Healing Oasis

August 11, 2010

Every architect, possibly anyone who has ever put brick to mortar, has dreamed of being given a completely unencumbered site on which to work, and a commission to build not just a single structure, but an entire organic, living, breathing system of buildings, a whole city, in effect; and, to top it off, the chance to work at the behest of an enormously rich benefactor whose sole purpose in granting this license was to have you produce a work that would directly benefit thousands of fellow human beings in sore need of help.

That romantic vision, in broad outline, is the situation that befell a design/engineering team at HLW International, New York. Ten years ago, they were given a million square meters in the desert 30 kilometers north of Riyadh, a budget that started at $125 million and soared to well over $200 million, and the blessing of a prince, and were set free to build an entire city devoted to rehabilitating Saudis and others who had been crippled by birth defects, automobile accidents, and the nine hundred ninety-eight other natural shocks that flesh is heir to.

As we shall see, however, translating such a dream into reality demanded enormous stores of teamwork, patience, diplomacy, grace, humility, and personal self-sacrifice. Years from now, members of the HLW team likely will look back at the Sultan Bin Abdulaziz Humanitarian City as one of the signal projects of their lives, not only for the sheer magnitude and scale of the work, but also for what it taught them about other cultures, religious values, human dignity, and, most of all, themselves.

The project got its start more than a decade ago with the recognition by Prince Sultan Bin Abdulaziz, brother of King Fahd and second in line to the throne, that the kingdom, while rich in hospital services, had no dedicated rehabilitation facility. Invoking the principle of Zakat, or charity, which constitutes one of the five pillars of Islam, he established a foundation to finance a whole "humanitarian city" devoted to rehabilitation.

In March 1994, the Riyadh firm Otaishan Engineering Office, at the behest of the sultan's advisers, contacted HLW partner Hakam Jarrar in New York and suggested forming a joint venture to create a functional space program for the project. HLW had developed considerable experience in both Saudi Arabia and Kuwait following the first gulf war.

 
The Sultan Bin Abdulaziz Humanitarian City, a $200 million rehabilitation complex in the desert 30 km outside Riyadh. HLW designers shaped the master plan around a shaib, an intermittent stream bed, on the site.


The final scheme, as we shall see, rested on three essential ideas: first, a cogent understanding of the place of the desert in Arabic culture, symbolism, and environment; second, an appreciation for traditional Mideast architectural forms without resorting to design clichés; and, finally, a medical master plan that responded to Saudi tradition and lifestyle, while bowing to Islamic principles of charity and social commitment.




Getting the right site took a certain degree of diplomacy. At first, the HLW/OEO team was given a plot of desert land that would have required stacking many of the buildings to a height of five or six stories to meet the program needs, making it "too urban," in the view of Richard Sprow, AIA, who developed the functional space program.

A solution came about in almost storybook fashion. "The sultan's staff invited us to a local camel race, which of course is a big thing in Saudi Arabia, and while we were there we got to talk with one of the sultan's sons," says Sprow, now a senior associate with Perkins Eastman, New York. Summoning their most delicate diplomatic skills, Sprow and his team suggested to the royal scion that they needed more space to work in. The word got back to the prince, and a short time later, a larger site miraculously became available.

The new site, along the Nadji plateau in the heart of the Saudi desert, hardly looked promising. "They sent us pictures, and every one looked like the other, flat and barren — not sand, just gravelly rock," says Tatiana Choulika, ASLA, a landscape architect and natural resources expert in HLW's New York office.

Two months of geologic analysis revealed the landscape to be much more complex than that. It turned out to slope gently from the southwest to the northeast, and it contained not one but two intermittent stream beds, known as shaibs, the more southerly of which would provide water to the site for plumbing, drainage, and irrigation when the rains came.

The discovery of the shaibs opened up the possibility of creating an oasis-like setting. From their OEO partners, they knew that creating an oasis on site would resonate powerfully with the Saudis. "They love the desert, it's their roots," says Choulika. According to Christopher Choa, AIA, HLW's senior partner and design director, the garden-like setting provided "an organic approach," a metaphor for the healing process that would be carried on in the facility.

The site analysis was instrumental in winning over the sultan's staff. "Our whole approach was environmental," says Choulika. "We understood the site and the problem of building a whole new place on bare ground."

This understanding carried over to the use of traditional forms of environmental control, notably optimal building orientation, shading, tinted glazing, and landscaping. "We didn't do anything earth-shattering or high-tech, just very straightforward," says Choa, who currently runs HLW's Shanghai office.

The second essential idea had to do with architectural form, and here, too, HLW reverted to tradition. The designers drew inspiration from Riyadh's Masmak Fortress, which was captured in 1902 by Abdul Aziz Ibn Abdul Rahman Al-Saud, who went on to establish the kingdom in 1932. Masmak has since been restored as a museum.

In traditional Mideast forms, the wall, or soor, protects against wind and enemies; the gate naturally provides a portal to the interior, the center of which was to be the most placid setting, the oasis itself. Choa says they were looking to emulate the traditional caravanseri walled structure, without Arabic geometric ornamentation. "We were striving for traditional architectural strategies, but with more contemporary features," he says, to achieve an international style comparable to the best in the U.S. or Europe.

After some arm-wrestling with the local architect assigned to the project (who wanted a circular configuration), HLW came up with a semicircular layout for the buildings. The axis, forming a line of buildings housing administration and ambulatory care, would be ringed on the arc by seven buildings devoted to rehabilitation services. A 240-meter enclosed air-conditioned pedestrian walkway connecting the ambulatory care center and the rehabilitation center would pierce through the wall to the main entrance. Nestled inside would be gardens and a kilometer-long body of water formed by the shaib and crossing under the elevated pedway.

Cultural and religious customs had to be accommodated and respected. Housing for single male employees would be isolated across the shaib. Toilets had to be oriented away from Mecca. Two mosques were to be built, plus family housing for as many as 1,500 physicians, therapists, and other staff out of a planned 2,000. In addition to a public entryway and a service corridor, a private ceremonial entrance also would accommodate the royal family. A kind of picnic area was to be created, where recovering patients could set up a tent and have a meal with their families, much as their ancestors did when they roamed the desert as Bedouins.

"My challenge was how to combine these complex programmatic and technical requirements into a comfortable social solution — high-tech overlaid with enormous tradition, pomp, and circumstance, within an Islamic background and the royal hierarchy," says Paul Boardman, AIA, an HLW design director at the time and now founder and managing director of Eclipse Development, New York.

He recalled being invited to an audience with the royal family, an all-night picnic in tents in the desert. "It was very important for the prince to have us understand the importance of the desert," he says. The sultan, he says, was less concerned whether the project "looked Arabic" than he was in making sure the designers understood "Arabic sensibilities."

The third ingredient was the medical plan. In March 1994, Sprow flew to Riyadh for three weeks of intensive work with OEO to develop a functional program that encompassed a million square feet of space. They built a foam model and flew to Jedda one night for a meeting with the prince. "He looked at the model and basically said, OK, and in 20 minutes he was gone," says Sprow.

After some delays, Sprow took a team of consultants on a whirlwind tour of leading rehabilitation centers in the U.S.: the Rusk Institute at New York University; the Rehabilitation Institute of Chicago; Genesis Rehabilitation and the Mayo Clinic in Jacksonville, Fla.; Atlanta's Shepherd and Nashville's Vanderbilt rehab centers. They flew to London to meet Audrey Wispey, one of the leading rehabilitation experts in the world. All this led to a room-by-room plan for the entire facility.

With no permanent medical staff in place to provide guidance, the task was even more complicated. "They just told us to make assumptions [about facilities and equipment], because they weren't going to hire people till much later," he says.

Most of the design was supervised by Joseph Hand, AIA, who arrived in Riyadh just a few months after the assassination in November of Israeli prime minister Yitzhak Rabin and the terrorist bombing of a U.S.-operated Saudi National Guard training center in the capital, in which seven American soldiers were killed. Hand, now an associate at Fox & Fowle, New York (he's project director on Renzo Piano's New York Times Building), says of the times, "There had been optimism in the Middle East, but [these events] really destroyed it." In five months, Hand got the project halfway through construction documents, then turned it over to HLW's New York office for specifications ("We didn't even have a modem," he recalls) and to the Basheer organization for construction.

Today, the Sultan Bin Abdulaziz Humanitarian City takes in $200 million in buildings alone, not to mention the cost of bringing highways and utilities to the site. At 700 staff, it is still only 25% occupied, with 284 two- to four-bedroom villas for medical staff and their families and separate bachelor housing facilities. Physicians and physical therapists are being recruited worldwide.

The medical program includes an ambulatory care center for medical and surgical care; an acute care center, for cases such as auto accident victims; a sub-acute recovery center, for patients needing up to six months of rehab; a day hospital for outpatient rehab services, mostly for the elderly to receive ongoing care; and a separate child care center.

Areas have been set aside for families to participate in care (a concept that is gaining acceptance in U.S. hospitals). The smaller mosque and the convenience retail stores are seen as having a clinical function as places where patients can gradually learn how to integrate themselves back into society in a dignified manner.

Those who worked on the project were affected by it personally. Tatiana Choulika says the experience taught her to look to the client for answers. "If I were working anywhere in the world, I would look at the client and say, 'I've got something to learn from you.'"

 
The larger of two mosques in the rehabilitation city. The project was sponsored by the sultan in fulfillment of Zakat (charity), one of the five pillars of Islam.


For Chris Choa, it was understanding that, "for large projects like this, be flexible, because requirements will change over time. But if you have a big idea and a system of how it will work out, the many people who work on it will be able to keep it consistent."




Paul Boardman says there was a grandeur to the project that "had to be attached to the intimate purpose of healing." Being able to mediate those two scales was "an unusual experience."

"The prayers, the food, the climate, the very strong family culture — all this taught me a lot about designing healthcare for different cultures," says Richard Sprow.

Joe Hand says the five months in the desert reshaped his values. "There was a buy-in to the extremes of the project — the extravagances at one end, to build the vision, and the opportunity to push the limits, in terms of form making, and apply a clean, modern vocabulary without going toward a horrid pastiche of Moorish architecture."