In an interview with Spectrum, Carey Carscallen, Dean of the School of Architecture & Interior Design at Andrews University, talks about the recently completed Mobile Mission Clinic Project and how it could benefit Adventist missionaries and those they serve.
Question: Almost exactly two years ago, I interviewed you about the Tiny House Project. During that interview we discussed future project ideas, including creating a mobile clinic made out of a shipping container. Tell us more about how you arrived at this idea.
Answer: It’s kind of a long answer. I was visiting with a missionary friend a few years ago whom we knew in Africa. He is a missionary pilot, and at the time of our conversation, he was working in Chad, and he had been looking at container clinics like this. The idea being, you could just go into a remote village, set down a container, and you’d instantly have a functioning medical service for the village.
Later, I was visiting friends in the Democratic Republic of Congo. They had asked me to come over to look at some work that needed to be done that their company could sponsor. The village they’re in has a mine out in a remote mountainous region of the Congo, and there’s no medical services there. They wanted to know what I would recommend.
They also wanted to build a church and a school there, but accessible medical service is the most critical. People who come to that area are mining in unsafe conditions and get injured, yet there’s no place to go. I suggested the idea of building a clinic in a shipping container and said I would help see what I could do to raise some money, since it’s an expensive proposition. They said yes, and I wrote a grant which got us enough money to get started on the project. They contributed part of the money as well. We had a shipping container here, so we contributed the container. We asked the various medical entities in the Andrews University area for donations, and we got a few things. That’s how it all came together and became our project this past semester for our Design Build Studio.
You and your family served as missionaries in Africa. What kind of challenges did you see first-hand during your mission experience? Do those same challenges exist for today’s missionaries or are their new challenges?
Access to health care is near the top of the list. Clean water, then health care, and then education. Those are the top three things that really allow people to improve their lives. Those issues are never-ending. There’s no other word for it. The population is growing fast, and the governments are just not able to provide for what the people need. Whether the governments can’t, or whether they even try to, you just don’t know. Like many governments around the world, things don’t function very well.
Where in Africa did you serve as missionaries?
We were in the Congo. At that time it was called Zaire. The name was changed back after we left.
Why craft a clinic out of a shipping container specifically? What kind of advantage does that provide?
Just getting it there is the first thing. Being able to send a building intact. These containers are designed to carry very heavy loads, inside, on top, and around them as well. So you know it’s going to get there in one piece. You’re also able to purchase them at a reasonable price after they’ve been used a number of times, and there’s only minor damage.
Are there other organizations you know of who are doing similar mobile clinic projects? If so, what are the similarities and differences between theirs and this one?
There’s at least one or two companies that build these commercially. When you’ve got a 20-foot container, 8x8x20, they are going to be similar simply because the space available is the same. When our students were doing their research for this project, they came across some that are already being built that they got some good ideas from.
What were the students’ reactions when they learned they’d be working on a mobile mission clinic?
They were very excited. Seeing something they’re doing—designing and building—going to a good cause like this makes them very pleased. They were very involved, from research and learning what this project would take, to the actual construction.
Have any of the students on this projects been involved in mission work, either within the United States or overseas? If so, how did their experiences shape their perspective?
Three of them went with me last year on our annual mission trip to Bolivia. That definitely helped to shape their interest in this project. But I don’t know that I would say they necessarily had more interest than the other students because the whole group was excited. These are all great young people.
Another thing that took place with this group in particular is that their class project the previous semester was in Africa. We have a student, Wandile Mthiyane, who won a design proposal award in Thailand and got $3,000 to do his project, which was to design and build low-cost housing in South Africa (where he’s from). He put together a group of students, and they formed the Ubuntu Design Group. After he finished his fourth year here (the Architecture program is five years), he decided he was going to take a year off, and he went back home to start work on his project.
At the same time, Professor Andrew von Maur was looking for a project for his Urban Design Studio for Fall Semester 2016. He’d been praying about it and finally came to the conclusion to use his class to help Wandile. All of the students in the course went to South Africa and put together a proposal for an entire community, part of which would be to design a house for a local couple, the Mtshalis, who are both handicapped and whose house had fallen down in a storm.
Wandile began a fundraising campaign for this project, and it all came together with our students there in South Africa. When they came back, the students were on fire to do this mobile mission clinic for the village in the Congo. They actually wanted to do both the mobile clinic and go back to South Africa to help Wandile build the house for the Mtshalis, but we couldn’t finance all that, and there’s only so much time in the semester. But the students did finalize the Mtshali house plans during spring semester, and that house is now in the process of being built. Brick walls are up, but it needs a roof. We still need to raise about $3,000 to finish it up.
This project is kind of a tangent from our mobile mission clinic, but it’s very much a part of the story because of the momentum it created for our students.
As spring semester wore on, we found out that the South African community project they’d done in the fall won a Congress for the New Urbanism Charter Award—the grand prize for student entries.
Your students have won that award in previous years as well, correct?
That’s at least the sixth time. There’s no other university in the United States whose architecture program has won as many awards as we have. Last year’s project was the Twin Cities Harbor Study, and we won second prize with that. Yale took home first. The other universities we compete against are always really big universities. God blesses our efforts, and we have a really strong program. The students do really good work.
Can you describe a bit about the students’ process for designing and constructing the mobile clinic?
We wanted it to be a self-contained clinic which meant it needed to be able to store its own water and electricity. At times, water isn’t available there. When the pumps are running, bringing water up the mountain, and when the generator is running, then there’s water. But if you have a medical emergency you need to have everything working all the time. The students had to figure out the electrical loads they’d need to provide for and figure out what kind of solar panel system would supply that much energy, how to store the energy, how to convert it back, and how to install the panels.
They also had to figure out what the needs are for a medical consultation room. It’s set up and outfitted just like a typical doctor’s office.
What challenges did you run into?
Not knowing exactly what kind of diseases or injuries would be encountered there, and so not knowing if specialized equipment might be better than what we’ve supplied. But we decided to go with the assumption that the everyday, run-of-the-mill things that people see worldwide would be seen there, and then you add to that the malaria and worms and things like that that don’t require different equipment but do require different medications.
If we were going to get into the diagnostic capabilities, then maybe a future project could be a medical lab so they could do all the testing that would be needed for this area. So, that’s a future idea. You can’t do everything in one project, so we tried to make this mobile clinic as generalized as possible to address the majority of health care needs.
That brings up a good point. If someone needs a blood test that has to be sent to a lab for analysis, how does that work when you’re in a remote village in the mountains?
It doesn’t. You just don’t do one. But quite often over there, if the nurse has been trained in a decent program, and has a microscope, they can do a slide and see if the patient has malaria right on the spot. So, tests that are easy like that can be done onsite. Anything more complex would require additional resources. We’ll see if this project leads into more projects like a mobile lab in the future. It would be nice to be able to create specialized mobile clinics. You could have one that was a maternity clinic, another that is a dental clinic, and then a minor surgery. You could line up a whole series that cover various patient needs.
Can you “walk us through” the mobile mission clinic? When people step inside, what will they find?
When the container arrives in the village, it will be set down on a foundation. One side has a water reservoir mounted on the door. The other door has all the batteries and the solar panel controls. Those doors swing wide open and inside of that there’s a wall with another door, and that is the entrance into the clinic. You open the door, and the first step is to remove all the solar panels that have been stored inside while it was shipped. Those are then reinstalled on the roof of the container to supply it with electricity.
With the water reservoir, whether you hook it up to a water faucet or just bring water by barrel to put into the tank, you turn a switch, and it’s ready to operate. There’s also a water heater bolted to the back of the container that runs on propane.
Once you walk in, after the solar panels have been removed, you see a very modern examination bed with a surgical light on an adjustable arm above the bed. Next to the bed is a wall-mounted diagnostic system for exams. In the back is a stainless steel countertop and a sink. There are cabinets above and below the counter with a small refrigerator below to hold medicine. There’s a little desk by the door for the nurse to use.
We’ve also included an oxygen concentrator. This container is going to a place with an elevation of about 8,000 feet, so if someone is in need of oxygen, we’ll be able to provide that. The container is also outfitted with heat and air conditioning. You think about Central Africa as being hot all the time, but at an elevation that high, it can get very cold at night.
We’ve also prepared a manual that outlines all of the medical equipment in the container.
You mentioned that you received a grant to help fund this, as well as contributions from donors. What is the total cost of this mobile mission clinic?
We’ve spent about $35,000. We still have to ship it over there, and people can still donate to the project if they’re willing. Of course, if you were building these commercially, the cost would be double that because you’d have to factor in labor.
Now that the mobile clinic is complete, what are next steps for this project?
Well, it’s almost complete. There are some final little touches. We don’t have a date yet for shipping it over there but my hope is it will be within the next month. Once we’ve double-checked that everything is working, we have to uninstall all the solar panels and pack them inside the container for shipping.
We’ve talked before about the ways in which Christian values are embedded in the Andrews Architecture program. When I interviewed you for the Tiny House Project, you told me, “We try to instill in our students the importance of civic responsibility and we integrate community service and service to the church throughout the projects we do.” In addition to the mobile mission clinic, what are some of the other ways or projects that accomplish this dedication to service?
I think our entire program is becoming more and more connected to service and community. We’ve become more intentional about our students thinking about their commitment to God and how they can use this profession to help others. After their third year, our students go on a required tour in Europe. They have five weeks in Europe where Professor von Maur takes them on an architecture tour and what has become a parallel Reformation tour. He’s choosing sites that specifically not only promote good architecture but also give students the opportunity to experience church history.
Then, we do a Waldensian tour where, after seeing some of the greatest European architecture, they can see the humble architecture of the Waldensians. The students get to learn how the Waldensians joined the Reformation Movement and stand on the field where they met to worship.
And then many of our studio projects focus on some aspect of helping the local community. Each year of the program the students are focused on that in some way.
What else would you like people to know about the Mobile Mission Clinic or the School of Architecture?
One thing is that we’re going to be starting an expansion of our Architecture building this summer. We’re still fundraising for that but have raised enough we can move ahead with our plans. It’s been a long time coming, and it’s only the first phase of what we want, but it will mean that instead of just having ordinary classrooms and a studio, we’re going to build a larger shop so our hands-on projects have more space. We just don’t have enough space for these large scale projects we’ve been doing like the tiny house and the mobile clinic. So, we’re going to combine our woodshop and our current hands-on area into a new facility that will be adjacent to our building. We’re really looking forward to that. It’ll be so much more efficient, having a larger area and all of our equipment together in one space. The students just love these projects. They really do. And now we’ll be able to serve them better.
Note: Each of the School of Architecture & Interior Design projects can be supported by visiting the Andrews University website at andrews.edu/go/give. Choose from the drop-down menu “Architecture Missions Group – Buy a Brick, Build a Home” (Mtshali house in South Africa), “Architecture Clinic in a Container – Congo” or “Architecture Building Addition.” Donations are tax-deductible.
Alisa Williams is Managing Editor of SpectrumMagazine.org.
Photo Credit: All photos courtesy of Troy Homenchuk.
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