um, you know, it’s providing the right building in the right spaces, but also electricity, clean water equipment and medicine.
Allison Adamson: Um, and we know maternal mortality is completely preventable. So providing this, you know, also with the right, um. Clinicians and, and staff that we can, we can work together to, um, you know, help some of these other, other countries and, and give, give everyone the right to, um, you know, good quality care. Um, and there’s, there’s also other ways to be involved.
Allison Adamson: You know, we don’t have to be, um, a doctor working in Sierra Leone at the MCOE to, um, to, you know, provide equitable care. Um, we work with a lot of local area hospitals, um, who. We’ll partner with and if they have medical equipment, beds, patient curtains, biomedical equipment that they’re replacing, it might still work perfectly fine.
Allison Adamson: Um, we’ll take it to our warehouse in Massachusetts and um, then eventually send it over to our building sites to actually equip the hospitals that we’re building.
Marissa Plescia: Yeah, yeah. Really interesting. Um, well, Allison, I just have one last question for you. Um, what’s ahead for Build Health International in the women’s health space?
Allison Adamson: we’re constantly taking on, um, more projects and, and constantly busy. Um, we are continuing to work with partners in Health, Sierra Leone. Um, um, lots of more projects that support the Cordo Government Hospital and the MCOE, including a warehouse to, um. Store medical equipment and medication, uh, staff training and dormitory is, you know, halfway through construction where we will hopefully, um, give capacity to hire, um, more staff and give them the training they need to provide the high quality care, a entry pavilion to help triage patients, um, to the hospital and to the MCOE.
Allison Adamson: Um, on my end specifically work the, um, working on healthcare design guidelines for Rwa Rwanda. Um, so we have a, a number of units including a, a maternal and neonatal unit that, you know, states all of the important spaces and clearances and, and things like that. Um, so that will hopefully influence, um, higher quality health service delivery in the country.
Marissa Plescia: Yeah. That’s great. Best of luck on those future projects, Allison. Um, this has been such an interesting conversation. Really appreciate you joining MedCity FemFwd.
Allison Adamson: Yeah, happy, happy to be here. Thank you for having me.
