November 4, 2016

Container to clinic: UM-designed pop-up clinic a first-of-its kind in Jamaica

It was inside-the-box thinking that led a multi-disciplinary University of Michigan team to reimagine a shipping container as an ophthalmology clinic in Jamaica.

Expected to open this month inside a 20-by-8-foot customized shipping container, the new facility is the product of an unlikely collaboration between faculty members at the medical and architecture schools, as well as the University Health Service. The idea was to create a clinic environment that would be uniquely self-contained – something that could be outfitted in the US, shipped complete, and unpacked with minimal set-up into a functional health center anywhere in world. This one happens to be in Sandy Bay, a small beachside community on Jamaica’s northwest shore.

Sandy Bay, Jamaica's newest (and only) community ophthalmology clinic is a converted shipping container designed in collaboration between UMMS and the U-M School of Architecture.

“We hadn’t done a lot of work in the kind of low-cost, large-impact design space that this project demanded,” said Geoffrey Thün, Associate Dean for Research and Creative Practice at the Taubman College of Architecture. “All of the projects we get involved in are interesting, but this one combined a particularly inspiring mission with a unique set of technical challenges, and we were up for it.”

The container clinic is part of a larger Third Century Initiative grant project under Professor and Interim Chair of Human Genetics David Burke, PhD, who is developing easy-to-use technology to help patients in underserved regions monitor chronic conditions without having to travel to a doctor. The long-term vision of Dr. Burke’s “Deep Monitoring” project calls for fully-automated technology that patients with chronic conditions can use independent of a doctor or even a medical technician. His team has been exploring potential autonomous devices across several medical disciplines and in several areas of world, including new eye imaging technology in Jamaica. That’s how he learned that U-M Optometrist Joseph Myers, OD, was planning to ship some new eyeglass lens grinding equipment to a partner clinic on the island.

The interior features a workspace and lens grinding equipment.

“The thinking was, if we’re sending the container down there anyway, can we add value to the container itself?” Dr. Burke said. “For a relatively modest amount of money, can we make the container into an attractive clinic where the stuff can be used?”

It turns out they could. Thün’s team modified a recycled shipping container with a sliding door entry, a solar array and electrical storage batteries, insulation and climate control, a fold-out shade structure, and more. The container, including the equipment, was shipped last month nearly 1,700 miles to Jamaica, where Dr. Myers and a small team of local volunteers unpacked and set it up in about three days.

“There’s a large surplus of these empty shipping containers around, and the logistics are built in because they are designed specifically to be shipped. So the idea is that this would be more cost-effective than building a new building,” said Dr. Myers. “I gave the architecture team some parameters and they ran with it. They were brilliant, showing us all of the possibilities and incorporating elements we never thought of.”

Site prep consisted largely of pouring a level concrete pad which, thanks to the container’s built-in shade awning, becomes an outdoor waiting room. Thün’s team also incorporated a screen for image projection on the exterior of the container so the space can be used for events, either medical education workshops or just general community occasions.

“We designed it to be flexible, since the specific use of the space within the container may change over time,” Thün said. “We thought a lot about standardizing the overall design while also making it flexible enough to fit the local community and cultural need.”

The prototype container clinic, which project leaders are calling “Common Health +”, will bring a brand new service to the residents of Sandy Bay. While the prototype will be manned by optometrists and opticians who will use the equipment inside to make eyeglasses for locals, future iterations are being planned to house Dr. Burke’s fully-automated diagnostic machines. A container clinic may be bound for Highland Park, north of downtown Detroit, as early as this summer.

“We wanted to see how well the container-as-clinic concept worked, both from a shipping standpoint and from an operational standpoint,” said Dr. Burke. “The notion is that if we can make this work in Jamaica, we can make it work anywhere. Location independence is really the driving factor. The experience remains consistent and the quality remains high independent of where the thing gets set down.”

Sandy Bay is a small community Jamaica's northern coast, about 30 minutes from Montego Bay.