Health Architecture, NEVOSH trip to Jinotepe, Nicaragua, 2003

Health Architecture / Design

Ali Hocek	Shahin Barzin	Dave Pritchard	Roberta Lavarello

The health architecture group is new to NEVOSH this year. While made up of veteran VOSHers, the team crystalized this year with the recognition that their skills in architecture and design are very applicable on a health care mission. They are focusing on health issues in the lives of residents of rural and urban Central Americans that could be prevented and improved with enlightened dwelling and appliance design. Specifically of concern is the widespread use of open fires and poorly ventilated woodstoves for cooking.

from Juan Carlos' Mission Report:
After we returned from the hospitals, Dr. Payáso took some members of our group who are architects to a new village the Rotarians were building, called Villa Rotaria. Our members were asked to make observations on the design and development of this village, which would be built by their future residents to specifications. In this village, as many as 100 new homes will be created, some of them are nearly done. Our members commented on potential environmental problems, construction issues, and waste management. A full copy of their report, written by Ali Hocek, will also be available to everyone on the Northeast VOSH website.
Read more of Juan Carlos' Mission Report

VOSH 2003 Nicaragua Mission

written by Ali Hocek

This mission was the first to address construction and environmental issues. Our team consisted of Shahin Barzin, David Pritchard, Roberta Lavarello, and Ali Hocek.

During the first two days of the mission, we participated with the set up of the clinic in Jinotepe and the first day of seeing patients in Screening. In Jinotepe, we met with Dr. Silvio Bayardo Rueda Morales, president of the local Rotary Club, who gave us a tour of their Villa Rotaria housing project. This project, funded by the Rotary Club, is providing the means for selected women to construct their homes on a tract of property on the outskirts of Jinotepe. The women construct their homes to specifications and with technical assistance from the project architects and planners. The women own their homes, yet they cannot rent or sell. Six or seven houses are near completion and foundations have been poured for as many more houses. Silvio anticipates constructing as many as one hundred houses on this site.

After our tour of the construction site we prepared the following comments and observation to Silvio:

Dr. Silvio Bayardo Rueda Morales
Re: Villa Rotaria, Jinotepe

Thank you for taking the time to show us the development and construction of the Villa Rotaria homes. We have found your project to be very thoughtful and it promises to be a success for many poor Nicaraguans.

After our visit to Villa Rotaria, Shahin Barzin, David Pritchard, Roberta Lavarello and myself discussed the project and would like to share our comments with you. We hope that our comments will offer you and your team the advantage of our objective observations and will ultimately be constructive.

A. Site and Master Planning Comments

1. Orientation of village on the east/west axis does not take advantage of the southern exposure of sunlight.
2. This orientation also places the houses in the direction of prevailing winds, which can be substantial in this area and quite unpleasant.
3. The wind may be particularly troublesome if kitchen smoke is blowing into the neighboring houses.
4. In contrast, the wind may be controlled by appropriate technology to create energy. This is probably not an immediate concern, however, any planning anticipating future objectives will be advantageous.
5. The houses appear to be too close together. This proximity to one another may create problems with run off rainwater collecting in the alleys between the houses and damaging the foundations. These spaces are also potential places for people to leave garbage and store unwanted things.
6. The current master plan arranges the houses in long straight rows. Your architects may wish to consider clusters of three or four houses to circumvent the problem of alleys and to allow for more exposure to sunlight. The small clusters are less regimented and may support community interaction.

B. Construction Materials and Methods

1. The horizontal beam between the middle of columns appears to be superfluous. Apparently, the earthquake code requires horizontal structure for columns above 3 meters. Material and work maybe conserved by eliminating this beam at all sides of the house.
2. Windows may be framed like the doors, with the area below the windowsill in-filled with either the stone blocks or with wood panels.
3. Consideration and guidelines should be considered for venting kitchen stoves adequately. This is a chronic problem in Nicaragua, and the cause of many illnesses we have witnessed here on our missions.

C. Waste Management

1. Consideration for sewage must be carefully considered and we expect you have already done so. Sloping sites are always problematic and pose a problem for avoiding the contamination of drinking water or the collection of impure water in stagnant areas.
2. Several houses may share a single cistern for the collection of rainwater from the roofs. This may be used for irrigation purposes if there is such a need. This will also address the potential problem of roof run-off rainwater from collecting between the houses, as mentioned in A 5 above.
3. It may also be advantageous for the community to create a collective garbage area. If the garbage is going to be burned, then this area may be carefully located to the direction of prevailing winds, so the smoke does not blow into the homes.
4. A collective garbage area may also be used for creating a compost pile. The compost may be used for fertilizer in the community gardens and/or sold to other people.

We hope our comments are useful. We applaud the good work of your team and wish you all the best success. Please feel free to contact us with anything concerning your project.

Thank you.

Ali C. Hocek, AIA

After our initial days in Jinotepe, our team moved to the city of Granada where we spent the remainder of our mission working with Donna Tabor and her students. Donna Tabor, who continues to collaborate closely with VOSH on a number of projects, is a former Peace Corp worker who works with street kids to provide them with the means to better their lives. Many of these kids are or were homeless and addicted to sniffing glue. Donna has built a small school with accommodations called Casa Nueva Esperanza. Currently it has five resident boys and 15 day students, one full-time educator/mentor, and two part-time educators. The school is located on Lake Managua in a destitute barrio. The barrio was the site of our mission.

Our mission was primarily to create case studies in homes to improve the ventilation of cooking smoke. Secondarily, we addressed alternative means of cooking. The intent of these case studies was to establish an example by which others could learn how to improve the ventilation in their homes. Many of the patients we saw in past missions suffered from ailments (eye irritations, dizziness, asthma, etc.) which we attributed to repeated exposure to household smoke.

Our case studies involved two houses. We separated into two groups. Ali and Shahin worked on house #1 and Roberta and David on house #2. In both houses we worked with some member of the household.

House #1 was approximately ten feet wide and thirty feet long and was the home for about ten people. It was separated from its neighbor by a six-foot dirt alley and had a rear open lot sixteen feet wide and about twelve feet deep. In the back was an enclosed latrine and next to it their stove and a sink for food preparation and bathing. The “kitchen” was covered by various sheets of metal supported on a flimsy structure. During the rainy season, the stove is brought inside, though we were told the heat of the stove is quite unbearable and it is preferable to keep it outdoors.

Smoke from the stove collects under the shelter. Jose, who lived in the home and worked enthusiastically with us, took down this structure on the first day of our visit. With materials we had brought and purchased locally, we constructed a stable structure. The structure was made of wood and covered in corrugated sheet metal (all locally purchased and cost about $50). The roof was made to slope up above the stove to provide a means for the cooking smoke to ventilate out. Side panels were added from above the stove to better direct the smoke. The new structure was extended sufficiently to provide shelter from the main house out to the kitchen, and we anticipate that the stove will no longer need to be brought indoors during the rainy season. The extent of this work took no longer than two days, with approximately three people working.

In house #2, the kitchen is outdoors sheltered by a lean-to structure attached to the end of the house. The house is located next to a polluted river (a factory approximately one mile away disposes of its waste into the river). The kitchen has two stoves located at the far end of the lean-to and therefore, at its lowest point. No ventilation was provided, except what was carried away by cross ventilation from the wall-less sides of the shelter. Of the two stoves, only one was working. This was a table like structure with brick enclosing the fire. Although this is a typical method of cooking, it is highly inefficient and difficult to vent without creating a hood like structure.

On closer investigation, we found that the second stove was a type similar to the “rocket” and “Lorena” stoves our pre-mission studies had led us to. The stove is raised to counter height. At one end wood is fed into a continuous chamber between the base and the cook surface. At the opposite end, a pipe ventilates the smoke from the chamber out above the structure.

In this instance, the ceramic liner at the feed end of the stove was cracked and the exhaust pipe was disconnected and there was no hole in the roof for the ventilation pipe to extend through. David and Roberta relined the chamber with aluminum sheet metal, where the ceramic was broken and added aluminum piping from the existing vent pipe up to and above the roof. The top of the pipe was capped with a hood, open at either end to keep rain water out and promote ventilation. Julio, one of the sons of the household, worked diligently with David and Roberta and showed considerable interest to learn more. This work was accomplished in one day, however, on the second day the mother of the family, Katarina, told us that the aluminum liner had melted. This was certainly the case, and we replaced it with a heavier gauge metal. Later we learned that to start her fires, she would pour a cup of kerosene, which burns at much higher temperatures than wood, and probably caused the aluminum to melt.

On the last day of our mission, we held a class in the construction of a rocket stove and a solar oven. The class was attended by the students of the school, two neighborhood friends, Jose and Julio of the case study houses, and Mario. Mario is an acquaintance of Donna Tabor’s who formerly abused drugs and alcohol and is now involved with construction. He showed excellent leadership and enthusiasm during the class.

Two rocket stoves were constructed under our guidance by the participants. One from pre-fabricated stove tubing we brought from the States, and the other from discarded cans. Both worked well and during a competition between the two stoves, the can construction boiled water faster.

Following this lesson, we fabricated a solar oven from cardboard boxes, a sheet of glass, crumpled newspaper for insulation, and aluminum foil. The boxes and newspaper were essentially waste material. The glass cost less than a dollar, and the roll of foil about two dollars. Both were locally purchased.

In conclusion, we found that correcting ventilation problems was a two-part issue involving both the extraction of smoke and the type of stoves. In the latter instance, the efficiency of material used to create heat, and the means by which it burned was directly related to the amount of smoke produced. By and large wood is used, however, gas canisters connected to light weight metal stoves appears to be a common alternative. The cost of the stove and the canisters may be prohibitive for poorer Nicaraguans, but this is worth further investigation as it burns cleaner and can be ventilated relatively minimally.

We found that the ventilation of existing wood burning stoves is particular to each home, and therefore, no one solution can be applied to all. In the next mission, it may be best if we were to isolate a particular neighborhood and analyze the condition in about a dozen homes, making design suggestions and then providing our assistance in labor and materials in implementing the corrective construction.

In the meanwhile, we have discussed with Donna how she can use the two homes we worked on as examples to raise awareness among the poor she is in contact with of the affects of bad ventilation and its solutions.

Our discussions with Donna also led to that part of the barrio where house #1 is. On that street, there are about twelve houses. Certainly house #1 is serving as an example, and at least two neighbors on the street have expressed an interest in improving their homes. To this mission could be added a small medical team, which could operate out of Donna’s school. It would be beneficial to have both our team and a medical team working in the same barrio as we could refer people to the other team. A synergy of both efforts will increase awareness and understanding of environmental causes and its health effects.

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