In 1971, His Highness the Aga Khan commissioned PAYETTE to design a new teaching hospital, together with a medical college and school of nursing, on a barren site on the outskirts of Karachi, Pakistan. Since then the population has grown from 5 million to well over 17 million, and today the Aga Khan University hospital complex occupies the geographic center of this ever-growing metropolis. Completed in 1985, it is now the premier medical center in Pakistan, providing advanced healthcare delivery, professional medical training, and scientific research.
In the past few years, PAYETTE has begunworking with other entities within the Aga Khan Development Network, taking us to Kabul, Afghanistan; Nairobi, Kenya; and most recently, Dar es Salaam, Tanzania, where we are currently doing a master plan and conceptual design for expanding the Aga Khan Hospital, a 74-bed secondary hospital that is a component of Aga Khan Health Services. In late August, Mark Careaga, Associate Principal, and Tom Payette, Principal, were in Dar es Salaam and at the client’s invitation, the discussed the project with The Citizen. Below are a few excerpts, published last Sunday (read the full article here):
Q: PAYETTE is one of the world’s leading architectural firms in health care design matching the challenges and complexities of design in your projects with innovative and sustainable built environments. How do you achieve this?
A: A lot of our success has to do with our culture as a firm. We maintain a singular office in Boston, Massachusetts in the United States and this allows us to practice as a think tank, cultivating young talent and allowing the accumulated wisdom of our collective intelligence to permeate projects throughout the office.
Our firm’s culture sets excellence as the standard by which we measure our work. We are constantly looking for new and better ways of solving the various problems we encounter through the design process. I think a lot of our innovativeness is a result of this open, inquisitive firm culture. The sustainable dimension of our work is deep-seated and has roots in our human-centered approach to design.
Q: PAYETTE has been notably associated with the use of research in healthcare design, a practice that is changing the way healthcare facilities and indeed other building types are designed. What are your thoughts on this?
A: Evidence-based design (EBD) is a relatively recent field that is doing some excellent work in identifying spatial configurations that are directly linked to improved clinical outcomes.
Essentially, EBD applies the rigors of the scientific method to techniques of performance evaluation that architects have used for decades, such as post-occupancy surveys. In our work we combine detailed first-hand observations of how existing facilities are configured and operated with our long-term experience with what has been successful. Our research is an on-going evolving project that builds on the collective body of our work.
Q: The Aga Khan University (AKU) Karachi Hospital, Medical College and School of Nursing was one of your first projects outside the United States. AKU was lauded as a benchmark for responsible development in the region. How did you achieve this?
A: A lot of the credit for the success of this first project should be attributed to His Highness the Aga Khan who is a highly educated patron and an astute critic of architecture. One of the first things Tom and his core team did at the outset of the project was at His Highness’ direction, undertook a six-week tour of historic Islamic architecture in Spain, North Africa, Persia, and South Asia.
From these first-hand observations the team came to realize that truly sustainable architecture lies at the intersection of climate and culture. By seeking a building form that reflects history and local patterns of inhabitation, the design team adapted traditional methods of building that are fundamentally sustainable: roof forms and portals that help channel prevailing breezes, veranda walkways that are shaded and which filter the harsh Karachi sunlight with terracotta block screens, and lushly-planted courtyards that mitigate the local microclimate.
Continue to the full article.
Site plan diagram of the proposed master plan
Model photograph of the proposed master plan
Aerial photograph of the site and surrounding context
Photograph of existing hospital from Ocean Road
Photograph of beachfront context, from existing hospital
Related Links:
Aga Khan University Faculty of Arts & Sciences Master Plan
Aga Khan University Hospital and Medical School Campus
The 2025 OpenLAB Boston studio work will be exhibited at Virginia Tech Monday, March 2nd through Wednesday, March 4th.
Please join us for the following events on Monday, March 2nd:
11:00am - Lecture with Parke MacDowell
1:00pm Lobby talk with Kevin Sullivan
This year’s studio identifies seven sites along the frayed edges of Boston’s Greenway. The Greenway is a one-mile-long linear park running through the heart of the city, reconnecting downtown Boston with its waterfront. Many of the parcels along its edges remain undeveloped and present mute, blank facades to the public realm. Addressing and repairing these edges through acts of infilling, layering, grafting, framing, and placemaking is the core focus of the studio—SUTURE.