Reframing Healthcare as Ecological Care


Without shaded gathering spaces, integration with water systems, or ecological features like trees and gardens, these clinics risk becoming sites of alienation rather than healing. They reinforce a model of care that treats bodies in isolation instead of supporting the full web of life and community that surrounds them.

In the coastal stretch between Kilifi and Mombasa, the landscape tells a quiet story of absence, an absence not just of sufficient medical services but of care embedded in form. Traveling along the ocean road, one finds scattered aid-funded health centers that aim to address acute needs: vision loss, childbirth, vaccinations, and wound care. Many of these centers are supported by organizations, including major campaigns, particularly during Ramadan and Eid. Cataract surgeries, eye care caravans, and temporary medical tents flood the region with generosity and resources. And yet, when you step into the permanent architecture of these spaces, what you often encounter is a room meant to complete a task, not a space meant to hold a person. These clinics tend to function as purely transactional environments: you arrive, you are treated, you leave. There is little room to linger, no space to exhale. The buildings feel like instruments rather than havens.

What is missing is not only infrastructure but affect, the sense that architecture can embrace, not just process. That a health center could be a place one wants to return to, not only when in pain, but when in need of connection, calm, or care. In these clinics, I saw concrete walls, corrugated metal roofs, and unshaded waiting zones that baked under the midday sun. There was no spatial memory of hospitality: no courtyard where one could rest or talk to another patient, no soft transitions between inside and outside, no seating carved into breezeways, no tree or corner where water might gather and offer pause. And in an environment where climate patterns are rapidly changing, where the rains are fierce when they come and their absence is equally sharp, these omissions become architectural failures. The roof sheds water but does not collect it. The walls protect but do not breathe. The floor is clean but it is cold.

My argument is that healthcare, especially when delivered through aid architecture, must be reimagined not only as a medical transaction but also as a spatial offering. What if clinics were designed not merely to “do the job,” but to dignify the patient? What if they were rooted in place, climate, and custom? What if the built environment of care began not with efficiency but with empathy? In my research and design proposals, I explored what it would mean to think of medical centers not just as treatment facilities, but as sites of healing in the broadest sense, where the architecture itself participates in the process of wellness. I looked at the use of courtyards as social medicine: spaces that allow family members to sit together, to share stories, to pass time while waiting, or to grieve. In many Kenyan coastal cultures, healing is collective. It is not confined to the moment of diagnosis or the hand of the doctor. It unfolds in time, with others, and often in public.

A shaded courtyard, a rain-catching roof, a bench under a neem tree—these are not luxuries. They are therapeutic environments. Even the sound of rain gathering in a carved basin or the movement of wind through a screen wall can soften the experience of seeking medical attention. And this is especially true for villagers who may arrive at clinics not only in pain but in fear, uncertain of procedures or costs, speaking different dialects, or bearing stigmas. The architecture must do more than house care; it must model it.

When I reflect on the existing health centers in Kilifi and Mombasa, I do not question the intention. The urgency is real, the needs are overwhelming. But the opportunity to respond with more than speed, with slowness, softness, and spatial intelligence, is still available. These centers can be reimagined as places where rainwater is captured and used to irrigate healing gardens, where treatment rooms are connected through breezeways that encourage airflow and conversation, where patients are not rushed out but invited to linger. In such a model, medical care becomes part of a larger ecosystem of trust and familiarity.

This is the future of health architecture: not sterile, abrupt, and alienating, but sensory, adaptive, and attuned to the lives it holds. To build spaces where villagers feel not just treated but welcomed, not just seen but held. That is the essence of doing well, not only as a moral intention but also as a spatial practice. And it is time we built toward it.