The MZS standard clinics and houses

The MZS (Medische Zending Suriname) provides primary health care in the large hinterland of Suriname. This hinterland of approx. 60.000 km2 is mainly dense forest and savanna forest. For the most part, there are no roads, but there are rivers and several small airstrips. The area is divided into 3 regio’s (east, middle, and west). Each region is served by one larger health center with a permanent doctor, and 15 to 20 small clinics in the villages, managed by one or two nurses. The head office of the organization is in Paramaribo. It contains management offices, a permanent communication center for all clinics, a distribution and logistics center, and a training center.
a regional health center consists of a large clinic and 8 to 12 houses
a village center consists of a smaller clinic and 2 houses.
All in all, MZS possesses a building stock of more than 250 units.

Construction in the remote hinterland is challenging. Partly materials are produced on site (e.g. cement blocks for the walls), but for the most part, materials are shipped to the site by canoe. In the area near Brazil, shipping is no longer possible, and materials are flown to the site with small airplanes.
KDV has worked with MZS since 1990. We have replaced almost all older wooden buildings with robust concrete ones, greatly reducing the amount of maintenance. We have standardized the models of clinics and houses so that planning and construction are easier. Only the regional centers are not standardized, and here a little architectural expression is permitted.

construction method
Each site is carefully chosen. It should be near the river so that people of nearby villages can reach the clinic easily. It should be large enough to contain a clinic and 3 houses. It must be above the maximum water level of the river. At some sites, the river may rise as much as 8 meters during the rainy season. Wooden constructions will be quickly attacked by termites, and therefore concrete constructions are to be preferred. Roof eaves should be large (1.50 meters) to protect the buildings against sun and rain. The attic space must be extremely well-ventilated to keep out bats. Each building is surrounded by a 1-meter wide walkway as protection against erosion on sloping sites. trenches are dug to lead the rainwater away from the building during heavy rain showers. Power is provided by solar panels, and the village generator usually provides additional power for a couple of hours per day. Rainwater is collected in large plastic containers.