AIDS and architecture : the study of an interaction : architectural responses to the development of the HIV/AIDS epidemic in KwaZulu-Natal.
Bingham, Kevin Gary.
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AIDS has established itself over more than three decades as a major international pandemic3. While initial cases of the disease were documented in 1981 in the USA and Europe, cases in Africa became known at around the same time. It is however probable that the disease existed in Africa long before this time (Pratt, 1986:17). Due to the prominence of the AIDS epidemic and its related opportunistic diseases in South Africa and most acutely in KwaZulu-Natal (Smith, 2002 and South African Department of Health Report 2006) , the associated impact of the need for care of those living with and those affected by the virus has been brought to the fore. The accommodation of these persons occurs in a variety of building forms and types, and may vary depending on the stage within the individual’s health cycle related to the impact of the virus. With the advent of medication, termed anti-retroviral therapy, designed to retard the development of the virus, life expectancy has been extended, but with no confirmed cure and viral resistances, death is inevitable. While those living with the virus may continue to live productive lives for some time, the infirm largely seek care within medical facilities. Should access to formal health services be difficult due to remoteness or a lack of transport, such people are often cared for within the homes of surviving family members – often by children - or by their community. With the largest impact on the population being found within the 20 – 29 age bracket in the late 1990's (Smith, 1999: HIV Positive Results, June 1998), shifting to the 25 – 34 age bracket from 2003 onwards (South African Department of Health Report 2006), tertiary education institutions, through their clinics, have increasingly dealt with the management of student and staff health. Other building types affected by the AIDS epidemic4 include prisons and mortuaries, while care for those remaining behind after the death of family members to AIDS is usually within children’s homes or street shelters. The impact of AIDS on the built environment professions will permeate its way to all involved. Through selected case studies one will observe the impact of the epidemic on existing facilities and examine current methods employed to accommodate the problem. Architects, through the modification of existing structures or through the design of new facilities, are assisting in the struggle. New methods of dealing with the care of patients are being considered as well as alternative and innovative design approaches. This includes the need for flexibility of building layouts and universal design. Most proposals in the researched context require cost effective and workable solutions. Hope for the future lies with the management of the virus through medication, enabling the extension of life expectancies. Architects need to adapt to the incumbent problem while medical researchers develop a workable vaccine to confine HIV/ AIDS to the history books with the likes of Bubonic Plague, Smallpox and Typhus. It is through good architectural design and detailing that Architects can assist in the AIDS fight. This can be achieved firstly through research – gaining an understanding of the AIDS Brief – then designing for the specific needs for the infected and affected. These needs will include comfort, accessibility, anthropometrics, ease of maintenance, affordability, ventilation and illumination conducive to good health, and sustainability. Architects therefore have a major role to play within this epidemic.