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  • Writer's pictureNigel Wakeham

Bwiam Hospital, West Coast Division, the Gambia

Bwiam Hospital, West Coast Division, the Gambia

During my recent visit to the Gambia to supervise a project that is constructing health facilities there, I visited Bwiam Hospital which will be renovated and extended under the project using funds from the World Bank.  The renovations and extensions to the hospital have been designed by GAP Consultants; an architectural practice based in Banjul.

Bwiam Hospital was designed by a well-known Senegalese architect called Pierre Goudiaby who was responsible for a number of other buildings in the Gambia such as a bank in Banjul and the international airport and who also designed many buildings in Senegal including the National Theatre and the African Renaissance Monument.

Bwiam Hospital was built in the 1990s but to me, is redolent of French architecture of the 1970s.

The buildings were laid out symmetrically around a central axis with most of the buildings set at angles to the axis.  The axis runs north to south but because of their orientation, most of the buildings have elevations that are facing north east, south east, north west or south west (and the elevations of one of the main buildings actually face east and west), none of which is ideal if you want to keep the sun off the windows and walls and reduce solar gains during the day (see the site plan below curtesy of GAP Consultants).

Curtesy of GAP Consultants


Besides the problems caused by their orientation, the individual buildings are not well designed for a tropical climate.  The windows have small, projecting concrete canopies to the top and sides which presumably are supposed to protect the windows from the rays of the sun but are not large enough to do this.  There are no over-hanging roofs to protect the walls and windows of the buildings from the sun and rain and this, together with a lack of maintenance, has had a deleterious effect on the buildings.  The roofs, although of profiled steel, are very low pitch and are hidden behind parapet walls (as are the gutters) making them difficult to maintain and the gutters difficult to clean.

The buildings are also not really designed as hospital buildings; they are merely agglomerations of rooms with names applied.  The operating theatre ‘suite’ (hardly a suite) for instance has no changing facilities for staff, no scrubs or gowning area and no red zone.  None of the wards (or any of the other rooms) has any cross-ventilation which might have helped to keep the internal temperatures down. 

There is an enormous double ramp at the rear of the hospital (between the buildings at the front and the wards behind) providing access to the first floor, the concrete of which could probably have built another small hospital and which is so large that a lot of patients are actually living in it!

All in all, the whole hospital complex is a triumph for ‘form over function’! See the gallery of photos below;


Architecture in Developing Countries: A Resource

The design and construction of appropriate, low-cost buildings for education and health in rural areas of the developing world.

Nigel Wakeham is an architect who lived for 23 years in Southern and West Africa and the SW Pacific working on education, health and other projects. He has since worked for over 20 years as a consultant for national governments and agencies such as the World Bank, DFID, ADB and AfDB on the implementation of the construction components of education and health projects in many countries in the developing world.​

​The objective of this website will be to provide the benefit of more than 45 years of experience of working in developing countries to architects and other construction professionals involved in the design and construction of appropriate, low-cost buildings for education and health. It will provide reference material from the projects that Nigel has worked on and technical information on the design, construction and maintenance of educational and health facilities and other relevant topics and these will be added to from time to time.

I am happy to be contacted by anyone requiring further information on any of the projects or resources referred to in this website or by anyone wishing to discuss work possibilities.


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