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Healing hand

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The Medical Foundation for the Care of Victims of Torture needed a design of great psychological sensitivity from RyderHKS

'It is a place of light from which to confront the darkest aspects of the human soul.' Thus Malcolm Smart, director of the Medical Foundation for the Care of Victims of Torture, describes the awesome role that the foundation has set itself. Individuals and families are drawn here by its reputation from nearly 100 countries. In the last full year, some 3,415 men, women and children were referred to the foundation, of whom 2,010 were accepted as clients. While there can be some group sessions, most medical treatment, listening and counselling are done on a long-term, one-toone basis and are, thus, very staff-intensive.

There are about 200 full-time and part-time paid staff and a similar number of volunteers.

Staff may also need support, as they become involved in the traumas of the clients.

Founded as an organisation in 1985, the Medical Foundation's new purpose-built facility is unique in the world. It has also established a base in Salford to support local groups and teach them skills. Another is planned for Scotland. And there are links with torture treatment centres in countries such as India, Egypt, Sudan and Sri Lanka.

The foundation is a charity, largely supported by the theatre and literary world.

Having engaged RyderHKS to join in developing the concept, the foundation used its sketch scheme and model for fundraising, raising funds in about four months, before finding a site in the desired locale. Like much about the foundation, there was an act of faith that the project would be realised.

Paul Hyett of RyderHKS has been drawn into this world; it has become personal. But his building is deliberately neutral, drawing only on universals of light, openness and water. It avoids both obvious references, like arched spaces reminiscent of underground vaults, and any more-specific symbolic narrative. It would be impossible to address directly the cultures and histories of such a diverse client base. This is a facility, a setting, for the personal healing interaction of diverse people.

Located on the busy Isledon Road in London N7, the main bulk of the building lies behind a blockwork screen wall that follows the pavement edge. This screen wall provides acoustic protection and enclosure to the enclave within. A set-back marks the entrance and, once through the door, the key client orientation points are clearly visible - reception, waiting, principal stair above, and garden - the wall of glazed doors alongside the waiting area invites use of the garden.

Above the waiting area are three floors of administration offices. The ground floor in the other, curved, leg of the L-shaped plan is mainly for staff use, with three floors of treatment rooms above. As translators are sometimes needed, rooms are a little larger than NHS norms, and those on the second floor for children and families are larger again. For the foundation, one message is the quality of the facilities as a reflection of its caring; on the other hand, it is a charity, and avoids opulence. For example, only in public spaces is the furniture new.

The scale of the foundation's current work means that the building is not on a domestic scale; there is not the homely informality found in Maggie's Centres, which are deliberately kept much smaller. Here, corridors curve, though the relative advantages of a long, straight (institutional) corridor compared with the curving corridor, where one is unsure what is around the corner, are not clear. Only the top-floor corridor terminates in the open, with a roof terrace, rather than in a dead end; the space for future expansion on the site is a continuation to the south of this curved block. In practice, staff usually come out of their rooms to collect clients.

But maybe an Oxbridge collegiate model of rooms grouped round staircases might have been more congenial (though at a higher construction cost).

The white-plastered treatment rooms currently feel somewhat stark; the clinical rooms necessarily clinical. It is early days for the foundation inhabiting these spaces, but creating specific character to rooms may be difficult where they are shared by several staff.

In evaluating this building, the more important frame of reference, of course, is that of its clients and staff, addressing whether it is effective as a supportive healing environment.

The staff we met on our visit had real enthusiasm and a sense of a new era beginning for the foundation. We also talked to someone who has known the foundation since its early days.

He provides a broader perspective (see box, page 38) on the clients' world, which cautions against making too-conventional judgements about this building.

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