Culturally Conscious Healthcare Design

Perkins Eastman’s international healthcare practice begins with tradition.

Regional customs and practices significantly influence architectural approaches in the diverse world of global healthcare design. While the United States prioritizes functional aspects such as code compliance, schedule, and cost, the approach in China places greater emphasis on incorporating elements of nature and Feng Shui, while in the Middle East, family involvement is deeply integrated into a patient’s recovery process. More than medical technology, these are the factors that initiate discussions with international healthcare clients, where Perkins Eastman has been progressively establishing its presence for the past 20 years. “We seamlessly blend these cultural nuances with modern international healthcare standards to create healing environments tailored to the specific needs of local communities,” says Brad Perkins, co-founder and chairman of Perkins Eastman.

Green Healing: Nature’s Integration in Chinese Hospitals

Nature is a critical component of overall health and well-being in traditional Chinese culture. This belief stems from the ancient Chinese Tao philosophy that emphasizes harmony between humans and the natural world. Incorporating elements of nature into the design of Xi’an Zhongda International Hospital in Xi’an, China, was one of the most integral parts of the project for the Perkins Eastman design team.

Xi'an Zhongda International Hospital

A rendering of the Xi’an Zhongda International Hospital showcases modern geometric forms that echo the precise, defined edges often seen in Chinese seals, symbolizing a bridge between the past and the present.
Rendering Courtesy Perkins Eastman

“We drew our inspiration from Han architecture principles and the motif of a Chinese seal, and designed the hospital around nine serene courtyards that create a therapeutic environment for patients,” says Nicholas Leahy, co-CEO and executive director of Perkins Eastman, who was also the design director of the project. The nine-courtyard layout received approval from a Feng Shui master, who was involved from the conceptual phase of the project to see that every aspect of the hospital design was aligned with these ancient design principles. For instance, the south-facing orientation of the building is beneficial not only for sunlight exposure but also for the flow of Chi, or energy, which is believed to enhance life and health. The internal layout of the rooms was intentionally designed to avoid lengthy corridors and foster a more harmonious atmosphere. And specific plants known for their healing effects were designated for the courtyards, which also showcase stone sculptures and water features.

Because the hospital is located in the city’s heritage protection zone, the design had to conform to strict guidelines on height, massing, and aesthetics. This process resulted in a structure crafted to a human scale in an effort to make the experience more welcoming and less intimidating than one might expect in a large hospital.

Xi’an Zhongda International Hospital

The patient rooms in Xi’an Zhongda International Hospital feature soothing earth tones and natural wood, which are associated with physical and spiritual health in Feng Shui. Rendering Courtesy Perkins Eastman

The principles of traditional Chinese medicine favor the role of natural light in enhancing patients’ well-being and healing process. The hospital design reflects that priority in every patient room, where floor-to-ceiling windows infuse the space with daylight, fostering a healing environment in line with ancient holistic health practices.

Desert Climate and Cultural Dynamics

The Middle East’s punishing climate is top of mind for designers in this region, right along with a culture that prizes family involvement in a patient’s recovery process.

The climate significantly influenced the design of the Sheikh Khalifa Specialist Hospital in Ras Al Khaimah, United Arab Emirates (UAE), where temperatures can soar to 125º F in the summer, coupled with high humidity and strong winds. The Perkins Eastman team positioned the building to maximize natural sunlight while minimizing direct sun exposure. They also used aluminum-composite panels on the exterior, where integrated thermal insulation effectively blocks out the sun’s heat. They clad the hospital in beautiful, locally-sourced limestone, which not only blends seamlessly with the landscape but also plays a crucial role in improving the building’s thermal efficiency. This combination of strategic building orientation and material selection enabled a thoughtful integration of the hospital with its natural setting, both visually and functionally.

Sheikh Khalifa Specialist Hospital

The Sheikh Khalifa Specialist Hospital’s landscape designers turned to xeriscaping to conserve as much water as possible. The approach specifies native, drought-resistant plants that need minimal water and aid in maintaining
local biodiversity. Photograph Gerry O’Leary/Copyright Perkins Eastman

Sheikh Khalifa Specialist Hospital was designed with larger waiting areas and patient rooms to accommodate patients’ extended families, who play an active role in their care and recovery. Family members are known to come for both lengthy day visits and overnight stays.

Sheikh Khalifa Specialist Hospital

Sheikh Khalifa’s interior echoes the desert’s natural palette, integrating organic materials and textures to create spaces that are both soothing and richly textured. Photograph Sarah Mechling/ Copyright Perkins Eastman

The hospital’s layout is also sensitive to the religious and cultural needs of the local community. “Considering the cultural norms surrounding gender segregation, we implemented separate zones for men and women,” Leahy says. This segregation extends to waiting rooms, staff lounges, and prayer areas, which are integral parts of hospitals in the region and serve as essential spaces for spiritual reflection and solace.

Designing for Tomorrow: The New Wave of Indian Healthcare Facilities

In 2017, India’s national Ministry of Health and Family Welfare announced it would expand the All India Institute of Medical Sciences (AIIMS) to three new locations beyond its main campus in New Delhi. The prime minister issued a directive for hiring the architecture firm that would design these new campuses: find one that had both Indian and international expertise. “Perkins Eastman was selected to plan and design all three AIIMS campuses,” says Supriya Thyagarajan, managing principal of its Mumbai studio and a firmwide executive director. “We were able to showcase our extensive experience translating international best practices into local context.”

All India Institute of Medical Sciences campus in Kalyani, West Bengal

The All India Institute of Medical Sciences campus in Kalyani, West Bengal, is surrounded by a landscape rich in indigenous plants, offering a peaceful and rejuvenating atmosphere. The other new campuses are in
Guntur, Andhra Pradesh, and Nagpur, Maharashtra. Rendering Courtesy Perkins Eastman

The site planning for all three AIIMS campuses comprise healthcare, academic, and residential zones, and they all must respect the principles of Vastu Shastra – an ancient Indian design concept that creates an environment in harmony with the laws of nature. The word “Vatsu” means dwelling and “Shastra” means science. This concept considers the orientation, placement, and proportions of various architectural elements to create a balanced and harmonious space.

Traffic is an important part of this equation. “One of the important elements of creating a holistic environment and reducing noise was traffic management,” says Thyagarajan. “We addressed traffic and noise by segregating different transport modes, such as private cars, taxis, and buses, into dedicated lanes. This approach improved the arrival experience for patients and visitors.”

It’s also common for Indian patients to be accompanied by several family members, who often take extended leaves to assist their relatives, especially when they travel to seek treatment. Family members typically spend their time waiting in the hospital or sitting outside. This situation results in crowded corridors, mixing healthy individuals with sick patients, and increased stress and confusion for everyone involved. Doctors and nurses are frequently diverted from their primary duties to manage the family groups, impacting their efficiency. Perkins Eastman addressed this issue in the AIIMS campus designs by separating outpatient and inpatient departments and creating separate entrances and drop-offs to the buildings. The outpatient departments feature expansive waiting and patient registration areas on the ground floor. And a thousand-bed guest house on each campus can accommodate visitors and family members away from clinical areas.

All India Institute of Medical Sciences campus in Nagpur, Maharashtra

AIIMS Nagpur prioritizes pedestrians and cyclists while still allowing for the circulation of automobiles and service vehicles. This approach fosters a welcoming, eco-friendly campus environment. Rendering Courtesy Perkins Eastman

Each campus is thoughtfully designed with sustainability and local cultural and environmental sensitivity in mind. The design team used passive design strategies to enhance sunlight and diminish heat absorption. And the buildings are clad with durable, locally-sourced materials like sandstone and granite, which are also effective at thermal insulation. Across all three campuses, there are Indian verandas that seamlessly transition into covered walkways. These structures are particularly beneficial in Nagpur, which is situated in one of the hottest regions of the country. The design allows physicians to comfortably move between hospitals and medical schools where they teach without being exposed to harsh weather conditions.

Managed by the firm’s Mumbai studio, the Perkins Eastman project team included design leaders and building experts from Dubai, Los Angeles, New York, San Francisco, Washington, DC, and Charlotte, NC. “This is a great illustration of our firm’s global capacity to deliver a project of this scale and complexity, working across four different time zones and seven studios,” Thyagarajan says.