A longstanding NGO, the Mae Tao Clinic (MTC) is situated in Mae Sot, Thailand, bordering Burma/Myanmar, with a predominantly Burmese population. MTC fills a gap in healthcare services by serving the displaced populations both sides of the border. It seeks to treat and prevent deaths from highly prevalent conditions within the community such as malaria, diarrhoea and HIV, whilst also offering a comprehensive health care service including: adult, child, and reproductive health inpatient and outpatient services, surgery, eye clinic, dental clinic, a prosthetics service, counselling and acupuncture. MTC also hosts a pharmacy, a laboratory, a blood bank, an infection prevention unit, health information systems and referral services, and runs extensive school health and reproductive health outreach programmes. In addition MTC serves as a centre for advocacy for issues related to the migrant community.
The current MTC site is located on leased land. Rising rents have resulted in MTC struggling to cover costs. MTC is therefore moving onto land that is already owned, by its sister organisation the Suwannimit Foundation, which will therefore significantly reduce costs and improve the sustainability of the MTC.
Whilst the masterplan for the relocation was completed in-house, MTC approached Arup for advice on the drainage and wastewater infrastructure design, as they do not have in-house engineering consultants. The wastewater system at the current site is dysfunctional, with chlorinated waste being collected almost daily by tankers; the MTC team is very aware that a safe and sustainable system is an essential requirement of the new clinic. In addition, Arup was invited to design the new Child Protection Centre (CPC): a place of outreach, education and community-building. Building on our multi-disciplinary expertise, MTC trusted Arup to play an integral part, through sensitive and effective design, in providing a more resilient, healthy and happy community in Mae Sot.
Construction of the new MTC is now well underway. Arup’s design of the CPC has been completed and embraced by MTC; construction will begin later this year. Advice on the wastewater collection and treatment system has been extensive and basic agreement on the principles and design to be followed has been reached: with this Arup input, a safe and sustainable collection, treatment and disposal system should be incorporated in the new clinic build. It is anticipated, however, that the dialogue regarding the wastewater system will continue until the system is fully constructed.
The Mae Tao Clinic forms an invaluable service within the local community on multiple levels: filling a gap in local healthcare it directly benefits the individuals with nowhere else to go for healthcare, and also provides a centre and a voice for displaced people. The number served by the clinic has risen by around 20% annually, recently stabilising at around 150,000 visitors per year. By contributing to design of the new Mae Tao Clinic, Arup is contributing directly to improving conditions for the considerable underprivileged populations in the region.
The critical and sensitive design of the Child Protection Centre for the new Mae Tao Clinic hopes to play an essential part in the necessary change to long-standing social and political suppressions in the Mae Sot community. Through design of a good community healing space Arup hopes to stimulate a healthier, happier and more resilient community.
The current Clinic site includes no water reuse, despite the presence of rainwater collection tanks. The septic system is simply one of collection in a large septic tank (which does not operate as originally intended), where it is chlorinated and then removed by tanker. Through collaborative design for the new MTC of safe and effective rainwater and wastewater collection, reuse and disposal systems – within the considerable practical restraints offered by the local conditions (to list a few hurdles: the area is prone to seasonal flooding; the site sits on clay with little absorptive properties; there are no sewers in the vicinity) – Arup hopes to ensure the new Clinic site drainage and wastewater systems make the most of the available resources whilst being safe, sustainable and minimising the potential negative impacts on the environment or to community health.
This project has provided Arup with an invaluable learning experience, introducing new discussion points and challenging our existing attitudes: something we consider to be key to being leaders in thought and pushing the boundaries of healthcare design in the future.
The optimism and hard work of those within Mae Tao clinic and Agora Architects have spurred on our enthusiasm to help build an improved clinic, to better serve the marginalized Burmese communities.
Nikki Shaw, Arup, Singapore