MArch Portfolio Y4

‘THE NEST’

[CAIRO CANCER CENTRE]

TESSA LEWES

THE BARTLETT SCHOOL OF ARCHITECTURE

PORTFOLIO 2022/23

UNIT 18

CONTEXTUAL FUTURISM

Isaie Bloch & Ricardo de Ostos

CONTEXTUAL FUTURISM

PROJECT STATEMENT

This project seeks to create stability in a Utopian Urban future. The ambition is to recalibrate a level of social equality in Cairo through a public healthcare facility that reinstates the historical values for human life that once underpinned Egyptian Culture.

The Cairo Cancer Centre is a support facility primarily for suffering cancer patients and their families, but also delivers an integrated public domain with opportunities for knowledge sharing, research and education on leading a healthy lifestyle and preventing cancer. A scene of havoc surfaced when began researching existing public healthcare facilities in Cairo; this is a system that is truly needed by it’s citizens whose health is highly effected by the city smog and enormous air pollution. This project aims to provide support for sufferers of the leading disease caused by this pollution.

In the contextual future of Cairo, I envisage this project to be the first of many public support buildings designed to release strain on health services whilst preventing future disease through education and research. The social purpose of the project lies hugely in removing the stigma associated with Cancer in Cairo, especially amongst women. There is potential for a community to be borne out of shared struggle but what is missing is a place to congregate.

The building philosophy is grounded in design of therapeutic space that holds, comforts and inspires a fight for life, whilst sparking curiosity through playful form-work.

To achieve Architecture of Hope constitutes designing one big orientation outwards and many little therapy foci inwards. Patients are fighting between fear and tentative hope, between preparing to die and fighting to live. Modern architecture can mirror these complex emotions through design of opposite ends.

CONTENTS

CHAPTER I

THE ARTEFACT

This project commenced with a study of Stanley Kubrick’s 1968 film 2001: a Space Odyssey. ‘The Bone’ was extracted as an artefact of interest and from this spurred research into man-made tools, our evolution, the paleolithic era and unto modern day tribalism. The artefact remixes the paleolithic bone tool into a future context, usable by modern indigenous communities; a sculpture of 3D printed bone to ergonomically fit the head of a tribal leader, significant in form and function. This exercise rooted my interest in the complexity of bone structure and how it can be exposed and celebrated for it’s symbolic and physical strength.

2001 A Space Odyssey (1968): The film precedent that kick-started the design of a ‘remixed’ artefact. Themes extracted from this study were contextualised into the city of Cairo, to later be explored on an architectural scale.

EVOLUTION

HUMAN TECHNOLOGY

The Cave

TOOLS

HUNTING TRIBALISM

SURVIVAL

The paleolithic bone ‘club’ identified in 2001 and it’s development into modern tools through touch of humankind. Bones as weapons could be considered the original tools, and the significance of their evolution is depicted in the microsecond transition of Kubrick’s frames.

The Sheiling

Human Evolution

Ape Homo-Habilis Homo-Erectus Homo-Neanderthal Indiginous Homo-Sapien

Architectural Evolution

The Branch Shelter The Hut

Beehive Huts Mud Huts

Tool Evolution EVOLUTION

Exploring the evolutions that ran in parralel with the transition implied in 2001. Evolution can be seen to have ‘paused’ when we consider our closest relatives to cave-men in the 21st Century; modern tribal hunter gatherers. How do these people live in the modern day and what tools do they use?

KUBRICK’S BONE

FIGURE 1.1

Interior Evolution of Spatial Art:

Exploring how cave, painted art has developed unto depiction of Objectified Art Mask artefacts in modern tribes. Both tribal contexts deny anthropocentrism and point to the dominion, power and strength we can find in animals, especially when we exhibit zoomorphic features in wearable art.

Developing the form of the mask:

Analysis of the evolutinary form of the skull and how forms might be taken/extruded/inverted and exhibited in the mask. In parallel, looking at the function and ergonomics of the mask; how focussing weight in certain areas might relieve pressure points on the head.

Cranial Reflexology Pressure Points

Cranial Sacral Therapy/ Egypt 2500BC

Ape

Homo-Habilis

Homo-Erectus

Meeting Point (relieves headaches, improves memory and concentration)

The Third Eye (Relieves relief from headaches, eye strain, ulcers and improve concentration)

Bright Light (relieves migraines, headaches, allergic symptoms, sinus problems and fatigue)

Upper Lip (relieves dizziness, cramps, fainting, improves memory and concentration)

Gates of Consciousness (relieves neck pain/stiffness, stress, insomnia and coughing)

Shoulder Well (relieves stiffness and tension in the shoulders and neck)

Homo-Neanderthal Indiginous Homo-Sapien

Identifying the Artefact User The Modern, Indigenous Homo Sapien. The tools and weapons used in modern tribes are hand-held; an additional new artefact might be exhibited and transported as headwear.

TRIBAL INVESTIGATION

Investigating how indiginous tribes express themselves today; their skills, way of life and what kind of tools they use. Remixed with modern technology to their advantage, what additional tools might be of use?

Temple Region (relieves headaches and migraines when stimulated collectively)

Sun Point (improves memory, concentration an mental state, relieves dizziness and headaches)

THE SKULL

Considering how bone might be morphed into a more technologically charged tool for tribes in a contextual future, in the form of a mask, inspired by the formations of the human skull.

Paleolithic Artwork in Lascaux, France. Photograph: Sissie Brimberg National Geographic

Evolution of the Skull

Iterative Development of a mask, incorporating a detachable paleolithic cutting tool and with an implicitly zoomorphic form.

FIGURE

A combination of tubular, plate and extruded facial bone forms. Paleolithic flints exist at the end of detachable zoomorphic tusks, within an overall ergonomic structure, as the form synthesises a remix between human and animal qualities, as well as form and function.

Biomaterial structure - composed of a 3D printed composite of calcium phosphate and collagen; a material exhibiting the same porosity as real bones. As modern technology is being used and designed for exhibition in a primitive, tribal setting, this artefact explores how our advancement in technology might be applied to reach a hypothetical alternative human reality. How might the tech of modernity have been used to enhance and embed our innate (yet suppressed) human drive for tribalism, if we hadn’t pushed it to become this threatening symbol of man.

Ornamental Exhibition and Storage:

The mask exists under a vacuum formed glass lid, matching the contours of the curved form like a skin. The bone structure becomes a piece of wearable architecture, protected by the envelope of a glass cortex.

CHAPTER II

THE PROGRAMME

The Architectural Programme developed via continued research into the prevalence of tribalism throughout Egyptian history. It surfaced that life in Ancient Cairo distinctly resembled the qualities of a tribal community. There was a shared value for all human life and every individual’s purpose in the world, people protected and respected their environment, and life served a constant oppourtunity for knowledge-sharing and research. An intense desire to understand human anatomy and heal the sick was key to progressing this community unto the prestige they hold today. Unfortunately, studies of modern Cairo exhibit the demise of this tribal and rigorous era. A programme that reinstates the lost value for human life and celebrates our modern knowledge of human anatomy may help reconnect this community to it’s heritage.

Cairo is a city with a rich and ancient history that dates back to the Pharaonic era of ancient Egypt. The city was founded in the 10th century AD, during the Islamic Golden Age, by the Fatimid dynasty, which was a Shia Muslim caliphate that originated in North Africa. Under the Fatimids, Cairo became a center of Islamic scholarship and learning, as well as a major commercial and cultural hub. The city became home to the Al-Azhar Mosque; still one of the most important centers of Islamic learning in the world. As a key center for trading and commerce, Cairo connected Europe, Africa and Asia and has continued to flourish and grow into one of the important cities in the Islamic world.

AL-QĀHIRAH (“THE VICTORIOUS”)

CAIRO

Overpopulation: Cairo is one of the most densely populated cities in the world, putting a strain on the city's infrastructure of housing and transportation.

POPULATION

As of 2021, the population of Cairo is estimated to be around 20 million people, making it one of the largest cities in Africa and the Middle East. The city has grown rapidly over the past few decades, with a population increase of more than 10 million people since the 1980s. Once both ethnically and religiously diverse, population is now predominantly Muslim.

RESOURCES & EXPORTS

Petroleum products: Egypt is a significant producer of oil and natural gas, and these resources are a major source of income for the country. Cotton: Egypt has a long history of cotton production, and its high-quality cotton is sought after in international markets.

Textiles: Egypt is home to a large textile industry, which exports a variety of products including clothing, bedding, and fabrics. Agricultural products: Egypt is a major exporter of agricultural products such as fruits, vegetables, and grains, including citrus fruits, onions, potatoes, and rice.

Traffic congestion: The city's roads are often gridlocked, causing delays and pollution. This is largely due to a lack of proper public transportation.

CLIMATE

Cairo has a hot desert climate, with very little rainfall throughout the year. The city is known for its hot, dry summers and mild winters. The average temperature in Cairo during the summer months (June-August) ranges from 30-35°C (86-95°F), with occasional heatwaves bringing temperatures above 40°C (104°F). During the winter months (December-February), temperatures are cooler, with an average range of 14-20°C (57-68°F).

HEALTH

The healthcare system can be stretched, especially in the public sector. High levels of air pollution have been linked to respiratory diseases and other health problems, and the water supply in Cairo is often contaminated, which can lead to water-borne diseases. In areas of poor sanitation and hygiene, Cairo is also at risk of outbreaks of diseases such as cholera and hepatitis and like many other cities, Cairo is facing a growing burden of non-communicable diseases, such as diabetes, hypertension, and heart disease.

ISSUES IN CAIRO

Water scarcity: The city is situated on the banks of the Nile River, but water scarcity is still an issue due to population growth and inefficient water management practices.

Poverty and inequality: Despite being the economic hub of Egypt, Cairo has high levels of poverty and inequality, with many residents lacking access to basic services such as healthcare and education.

Air pollution: Cairo has some of the worst air quality in the world, due to a combination of factors including heavy traffic, industrial pollution, and poor waste management practices.

CITY CONTEXT

Urban sprawl: Cairo's urbanization has been largely unplanned and unregulated, resulting in haphazard development and a lack of basic infrastructure in many areas.

DRIVING THEMES

Depicting the contextual link between Cairo’s heritage and the tribal bone mask to be the study of human anatomy, and using this to narrate the basis of a programme.

The advanced knowledge and understandings of the human body that originated in Ancient Egypt is recorded in the 7 Medical Papyri:

The Kahun Papyrus 1825BC (Gynecology)

The Ebers Papyrus 1534 BC (Internal Medicine)

The Edwin Smith Papyrus 1660 BC (Surgical wounds and Fractures)

Egyptians read the body as a Network of interconnecting channels (Metu) like branches of the Nile, with the heart at the centre of all functions. There was immense value placed in developing understandings of anatomy and in turn, the healthcare of Egyptian Citizens.

The social and environmental context in Cairo reveals the potential for architecture amongst: Environments of natural beauty, clustered facilities and communities, close proximity to contrasting areas of both poverty and affluence, and a range of age demographic. Residential population increases in the areas of poverty and informal settlement. Dust and smog pollution sweep through the city via the winds from the Noth East and pollution is also audibly prevalent around the busy roads and junctions of the city centre.

Life as Sacred, Birth and Gynaecology, Pregnancy tests

Mummification & Embalming

Surgeries and Surgical Tools

Pharmaceuticals / Canopic Jars, providing drugs from plant, mineral and animal kingdoms. Strong understandings of botany aided discovery of the first antibiotic.

Organ understanding from Autopsy

Understanding of Prosthetics

Holistic Healers, Specialist Physicians Neurologists, gastroenterologists, proctologist and internal medicine specialists.

Schools of Thought / Houses of Life, lifestyle education.

Medical Dictionary for records and knowledge sharing

AIR POLLUTION

Cairo, with its poor air and water quality, congested traffic and long-standing waste management issues, has often ranked as one of the world’s most polluted cities. If the Nile is Cairo’s ailing heart, then polluted skies are its black lungs. Life can seem like a perpetual battle to breathe.

(The Government’s 2021 Egypt Human Development Report)

Vehicular emissions: Cairo's heavy traffic of cars, buses, and trucks. Old and poorly maintained vehicles often emit high levels of pollutants, including nitrogen oxides, sulfur dioxide, and particulate matter.

Industrial emissions: Cairo’s factories and industrial facilities significantly contribute to air pollution.

On average, residents of Cairo breathe in air suffused with 11.7 times the WHO recommended safe level of PM2.5 and 14.2 times the safe level of PM10.

Open burning: Burning of waste, crops, and other materials in open fires is a common practice in the Nile Delta region above Cairo. When this smoke blows down into Cairo it is a major contributor to air pollution.

Roughly 40,000 people are dying from pollution-related problems across Egypt every year, according to Breathe Life 2030.

Dust and sandstorms: Common especially during the spring and summer months, these storms can exacerbate air pollution by spreading particulate matter and other pollutants.

CAUSES

PUBLIC HEALTH

HEALTHCARE SYSTEMS PRIVATE PUBLIC

The air pollution plaguing Cairo constitutes a health emergency for it’s citizens yet the required rise in healthcare appointments has failed to keep up. Citizens are forced to turn to private systems of care due to the lack of funding and support in the public sector. As this transition has accelerated, demand for public healthcare

Cairo’s trust and belief in public healthcare has been fragmented via both the rise of competing private healthcare and lack of funding and support in the public sector. The social divisions created by this split expands the poverty gap.

DEMOGRAPHIC

There is an increasing population of individuals who are neglected by the public health system and cannot afford the crippling costs of the private sector. Public healthcare facilities that support both the affluent and deprived population demostrate that good health is of universal importance, which must be re-introduced as a new, convincing typology.

Respiratory problems: As well as coughing, wheezing and shortness of breath, exposure to high levels of air pollution can increase the risk of lung cancer, chronic obstructive pulmonary disease (COPD), and other respiratory diseases.

Cardiovascular problems: Heart disease, pulmonary infections, stroke, high blood pressure and blood clots are all health risks associated with polmonary infections.

ACCESSIBLE INFRASTRUCTURE

REDUCE, RE-USE & RECYCLE WASTE

Consider new ways of re-using waste products in agriculture and industry and methods of offsetting carbon emissions.

Creating public transport links and building new facilities in convenient locations, accesible on foot

Cancer: Polycyclic aromatic hydrocarbons are produced when organic materials are burned. Exposure to PAHs has been linked to an increased risk of lung, bladder, and skin cancer. Similarly, exposure to nitrogen oxides (NOx)produced by combustion processes in vehicles and power plants have been linked to an increased risk of lung cancer.

Quality of Life: Researchers suspect that pollution is connected to obesity, insomnia, depression, as well as effects on the immune, endocrine, and reproductive systems.

NEW TECHNOLOGIES

Reduce the burning of fossil fuels for transportation, energy production, and industrial processes by encouraging the use of cleaner energy sources like solar, wind and hydropower.

EDUCATION

Mr El Kady said the government must address the problem of public awareness by educating students in schools and universities from an early age about the importance of recycling and sustainability.

The Universal Health Insurance (UHI) plan was launched in 2018 to reform the fragmented healthcare system in Egypt by 2032, with implementation taking place over six phases. The law will ensure adequate and sustainable funding for health and intends to reduce out-of-pocket expenditures.

FIGURE 2.2

FIGURE 2.3

PERCEPTIONS AND REACTIONS

• Women passively follow recommended investigations and treatments on the periphery of decisions.

• Fear and mistrust in non-specialist healthcare professionals results in uncertainty of diagnosis and the perception of breast cancer as a death sentence.

• Cancer treatments are labelled as ‘losses’; losing hair, a breast, a normal life, fertility, independence, autonomy, physical attractiveness, bodily coordination, quality of life, well being, body image and relationships with their husbands.

COPING WITH BREAST CANCER

• A continuous battle, not just against cancer, but also against stigmatisation.

• Challenges include the financial burden of treatment, pain and the fears of cancer recurrence, infertility, divorce, and dying alone.

• Women feel pitied, shunned and blamed for their cancer, they isolate themselves which can lead to low mood and depression.

• Faith in Allah provides a comfort; beliefs that life and death are predestined and controlled, and breast cancer is a test of faith, to respond with patience, endurance and acceptance. Cancer can encourage a re-evaluation of what was important in life and in the afterlife.

Maggie Keswick Jencks’ insistence, as cancer closed in on her, was that ‘What matters is not to lose that joy of living in the fear of dying.’

PRECEDENT PHILOSOPHY

BREAST CANCER AND ROLES

• The role of women in Arab societies is primarily viewed as being a daughter, wife and mother; a diagnosis of breast cancer can threaten and shatter these identities and roles.

• The principle priority for many Arab women is to protect and promote their family’s well-being. Women often conceal their diagnosis to protect others from distress and sadness. Women experienced frustration, sadness and feelings of failure when breast-cancer rendered them care-receivers in contrast to self-sufficient care-providers.

The Deep Affinities between Architecture and Health

DESIGN MOTIFS

• ‘Kitchenism’ the kitchen area on first arrival that gives a sense of informality and a place to have a cup of tea.

• Group meeting areas as hybrid spaces for varying activities.

• Affinity and orientation to Nature - ‘take your grief to cosmos’ (Christian saying) as only nature is big enough to contain it. Maggie’s centres tend to promote the big sky-view but also the smaller, contained inglenook gardens.

• Architecture of Hope is one big orientation outwards and many little therapy foci inwards. Patients are fighting between fear and tentative hope, between preparing to die and fighting to live. Postmodern architecture can mirror these complex emotions through design of opposite ends

• The architecture stands out but also disappears, becoming Mies Van der Rohe’s ‘almost nothing’.

• In first instance, design supports the carers; caring for them with a good ambience means they look after patients well.

Ranging shapes from pin-wheel forms, spirals, doughnuts, blobs and rectilinear plans. Such striking architectural forms can have an impact in encouraging the visitors to take that first step over the threshold. Intrigued, this architecture encourages patients to forget their cancer for a few minutes.

From the street, the understated Centre resembles a variegated hedge and the entrance is not immediately obvious, but a break in the low wall and hedge is indicative and guides you. Coming in, is simple – no paraphernalia, buzzers or intercoms. The first stop is the kitchen table, where the volunteers gather, offering food and drink, far from the world of the reception desk, the appointment book or the long wait in the corridor. Clerestory voids allow in light but not rain and leveling maintains clear links between the office workers and the therapies going on below.

ARCHITECTURAL ATMOSPHERE

• Affects, sensations, materialities, emotions and meanings are all enrolled within the force-field of an atmosphere.

• The induction of maggies staff members is actually to sit and absorb the atmosphere and watch what is going on.

• The centres should be considered a ‘silent carer’, almost womblike, with a similar level of spirituality as a religious space.

• Holistic planning on a domestic scale creates spaces that counter the anxieties associated with cancer treatment.

Architectural focus shifts from design of objects to design of situations and practices.

• The atmosphere shouldn’t patronize you by being too cosy - ‘the building is trying not to be there, it’s spare’.

• ‘It needs to have the closeness that you need to feel held in it’

• ‘When you walk in you won’t tell a volunteer from a carer from a staff member or someone who’s terminally ill. That’s another degree of levelling, they’re here for us’

Maggies Leeds Heatherwick

"By only using natural, sustainable materials and immersing the building in thousands of plants, there was a chance for us to make an extraordinary environment capable of inspiring visitors with hope and perseverance during their difficult health journeys."

Around three mushroom shaped volumes housing counselling rooms, communal areas including a kitchen, lounge and exercise room unfold under the curving timber gills. Glazed outer walls look over the tree-filled gardens.

The Orchestration of architectural atmospheres

THE STIGMA OF CANCER AS A ‘DEATH SENTENCE’ IN CAIRO

Maggies Architectural Forms

Maggies Manchester Foster & Partners

FIGURE 2.4

FIGURE 2.5

FIGURE 2.6

[Cairo Cancer Centre]

HISTORIC & CULTURAL CONTEXT

This specialist centre aims to reinstate the thirst for knowledge in the world of human anatomy and medicine, that once defined Ancient Egypt. A drive to understand the human condition and provide new, pioneering therapies for complex illnesses has been lost, where it used to underpin the status of Egyptian society.

CURRENT HEALTH SERVICES

Many specialist private hospitals cluster around this site but all deliver clinical care in clinical spaces. The master-plan lacks the complimentary support of softer health services for these large hospitals. Cancer support centres are hugely accredited in the UK but ‘invisible’ care is less regarded the benefits hardly available to the people of Cairo.

ECONOMY & FUNDING

Public funding in Cairo is limited; a facility that doesn’t require the specialist staff, equipment and upkeep of a general hospital has more feasibility. Without the experience and understanding of the benefits, the people of Cairo may not consider paying for invisible care, therefore it must be a public service.

PATIENT BENEFITS

The centre would offer a range of services for emotional and psychological support, e.g. counselling, support groups, and complementary therapies. Practical support is also offered, such as advice on financial and legal issues, and access to benefits and entitlements. A welcoming and supportive environment encourages connection between those who are going through similar experiences, reducing feelings of isolation and building a new community.

PROJECT SOLUTION EMPOWERMENT

Contact with other women with cancer helps patients cope with their own diagnosis, especially empowering women post-treatment and in good health. Pity, blame, failure

By incorporating public facilities into this programme it encourages direct and indirect interactions between patients and the public. Cancer becomes less taboo when patients are recognised as normal, capable people as opposed to the contagious walking undead.

UNAPPARENT IDENTITY

This building facilitates patients, families, volunteers, permanent staff and the public. Uniforms don’t exist and divisions are unclear meaning there is no sense of hierarchy or fear for the carers. Everyone is grounded and equal.

‘NORMAL’ ACTIVITIES

Patients are encouraged to bond over ‘normal’, domestic activities to reinstate their identities as mother and wife. Upholstery, gardening, cooking, reading and simply chatting are all available group therapies which encourage open discussion in a familiar environment.

COMMUNITY BENEFITS

This programme is just as much about supporting patients as it is family and friends effected. Providing community education about cancer prevention, early detection, and treatment options, this can help increase awareness, promote healthier lifestyle choices and help people make informed decisions about their health and treatment options.

A PIONEERING FLAG-SHIP

This unique health facility neutralises the staggering gap between the standards of public and private systems of care in Cairo. It’s aim is to help kick-start a new belief and trust in the new brand of public healthcare, levelling it’s users to reduce stigma in the poverty gap.

TACKLING AIR POLLUTION

As well as treating patients struck by the consequences of Cairo’s air pollution, this programme aims to chip at the crux of this vast issue. The centre will educate the public about the risks they face and inform on how to make change. The Architecture will make use of technology that provides an ‘oasis’ of clean air within this building; the respite that the vulnerable deserve.

RECOVERY Patients recover from cancer with a new outlook on the value of life. They seek to impart their wisdom to others and prevent other’s diagnosis.

EDUCATION

Teaching the public and future generations about causes of cancer and how to combat rising air pollution and climate change.

PREVENTION

In an effort to combat the risks of their future, people make lifestyle changes to reduce air pollution in the city.

PROGRAMME LIFE-CYCLE CRADLE TO CRADLE

TREATMENT

Those who are struck with cancer are supported by the facility and spread awareness of their struggles and prevention.

DEFINING THE PROGRAMME SPATIAL ADJACENCIES

Envisaging the project as the ‘lungs’ of the city as it tackles the consequences of air pollution.

CHAPTER III

MASSING & SPACE

Massing and spatial coordination sprung from an interest in celebrating the bone structure that defined the term 1 artefact. Delving deeper into the anatomy of bone, the inner spongy trabeculae bone presented a fascinatingly complex system of layering and cavities for transactions. The process of design was long and iterative as I aimed to house the programme within a permeable skin inspired by a celebration of trabeculae.

DEVELOPMENTAL UNDERSTANDINGS OF ANATOMY TO HISTOLOGY

HUMAN STRUCTURE

ANCIENT EGYPT

TOOLS

MEDICINE

ANTHROPOLOGY

MICRO- STRUCTURE

NANO - STRUCTURE

ANATOMY

HEADWEAR

ULTRA STRUCTURE

RESEARCH

STRUCTURAL INTEGRITY OF THE TRABECULAE

The integrity of the skeletal system is maintained by a continuous remodelling process that responds to mechanical forces. This results in the coordinated resorption and formation of skeletal tissue- when trabeculae fails to reproduce at the same rate, it results in osteoporosis.

Trabecular Bone with resorption Areas

Trabecular Bone with micro-cracks

Osteoporotic Trabecular Bone

BONE HISTOLOGY

Exploring bone under the microscope to honour the egyptian thirst for depth of knowledge. Structural integrity can be found in the internal, uncelebrated spongey lattice.

I believe there is potential for the inhabitation of the enclosed nooks in this structure, that may produce a quality in line with the programme of a cancer centre. I would like to invert, expose and therefore celebrate the quality of this complex system into architecture that makes its patients feel held, protected and safe.

TRABECULAE ARCHITECTURE

Testing how the trabeculae structure might act as a spatial device on an architectural scale.

SPONGEY BONE “TRABECULAE”

Massing development distinguishing a public and patient centred domain, incorporating landscape inside and considering the permeable journey through the building.

Introducing a building ‘skin’ inspired by precendent permeability.

FIGURE 3.1

Translating

The skin works in a very two dimensional manner- it could inhabit light, shrubbery and wildlife in a much more experiential way.

The skin appears awkwardly detached from the building, but there is an opportunity to inhabit the space between the two; making the skin an experiential device.

Creating a dialogue between the elements began by pulling the mass apart and offsetting the levels to create intricate, porous spaces between. By making the skin three-dimensional and moving the circulation to the outer edge, it becomes part of the building journey as opposed to part of a neglected garden. The masses respond to the thicket like pieces being carved out to become inhabited cavities, like those in the trabeculae bone.

SPLITTING THE MASSING

Adjusting permeability and introducing domesticity by creating inglenooks between smaller masses.

INHABITING THE SKIN

Externalising the circulation so the skin becomes an unavoidable experiential device under an interesting sheltered threshold of feeling both inside and outside.

WRAPPING THE SKIN

RATIONALISING THE PLANS

Centering the programme around a dynamic courtyard, a public domain dominates the lower mass whilst the more private cancer patient activities inhabit the upper. Circulation landings begins to seep into the framework of the skin for an enhanced experience inside the skin.

Extending the skin over the building to shelter the roof, the daylight streaming through can be manipulated. The masses appear more directly carved out from the bone structure, uniting the building with it’s envelope.

1:500 BUILDING ENVELOPE MODEL 1:50 ‘CHUNK’ MODEL

This junction is used to show the extension of the nest but also the circulation journey and how trees and shrubbery might become seamlessly incorporated into the man-made structure.

An exercise to show the relationship between a structural series of timber columns and a nest of timber that erupts above and wraps around the facade.

LANDSCAPING

There are four different opportunities to enter on the GF to grant public and more private access from the surrounding public gardens.

PLANNING

The ground floor is a dynamic layer for coming and going where consulations and group therapies occur whilst the first floor offers quieter therapies for contemplation and peace.

Attempting

to highlight the layers of inhabitation, how the GF connects to the ground and the FF opens up to the sky, shletered behind a green barrier that shields the building from the

ELEVATION

The nest responds to its context as both a shading and experiential device. The roof line shopes up and the nest becomes thicker as more shading is required and it also drops up and down

CHAPTER IV

MATERIAL DETAIL

The project was rationalised through the Term 2 Design Realisation Report. The form began to directly respond to the environmental context of Cairo and structure was designed to be celebrated and help build a clearer relationship between the mass and the skin. As well as providing a programme that responded to the consequences of air pollution, I investigated how this theme might physically manifest in the building fabric. Rice husk ash is engrained in the walls of the building to make visible to the users that this building is a product of their local culture and context.

A

The round-wood timber Nest extends from glulam columns that rise beyond the roof, and structural roof beams, This is designed to hold bibliophile, conjure an atmospheric journey and for shading purposes. The density of the nest varies where more or less shading is required.

Low-e Glass Panel roofs supported by roof beams.

Concrete Roof encloses the protected cores.

Glulam Timber Roof Beams, connecting to the nest.

Glulam Timber Floor Beams

Glulam Timber Columns rise beyond the roof line and connect to the nest.

Curtain Wall Upper Glazing

Rice Concrete bracing brickwork constitutes an interior thermal mass.

Titanium Dioxide GRC Cladding System

Timber Frame Stud walls

Timber External Stair System

Rice

PRIMARY STRUCTURE

SECONDARY STRUCTURE

RICE-CONCRETE BRICKWORK

GLULAM TIMBER

rice-concrete thermal labyrinth basement is cast in situ, coated with titanium dioxide to clean the Cairo smog from the air as it cools.

concrete foundations and risers level the site.

Farmers then set fire to the field, burning it down to the ground. This is for the benefits of pest and disease control, removing weeds and improving soil fertility as nutrients in soil are released. This is a quick and traditional method to efficiently clear the field after harvest before the next planting season, although a variety of pollutants are released into the air, including carbon dioxide, carbon monoxide and particulate matter.

[AIR POLLUTION]

BURNT STATE (RICE HUSK ASH, RHA)

• In Cairo there is no useful application of RHA and it is usually dumped into water streams or landfills, polluting air, water and soil. RHA could be used as a material in the production of cement and concrete. When mixed with cement, RHA can improve the strength, durability, and workability of concrete.

Considering a method to test the capacity of this new material, comprising the exposed internal wall material, for thermal mass and tactile design purposes.

RICE GROWTH & ANATOMY - Seed to Mill

FIGURE 4.1

RICE-CONCRETE TESTING

Concluding that the strength of concrete is actually increased when Rice Husk Ash is incorporated into the pure cement mix.

Titanium dioxide (TiO2) is an excellent photocatalytic material that imparts biocidal, self-cleaning and smog-abating functionalities when added to cement-based materials. The presence of TiO2 influences the hydration process of cement and the development of its internal structure.

Special types of TiO2 can remove harmful nitrogen oxides responsible for the formation of smog in the air through ‘photocatalysis’ – a process where light speeds up a naturally occurring chemical reaction called photolysis. Photocatalysis results in the rapid conversion of nitrogen oxides into harmless soluble nitrate salts which are removed from a building’s surface by wind or rainfall.

TiO2 cement also finishes the walls of the thermal labyrinth passages. The smog saturated air is drawn through the system and purified before entering the air handling units and risers. The TiO2 isn’t consumed or degraded, meaning that the TiO2 infused cements will continuously remove the pollutants from the air, helping to making it a cost-effective and low-maintenance solution.

Published 2020 Nov 17. doi:10.3390/molecules25225364

https://www.tdma.info/uses-of-titanium-dioxide/the-buildings-that-clean-our-air/

GRC TiO2 Cladding Panel System SMOG REPELLING

A ‘smog-repelling’ outer material that encourages an oasis of clean air inside.

- 15 % Rice Husk Ash 6 - 20% Rice Husk Ash

1 Portland Cement

1 - Portland Cement

4

3

- 10% Rice Husk Ash

-

- 20% Rice Husk Ash

Diamantopoulos G, Katsiotis M, Fardis M, et al. The Role of Titanium Dioxide on the Hydration of Portland Cement: A Combined NMR and Ultrasonic Study. Molecules. 2020;25(22):5364.

‘PHOTOCATALYSIS’

TITANIUM DIOXIDE FINISH

TiO2

CH. 4 CH. 4 MATERIAL DETAIL MATERIAL DETAIL

TITANIUM DIOXIDE GRC

CLADDING

PASSIVE VENTILATION

Natural N/E Breeze circulates through openable windows.

SOLAR SHADING VIA TREES, FLORA & FAUNA AND THE NEST

LOW-E GLASS PANEL ROOF Tinted blue, the e-coating repels UV and Infrared whilst absorbing visible light.

VENTS CIRCULATE VENTILATED AIR

THERMAL LABYRINTH

An underground structure used for heating, cooling, and ventilation, made up of a network of underground tunnels or passages beneath the building's foundation. The labyrinth regulates the air temperature in the building by taking advantage of the natural thermal mass of the earth.

When heating is needed by night, cold air is drawn into the labyrinth, where it is warmed by the surrounding earth. The warmed air is then drawn up into the building, providing heat without the need for additional energy. When cooling is needed by day in a hot climate such as Cairo, hot air is cooled in the labyrinth by the lower earth temperatures before being circulated back into the building. The thermal labyrinth is also used to ventilate fresh air throughout the building, reducing the need for a mechanical ventilation system.

DUCTWORK FOR MECHANICAL VENTILATION

Thermal labyrinths are a sustainable and energy-efficient means of ventilation that are particularly well-suited to climates with large temperature swings between day and night and seasonal extremes.

ENDANGERED SPECIES

Birds in central Cairo have been driven away from their natural habitats on the Nile and are forced to nest in air-conditioned spaces in high rise buildings. This project encourages a new nesting area for these local birds.

Biodiversity is crucial for maintaining healthy ecosystems and the services they provide, such as pollination, nutrient cycling, and water purification. In urban areas like Cairo, where natural habitats have been largely replaced by buildings and pavement, it is especially important to protect and restore the remaining green spaces to support local biodiversity.

By planting an array of flora and fauna to grow within and around the nest, the structure gradually becomes an extension of the surrounding landscape, provides biophilic interaction for patients and encourages the growth of new life and habitats.

COOLING STRATEGY

Tackling the strong saharan heats of Cairo using mechanical and natural ventilation and shading.

REWILDING

Designing a building for a biodiverse community, encouraging re-growth of local species for biophilia sure to benefit the building users.

LOTUS

LILY JASMINE CYPERUS PAPYRUS MIMOSA JACARANDA

PARAKEET HOUSE SPARROW BLACK KITE PALM DOVE

GLULAM

Made by bonding multiple layers of wood together, the adhesive used in the gluing process ensures that the wood remains stable and does not warp, twist, or crack over time. Glulam requires minimal maintenance and can last for decades with proper care, such as periodic inspections and treatments to prevent decay and insect infestation.

ROUNDWOOD

Aside from stripping bark, roundwood logs entail very little engineering and waste from forest to construction. They maintain an organic aesthetic where less strength and durability is required in the outer nest. Vertical posts provide the structural integrity for the rest of the ‘added on’ structure.

UCHRONIA IN THE NEVADA DESERT

BY SCULPTURAL ARTIST ARNE QUINZ

CONSTRUCTION ENGAGEMENT

Surrounding the main, rigidly designed timber structure, wooden trusses are nailed together randomly to form the sculptural mass. This process requires creativity without finesse and provides an opportunity for engagement with the local community This can be translated into this project where trusses are nailed to the structure of the nest where it requires thickening. Locals can see where they have left their own mark on this human, imperfect sculpture, creating a public affection, value and pride for this building.

CAIRO’S TRIBE OF USERS

The Maggies Philosophy for establishing a ‘tribe’ of users is key in this project. Whilst patients are at the heart of the programme, it also designs for their families, their carers and their fellow community. Spaces are not designed to be cancer-patient specific; group rooms might accommodate a debrief discussion for carers, therapy rooms might serve an entire grieving family, and the frontal public cafe serving the public is run by patients themselves. The unity and levelling of users makes for a tribal setting.

TIMBER

Considering the material connections of the structural, performative and decorative timber structure.

PATIENTS

COMMUNITY ENGAGEMENT

Considering the social benefits of teh project beyond the programme.

Forestry in Egypt

FIGURE 4.2

DESIGN DEVELOPMENT

To blur thresholds further and extend the nest into the landscape more, the nest could extend into a public canopy. A longer superstructure incorporates the whole site and nestles the building, removing any sense of a fortress.

1:50 ‘CHUNK’ MODEL

Exploring the gradual change in threshold between the landscape to the nest, stairs and internal space. The thicket becomes more dense when it surrounds resting points.

CHAPTER V

FINAL DRAWINGS

The Nest attempts to seamlessly rise from a green landscape beneath and exhibit a form grounded in permeability. In walking distance from the surrounding communities, the project hopes to inspire curiosity from afar. The programme and building itself isn’t immediately obvious but routes guide people inside to an oasis of protection from smog, heat and the stigma against cancer. The emotional therapy of being held in a therapeutic space such as The Nest offers a futuristic vision for healthcare facilities in Cairo. This typology of complimentary healthcare is introduced through a unique design that encourages re-wilding, regrowth, and recalibrating amidst the concrete of the city.

PSYCHOTHERAPY

EDUCATION

BIRDS EYE VIEW

Under a canopy that stretches across the site, people interact with this scheme simply by being amongst the green landscape. Solace and shade are provided in a public outdoor space that draws your vision towards the heart of the building and into the programme that is embedded in the structure. The nest delicately reaches beyond the edge of the building like a lattice of roots and trees are encouraged to grow and support the structure alongside birds encouraged to nest. If one were to look up from underneath there would be an array of wildlife and sunlight filtering through. The stretch of the building aims to encourage and welcome people inside from afar.

THE APPROACH

Routes on the site come together at a point that gradually reveals the main entrance to the building. There is no harsh ‘front door’ to allow and encourage discrete entry upon curiosity or anxiety. The dynamic kitchen courtyard becomes visible from afar to offer transparency and the immediate ease assosiated with a domestic setting. Upon the approach people can enjoy the fruit trees and flowerbeds of the gardens that are intertwined with the nest that swoops down from a canopy to shelter the facades of the building and external circulation routes.

GROUND

Entering into a courtyard space you are met with an open cafe run by patients and volunteer. Each building block is fronted by a sitting room, maintaining a domestic scale and encouraging opportunities to rest in peace. Group rooms offer activities such as upholstery, gardening, cooking, reading as well as simply talking over a cup of tea- all activities that make patients feel more normal as they bond over their struggles. Children can be looked after as a mother undergoes her treatment and members of the public are welcome to attend group therapies and talks from leading professionals about life-style and cancer prevention.

The first floor is accessed via external circulation that offers opportunities at landings to sit and have a conversation, or to rest and contemplate the therapy you’ve just had or the news you’ve just received. Landings break into the structure and these areas are hugged by trees and wilderness to make the vulnerable feel protected and safe but also free to see and experience the outside.

STAIR LANDINGS

FIRST FLOOR

The stairs lead up to a quieter floor with more private talking therapies, counselling, chemotherapy, meditation and prayer, as well as a research and classrooms to introduce opportunities for knowledge sharing. The spaces of the first floor are visually connected to the outside as the timber columns carry the eye upwards unto the expansive nest and into the sky above.

CHEMOTHERAPY

Those receiving chemotherapy sit where they can see movement and the world going by outside, without being shunned behind closed doors. This treatment lasts for hours so views are focussed on the green bridge, courtyard, and the nest sheltering above leading to the sky. Like a Maggies Centre, the building promotes the big sky-view but also the smaller, contained inglenook gardens. An affinity and orientation to nature means one can figuratively ‘take your grief to cosmos’ (a Christian saying) as only nature is big enough to contain it.

THE COURTYARD

Following private therapies, patients might want to contemplate in quiet space away from other building users. The courtyard offers both dynamic and peaceful respite via the different levels. Staff, patients and the public all have the same access to the central space, removing hierarchy and encouraging interaction of a somewhat tribal community.

ELEVATION

Market stalls might inhabit the rear entrance of the building selling local produce and attracting the residents of the informal settlements, whilst the green space offered at the front provides solace for these people with so little space. The thickness of the roof takes steps down towards the north side as less shading is required and the nest can be seen to peel away from the building as it extends into public canopy. It rises from the ground at points of entry and trees populate in areas that surround landings for resting. The low profile does not compete with the city roof line as it lies low in height and stature.

SECTION

Nestled within the expansive timber lattice, the building itself offers many different spatial experiences.

The group therapies of the ground floor offer a spatial quality similar to the cosiness of home and feel contained enough that patients can think and speak freely together. Above, talking therapy spaces are much lighter as they look up to the depths of protective nest and bright sky beyond. At their most vulnerable, patients know they are never far from the outside. In the public domain, children enjoy educational spaces close to the sky as knowledge shared with the public in auditorium talks ground level.

Architecture of Hope one big orientation outwards and many little therapy foci inwards. Patients are fighting between fear and tentative hope, between preparing to die and fighting to live. Modern architecture can mirror these complex emotions through design of opposite ends.

CHAPTER I - THE ARTEFACT

2001 A SPACE ODYSSEY

2001: A Space Odyssey. 1968. [film] UK/USA: Stanley Kubrick.

TRIBALISM

Junger, Sebastian. 2017. Tribe. London, England: Fourth Estate.

Heying, H., & Weinstein, B. (2021). Hunter-Gatherer’s Guide to the 21st Century: Evolution and the Challenges of Modern Life. Penguin Publishing Group.

https://www.bbc.com/future/article/20140804-sad-truth-of-uncontacted-tribes

CHAPTER 2 - PROGRAMME

PAGES 16-27

Some content previously assessed as part of the Bartlett School of Architecture BARC0013 Design Realisation Report by Tessa Lewes, submitted on 10/5/23.

CAIRO CONTEXT

Elshahed, Mohamed, Cairo Since 1900: An Architectural Guide (American University of Cairo / American University of Cairo Press, 2019).

AIR POLLUTION

Imane, S., Oumaima, B., Kenza, K., Laila, I., Youssef, E. M., Zineb, S., & Mohamed, E. J. (2022). A Review on Climate, Air Pollution, and Health in North Africa. Current environmental health reports, 9(2), 276–298. https://doi.org/10.1007/s40572-022-00350-y

SOCIAL HEALTH INSURANCE

https://www.emro.who.int/egy/egypt-events/releasing-new-video-about-the-comprehensive-social-health-insurance-in-egypt.html

PUBLIC HEALTH

CHAPTER 4 - MATERIAL DETAIL

PAGES 56-67

Content previously assessed as part of the Bartlett School of Architecture BARC0013 Design Realisation Report by Tessa Lewes, submitted on 10/5/23.

RICE HUSK CEMENT

Maraveas C. (2020). Production of Sustainable Construction Materials Using Agro-Wastes. Materials (Basel, Switzerland), 13(2), 262. https://doi.org/10.3390/ma13020262

TITANIUM DIOXIDE

Diamantopoulos G, Katsiotis M, Fardis M, et al. The Role of Titanium Dioxide on the Hydration of Portland Cement: A Combined NMR and Ultrasonic Study. Molecules. 2020;25(22):5364.

Published 2020 Nov 17. doi:10.3390/molecules25225364

https://www.tdma.info/uses-of-titanium-dioxide/the-buildings-that-clean-our-air/

LIST OF FIGURES

[ALL ILLUSTRATIONS ARE ASSUMED AUTHOR’S OWN UNLESS LISTED AS FIGURES BELOW]

1.1 - A SPACE ODYSSEY

2001: A Space Odyssey. 1968. [film] UK/USA: Stanley Kubrick.

1.2 - PALEOLITHIC ART

Artwork in Lascaux, France. Photograph: Sissie Brimberg / National Geographic

2.1 - ANCIENT EGYPT ANATOMY

Fasseeh, A., ElEzbawy, B., Adly, W., ElShahawy, R., George, M., Abaza, S., ElShalakani, A., & Kaló, Z. (2022). Healthcare financing in Egypt: a systematic literature review. The Journal of the Egyptian Public Health Association, 97(1), 1. https://doi.org/10.1186/s42506-021-00089-8

MAGGIE’S PHILOSOPHY https://www.maggies.org/about-us/publications/

Jencks, Charles. “Maggie’s Architecture: The Deep Affinities Between Architecture and Health.” Architectural Design 87 (2017): 66-75.

Martin D, Nettleton S, Buse C. Affecting care: Maggie’s Centres and the orchestration of architectural atmospheres. Soc Sci Med. 2019;240:112563. doi:10.1016/j.socscimed.2019.112563

BREAST CANCER IN CAIRO

Traboulssi M, Pidgeon M, Weathers E. My Wife Has Breast Cancer: The Lived Experience of Arab Men. Semin Oncol Nurs. 2022;38(4):151307. doi:10.1016/j.soncn.2022.151307

Fearon D, Hughes S, Brearley SG. Experiences of breast cancer in Arab countries. A thematic synthesis. Qual Life Res. 2020 Feb;29(2):313-324. doi: 10.1007/s11136-019-02328-0. Epub 2019 Oct 23. PMID: 31646417; PMCID: PMC6994422.

https://www.bridgemanimages.com/en/noartistknown/egyptian-papyrus-depicting-woman-giving-birth-aided-by-maids-and-midwife/nomedium/asset/922057 https://mcdreeamiemusings.com/blog/2021/3/11/how-that-one-thing-we-all-know-about-egyptian-mummies-is-wrong https://exploretravelandcruises.com/medicine-in-ancient-egypt-3/ https://en.m.wikipedia.org/wiki/Canopic_jar https://www.realmofhistory.com/2017/06/22/egypt-oldest-prosthetic-device-history/ https://iseumsanctuary.com/2020/04/02/magical-herbal-medicine-of-the-ancient-egyptians/ https://www.researchgate.net/figure/Part-of-the-Ebers-papyrus-one-of-the-earliest-known-descriptions-of-cancer-documents_fig1_40535996

2.2 - AIR POLLUTION

https://blogs.worldbank.org/arabvoices/reducing-air-pollution-greater-cairo-involves-switching-private-vehicles-improved-public

2.3 - PUBLIC HEALTH

https://www.nytimes.com/2015/07/25/world/middleeast/egypt-facebook-pages-highlight-decrepit-public-facilities.html

2.4 - MAGGIES CENTRE FORMS

Martin D, Nettleton S, Buse C. Affecting care: Maggie’s Centres and the orchestration of architectural atmospheres. Soc Sci Med. 2019;240:112563. doi:10.1016/j. socscimed.2019.112563

2.5 - MAGGIES MANCHESTER

https://www.ribaj.com/buildings/the-maggie-s-ethos

2.6- MAGGIES LEEDS

https://www.archdaily.com/941540/maggies-leeds-centre-heatherwick-studio/5ee2329bb357655b9e000229-maggies-leeds-centre-heatherwick-studio-east-elevation

3.1 - THE BROAD MUSEUM

https://www.archdaily.com/772778/the-broad-diller-scofidio-plus-renfro

4.1 - RICE BURNING bioknot.org.uk/news/the-vicious-cycle-of-rice-straw-burning-in-vietnam/

4.2 - ARNE QUINZ

https://www.arnequinze.com/art-and-exhibitions/uchronia