Sri Lanka is known for its serene sandy beaches, mountain waterfalls, jungles, and ecological sites, as well as a culture that embraces, sustains, and lives off the goodness of the Earth. A 25,000-square-mile (65,750-km2) island-nation off the coast of India, Sri Lanka has 21 million residents and a gross domestic product of about $32 billion—about $1,600 of income per capita. About 15 percent of the country’s population remains impoverished. Although Sri Lanka is a natural wonderland, it also is a developing nation yearning to advance economically.

Scheduled to open in the city of Colombo in 2011, the Embassy Medical Center is intended to be an academic medical center that will support patient care, medical education, and research. It is part of a joint effort between the Sri Lankan government and the medical center’s owner, Silvermere Hospitals Group, Daluwakotuwa, Kochchikade, Sri Lanka, to address the needs of an undereducated and underemployed population, as well as the needs of an educated sector yearning for a more sophisticated lifestyle.

World-Class Medical Care

The underlying assumption is that the private payer clientele will be able to remain in Sri Lanka and receive the sophisticated care they expect. Being able to capture some of that market will provide a safety network for those who have been unable to afford health care in the past and will afford the community the critical mass to underwrite the local education and training of essential clinical providers and technologists.

The Sri Lankan government’s role has been to secure the rights to the land necessary for development and to assist in creating the surrounding infrastructure to support such a development. The project will create construction jobs and provide the education and training for future jobs in the design and engineering professions and the construction trades, as well as health care.

"We're essentially starting from scratch and creating a new health care business for the region,” says Chuck Knight, designer with Perkins+Will, Minneapolis. “The business will change and evolve over time. So on the planning side, we're focusing on basic programs, with the flexibility to grow into more advanced subspecialty programs.”

The Embassy Medical Center will incorporate a hospital, clinic, dormitory, hotel, parking structure, and power plant, along with sophisticated medical technologies and design features to assist its doctors in offering world-class medical treatment. Although there are existing government and private hospitals in Colombo, they do not have the capacity to meet the exploding demand for medical care from the city’s 1.3 million residents.

“There is no doubt that the Embassy Medical Center will be an advanced health care facility that will serve the community, the country, and people from around the world in need of premier medical care,” says Tariq Rauf, managing director of Silvermere Hospitals Group. “And by providing state-of-the-art health care, the facility will also contribute to the financial health of the community.”

Environmental Concerns

The project is pursuing a LEED for New Construction 2009 Platinum certification from the U.S. Green Building Council and two Living Building Challenge Modules for 100 percent on-site renewable energy and 100 percent recycled water use from the Cascadia Region Green Building Council. The power infrastructure is being designed in the hope that it would not only meet the hospital’s energy needs, but create enough power to give back to the city grid.

The center is located on a 13-acre (5.3-hectare) site near the New Kelani Bridge in the suburbs of Colombo, adjacent to the new freeway that connects the city’s central district with its international airport. The campus is designed as a series of multistory patient, educational, hospitality, and administrative buildings, linked internally for easy pedestrian access. The massing of the buildings, with their narrow floor plates, courtyards, and light shafts, is designed to maximize energy efficiency through daylighting and natural ventilation. Photovoltaic arrays on roof gardens will harvest sunlight for electricity and provide shade for patients and staff.

Another of the owner’s goals is to rely on renewable sources of heat as the main energy drivers. These sources include a solar hot-water system and a high-temperature anaerobic digester, a process that uses natural composting cycles to break down organic waste in a non-oxygenated vessel. This produces biomethane, which is then modified to create pipeline-grade natural gas. The digester is fed with 50 to 75 percent sewage and 25 to 50 percent agricultural residue and organic garbage. Sewage and organic garbage will come from the surrounding community. Agricultural residues will come from the rural areas on the island.

The Embassy Medical Center is being designed to recycle 85 to 98 percent of its waste on site; use 30 to 50 percent less energy to operate than similar-sized facilities; collect or process 100 percent of all water needs on site; reduce water usage 40 to 60 percent compared to hospitals of similar size; and produce 100 percent of the natural gas and electricity on site needed to operate the hospital. Water reduction comes from stormwater management methods such as on-site cisterns that collect rainwater that has been filtered through green roofs. Waste handling primarily is dealt with by the digesters, which convert the waste into natural gas. The facility’s cogeneration plant uses the natural gas from the digesters to create steam to generate electricity, reducing overall energy usage. After turning a turbine, the steam is sent to the absorption chiller and is used to create chilled water for cooling the facility.

This facility also will be among the first of its kind to consider high-sea flooding, tsunamis, earthquakes, and other catastrophic events so that it might remain open and functioning during a natural disaster—not only to provide medical care for patients but to provide refuge for the community. In fact, all necessary hospital functions will operate at least 25 feet (7.6 m) above the ground. The second floor of the clinic building is being planned to support large-scale triage and assessment. The power plant, as well as all life-support and electrical service systems, are buried within the parking structure on the second and third tier. Earthquake- and hurricane-proofing techniques will be considered for the building structure and enclosure.

“Climate and environment-based design is just beginning to evolve,” says Doug Pierce, senior associate with Perkins+Will, the architectural firm designing the facility. “Yet it is at the very core of the Embassy Medical Center. This is a facility that will withstand natural crises and promote self-reliance. This facility embodies social, economic, and environmental sustainability all at once.”

Job Creation

Not only will the finished Embassy Medical Center be a boon to Sri Lanka’s economy, due to the influx of dollars from traveling patients, but building the center will also be the source of additional jobs. All foreign firms are required to engage a local counterpart who can participate during construction and later maintain the campus and manage future hospital development.

“The Embassy Medical Center is more than a hospital campus. It is a new business venture for the entire community to support and benefit from,” explains Pierce. “As the business changes and grows over the coming years, so will the job opportunities.”

The complex will include a small college-like campus, complete with dormitories and classroom space so local residents can be trained to perform hospital functions and duties. Residential waste will be collected and brought to the facility for use as an energy source. Biowaste will be converted to biofuel that will then be used for heating and cooling, electrical generation, and hot-water production. Local residents will be hired to collect and transport the waste, as well as be trained in landscaping, design, and construction so they can maintain the facility on an ongoing basis.

The Embassy Medical Center will be a superior health care facility that will serve its community and its country. The state-of-the art medical facility will balance the needs of the environment with the safety, medical health, and financial needs of the community. In addition, it will be an example of how two very diverse cultures—that of the U.S. and Sri Lanka—can work together to plan, design, and develop a facility that will change thousands, if not millions, of lives.

GREEN TEAM

Owner: Silvermere Hospitals Group Ltd., St. Paul, Minn., www.silvermereinternational.com
Architect: Perkins+Will, Minneapolis, www.perkinswill.com
Associate Architect, Civil Consultant, Landscape Consultant and Structural Consultant: LHB, Minneapolis, www.lhbcorp.com
Mechanical, Electrical, Plumbing and Fire Protection Consultant: Affiliated Engineers, Madison, Wis., www.aeieng.com

Rick Hintz is the health care market sector leader for the Minneapolis office of Perkins+Will. He has nearly 30 years of specialized health care architecture experience and is leading the Embassy Medical Center design team for Perkins+Will. He can be reached at [email protected].