Bayalpata Hospital / Sharon Davis Design

Architects: Sharon Davis Design
Photographs: Elizabeth Felicella
Municipality: Achham
Country: Nepal

Bayalpata Hospital, designed by Sharon Davis Design in Achham, Nepal, enhances healthcare access in one of the country’s poorest regions. Constructed from rammed earth, the hospital replaces a smaller clinic and includes five medical buildings, an administrative block, and housing for staff, organized around shaded courtyards for a familiar, calming atmosphere. Developed with Possible Health and the Nepalese government, the facility serves over 100,000 patients yearly. Local materials like sal wood and stone were used for sustainability and cost efficiency. Clerestory and large windows provide natural light and privacy, while solar energy and passive climate control support sustainable operations. The campus manages monsoon erosion with terraces and bioswales, enhancing resilience.

Bayalpata Hospital, a medical complex in Achham, Nepal, was constructed from rammed earth by the American architecture firm Sharon Davis Design. Located in one of Nepal’s most impoverished and remote areas, Bayalpata Hospital replaced a smaller clinic that could no longer meet the high demand for patient care.

The campus, set on a hilltop in the Seti River Valley, consists of five medical buildings and an administrative block, with gabled structures arranged around shaded courtyards where patients can wait comfortably. Moreover, the development includes ten houses and an eight-bed dormitory for hospital staff accommodations.

Bayalpata hospital / sharon davis design

New York-based Sharon Davis Design collaborated with the non-governmental organization Possible Health and the Nepalese government on this project, aiming to improve access to affordable healthcare in the region. According to the World Health Organization (WHO), 45 percent of Nepal’s population lives below the poverty line, with rural areas like Achham facing a doctor-to-patient ratio of one to 18,000.

The use of rammed earth allowed the rural hospital complex, designed to serve 100,000 patients annually, to be both cost-effective and more sustainable. Sharon Davis, founder of the studio, explained that the project demonstrates how rammed earth and other traditional materials can contribute to modern architecture. Given the hospital’s remote location—a 10-hour drive from the closest regional airport and three days from manufacturing centers near Kathmandu—using locally sourced materials was essential to making the project feasible.

Reusable plastic formwork enabled the team to construct the hospital campus quickly, utilizing untrained local workers from Achham. Local stone was incorporated into the foundations, retaining walls, and pathways, while wood from the native sal tree was used for exterior doors, window louvres, and indoor furniture.

Soil from the site was combined with a small amount of cement to reinforce the walls, enhancing durability and resistance to the area’s frequent seismic activity. Sharon Davis Design selected rammed earth to give Bayalpata Hospital’s facilities a warm, non-clinical atmosphere. Since many local homes are also built with earthen walls, this choice creates a more familiar and calming environment for patients.

Tall windows in the main buildings frame views of the terraced hillsides, while clerestory glazing allows natural light to enter while maintaining privacy. The courtyards serve as informal waiting areas, and each patient room opens onto a garden or balcony.

Bayalpata Hospital features emergency medical services, two operating theaters for surgeries, inpatient and outpatient facilities, and antenatal care. Additional amenities include a pharmacy, radiology equipment, and a laboratory. A 60-seat canteen is also provided to serve the on-site medical staff and their families.

Solar panels installed on all south-facing roofs supply power to the hospital, while passive heating and cooling limit mechanical air conditioning to the surgery rooms only. Insulated roofs retain warmth during winter and prevent overheating in summer, while breezes flow from the courtyards, enhanced by ceiling fans. The campus also has an independent water supply, and a system of terraces and bioswales helps prevent soil erosion during the monsoon season.