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Cultural inclusivity and community drives the design of new Cowichan District Hospital in British Columbia

At the core of the Cowichan District Hospital Replacement Project (CDHRP) which is being built in North Cowichan on the unceded traditional territory of Cowichan Tribes, lies a deep commitment to cultural sensitivity and inclusivity. The journey towards creating a hospital environment that honors Indigenous customs, fosters a sense of belonging and is built on a community of care began with a collaborative process with local Indigenous communities.

Our approach to working collaboratively with the Nations was rooted in humility and a genuine willingness to learn. From the outset, project leadership was invited by the Cowichan Tribes for immersive cultural education, providing invaluable insights into cultural safety and customs. This educational journey has extended to our entire design and project team, who participated in cultural safety training equipping us with foundational knowledge and understanding necessary for meaningful engagement with the communities.

Central to our approach was recognizing that the process needed to be Indigenous led, with regular feedback sessions ensuring that the design truly reflected the aspirations and values of the local Indigenous communities. We prioritized active engagement and touch points with local elders, language experts, indigenous food experts, an Indigenous Advisory Council, regional nations leadership groups, and the general public. As social architects, we understand the importance of building local and holistic approaches that are a reflection of the place. These engagements took various forms, including journey mapping sessions and shared meals, allowing us to build meaningful connections and gather insights into the customs and needs of the community.

The result is a welcoming place of hope and healing. The design by Parkin Architects and ZGF Architects responds to cultural customs and needs but also reflects vernacular architecture and fosters a sense of cultural identity and pride. Some examples of this included the platforms and use of wood structure in the Community Hall, a two-storey atrium space at the heart of the facility. The design is inspired by Coast Salish Big Houses. In addition, the Indigenous Health Department and healing garden were relocated from their original place in the design in response to feedback received during engagement sessions, with the new location providing a better connection to landscape and east, south and west exposure.

The initial design specified just one room to be equipped with provisions for Indigenous healing practices involving burning (in Hul’q’umi’num: shqw’uqw-wiils – something used to spiritually cleanse). The design team responded to feedback by providing accommodations in 185 patient and staff spaces to carry out this protocol. The design team is working closely with the Arts Advisory Council, made up of local artists and experts to include an extensive art and artifact collection. This process will include decolonizing the procurement process for new art pieces and creating opportunities for emerging Indigenous artists.

The new hospital will be three times larger than the current hospital and the first fully electric hospital in British Columbia and will be built to LEED Gold standards. It will be 30% more energy efficient and 60% more water efficient than the current hospital with a 75% reduction in greenhouse gas emissions. There will be culturally safe spaces to accommodate traditional healing practices, cultural practices, traditional foods, a Gathering Space, Indigenous Kitchen, Indigenous Health department and room for loved ones to support patients during stays.

“Parkin’s approach to social architecture is centred around dedicated engagement with interest groups, program users, and rightsholders to build strong relationships and consider the community’s culture, history, and shared values. Through this we create spaces that foster connection, support, inclusivity, and a sense of belonging for all individuals in the community.” Shane Czypyha, Principal, Project Architect for Cowichan District Hospital

Architects working in healthcare can draw essential lessons from the CDHRP project, particularly emphasizing humility, cultural sensitivity, and inclusivity. Through immersive engagement led by Indigenous communities, architects can rebuild trust and foster connections, ensuring designs truly meet diverse community needs. Collaboration, and active listening are paramount, ensuring regular feedback sessions and ongoing dialogue to incorporate multiple perspectives. By prioritizing meaningful engagement, relationship building and embracing a collaborative approach, architects can create healthcare environments that promote healing, foster belonging, and honor diverse cultural traditions, ultimately enhancing the quality of care for all.

Parkin Architects in association with ZGF Architects, led the design of Cowichan District Hospital Replacement Project, working collaboratively as part of the Nuts’a’maat Alliance. 

Artist renderings – details are being finalized during design & construction.

Design by Parkin Architects Western Ltd. and ZGF Architects Inc.

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