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Gardens for Health / B.S.E. Hospital and National Rehabilitation Center

Fábrica de Paisaje

Montevideo, Uruguay

May 2019


Marcos Castaings, Javier Lanza, Diego Pérez, Fabio Ayerra



Banco de Seguros del Estado


Javier Agustin Rojas


The greatest challenge of the Contest for the National Hospital and Rehabilitation Center of the Banco de Seguros del Estado is, possibly, conjugating the strong specificity (and rigidity) of the architectonic solutions frequently associated to this kind of functional program, with the cultural and aesthetic emergences of the contemporary architectonic scene, as well as with other innovations related to how these structures are conceived which constitute the "state of the art" for health architecture.

In that sense, this project firmly bets on a limited number of decisions that attempt to connect those two last aspects. The accent on "urbanization" for hospital buildings, the preference for smaller equipments, the construction of spaces oriented on the user and the realization of spaces representative of the patient's empowerment (seen more as wellbeing and care centers rather than facilities for curing diseases) are materialized through these solutions: the strong presence of a highly specific exterior that is both contemplative and adaptable, the separation of the functional program into smaller independent yet linked structures, the modular structuring along the land as a way to dominate, control and anticipate the future image of the city.


The Banco de Seguros del Estado is the state insurance company of Uruguay, which is also the market leader. Its hospital is the National Reference Center for all occupational accidents, which is why it has a very particular condition. The B.S.E. Hospital and National Rehabilitation Center is a hospital for healthy people who have, unfortunately, suffered an accident. For this reason, the focus of this building is on health, and the search for ways to recover it, instead of fighting disease.

This also makes the architectural program quite different from that of traditional hospitals. The consultation and rehabilitation areas are much larger. The emergency and surgery areas have another specificity, being focused on accidents and not on chronic pathologies.

In this context, the outdoor areas also have a specific function, since they go beyond their contemplative nature to be specific spaces for physical rehabilitation tasks. These are also spaces where the outside world, the world of health, continues to flow. Therefore, they also intend to act as motivation for the effort of personal rehabilitation.

The hospitalization areas are also different, since the hospital receives patients from all over the country who, many times, must stay there for prolonged treatments. For this reason, the entire last level is dedicated to accommodation for the relatives of these patients.

The building is also located in a peripheral area, currently being consolidated, for which a moderate, consistent, but also attractive urban and landscape environment is also striven for.


A: Three gardens and two squares

As opposed to the courtyards common in hospital ground floors (dry, small, filled with equipment) this true picturesque gardens are thought of as authentic "hidden worlds", as expressions of beauty and of the optimism necessary in health care. These gardens are also spaces for strolling, thinking, retreating and exercising, supporting the spaces for rehabilitation and the waiting areas. Although similar, they become progressively more secluded as we move towards the back in agreement with the functions they support. The back square hidden behind the topography of the garden is a multi-functional platform with an ample meadow that work as a reserve space.

B: The building: structures, macro-organization, neutrality and growth

The building is strongly modulated in both directions, which allows for great flexibility in use and transformation. The functional packages are made to correspond with the structures which compose the building. The circulation structure of the base is composed of two interlinked "Es", spaces for the circulation of public and technicians respectively. Additionally, the main vertical connections become gradually private towards the back, being: public areas, technical areas for staff and patients and technical supply areas.

C: The city: relationships and urban times

The development is not only considered in terms of an optimum heliocentric orientation for the inpatient ward but also from a myriad of aspects of its relationship to the city. The base, with a bounded height, mediates towards the long facade with the future side streets considered in the respective landscaping.

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