The value of such an approach is highly visible in a project currently in design in our New York City office. An architect I¡¯d worked with prior to joining Â鶹´«Ã½ had embarked upon an ambitious project: an 85,000-square-foot hospital in a small village in Burundi, a country ranked among the poorest in the world. Specializing in women¡¯s health services, it would be the first major development in the area; it would require new roads, power, and infrastructure. He explained that construction of the building and a hydroelectric plant was underway, ¡°but there is bigger potential here. We need a landscape architect!¡± He was pointing to the expansive vision of landscape architecture; naturally, I signed on.

The project had been initiated by Village Health Works (VHW), a nonprofit dedicated to providing quality health care in Burundi. VWH envisioned a landscape design that would complement the new hospital building¡ªa colorful entry garden at the drop off, agricultural plots to grow food for use in the kitchen, a water garden visible from labor and delivery, a medicinal garden outside of the patient recovery wing. The gardens would support the hospital by extending its program into the landscape, embedding it more meaningfully in its site. As I learned more about the project¡¯s mission, it became clear that the landscape should do more.

VHW was founded to address Burundi¡¯s medical needs within the context of larger issues the country faces: malnutrition and hunger, political instability after years of civil war, and ecological degradation resulting from loss of almost half its forest cover. VHW¡¯s mission is to provide a range of community resources alongside critical medical care¡ªnot the least of which is the resource of the campus itself, where thoughtfully designed spaces might nurture a vital sense of human dignity. This broad vision would need to be brought to the landscape design itself, a systems approach to match VHW¡¯s holistic mission.

Our team began by looking beyond the hospital building at the elements that would form the framework of the campus: access, arrival, stormwater management, erosion control, and circulation. Tight property constraints meant access would occur over a steep slope, made more extreme by VHW¡¯s desire for a vehicular drop off, even as few would arrive by car. Nearly all patients would arrive on foot accompanied by family members from villages across the region. But the entry road and drop off loop weren¡¯t simply about access. Amid steeply sloping terrain, the wide oval of the drop off would become a generous landing that communicates arrival at a special place¡ªone that is nurturing and secure.

The entry road was also designed to direct concentrated flows of water from Burundi¡¯s heavy rains into bioswales, and the resultant system of detention terraces generated a language of steppes unifying the site. The stepped terraces slow water and create places to be: places to grow food, places to sit, ornamental gardens, medicinal gardens, connected by a network of pathways linking to the existing facilities scattered across the hillside. Stormwater is collected in tanks for irrigation of the gardens in the dry season, while large flows from above the campus are directed through a broad swale to the hydroelectric plant down the hill.

The campus design is a water management structure in the form of a terraced garden landscape. The presence of groups of people waiting for admitted patients will put a demand on the landscape for a range of paths, gathering spaces, and places to sit throughout the campus. It will also create an opportunity for supplementary community services: gardens to teach people about growing crops with high nutrient value and shady walks that point to the need for reforestation. Normally, walls needed for terrace construction would raise cost concerns, but in this region materials and labor are readily available, and the construction of retaining walls is regarded as an opportunity to provide education about building techniques to prevent erosion.

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While the architect has been rightly focused on the precise programmatic requirements of the hospital building, he was attuned to the potential of the landscape design to respond to the bigger mission of VHW. As the landscape design evolved, and continues to evolve, VHW¡¯s founder began to refer to the project, with its many hopes and ambitions, its vast range of programs and services, its infrastructure and its ornament, simply as ¡°our garden¡±¡ªnomenclature that speaks to the deceptive simplicity and unifying power of landscape itself.