dcsimg Kabul Family Hospital - Ramboll UK Limited

NCLC Hospital & Afghan Centre of Medical Education

In 2004, Ramboll engineer Khoshhal Azeemi volunteered his skills on a project to provide a hospital in Kabul. Little did he realise what an extraordinary journey was about to begin. In 2008, the ICE recognised his achievements by awarding him its International Medal.
Kabul Family Hospital
By the time the Kabul Family Hospital opened in 2007, Khoshhal Azeemi had fulfilled the roles of project manager, architectural and engineering designer, and construction manager, delivering two buildings on budget in a country with almost no functioning public services or infrastructure.

The NCLC Hospital & Afghan Centre of Medical Education, to give it its full name, is a joint venture by New Central London College and the Ministry of Higher Education of the Islamic Republic of Afghanistan. Khoshhal got involved with NCLC — a training organisation run by Afghan doctors — in London. In 2002, NCLC formed a steering group to help guide the future of healthcare in Afghanistan. In particular, they want to help the government introduce a preventative medical system based on the UK's general practitioner (GP) model.

In consultation with the Afghan government, NCLC decided to build something independently as a model of best practice. Khoshhal volunteered to take responsibility for the design of the project, hoping to use his connections in the construction industry to get it realised. Funding was provided by NCLC and the initial brief was for a two storey concrete frame GP's surgery on a site next to Kabul University's medical campus.

He then went to Kabul on NCLC's behalf to look at the site and construction costs and to assess the demand for medical services. He soon realised they'd need something bigger. He suggested two buildings: one for training and one for treatment, including diagnostic, outpatient and operating facilities. The expanded project needed more land and Khoshhal negotiated this with the government. Back in London, the budget was increased and Khoshhal set about revising the design and construction programme.

For the planning of the building, the NCLC doctors were clear about what they wanted. Khoshhal found recommendations for NHS flow patterns and department relationships in medical buildings and used these to make an initial design. He then put together a team of volunteer advisors, including architects from Work Shops, structural engineers from what is now Ramboll UK and M&E engineers from Arup. Together with the client, the team developed a site master plan and preliminary architectural drawings.

In developing structural and construction solutions, Khoshhal drew upon the feasibility study, site investigation work and assessment of local construction capabilities he had personally carried out in Kabul. In addition, the city is in a seismic zone, so naturally this was a major consideration. He developed a rectangular building plan with a stiff, symmetrical structure and heavy loads located at lower levels, all measures designed to minimise earthquake damage.

He also took measures to address environmental and sustainability issues. All materials resulting from demolition works were recycled for the new construction. In the buildings, use of natural ventilation was maximised and thermal energy from the surrounding ground used to regulate temperature. The lower level of the main building is cut into the site and the south facing elevation has most of the windows, both of which help it perform better thermally.

In April 2005, Khoshhal took sabbatical leave and went back to Kabul as main contractor. He supervised every aspect of the construction process — hiring workers, interviewing and assessing potential subcontractors, dividing the work into subcontractor packages, securing and maintaining the supply of materials, setting up QA systems, setting up health and safety regimes, running the finances. All familiar contractor tasks, perhaps, but many of them unfamiliar to the Afghan building industry. Lack of public utilities and infrastructure, uncertain supply of materials and an inexperienced workforce all contributed to the difficulties Khoshhal faced in the two years it took to complete the project.

The result is a 2,000 sq m main building on three levels (NCLC Hospital) and a 1,000 sq m second building on two levels (Afghan Centre of Medical Education), plus landscaping, access roads, site infrastructure such as clean water storage, a transformer substation and wastewater treatment works.

For Khoshhal, who was born in Kabul and grew up in Russia, it was a more than worthwhile experience: "It gives me confidence that if you really want to, you can do anything." In October 2008, The Institution of Structural Engineers awarded him its International Medial in recognition of his exceptional work on the hospital project.