Connecting Care

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With Leandro Couto de Almeida, Matthew Dunn, and Jessamin Amelia Straub for the LSU Coastal Sustainability Studio.


With a population of 1.2 million inhabitants, and growing, the Tonlé Sap Lake must be considered an urban condition, requiring unconventional methods of development that address the unique biophysical demands of this ecosystem and its human settlement. The dramatic flood pulse between wet and dry seasons poses a distinct set of challenges to traditional infrastructure; the fluctuating ecology and hydrology of the Tonlé Sap demands an architecture that envisions new ways of engaging with these dynamic environmental conditions. The proposed framework for health care, research, and education, facilitate a plan for connecting ecological and human systems through architecture.

In this project architecture is presented as a continuation of the Tonlé Sap’s dynamic processes: a series of methods for supporting complex interactions between humans and natural systems. This project proposes a network of structures that provide medical aid, water quality research and monitoring, and education as a strategy for confronting the Tonlé Sap Lake’s mounting ecological and sanitation challenges. Each node on the network embraces a different architectural response to flood conditions: the Lake Health Center is elevated above the water on stilts, the Clinic + Research Boats are mobile across the lake, and the Clinic + Research Buoys are tethered in place, rising and falling with changing water levels, creating a responsive wayfinding infrastructure.  Human health is directly related to the ecological health and productivity of Tonlé Sap Lake and this design integrates existing environmental conditions as a strategic measure with which to gauge solutions.

Lake Health Center

The Lake Health Center (LHC) serves as the hub for the Tonlé Sap Lake network of healthcare.  The facility houses a clinic, emergency care, long-term care, and educational space.  It also serves as the connection between the lake’s population and the Angkor Hospital for Children (AHC).  Children needing specialized care are transported from the LHC to AHC.  The educational area doubles as sleeping area for parents and family members who have accompanied sick children to the Lake Health Center.  Kitchen facilities are available for family members to prepare meals.  This hub is elevated to account for the seasonal flood pulse.  The lower level, which serves as community gathering space and dock, is available as an additional amenity during the dry season.  Each clinic boat and buoy is GPS located and tracked from the LHC, this aids AHC in locating children in need, supports research efforts, and allows LHC to find buoys during storm events.

Clinic + Research Buoys

Buoys are strategically located throughout the Tonlé Sap Lake near areas of high concentrations of population. They are easily identified by flags flying the Angkor Hospital for Children logo. The buoys serve multiple purposes; they provide precise wayfinding through coordinated GPS tracking, temporary clinic space for doctors and medical staff to see and triage sick children from the local area, a communal gathering space residents, as well as a floating research facility from which to collect data on water quality and general ecological health of the lake.  Buoys are tethered to the lake bottom, allowing them to shift with the lake’s wet and dry seasons, while remaining in place.  Existing nautical buoys are re-purposed for the base of these facilities.  Bamboo and sail cloth create enclosed spaces for inhabitation.  Plants indigenous to the region surround the buoys, acting as indicators for water quality and pollution, while also cleaning and filtering the water.

 Clinic + Research Boats

The clinic boats are used to ferry doctors and medical staff between the Lake Health Centers, buoys, and adjacent population hot-spots.  The boats make rounds on a daily basis to provide medical care to the residents of Tonlé Sap Lake, then return to dock at the Lake Health Center at the end of the shift.  The boats can stand alone as small medical facilities, allowing doctors to exam patients, administer vaccinations and/or provide educational talks to small groups of villagers.  When docked at the buoy facilities, the boats expand the examination facilities available to the doctors and medical staff.  The boat’s design is inspired by netting and framework of the local shrimp boats on the Lake.  Bamboo and sail cloth are used to create the floating facility.

Materials + Assembly

The material palette for this project is based on materials and construction techniques that are easily found around Siem Reap and the Tonlé Sap Lake.  Structural bamboo is used in the construction of clinic boats and buoy structures.  A white sail cloth, inspired by the netting of the shrimping boats, is used to delineate spaces and provide shade.  Floors and structural frames are made from reclaimed wood, providing spaces for storage of medical equipment and refrigerators that contain temperature sensitive medicines. The easily recognizable AHC heart logo and AHC ‘green’ are used to strengthen the lake clinic’s association with the successful legacy of the Angkor Hospital for Children.

Indicator Species

Indigenous aquatic plants serve as indicator species to monitor water quality and pollution. These species survive in a range of environmental conditions, changing color in response to harmful excess nutrients and pollutants. The plants react to conditions such as change in water acidity, dissolved oxygen, suspended particles, and excess algae growth, indicating increases in sewage and organic matter. The plants are used to monitor for health and research purposes, allowing residents to see first-hand the changes in water conditions and recognize when there may be additional risk associated with the lake water. These indicator species are incorporated into research buoys along the lake, in tandem with water quality testing probes that collect data and information at regular intervals in order to understand current conditions while also establishing long-term trends.

Confluence of Rivers

 Each year, monsoons and snowmelt cause the Mekong River to flow into the Tonlé Sap with such force that the Tonlé Sap reverses flow and floods the surrounding region to roughly four times its dry season area and depth, resulting in one of the most delicate and diverse ecosystems in the world. This seasonal flood pulse sustains the region: the Basin’s fisheries are replenished, floodwater is stored for use in the dry season, flood-deposited sediments improve soil fertility across the Mekong flood plains, and groundwater aquifers are recharged. Conversely, severe flooding results in loss of life, damage to agriculture, property and infrastructure, and disrupts social and economic activities throughout the Lower Mekong Basin. Flood management must therefore achieve a delicate balance to preserve the benefits of this dynamic environment, while reducing the negative impacts for human life and property.




  • Filed under: Architecture, Research, Urban Design