Legacy in Architecture: Chapter two


The first chapter on Legacy in Architecture focused on a recently opened health-care project in the Western Cape. This chapter now turns to a research project focused on new ways of thinking about health care. Academia is often the testing ground for new thinking. The Masters in Architecture (Professional) course is the fifth and final year of architectural studies at and the University of Pretoria. It is a year of self exploration in which the students choose their own site and program but, more importantly, a focus on an particular architectural issue. In 2014, Claire du Trevou tackled the problem of health in the informal settlement of Alaska in Mamelodi, located to the north-east of Pretoria. She undertook research through a studentship, awarded by the Council for Scientific and Industrial Research (CSIR) in pursuit of its human capital and young researcher development objectives1. The CSIR is currently investigating the design of treatment facilities, and in particular the organization of space, to prevent the transfer of airborne disease.

"A hybrid clinic" (du Trevou, 2014:53)

Health clinic design in South Africa has generally been guided by 'Western' medical models. Claire questioned whether there could be a synergy between Western and traditional medical practices through participatory architectural processes. "Through investigating the overlaps and areas of antagonism in scope between western and traditional medical models and engaging in a collaborative design approach; the dissertation sets out to investigate how the architectural, spatial and detail expression of these similarities and disparities, can result in a new healthcare facility model? One which is integrated into place, patient-centric, and adaptable , in order to constantly foster physical, social and mental well-being, despite any fluctuations in the context or changes in disease which may occur" (Du Trevou, 2014: 49).


Although the technical focus of Claire's project dealt with airborne disease her concerns were broadly aligned with spatial, procedural and cultural legacies of informal settlements, like Alaska.

The contextual blight of the settlement informed design of the clinic as an urban catalyst. This generated the analogous title of the dissertation "Suture and Santé, a place making procedure". All building edges respond to issues that need to be addressed in the existing context and are designed with specific functions in mind. The south western edge provides a market space that relates to the existing informal taxi rank. The north western edge borders a rejuvenated wetland and is designed as the main external waiting space facing north. The south eastern edge acts as service access and the north-western edge houses the traditional healers close to the community they serve.

Claire sees the procedural role of an architect as an agent of change, not working in isolation but in tandem with the very community he or she serves. These participatory processes, very much like the work of the Cape Town based architect Carin Smuts, place the concerns of the local and affected inhabitants at the forefront of decision making processes. Their participation imbues a sense of responsibility and ultimately ownership of any project. This process also critiqued the poor design of waiting spaces found in many clinics. The disorientation of patients due to illness, is exacerbated by a completely internalised condition and lack of adequate natural light and ventilation. Here, Claire has designed a range of waiting spaces from completely external and uncovered to internalised and protected.

On-site mapping was undertaken to understand the culture of current health-care practices in Alaska. This uncovered the roles that community healthcare workers from UP and the traditional healers2 play. This understanding of existing cultural practices has been used to diffuse hierarchical doctor-patient relationships in the new design. Claire mapped the layouts of traditional healing sites and buildings in Alaska and adapted the threshold conditions in the design of consultation and treatment rooms. This process also facilitated a spatial layout that limited the transfer of airborne disease.

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Conceptual intention diagrams © Du Trevou, 2014.

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Concept development drawings © Du Trevou, 2014.


17 Ground Floor Plan

Ground and site plan © Du Trevou, 2014.

 16 Waiting Perspective

Entry and external waiting courtyard as seen from road. © Du Trevou, 2014.

33 Bloods Waiting Room

Bloods waiting room © Du Trevou, 2014.

19 1 20 Section

Final construction section through the treatment room with explorative sections of air movement below. © Du Trevou 2014. Ground floor and site plan of the clinic. © Du Trevou, 2014.

32 Tower Render

Top: Entry courtyard off road with market space to the right. Bottom: Rear view of treatment rooms with ventilation stack to deal with airborne disease. © Du Trevou, 2014. 

Intelligent legacies

To date Claire has presented her design and research to the ASF-UK Change By Design Group, Gauteng of Department for Infrastructure Development and the Western Cape Department of Public Works: Programme/Projects Infrastructure Delivery Health. Her project has been warmly received and I am hopeful that the approaches she has developed will have a long lasting legacy with both her and the people she comes into contact with.

As designers, we need to be cognisant of the problems of our spatial legacy but should also appreciate the value of our rich cultural legacy. By doing this we can make a sensitive and decisive impact on our built environment.

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1. Claire's project (that was awarded a distinction for design) follows on a series of 2013 MProf research projects where 5 final year students of the Department of Architecture at the University of Pretoria undertook design work on resilient cities for the National Research Foundation (NRF) under the guidance of Prof. Chrisna du Plessis at the Department of Construction Management. One of the students, Heidi van Eeden, was the recipient of the 2013 National Corobrik award as well as the 3rd prize in the international Holcim Next Generation competition in October 2014.

2. "In the South African context, traditional practitioners can be classified into 3 broad groups: traditional doctors or Inyanga, Diviners or Sangomas, and Faith Healers or Umprofethi" (Du Trevou, 2014:68).


  1. Du Trevou, C. 2014. Suture and Santé. A placemaking procedure. Unpublished MProf(Arch) dissertation. University of Pretoria.