SUPER GREEN - the International Academy of Design and Health

Market Report: Eastern EuropeIt has been 17 years since the collapse of the Soviet Union, but it is only now that the rebuilding of the healthcare sector in thecountries of the former USSR and Eastern Europe is really beginning to get under way. Years of neglect have left buildings in a poorcondition, impacting on patient care. And as they look for ways to modernise, architects and construction specialists from around theworld are looking at how they can get involved.During the Soviet era, health was not a priority and investment was low. At the same time, there were large numbers of smallhospitals. The primary care sector was relatively undeveloped, hospitals were often disease-focused and there were parallel healthsystems for specifi c sectors, such as the army, the police or transport, each with their own set of hospitals and medical care.In the USSR, funding was focused on bed numbers rather than the care provided. This, says Bernd Rechel from the LondonSchool of Health and Tropical Medicine, led to unnecessary hospitalisation and an ineffi cient use of resources. In its 2004 report onhealthcare in the Ukraine 1 , the EuropeanObservatory on Health Systems andEasternPolicies said: “Despite the limited resourcesavailable for the healthcare system, planningcontinued to be oriented towards the goalof ever-increasing capacity, measured bythe number of hospital beds and of healthpromiseThe modernisation of healthcare facilities and reform ofthe healthcare sector is gaining pace in Russia and EasternEurope. Kathleen Armstrong looks at recent developmentsand the challenges and opportunities they providepersonnel. As a result, Ukraine, as manyother former Soviet republics, had one ofthe world’s highest numbers of hospitalbeds and physicians per capita. Inevitably,increased quantity was at the expenseof quality, and in many cases encouragedharmful practices such as lengthyhospitalisations for minor disorders.”Under-investment in facilities meant thatsome hospitals in rural areas didn’t evenhave basic amenities, such as running wateror sewerage 2 .After the fall of the Soviet Union, mostof the countries in the former USSR andin Eastern Europe fell into a period ofeconomic decline and, as a result, healthcaresuffered further. In Russia, the “worseningeconomic situation in the 1980s and 1990sled to a slow deterioration in services, asequipment became antiquated or needed to be replaced, drug stocksdwindled and the fabric of buildings decayed” 2 .A mixed storyCountries in the region are now stepping up investment in the sector.Funding is most secure in Russia and Kazakhstan who are reaping thebenefi ts of the oil boom and, therefore, have more funding availableMedicover Hospital, WarsawCost: approx £13million (at 2006 prices)Client: MedicoverLead Consultant: ArupArchitect: Nightingale Associates and Atelier 7Health Planners: TribalStructural Engineer: ArupServices and Environmental Engineer: ArupQuantity Surveyor and Planning Supervisor: ArupLandscape Architect: Atelier 728 October 2008 | WORLD HEALTH DESIGN