Mzuzu University Health Centre


Mzuzu, Malawi​


Fielden Foundation (FCBStudios)


Mzuzu University


Happold Trust (Buro Happold Engineers)

Max Fordham LLP (Environment Engineer)


110sqm (Phase 1)

70sqm (Phase 2)


£15,000 (Phase 1) $27,000 $245/sqm

£20,000 (Phase 2) $30,000 $430/sqm



The AIDS and Malaria treatment centre at Mzuzu University in Malawi was designed by Fielden Foundation volunteer architects, in a two-phase project that commenced in 2004. While the initial brief specifically called for a new health clinic, the wider objective of the project was to design and prototype an affordable alternative to the university's usual practice of importing expensive and environmentally inappropriate prefabricated buildings. The architects' aim therefore, was to provide the university with their own modular self-build system, which would utilise locally sourced and sustainably produced materials, and more significantly employ and develop the skills of local people.

Phase 2 of the project was instigated 10 years later to relieve pressure from the existing clinic, allowing it to house a larger and more welcoming entrance and administration building. The new building adapts and enhances the 'kit of parts' construction system developed during Phase 1. But simple micro-budget buildings provide an environmentally sensitive approach to design, utilising various passive design principles while minimising the use of cement and hardwoods.

General Arrangement


Mzuzu University Health Centre is organised around a circulation spine, which extends south across the site with east-west axis buildings feeding off it. The northern most building is Phase 1 of the project, the Richard Fielden Clinic, a simple mono-pitch two-bat building, which now provides an entrance and administration block. The second building is the Phase 2 Treatment Centre, which houses examination and treatment rooms, which will be followed by a future Phase 3 ward.

Solar Shading


The precise position of the buildings was carefully calculated to keep the clinic as cool as possible. Each of the buildings, including the future Phase 3 ward, are oriented on the east-west axis with openings predominantly to the north and south. The buildings are offset from one another to ensure free-flowing movement of air.

Trees and Planting

Efforts have been made to retain existing trees wherever possible to maximise shading of the east and west elevations. Where trees have had to be removed to facilitate construction, new ones have been planted in their place.

Roof Colouring

The health clinic uses 10.7m lengths of shiny galvanised 'alu-zinc' roofing sheets to reflect solar radiation, helping to reduce radiant heat transfer to the interior spaces. Due to the low mono-pitch roof design the roofing material is barely visible, eliminating potential aesthetic concerns.

Double Roof

The modular cassette design means that the roof has an inbuilt ceiling and ventilated air space, which helps to keep the building cool as well as concealing plumbing and electrics. Phase 2 enhances the double roof shading effect by incorporating foil sisilation into the cassette design. This reflective foil lining further blocks radiant heat from penetrating into the spaces below.


Passive Ventilation


The initial column design of the Phase 1 clinic incorporated ventilation slots within the structure, which in theory eliminated the need for opening windows within the blockwork walls. On reflection, this strategy was found to be inefficient and overcomplicated to construct. The Phase 2 column design was simplified to become a solid unit, with ventilation being provided via mechanical glazed louvres.


Participatory Process

Modular Systems

The primary focus of the project was to develop and prototype a highly affordable DIY construction system that could be further handed over to the university to develop and replicate during their planned expansion. The concept was to create a 'kit of parts' that could be efficiently fabricated and erected by a small team of craftsmen without the need for cranes or scaffolding.

The system is comprised of a modular timber frame with an infill of stabilised soil blocks. A series of timber cassettes based on plywood sheet modules initially prop the frame before being manually lifted into place to form the roof. The system can be used in a number of configurations depending on the university's specific needs - classrooms, hostels or treatment wards.

Research by Design

A considerable amount of research was undertaken to decide on an optimum soil mix for the stabilised soil blocks, which combined a unique colour balance with a suitable brick strength. The bricks were tested for their density and compressive strength at the Ministry of Works in Mzuzu. The final mix was comprised of soil, sand and cement at a ration of 5:1:1.

Post-Occupancy Analysis

The architects used a small temperature measuring device called a Tinytag to assess the performance of the Phase 1 clinic, in order to inform the thermal mass and ventilation strategies during Phase 2.

Tinytags were located both inside and outside of the building and set to take recordings every 30 mins during a 24 hour period. The readings showed that the building was successfully 'peak-looping', with the inside staying cooler than the highs experienced outside, with an average maximum temperature difference of 3.3ºC. This pattern was repeated at night, but with the  building staying approximately 2.3ºC warmer than outside.


Sustainable Materials

The Mzuzu modular system provides a low carbon solution to building construction through avoiding the use of cement and hardwoods, focussing specifically on the innovation of a modular softwood frame and two-types of compressed earth blocks


The health centre adopts - rather unconventionally for Africa - a loadbearing timber frame structure. The softwood timber frame is handcrafted from locally and sustainably managed pine plantations, eliminating the need to transport large bulky components for thousands of miles to site


Mzuzu Phase 1 uses interlocking soil blocks which were machine-made using an efficient hydraform press. The interlocking module allows the bricks to be laid dry without the need for cement mortar. Furthermore, Phase 1 predominantly uses locally produced lime as a binding agent instead of cement, although a cement stabiliser is used on blocks below 600mm due to its waterproofing properties and higher loading from the walls above. There is some trepidation around using lime as a replacement for cement, and this project proves that it is a viable alternative  - Phase 1 was completed around 15 years ago and is happily still standing!


Mzuzu Phase 2 uses a non-interlocking soil block which allows for greater design flexibility but requires a 12mm cement mortar joint between courses. The blocks were manually pressed using a man-powered machine press, with a mix comprised of soil, sand and cement at a ratio of 5:1:1

Fired Clay Tiles

The flooring inside and immediately outside the health centre is inlayed with 7000 fired clay tiles, which were produced in a local pottery. The interior is characterised by square tiles, while the external spaces have rectangular tiles laid in a repetitive pattern. The tiles provide a hard wearing and attractive alternative to concrete flooring that can be easily mopped clean to keep the hospital environmentally sterile.