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Listening to the land to design an urban Indigenous healthcare facility

August 17, 2021

By Suzanne Crysdale and Michael Moxam

How landscape and culture shaped a new health home for Toronto’s First Nations community

This article first appeared as “Listening to the land” in Stantec Design Quarterly, Issue 12.

Anishnawbe Health Toronto (AHT) places traditional Indigenous practices at the center of its health care model, programs, and services as it provides care to hundreds of Indigenous groups in the Toronto area. For decades, AHT and its clients have made do with a patchwork of three separate facilities in downtown Toronto, making it difficult for AHT to integrate its services.

But no longer. AHT’s purchase of a downtown city block means, for the first time, AHT will unite its services under one roof to centralize and improve access to health services for Toronto’s Indigenous communities.

The new Indigenous Hub, slated for completion in 2023, occupies a prominent location in Toronto’s Canary District in the West Don Lands, within what was once the delta of the Don River. It’s important traditional indigenous land with human settlement traced back 7,000 years. The site is highly visible and accessible within the downtown core.

Rendering of the new Anishnawbe Health Toronto Indigenous Community Health Centre (AHTICHC) in Toronto, Ontario.

The vision for the Indigenous Hub evolved through years of engagement with the First Nations community and other stakeholders. Stantec collaborated with BDP Quadrangle, the site developer’s architect, and Two Row Architect on the master plan. The site will accommodate condominiums and 200 units of rental housing, an education and training facility, a daycare, and the adaptive reuse of the heritage designated Canary Building (all designed by BDP Quadrangle and Two Row). The heart of the Indigenous hub is the four-story, approximately 45,000-square-foot Anishnawbe Health Toronto Indigenous Community Health Centre (AHTICHC), designed by Stantec together with Two Row Architect.

Land has a cultural and spiritual dimension in many First Nations cultures. As Joe Hester, executive director for Anishnawbe Health Toronto, has said, “Our view of land is a little bit different. In terms of orientation, directionality, how it’s utilized, the idea of the medicine garden. Land is a partner in the healing process.”

The building exterior curves and folds like a shawl, offering comfort and protection to its users.

We took inspiration from the land by looking at the city block first as a landscape to inform the masterplan for the Indigenous Hub. If we think of the block as landscape first, it suggests a new paradigm in how built form is introduced. Rather than the usual “build to the street edge,” it implies a dominance of landscaped street edges that are more about transparency and connection to inner landscape than typical street definition. The masterplan features a fully accessible public piazza at the corner of Mill and Cherry streets as well as a central landscaped courtyard fully visible from the surrounding street edges—a unique condition for any city block.

The AHTICHC building is located midblock on Cherry Street at the center of the Hub. Its design is inspired by indigenous cultural touchstones—the land, natural remedies, traditional healing, sunrise, and woven patterns. Landscape was a primary driver.

Joe Hester pushed for the Health Centre itself to rest directly on the land, so rather than placing parking underneath, the AHTICHC connects directly to the earth.

The new AHTICHC is part of an Indigenous Hub, a full block in downtown Toronto. (Image: BDP/Quadrangle)

The central landscaped courtyard, rising 21 feet from the street level and accessible from the first and second floor of the AHTICHC, is unique to this project and emblematic of our land-inspired approach. We designed this landscape with a sensitivity to an Indigenous perspective with native trees and traditional healing plants. The building and landscape relate to each other almost as if they are one. The elevated green space provides essential landscape access for the AHTICHC, conceals services and support spaces, and acts an amenity for the surrounding residential portion of the development.

The upper three floors of the AHTICHC are lifted to allow a visual and physical connection via the ground floor public space through the building from the city through to the elevated courtyard.

Our design treats important programs located on the ground floor—the ceremonial space, community kitchen, and traditional healing areas—like standalone pavilions inspired by pebbles in the stream of the Don River Delta.

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An elevated landscape is part of the AHTICHC. The landscape also includes native trees and traditional healing plants. (Image: BDP/Quadrangle)

Curvilinear design and organic shapes are embedded elements of Indigenous culture. For AHTICHC, we embraced natural forms whenever possible: the pavilions on the ground floor, the shape of the floor plates from level two to four. All of these took on curvilinear forms. The spaces for the Traditional Healer on levels two, three, and four are curved. This is expressed in the exterior as a Corten-clad cylinder culminating in the entry vestibule at street level—visitors and staff enter through the “influence of the healer.”

The traditional Indigenous woven shawl serves as our inspiration for the building cladding—an idea that emerged from dialogue at user-engagement sessions. The building exterior curves and folds like a shawl, offering comfort and protection to its users. This idea is expressed in perforated aluminum panels that suggest folds in fabric and reference traditional Indigenous textile patterns. A stainless-steel mesh is suspended from the bottom edge of the cladding and is intended to move and sway in the breeze.

Levels two, three, and four are connected to the main floor through the central four-story high, east facing atrium. “The Shawl” opens at the atrium, letting in all the east light and providing dramatic views to the central landscape from each level. The red staircase was inspired by “the red road,” an Indigenous metaphor relating to making wise and spiritual choices in life.

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Curvilinear design and organic shapes are embedded elements of Indigenous culture and a significant AHTICHC feature.

Art is an important part of storytelling and Indigenous culture. The design weaves art into the building fabric itself through interior glass panels displaying patterns and artwork chosen by the community. We have incorporated exhibit space within public zones and corridors where AHT can display its extensive art and craft collections.

The Anishnawbe Health Toronto Indigenous Community Health Centre is an important project within the landscape of the Indigenous Hub and Toronto’s urban core. The design team had the opportunity to bring together diverse perspectives to deliver a unique building, one that is respectful of its site, history, and culture. It will enrich the urban landscape of Toronto with a new layer of Indigenous culture and presence, while making a difference in the lives of the city’s Indigenous people through better access to care services and their cultural heritage.

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  • Suzanne Crysdale

    An exceptionally organized and extremely personable architect, Suzanne’s strength is her collaborative and diligent approach to everything she does. Her skills include design, construction documents, project management, and contract administration.

    Contact Suzanne
  • Michael Moxam

    As vice president and design culture leader of Stantec Architecture, Michael is committed to excellence in all aspects of the design process.

    Contact Michael
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