The healthcare model in India is universal, directed by the State, rather than the federal rule. As generally known, the public organization is usually free, except for some symbolic payments. Therefore the Indian State is responsible for raising the living standards of its citizens while assuring the continuous evolution of public health. Indeed, the government spent a total of 36 billion dollars in 2019, which equals around 1.23% of the GDP, for healthcare.

The constant update of the National Health Policy since 1983 focused on the actions of the vital healthcare industry. 

In 2018, the system of health insurance was funded by the government. The idea was launched by Ayushman Bharat, India’s Government. By doing so, 50% of the population was offered free treatment at private institutions. 

Rajiv Gandhi Government General Hospital

Evolution of Healthcare Architecture in India - Sheet3
Dr. Narayansamy takes over as dean for Rajiv Gandhi Government General Hospital, MMC ©newindianexpress.com

Rajiv Gandhi Government General Hospital is one of the oldest significant hospitals owned by the State in India. It is located in Chennai and is currently funded and managed by the government of Tamil Nadu. Today, this healthcare facility supports 2,722 beds and is affiliated with Madras Medical College. 

Rajiv Gandhi Government General Hospital was founded by the British East India Company on November 16th, 1664. Being the first medical institution in India, the hospital was used to treat British East India’s sick soldiers. 

During the first few years, the Government General Hospital was located at Fort St. George. It snowballed to become a formal medical institution thanks to Sir Elihu Yale, who instrumented the hospital’s development by giving it new premises in 1690. Sir Yale is the benefactor of Yale University. 

After the British French war, the Government General Hospital took over 20 years to settle in its current location. By 1772, this healthcare facility was a training house for Europeans, natives, and Eurasians. 

The main building, which is known to have an H-shape, was built in 1842. At that time, the hospital opened its doors to the Indians, and Madras Medical College started functioning as a medical school. The hospital’s expansion was done between the years 1928 and 1938 for the facility to welcome more patients. By the end of the 1990s, the demolition of the old building was ordered. The idea was to replace it with blocks of two towers. 

The city of Chennai is located inside of a critical seismic zone, type III. Therefore, the Rajiv Gandhi Government General Hospital structure was, in fact, thought in a quake-resistant way. Its superstructure consists of pile foundations and a framed structure. The two new towers were built with aluminum, Nova Kote finish, structural glazing, and composite panel cladding. 

In order to allow the flow by the gravity of rainwater, the ground level was raised around 1.40 meters above the ground. Tower I makes an area of 31,559 square meters, whereas tower II 33,304 square meters. These two towers are equipped with three different staircases, eight lifts, and a ramp that facilitates access to all floors. Obviously, a fire-escape staircase is placed separately, as well as a garbage disposal life. The blocks are 8-storeys high. 

The whole Government General Hospital has 52 operation rooms, as well as IC units and post-operative blocks. This hospital became the first to hold an oxygen tank with a capacity of 13,000 liters of oxygen of continence. It was the first to install color-coded areas, according to the Tamil Nadu Accident and Emergency Care Initiative guidelines. 

This facility owns a corporation canteen of 5,000 square feet. It is still under construction but will have the capacity of welcoming 12,000 outpatients and 3,000 inpatients, as well as thousands of people between visitors and hospital staff. This canteen unit will be equipped with an access ramp.

Osmania General Hospital

Evolution of Healthcare Architecture in India - Sheet2
Osmania General Hospital ©Wikipedia.com

Osmania General Hospital is one of the oldest healthcare facilities in India too. It was built in 1866, under the name of Afzal Gunj Hospital by Salar Jung I. The last Nizam of Hyderabad, Mir Osman Ali Khan, ordered the completion of the actual hospital building in 1919. Nowadays, the Osmania General Hospital is home to more than a thousand beds. 

OGH was designed by the British architect Vincent Jerome Esch and Nawab Khan Bahadur Mirza Akbar Baig. It has an architectural style called the Indo-Saracenic style. The Indo-Saracenic style, also known as the Neo-Mughal, or Hindu Style, was a revivalist architectural style that aimed at bringing back elements from the native Indo-Islamic Architecture. It was used by British architects who were in India during the 19th century.

Tata Medical Center

Evolution of Healthcare Architecture in India - Sheet3
Tata Medical Center // CannonDesign ©archdaily.com
Evolution of Healthcare Architecture in India - Sheet4
Tata Medical Center // CannonDesign ©archdaily.com
Evolution of Healthcare Architecture in India - Sheet5
Tata Medical Center // CannonDesign ©archdaily.com
Evolution of Healthcare Architecture in India - Sheet6
Tata Medical Center // CannonDesign ©archdaily.com

From 1900 to 2016, India has seen a doubling in cases of cancer and cancer-related deaths. The main reason? The shortage of accessibility to treatment. 

In that framework, the Tata Medical Center was conceived: the shed of light that would increase cancer survival rates. In 2019, these numbers were around 80% of survival in Kolkata, where the hospital is located. This healthcare facility was designed by CannonDesign and partnered with international manufacturers such as AutoDesk, Saint-Gobain, Hunter Douglas, and others. 

2011 was the year when the Tata Medical Center opened its phase I units. During that phase, a considerable demand had to be cut out due to the lack of available beds. Doctor Mammen Chandy, the Tata facility director, claims that around 30% of patients were rejected. However, when phase II of construction was completed in 2019, 240 beds were added to the initial buildings. Additionally, an academic medical research center was injected so that students and visiting faculty members could enhance their knowledge. 

The main aim of this healthcare facility is to improve the experience. One shouldn’t forget that these patients are facing life-saving treatments and should be present in the most pleasant environment possible. The gradation between public and private space is made subtle thanks to courtyards. In that sense, the facility becomes a friendlier, campus-like hospital. 

Bouncing back to the idea of private treatment paid by government insurance that we discussed earlier, the Tata Medical Center offers more than 50% of its inpatient’s free treatment. This forms a significant critical evolution in cancer detection and early treatment.

A Considerable Change

As times pass by, technologies evolve, and knowledge grows, the Indian Healthcare system never accepts going back. The continuous increase of will to change and upgrade healthcare facilities is alimented by the government’s desire to make medicine and treatment more accessible, reachable, affordable, and amazingly humane design standards. 

As we saw through those three examples, having each one its own divergent perceptions, all of them agree that hospitals should promote comfort and stress-free environments. Adding on to that, the demand for hospitalization is growing bigger and bigger. This leaves this kind of facility under a challenge, which they are successfully winning.

Dima Fadel
Author

Dima Fadel is a passionate and curious architect, constantly seeking new knowledge. She graduated with a Bachelor Degree in Architectural Studies from the Académie Libanaise des Beaux-Arts in Beirut last summer, and is currently pursuing her MSc in Integrated Architectural Design at La Salle, in the urban laboratory of Architecture: Barcelona.

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