Contract - Designing for Health: Special Design Considerations for the Middle East

design - essay



Designing for Health: Special Design Considerations for the Middle East

02 April, 2012

-By Barbara L Burnette, IIDA, LEED AP BD+C, EDAC



In the midst of a slowing construction industry in the United States, international projects—especially those in areas of the Middle East—have become a focus of many Western architecture and design firms in recent years. These Middle Eastern countries, including Qatar, Kuwait and the Kingdom of Saudi Arabia are currently experiencing vast growth in the education, healthcare, research, and social development sectors. It is important to understand how the regional, cultural and religious aspects of the Middle East require us to consider the special nature of design for projects there.

About four years ago, I was assigned to a significant project in Riyadh, Kingdom of Saudi Arabia, which is among the most conservative of all Middle Eastern cultures. The project was an entire campus dedicated to women, a progressive project in a country where currently women are not permitted to drive, be in public without coverings, and must be accompanied at all times by a male family member. However, just recently “the Saudi government is beginning to encourage the mixing of men and women in some universities and women are even being allowed to drive in some locations,” according to Abdulrahman Ismail, contracts manager at Arabtec.

At the onset of the project our design team was given advice on many “guidelines” which we were to follow, most of which we simply did not believe. We were told about powerful sandstorms, the importance of privacy and modesty, the separation between single men and families, how toilets can never face directly toward or away from Mecca – the list went on and on. We soon learned firsthand the stark reality of living and designing in the region.  

The climate in Riyadh was extreme at times. We experienced incredible heat in the summers, with temperatures sometimes reaching as high as 135 degrees Fahrenheit. The average highs are 113 degrees Fahrenheit from July to August and average lows hit 37 degrees Fahrenheit from January to December, which is something to consider when selecting materials, since most project interiors are installed concurrently with the exterior. In our experience, wood and other delicate materials were installed before the building envelope was closed up – prior to humidity control or air conditioning. Therefore, most of the delicate materials had to be replaced once the spaces were conditioned.

Sandstorms are another natural weather occurrence with major design implications. During a sandstorm, day appears to become night: Fine sand and dust permeates every surface in its path. Shiny surface floors become extremely slippery. Horizontal, shelf-like surfaces and any nooks and crannies become dust laden and difficult to maintain. During the sandstorms that our team experienced, it was not uncommon for us to find sand filling the lobby of our hotel even through the sally port entry. Therefore, material selection and design details for easy cleaning are critical when designing for this region.

In addition to climate differences, we noticed many cultural differences that affected our work, including perception. Some of the finishes that we would find here in the States to be upscale, such as terrazzo flooring, are seen as “cheap” in the region. Terrazzo tile is typically used as subflooring rather than a finished floor system. In some cases granite or other stones were preferred over plastic laminate as being more readily available and less expensive according to the contractors we worked with.

Another cultural difference with design implications— especially for healthcare projects—is the sheer size of the family unit. Typically, a family will travel together to seek care for an ailing family member, similar to what we experience in regional hospitals in the States. However, the difference is that the average size of a Saudi household is 5.84 people, which suggests a need to plan for a surplus in family space in waiting, exam and patient rooms. By comparison, in the United States the average size of the household is 2.62 persons. 

A religious requirement to consider when designing any public space is the separation of single men and family groups (including married men and women), children, and single women. This often means accounting for additional waiting rooms in hospitals, and separate entrances and dining areas in restaurants. Privacy and modesty are further aspects that affect how we design spaces. This is evident throughout Saudi Arabia, where screens are used to create visual barriers to public toilet rooms, there are no dressing rooms within retail stores and visual imagery of the human figure is blurred, or faces are not shown. Animals and people (other than images of the King) are not allowed to be depicted in artwork or other graphics.

It is law that a black abaya must be worn by all women in Saudi Arabia.  An abaya is a long-sleeve, plain, robe-like dress worn by women over their regular clothing.  It covers the entire body except the face, feet and hands.  This is the Muslim woman’s traditional form of dress for many countries of the Arabian Peninsula, including the United Arab Emirates.  It is important to note that the black color from the abaya can transfer onto light-colored seating, so special consideration should be made when selecting upholstery or seat shell color to ensure that any discoloration will not be apparent. 

Living and breathing the culture was truly an experience of a lifetime as a designer.  The value in being immersed into the culture and experiencing the differences firsthand gave our team amazing insight and invaluable lessons learned, the most important being that we should be more open to cultures far different than ours in the West. “Taking the time to put aside our Western ideas of doing business, taking the time to listen, sit and have tea with the team, relax and find out the contractors perspective can be invaluable,” according to Julie MacLeod, senior designer with Perkins+Will on several Saudi projects.  Julie also noted that, “once you realize the cultural and social aspect of communicating in a different way, you will get better results.” Understanding those differences in the design process can go a long way toward creating successful projects in the Arab Peninsula.

Photos

A teammate during a sandstorm, taken outside of our site offices at 3:00 pm in Riyadh, Saudi Arabia.  
Photo credit: Andrew Kordon

Separate entrances for single men and single women/families at a café in Riyadh. The family entrance is obscured.  
Photo credit: Barbara L Burnette

Blurred face, leggings and revealing areas of skin are blurred to maintain modesty outside a popular clothing chain in a Riyadh shopping mall.  
Photo credit: Barbara L Burnette


Sources
Saudi Women Target Guardianship Laws To Ease Employment Restrictions, Eurasia Review News and Analysis, by Rob L. Wagner  (January 16, 2012)
Saudi Arabia Climate Guide to the Average Weather & Temperatures with Graphs Elucidating Sunshine and Rainfall Data & Information about Wind Speeds & Humidity, climatetemp.info/saudi-arabia/
Shrinking Family Size to Help Saudi Housing Sector, Kingdom’s Population Grows by Around 2.6% since 1992, Emirates 24/7, by Nadim Kawach, (August, 9, 2010)
Current Population Reports, Projections of the Number of Households and Families in the United States: 1995 to 2010, U.S. Department of Commerce, Economics and Statistics Administration, Bureau of the Census
Saudi Arabian Women Clothing – Traditional Dress Abaya, saudigirlslife.com, posted by admin in Arabian Women Clothing,  (August, 22, 2010)


Bio
Barbara L Burnette, IIDA, LEED AP BD+C, EDAC, is a Senior Project Interior Designer with the Perkins+Will Chicago office.  She has experience working across a wide range of market sectors, including specialized experience in the healthcare and higher education markets.  Barbara is responsible for leading the interior design team and overseeing all aspects of the design process.  She can be reached at barbara.burnette@perkinswill.com
Editors: Robin Tkach and Hannah Jefferies, MFA, IIDA, LEED AP ID+C, EDAC

"Designing for Health" is a monthly, web-exclusive series from the healthcare interior design leaders at Perkins+Will that focuses on the issues, trends, challenges, and reserach involved in crafting today's healing environments. Past installment of "Designing for Health" include (click on the title to access the full article):


Exploring Collaboration in the Consolidated Interventional Platform
The Differences between U.S. and U.K. Clinical Planning Models
Widening a Circle of Natural Inclusion
Mentoring the Next Generation of Healthcare Design Professionals
When the Professional Becomes the Patient--An Insider's Perspective
The Evolving Role of the Design Professional Through Public Private Partnerships


Designing for Health: Special Design Considerations for the Middle East

02 April, 2012


Andrew Kordon

In the midst of a slowing construction industry in the United States, international projects—especially those in areas of the Middle East—have become a focus of many Western architecture and design firms in recent years. These Middle Eastern countries, including Qatar, Kuwait and the Kingdom of Saudi Arabia are currently experiencing vast growth in the education, healthcare, research, and social development sectors. It is important to understand how the regional, cultural and religious aspects of the Middle East require us to consider the special nature of design for projects there.

About four years ago, I was assigned to a significant project in Riyadh, Kingdom of Saudi Arabia, which is among the most conservative of all Middle Eastern cultures. The project was an entire campus dedicated to women, a progressive project in a country where currently women are not permitted to drive, be in public without coverings, and must be accompanied at all times by a male family member. However, just recently “the Saudi government is beginning to encourage the mixing of men and women in some universities and women are even being allowed to drive in some locations,” according to Abdulrahman Ismail, contracts manager at Arabtec.

At the onset of the project our design team was given advice on many “guidelines” which we were to follow, most of which we simply did not believe. We were told about powerful sandstorms, the importance of privacy and modesty, the separation between single men and families, how toilets can never face directly toward or away from Mecca – the list went on and on. We soon learned firsthand the stark reality of living and designing in the region.  

The climate in Riyadh was extreme at times. We experienced incredible heat in the summers, with temperatures sometimes reaching as high as 135 degrees Fahrenheit. The average highs are 113 degrees Fahrenheit from July to August and average lows hit 37 degrees Fahrenheit from January to December, which is something to consider when selecting materials, since most project interiors are installed concurrently with the exterior. In our experience, wood and other delicate materials were installed before the building envelope was closed up – prior to humidity control or air conditioning. Therefore, most of the delicate materials had to be replaced once the spaces were conditioned.

Sandstorms are another natural weather occurrence with major design implications. During a sandstorm, day appears to become night: Fine sand and dust permeates every surface in its path. Shiny surface floors become extremely slippery. Horizontal, shelf-like surfaces and any nooks and crannies become dust laden and difficult to maintain. During the sandstorms that our team experienced, it was not uncommon for us to find sand filling the lobby of our hotel even through the sally port entry. Therefore, material selection and design details for easy cleaning are critical when designing for this region.

In addition to climate differences, we noticed many cultural differences that affected our work, including perception. Some of the finishes that we would find here in the States to be upscale, such as terrazzo flooring, are seen as “cheap” in the region. Terrazzo tile is typically used as subflooring rather than a finished floor system. In some cases granite or other stones were preferred over plastic laminate as being more readily available and less expensive according to the contractors we worked with.

Another cultural difference with design implications— especially for healthcare projects—is the sheer size of the family unit. Typically, a family will travel together to seek care for an ailing family member, similar to what we experience in regional hospitals in the States. However, the difference is that the average size of a Saudi household is 5.84 people, which suggests a need to plan for a surplus in family space in waiting, exam and patient rooms. By comparison, in the United States the average size of the household is 2.62 persons. 

A religious requirement to consider when designing any public space is the separation of single men and family groups (including married men and women), children, and single women. This often means accounting for additional waiting rooms in hospitals, and separate entrances and dining areas in restaurants. Privacy and modesty are further aspects that affect how we design spaces. This is evident throughout Saudi Arabia, where screens are used to create visual barriers to public toilet rooms, there are no dressing rooms within retail stores and visual imagery of the human figure is blurred, or faces are not shown. Animals and people (other than images of the King) are not allowed to be depicted in artwork or other graphics.

It is law that a black abaya must be worn by all women in Saudi Arabia.  An abaya is a long-sleeve, plain, robe-like dress worn by women over their regular clothing.  It covers the entire body except the face, feet and hands.  This is the Muslim woman’s traditional form of dress for many countries of the Arabian Peninsula, including the United Arab Emirates.  It is important to note that the black color from the abaya can transfer onto light-colored seating, so special consideration should be made when selecting upholstery or seat shell color to ensure that any discoloration will not be apparent. 

Living and breathing the culture was truly an experience of a lifetime as a designer.  The value in being immersed into the culture and experiencing the differences firsthand gave our team amazing insight and invaluable lessons learned, the most important being that we should be more open to cultures far different than ours in the West. “Taking the time to put aside our Western ideas of doing business, taking the time to listen, sit and have tea with the team, relax and find out the contractors perspective can be invaluable,” according to Julie MacLeod, senior designer with Perkins+Will on several Saudi projects.  Julie also noted that, “once you realize the cultural and social aspect of communicating in a different way, you will get better results.” Understanding those differences in the design process can go a long way toward creating successful projects in the Arab Peninsula.

Photos

A teammate during a sandstorm, taken outside of our site offices at 3:00 pm in Riyadh, Saudi Arabia.  
Photo credit: Andrew Kordon

Separate entrances for single men and single women/families at a café in Riyadh. The family entrance is obscured.  
Photo credit: Barbara L Burnette

Blurred face, leggings and revealing areas of skin are blurred to maintain modesty outside a popular clothing chain in a Riyadh shopping mall.  
Photo credit: Barbara L Burnette


Sources
Saudi Women Target Guardianship Laws To Ease Employment Restrictions, Eurasia Review News and Analysis, by Rob L. Wagner  (January 16, 2012)
Saudi Arabia Climate Guide to the Average Weather & Temperatures with Graphs Elucidating Sunshine and Rainfall Data & Information about Wind Speeds & Humidity, climatetemp.info/saudi-arabia/
Shrinking Family Size to Help Saudi Housing Sector, Kingdom’s Population Grows by Around 2.6% since 1992, Emirates 24/7, by Nadim Kawach, (August, 9, 2010)
Current Population Reports, Projections of the Number of Households and Families in the United States: 1995 to 2010, U.S. Department of Commerce, Economics and Statistics Administration, Bureau of the Census
Saudi Arabian Women Clothing – Traditional Dress Abaya, saudigirlslife.com, posted by admin in Arabian Women Clothing,  (August, 22, 2010)


Bio
Barbara L Burnette, IIDA, LEED AP BD+C, EDAC, is a Senior Project Interior Designer with the Perkins+Will Chicago office.  She has experience working across a wide range of market sectors, including specialized experience in the healthcare and higher education markets.  Barbara is responsible for leading the interior design team and overseeing all aspects of the design process.  She can be reached at barbara.burnette@perkinswill.com
Editors: Robin Tkach and Hannah Jefferies, MFA, IIDA, LEED AP ID+C, EDAC

"Designing for Health" is a monthly, web-exclusive series from the healthcare interior design leaders at Perkins+Will that focuses on the issues, trends, challenges, and reserach involved in crafting today's healing environments. Past installment of "Designing for Health" include (click on the title to access the full article):


Exploring Collaboration in the Consolidated Interventional Platform
The Differences between U.S. and U.K. Clinical Planning Models
Widening a Circle of Natural Inclusion
Mentoring the Next Generation of Healthcare Design Professionals
When the Professional Becomes the Patient--An Insider's Perspective
The Evolving Role of the Design Professional Through Public Private Partnerships
 


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