Hillbrow Health Precinct is born

A drawing of the refurbished theatre building, with its top steel and glass floor (pic: henry paine + barry gould architects)A drawing of the refurbished theatre building, with its top steel and glass floor (pic: henry paine + barry gould architects)

HILLBROW and excellence are words that don't usually go together. But that is to change soon – a health centre of excellence is taking shape within the suburb.

The Hillbrow Health Precinct's prime function will be to offer excellent care for the treatment of sexually transmitted infections (STIs) and HIV/Aids in vulnerable women and children. Bounded by Hospital, Esselen, Klein and Smit streets, the precinct will be located on the site of the defunct Hillbrow Hospital.

It will also be a world-class research and training centre for health professionals. The project is unusual in that it combines inner city rejuvenation with poverty alleviation, primary health care and world-class research on HIV/Aids.

The Hillbrow Hospital site has a long history, going back to 1889 when the town's first hospital was built here. It served the city until 1983, when the new general hospital was built on the Parktown ridge. Interestingly, the hospital served both black and white residents of the city for 35 years, until 1924.

The former 83-year-old, three-storey operating theatre and main x-ray department block, consisting of three operating theatres and an X-ray room, is the focus of renovations at present, says Yael Horowitz, the project manager of the R28-million revamp.

It is a private-public sector undertaking. The precinct's private sector partners are Vodacom, Altron and Altech. Vodacom is providing R14-million, while the others are giving R7-million each. The Gauteng province and the City of Johannesburg are the public sector partners. The building will be known as the VAAC for Specialised Services and will provide expert medical care to pregnant women and children infected with HIV/Aids and tuberculosis.

"The Vodacom Altron Altech Centre for Specialised Services will constitute one of the key health projects supported by the Vodacom Foundation," said Mthobi Tyamzashe, the chairman of the Vodacom Foundation, at the announcement of the project two weeks ago. "We are excited at the possibilities created by this public-private partnership in enhancing child and maternal health and simultaneously contributing to inner city renewal through the centre. It is also a demonstration of our commitment to complementing government efforts in the fight against HIV/Aids."

At the 1928 heritage building, for which permission to conduct changes had to be obtained, the lofty theatres will become consulting and delivery rooms, while the crudely constructed extension, the slanted roof level, will be removed and replaced with a glass and steel floor, accommodating a state-of-the-art African-based research centre, confirms Horowitz.

"The heritage value of the original building is determined on the grounds of architectural value, historic associational importance, and lastly, the contextual importance of the building," according to a heritage report by Henry Paine + Barry Gould Architects.

Another building on the site, the antiretroviral clinic, is also being renovated, with a donation of R10-million from international donors. To be completed in October 2011, the first and second floors will be renovated to supply services and a pharmacy to the community.

RHRU

Wits University's Reproductive Health and HIV Research Unit (RHRU), established by Wits in 1994, is co-ordinating the project. It has been the driving force getting it off the ground, with professor Helen Rees, the executive director of the RHRU, the brains behind the precinct.

The first building on the site, the 1897 operating theatre, to become a coffee shop in the futureThe first building on the site, the 1897 operating theatre, to become a coffee shop in the future

The unit was upgraded to an institute in October 2010, and is now known as the Wits Institute for Sexual and Reproductive Health, HIV and Related Diseases, or WRHI. It has earned international recognition for its work in the fields of reproductive health and HIV and other related infectious diseases.

The site, the original Johannesburg Hospital which became the Hillbrow Hospital, is a dense conglomeration of buildings where the Hillbrow Community Health Centre is the only fully functioning hospital service on offer.

The main hospital building, the mortuary and various other wards, have been closed for some time. The RHRU has occupied the renovated Hugh Solomon Building on Klein Street since 2006. Renovations to the building were done by the Johannesburg Development Agency in 2004.

Eugene Sickle, the head of strategy and development at the WRHI, said: "The establishment of this centre within the Hillbrow Health Precinct represents a ‘tipping point' for this project and creates a crucial focal point around which further development will take place. The public and private sector partners are to be congratulated for their extraordinary commitment to this endeavour."

He continued: "The WRHI has a long-standing commitment to work with the inner city community around the provision of health services and issues of transformation. We recognise that partnerships of this nature are crucial to addressing the long-term challenges we face as a country."

The oldest building on the site, the 1897 operating theatre, is to become a coffee shop in the future. At one time it was used as the hospital's butchery.

Restoration and renovation

Renovation comes not a moment too late. Already water has begun to damage the steel reinforcing of the building, and it lies in pools in the rooms, overflowing from the blocked roof drainage system.

The interior of an operating theatre, where operations were done under natural lightThe interior of an operating theatre, where operations were done under natural light

An unusual feature of the building is the glassed external viewing platforms, allowing student doctors to observe operations in progress. These will be restored but will not be functional.

Horowitz, who brings much-needed drive and enthusiasm to the project, explains that several courtyards are to be restored around the renovated building. This involves demolishing unattractive asbestos additions, and planting trees and installing benches and play areas for children. An extension of this is the re-instatement of walkways between and through the buildings, improving the flow of the precinct.

Wooden doors and windows are to be sanded down and restored, enhancing the lovely arches in the passageways. Light wells will also be re-instated. Unfortunately, wooden and brass hand rails and door handles haven't survived the ravages of time and use and have gone missing. New signage and wayfinding will make the mass of buildings more user-friendly.

Consulting rooms will be on the northern side of the building, with windows opening widely, an essential part of treatment of patients with TB, as germs can spread easily to other patients in a closed room.

"The renovations are going to incorporate heritage and functionality," says Horowitz. Where possible, materials will be re-used, and of course, the old building will be re-used by being given a new function.

Previously bricked-up arched windows have been cleared, and the original windows are still intact, says Horowitz. A large, unsightly pipe protruding from the upper floor wall to carry medical waste has been removed too.

Amazing building

Henry Paine, the conservation architect involved in the renovation, describes the work as one of his "favourite projects ever". It offers everything, he says – social benefits to the community, history and heritage, and interesting construction.

The refurbished Hugh Solomon building, occupied by the WRHIThe refurbished Hugh Solomon building, occupied by the WRHI

"It is an amazing building, which is so easy to adapt – it has a passage down the middle, lovely windows and high ceilings."

It is a Gordon Leith design, a Joburg architect who has left a legacy of wonderful homes, hospitals, office buildings, residential blocks and banks across the Witwatersrand and as far afield as Cape Town and Bloemfontein.

The most memorable public buildings in Joburg are the old Johannesburg General Hospital in Hillbrow (1939), the Chamber of Mines Hospital in Cottesloe (1942), the Queen Victoria Maternity Hospital Nurses' Home in Braamfontein (1932), the old Johannesburg railway station (1932), and the SA Reserve Bank building in Simmonds Street (1934). The now-demolished Rand Water Board building in the CBD (1925) was a much-admired structure.

"I like to think he would do these changes too," says Paine, "I hope he would approve."