Illustration of Espoo Hospital. The Museum of Finnish Architecture and the Finnish
Association of Architects are holding an exhibition at the Museum of
Finnish Architecture showcasing hospital and health care from
the late 19th century to the present day. Photo by K2S Architects.
Illustration of Espoo Hospital. The Museum of Finnish Architecture and the Finnish Association of Architects are holding an exhibition at the Museum of Finnish Architecture showcasing hospital and health care from the late 19th century to the present day. Photo by K2S Architects.

In sickness and in health – supportive architecture

As part of its series on architectural competitions, the Museum of Finnish Architecture is holding an exhibition on the history of buildings designed for cure and care in Finland in its two halls until 5 June 2016. The material consists of drawings, photographs and texts as well as models and moving images. The exhibition also comprises lectures and discussions.

Hospitals are complex design tasks which need to take account of both treatment efficiency and patients’ personal needs. Over time, the emphasis has varied between an industrial approach, importance to society and respect for the individual. Today, mental support for the patient is again understood to be of central importance. The architecture of some new hospitals and care facilities is supportive. The primary concern is efficient treatment, but if that can be hastened by means of architecture, the extra expense in relation to the total cost is insignificant. In addition to medical care, people’s mood is lifted.

Architectural competitions have been a means to solve the problems involved with hospital buildings ever since 1877, when the Finnish Senate announced an open international competition for the design of the Helsinki Surgical Hospital. Twenty seven entries were submitted, and the winning design was by Sigismund Ringier and Ludvig Bohnstedt. It was, however, architect Frans Anatolius Sjöström who was commissioned to design the hospital. His basic idea is a cluster of pavilions interspersed with planted courtyards to refresh the mind and clean the air. Daylight came in through the big windows in the wards, and patients could breathe fresh air on the wooden balconies. Outwardly the architecture is plain compared to the rich decoration of the era, yet noble and expressive of the pride of the nation.

Surgical Hospital in Helsinki. Photo by MFA.

Surgical Hospital in Helsinki. Photo by MFA.

Along with functionalism, lifts and the spread of tuberculosis, ideas varied as to how to promote health. Buildings grew higher and bright colours were used both externally and internally. Whiteness, commonly associated with health care, appears as a metaphor for purity in the walls of functionalist buildings. Tuberculosis was treated in the countryside, in the fresh air of pine groves. Paimio Sanatorium, completed in 1932, originally had a high wing with open balconies. The patients moved on to the balcony and lounged there  during the day. The impressive building complex is arranged freely in a woodland setting. Alvar Aalto’s design is still heroic although the building has not been fully utilised for years.

Paimio Sanatorium. Photo by Jussi Tiainen.

Paimio Sanatorium. Photo by Jussi Tiainen.

After the Second World War the principles of hospital design changed, and for many decades hospitals were typically large structures set apart from their urban environment, with wards in towers surrounded by operative spaces bursting with technical equipment. This industrial approach usually produced both consistent and impressive architecture. What was negative in it was its large scale that is drastically at odds with the size of the human body.

As techniques and methods have advanced, even some of the newer hospital buildings have become problematic. The huge Turku University Central Hospital will be vacated by 2018 and will probably be pulled down. The imposing building was the winner of a competition organised in 1955. Oulu University Central Hospital, designed in 1965 and with a varied patchwork look, is being disfigured by modernisation. The fine winning entry of the competition for the Lahti Central Hospital, organised in 1964, was never built. Based on low wings, this subtle, well thought-out design remained on paper. The hospital that was built was designed by other architects.

Turku University Hospital. Photo by HedeFoto.

Turku University Hospital. Photo by HedeFoto.

Oulu University Hospital. Photo by Laukan kuvaamo.

Oulu University Hospital. Photo by Laukan kuvaamo.

The model of Lahti hospital. Photo by Kuvakiila.

The model of Lahti Hospital. Photo by Kuvakiila.

Wings with large windows that reach out to nature bring the comforting presence of vegetation and the sky into hospital wards. This can be seen in the most recent hospital designs, which have reverted to a low construction style. The smaller exhibition hall in the Museum of Finnish Architecture presents the unbuilt Espoo Hospital, whose curving forms lend it a soft, empathetic character. A similar atmosphere can be found in the fresh design for the extension of the Lapland Central Hospital, which is organised around the existing group of buildings completed in the 1980s.

The model of Espoo Hospital.

The model of Espoo Hospital.

As with curing people, caring for them is a task that falls upon society. Care facilities are also homes, so a small scale and cosiness are important qualities in them. The designs for assisted living facilities and old people’s homes are mostly successful, because other factors take a back seat. Still, partly because of a change in thinking, there is much scope for improvement. A brusque institutional approach must be avoided; small scale can never be emphasised too much. There is an underlying contradiction: efficiency is accentuated in large units while homeliness calls for a small scale. Assisted living facilities must allow rapid and skilful intervention in case of emergency. On the other hand, health must also be fostered continuously and slowly.

The following designs stand out in the exhibition; of these, the Lahti and Espoo hospitals were never built and the Laakso-Aurora Hospital and Lapland Central Hospital remain on paper:

  • Sigismund Ringier and F. A. Sjöström: Helsinki Surgical Hospital, 1877
  • Alvar Aalto: Paimio Sanatorium, 1929
  • Jussi and Veli Paatela: Töölö Hospital Extension, Helsinki, 1945
  • Erkki Helamaa and Veijo Martikainen: Tampere Central Hospital, 1955
  • Ragnar and Martta Ypyä: Turku University Central Hospital, 1955
  • Antero Pernaja and Nils-Henrik Sandell: Lahti Central Hospital, 1964
  • Reino Koivula: Oulu University Central Hospital, 1965
  • Reino Koivula: Jorvi Hospital, Espoo, 1965
  • Mikko Kaira, Pentti Kareoja, Ilmari Lahdelma, Juha Luoma, Rainer Mahlamäki and Markus Seppänen: Hausjärvi Health Centre and Senior Home, 1986
  • Liisa and Markku Sievänen: Ulrika Home for the Elderly, Loviisa, 1999
  • Kimmo Lintula, Niko Sirola and Mikko Summanen: Espoo Hospital, 2008
  • Antti Karsikas, Ville-Pekka Ikola ja Kalle Vahtera: Senior Citizen’s Residence for Tuira, Oulu, 2008
  • Jonna Taegen: Laakso-Aurora Hospital, Helsinki, 2013
  • Väinö Nikkilä, Jussi Palva, Riina Palva ja Ilkka Salminen: Rovaniemi Hospital/Lapland Central Hospital extension, 2015

Dates refer to the date of the competition. The exhibition sites were selected by Hennu Kjisik.

 

Text by Roy Mänttäri
English t
ranslation by Maija Kasvio

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