21 May 2024

“Who were the ‘experts’ here anyway?”:
Care, Architecture, and Terminal Illness
in Oxford, 1978-1995

McGill University School of Architecture

Respondent: Gabrielle Schaad, TU Munich

Helen House Hospice for children and young adults, Magdalen Road, Oxford: the nurse's station with the children's rooms radiating off the corridor. Bicknell & Hamilton Architects, 1982 (John Donat / RIBA Collections).

This paper presents a significant case study in the history of care architecture. It illustrates how the work of care, mothering, and architectural production can be inextricably linked—albeit often invisibly. It builds on the scholarship of Annmarie Adams and Cynthia Hammond, who have each argued that certain groups of women, historically credited only with domestic, medical, or caring skills, also had significant spatial knowledge and influence. The paper emerges from a chapter of my current dissertation work on the role of architecture in the development of then-subversive care philosophies.
Helen House (Oxford, UK, 1982), was the first paediatric hospice in the world. Designed by architect John Bicknell of Bicknell and Hamilton (London, UK) and accommodating eight children at a time, the house was named for Helen Worswick: a child who, at two years old, was found to have a brain tumour.
In this paper, I tell the story of Helen House from the perspective of its architecture, specifically tracing the contributions of Helen’s mother Jacqueline, Helen House founder Sister Frances Dominica Ritchie, and Helen herself.
First, like Adams and Hammond before me, I demonstrate that the story of Helen House and paediatric hospice care is yet another where non-architect, women carers were deeply involved in creating architecture. Second, I suggest that even down to the name, Helen House leveraged domesticity and mothers’ expertise to create a more palliative architecture for children with life-limiting illness—reinforcing the long-running image of the domestic sphere as a woman’s, more specifically a mother’s, domain. Finally, I argue that the creation, design, and building of Helen House served as a testing ground for the new philosophy, allowing it to grow and come into its own spatially, functionally, and theoretically.


Malaria Division of Venezuela

Cornell University

Respondent: Cansu Degirmencioglu, TU Munich

Advertisement for the Malaria Division's Rural Housing Program,
Venezuela's Ministry of Health and Social Assistance, Punto Magazine,
No. 12,
1962. https://fundaayc.com/tag/division-de-malariologia/.

While visiting the hamlets that seemed to emerge from the rural landscape, a group of men from the Malaria Division of Venezuela became concerned about the unhealthy conditions of the houses they surveyed. The “rancho”—a common dwelling—was, for these experts, particularly troubling.
Made up of thatch roofs, rammed mud walls, and compacted earth floors, the rancho was a site of both social and physical corruption. The proposed solution was to eliminate such dwellings, bringing not only a change in health status but also a change in people’s way of living. By replacing the rancho with a modern dwelling made up of cement blocks and concrete slabs, the experts suggested, the rural man could be saved from his diseased environment but, more significantly, from himself. Enunciated by doctors, not architects, these architectural recommendations and demonstrations of sanitary expertise became a staple of a meliorist approach to both the environment and bodies that malaria eradication campaigns in the Americas promoted between the 1930s to the 1960s.
This paper traces the entanglement between architecture, landscape, and medicine, attending to the role that sanitary experts played in transforming medical knowledge into a spatial practice. Architecture, in this story, was the technology that the medical and sanitary technocrats used to incorporate agrarian regions and their people into activities tied to resource extraction.
The paper asks: How was it possible to equate the amelioration of the environment with the betterment of bodies necessary to carry out the works of modernization? And what social, spatial, and racial meanings did sanitation work carry? By looking at Venezuela's eradication campaign, this paper writes the history of a Venezuelan technical elite into larger histories of medical and racial formations that help reframe a history of the built environment that was increasingly shaped by these experts' approach to sanitation.

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