Skip to main content
skip to content Français Search
Start of main content

Indigenous healthcare: Connection to place and sustainability key design considerations

Part 2: Three healthcare designers talk about experiences working in urban, rural, and remote contexts

By Bruce Raber, Vice President, Healthcare Sector Leader (Vancouver, British Columbia)

Stantec designs healthcare facilities globally. In Canada, this often gives us an opportunity to collaborate with communities that include First Nations, Inuit, and Métis peoples.

Recently, we gathered three architects who presented on the topic at the RAIC conference to talk about their experience working on healthcare projects for indigenous populations in urban, rural, and remote contexts. Our panelists include:

Bruce Raber, OAA, MRAIC, AIBC 
Sector Leader for Health, Stantec Architecture Vancouver
Projects: North Island Hospital, Vancouver Island, British Columbia

Celeste MacKay, NWTAA
Senior Associate, Stantec Architecture Yellowknife
Projects: Various community health centers, Nunavut and Northwest Territories.

Vlad Bortnowski, OAA
Senior Architect, Stantec Architecture Toronto
Projects: Meno-Ya-Win Health Centre in Sioux Lookout, Ontario
Master planning and pre-design for Anishnawbe Health (Aboriginal Community Health Centre and the Aboriginal Community Hub), Toronto, Ontario

How is sustainability important in these projects?

Vlad: Sustainability is very much part of the indigenous culture. Our current project has to be LEED Gold, it’s in an area where this is mandated. So orientation and taking advantage of two faces of building are important in mitigating the heating and cooling needs. But our client is exploring going further, we’re looking at the possibility of reaching Net Zero and there appears to be political support and hopefully funding for this goal. Stantec has all this expertise on Net Zero, and we’re trying to take advantage of that.

Connection to the land?

Celeste: We are working in places that are very cold and experience long months of darkness in the winter, coupled with summers of sometimes 24-hour sunlight. A connection to place is very much a part of the culture. Where we locate buildings, how we orient them, how we take advantage of low sun angles to bring in natural light, placing entrances relative to prevailing winds and snow drifts. We are often given advice on this by the local residents, only to have their advice echoed by geotechnical experts or microclimate modeling.

Vlad: It is a fundamental issue for most cultures I have been privileged to work with. We are talking about a spiritual connection as well as a literal one: traditional ceremonies must occur in direct contact with the ground, no spaces such as basement or parking can be located underneath.

Related item: Architecture and Interior Design: Shaping our communities

Related item: Health: Designing vital healing spaces

What were the logistical challenges of designing and building in a remote location?

Construction challenges above the 60th parallel include a limited window for shipping materials and construction on permafrost.

Celeste: Construction and materials shipping is very challenging in these remote areas. Many of the communities we work in are not connected by road. This means we are relying on ice roads in winter to take us to the further reaches of the territory, or relying on barges to transport building materials over water, which means having shipments ready for a very limited window. It requires careful planning. Flying in materials is very expensive.

It’s interesting to be in the community when the barge arrives. Most families get their year’s supply of non-perishables on a barge, as well as building materials, vehicles, anything at all.

This figures in the design of the health centers, as they need enough storage space to accommodate a year’s worth of storage on site for their paper products and other materials. Much of what is needed to operate that facility will arrive once a year on a barge.

Vlad: Sioux Lookout is served by only one electrical line. The hospital has to plan for days of relying on generators in the event of the line going down during a forest fire.

Related blogs:

Architecture & Interior Design Blogs
Healthcare blogs

What kind of professional satisfaction do you get from these projects?

Vlad: It’s extremely fulfilling to be able to—with humility—say we understand a bit of that culture without being indigenous ourselves. We try to apply the approach of truly listening to the community and distill the meaning of the place. When that cultural resonance is achieved the fulfilment goes well beyond the normal pleasure of the work well done.

For many communities, a new healthcare facility will likely be the most significant building. Pictured is North Island Hospitals—Comox Valley Regional Hospital in Courtenay, British Columbia, on Vancouver Island.

Is the project a point of pride for the community?

Bruce: A new $250 million hospital in a community like Campbell River or Comox Valley is likely the most significant building that will ever be done in that community. Virtually everybody in that community will be impacted by it. It’s a lot different from putting a hospital in Toronto or Vancouver where they have dozens of hospitals and many projects of that scale are much larger. And everybody knows about it. From the moment you arrive, everybody has something to say about it.

Related item: State & Provincial: Supporting projects with the right people

Celeste: A community health center is one of the key buildings in the community, along with the school and hamlet office, and the community takes pride in it. More importantly, it is the first point of contact for any of the residents to enter the healthcare system. They may see a healthcare worker in the far reaches of the North and could end up in a city-center for more complex care. It’s a hierarchical system of care, as your needs become more complex, you move to the next largest center and eventually are funneled down to southern Canada.

Having the local community members at the table and making them a part of the design discussion is important. It helps us tease out the subtleties of their needs and gives them a sense of ownership. That’s the goal.

Also by Bruce:

Planning for Baby Boomers
Focusing the vision of healthcare design
Tending the garden of ‘generative space’

Bruce is a vice president and the sector leader for our companywide Health Studio. Celeste is a senior associate and architecture lead in our Northern Canada offices. Vlad has 30-plus years of professional experience, with more than half of them focused on healthcare projects.

We try to apply the approach of truly listening to the community and distill the meaning of the place.

comments powered by Disqus

View A Project Near You

Find Stantec projects near you
End of main content To top