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Ebola Epidemic: What can Architecture do?

Architect Killian Doherty’s practice in Sierra Leone is one of many affected by the Ebola outbreak. Here he reflects on the limits of architectural power against an immaterial enemy

The destruction of the built environment by natural or manmade disaster is clear cause for architects’ intervention, and has given rise to what we refer to as humanitarian or emergency architecture. Architectural practices and NGOs widely find opportunities to aleviate suffering through the desgn of infrastructure, buildings and amenities. But when the disaster itself is immaterial, without discernible physical damage, what role at all can a response through architecture play? The current Ebola crisis that has killed almost 1,200 people across West Africa is a formless natural disaster that poses questions, in this case, about the limits of this form of architectural practice.

Sierra Leone is a country that still bears the hallmarks of post-conflict fatigue in which political cronyism nourishes widespread poverty. Future projections for Ebola estimate an increase from 500 to 550,000 cases over a period of four months. Prior to the Ebola outbreak, Sierra Leone’s built environment had long been neglected with central government failing to encourage public or affordable housing, compared with the rest of the African continent. Working amid Sierra Leone’s Ebola outbreak has made steering architectural practice through an already foreign landscape even more bewildering where frustrations and challenges emerge from elsewhere.

A rural education project we have been working on has been delayed due to reports of Ebola victims fleeing from nearby treatment centres, preferring to die in secrecy alongside relatives. As we move door to door for a heritage-mapping project we have adopted Ebola sensitisation measures and public health strategies by providing household disinfectant to community participants. The Scottish architectural practice Orkidstudio was barely four weeks from completing the construction of a school just as the Ebola outbreak began to unfurl in the rural district of Kenema forcing construction to cede. The Sierra Leone government has since banned all public gatherings, which includes the closure of schools for up to six months – possibly longer. The education of Sierra Leone’s youth has again been waylaid.


An Ebola Treatment Centre. A medical team make a round of the patients in the high-risk area.

My own position as an architect comes under self-scrutiny in the design and construction of isolation or viral haemorrhagic fever treatment centres that form the built response to the Ebola disaster. These ‘rapid deployment’ treatment centres are sited close to outbreak epicentres. The treatment centres comprise generic, rudimentary tents draped with tarpaulin and arranged to limit cross-contamination between patients. The shortage of public services in Sierra Leone is widely acknowledged and the rate of new Ebola patients and fatalities now outstrips the supply of hospital beds and body bags. The case for new facilities is incontrovertible yet while these treatment centres and government hospitals themselves are the most direct part of the Ebola response, their ineffectiveness is manifesting in unpredictable and deeply troubling ways.

There are at least 15 ethnic groups within Sierra Leone, each tribe with unique burial traditions and ceremonies. Ebola treatment centres require the disposal of victims’ bodies anonymously as a means of preventing further contamination. Overcrowded and poorly equipped, in the eyes of the medical worker they can become places of increased risk or exposure to infection. Or to the Sierra Leonean patient they represent a Western tomb to die alone in, deprived of a family-led burial.

Within the Western world, Ebola is categorically an epidemic, combatable through modern medicine and public health practices. In Sierra Leone it is all at once an apocalyptic curse; a by-product of local witchcraft: a political manoeuvre; or a Western imposition that is treatable by spiritual healers. To those coping with Ebola, treatment centres do not symbolise places of hope and both local care workers and patients are avoiding these buildings. Limited in coping with widely held and shifting beliefs, these treatment centres fuel local fear and suspicion, consequently they struggle to contain the spread of this rampant virus.

Such localised interpretations directly undermine and impede an effective response to Ebola. But more importantly, the very form and aesthetics of the treatment centres themselves appear to be complicit. Deeply embedded within the psyche of locals, these centres are perceived as Western institutions and present a semiotic conundrum that requires dismantling fears that are residue from colonial occupation.

The intangibility of the Ebola outbreak makes it a disaster in which it is difficult, almost irrelevant, to place architecture as part of discussions surrounding intervention. As a disaster it appears to hint at the limits of architectural practice in this regard that might well signal an example of a world problem that Rory Hyde rightly suggests might lie beyond solving through form and design. Yet as an architect looking on, that remains a hard pill to swallow.

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