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CEBU INSTITUTE OF TECHNOLOGY-UNIVERSITY

College of Engineering and Architecture

Department of Architecture

ARCH462 - R4C2
Design 8: Design of Complex Structures

Plate No. 1
Medical Tourism Complex
with residential-commercial and public mixed use buildings

Research Paper

Cubilla, Jahzeel Joseph


Hipulan, Ann Molly
Mendez, Carlo John

April 2022

Arch. Francisco Epe


Instructor
ABSTRACT

The study aims to propose a Medical Tourism Complex in South Road Properties which this
proposed project will accommodate people amidst in pandemic situations and also can help to
reduce environmental pollution.

South Road Property is one of Cebu City's main routes, connecting to the Cebu Coastal
Road to the north reclamation area near the Sto Nñio church. It was created in 2001 and completed
in 2011. The south road properties, or SRP, feature numerous tall structures such as Sm Seaside
and the ongoing construction of the Nustar Resort and Casino. The City de Mari has the largest
development in SRP. The freshly opened expressway, the Cebu Cordova Link Expressway (CCLEX),
will undoubtedly aid in the proposed complex for better road ways that come from a different location
for medical support.

The researchers primarily examine what are the deficiencies of medical complexes in the
Philippines, allowing us to identify issues such as incorrect space design and zoning, as well as a
lack of services and utilities. Pollution is a severe problem in the Philippines that should be
addressed as soon as possible because it can seriously harm people's health. The issue and
problems with the facility could have a severe influence on the community, particularly on tourists.
CHAPTER ONE
INTRODUCTION

1.1 Background of the Study

The health tourism industry is defined “as the attempt to attract tourists to a place by
deliberately promoting health-care facilities alongside regular tourist amenities” (Goodrich &
Goodrich, 1987). Currently known as Medical Tourism, this industry traces its origins to how people
living in the Neolithic period traveled long distances to conduct rituals and for perceived health
benefits (Smith, 2008). This practice has unraveled through the test of time and has now become
one of the high income-generating industries in the 21st century.

In developed and first-world countries, skyrocketing medical and healthcare services has
pushed patients to outsource medical services from Southeast Asian countries that offer quality
services at a much more workable price range. Countries in the ASEAN region such as Singapore,
Thailand, Malaysia, and Vietnam, have seen dramatic increases in the global market of the medical
tourism sector with an estimated growth rate of 15.5% between 2017 and 2023 (Medical Tourism
Magazine, n.d.). The Philippines, along with its southeast asian neighbors, also experienced an
emergence of its medical tourism industry, resulting to the establishment of a broader range of
services in the sector, such as the Philippine Heart Center, National Lung Center, and the National
Kidney and Transplant Institute, that attracted international and local patients, and healthcare
professionals from across the region (Garcia & Besinga, 2006).

However, minimal investments were made in the medical tourism industry to help boost the
country’s economy. Way back 2010, the Philippines used to be among one of the countries in Asia
that trailed Thailand, Singapore, India, and Malaysia that are involved in the medical tourism
industry, following the countries that held a larger share of the market such as, Taiwan, South Korea,
and China (Youngman, 2012). Currently in 2022, the Philippines is lagging behind in the number of
internationally-accredited facilities, the number of foreign health tourists, and the revenue generated
by the medical tourism industry in comparison to its competitors in the Asia-Pacific region such as
Thailand, Malaysia, South Korea, Singapore, and among others. The Medical Tourism Index has
observed a significant decrease in the attractiveness of the country’s medical tourism industry from
the 8th place in 2014, to the 24th place in 2020. To date, there are only twenty-one (21)
internationally-accredited health facilities in the Philippines. This number is relatively small in
comparison to its neighboring countries such as Malaysia and Thailand, with
internationally-accredited facilities at 79 and 118, respectively.
The Philippines is likely to develop and possess a wide range of undeveloped potentials and
opportunities when it comes pursuing development and progress towards a healthy and resilient
country. As part of the Philippine Development Plan for 2017–2022, AmBisyon Natin 2040 focuses
on the Health System Improvement, the Regional Development, and the Learning Continuity sectors.
The Health Tourism Industry is one of the key factors for the economic development of the country,
as it can be tackled and addressed with the current Health and Environmental Trends. Adapting the
theme, “Medical Tourism Philippines 2050: A Global Vision of the Medical, Health & Wellness
Service in the Philippines,” the program aims to raise awareness of promoting one's health and
well-being through medical, health, and wellness services towards a future that considers the
environment of the generations to come.

1.2. Trends

In recent years, the medical tourism industry in the Philippines has become a vital part in the
growing economy of the country. Based on the 2014 Survey of Tourism Establishment in the
Philippines of the Philippine Statistics Authority, 18.4% of the tourism industry establishments in the
country are involved in health and wellness activities, with a total revenue of around 45.3 billion
pesos generated from health and wellness tourism establishments themselves.
The health tourism industry is seen as one of the high income-generating industries, wherein
the estimated global market sizes of medical tourism and wellness tourism are worth 104.68 billion
USD and 639 billion USD, respectively. With three of the market leaders of medical tourism located
in the Southeast Asian region– namely Thailand, Singapore, and Malaysia–, the health industry has
accumulated around 2.4 billion USD in revenue, with more than 5 million tourists in 2016.

To help emerging and developing countries assess the trends of the medical tourism industry,
the Organization for Economic Cooperation and Development (OECD) has analyzed some of the
positive prospects of the industry into the following growth drivers:
a) Economically, high medical costs will continue to escalate. OECD has anticipated more
countries to be more stringent in implementing health reforms. To bring to context, the newly
passed law in the country, the Universal Health Care Law, has automatically enrolled all
Filipinos in the National Health Insurance Program and has prescribed complementary
reforms in the health system of the country. (WHO, 2019)
b) Demographically, most of the world’s populations are aging. OECD is anticipating the aging
adults to be availing of the more intensive use of medical care.
c) Epidemiologically, the global disease burden has shifted to non-communicable and chronic
diseases, emphasizing the need for greater hospitalization. However, the COVID-19 global
pandemic has dramatically turned the attention of hospitalization to highly-contagious
diseases.
d) Technologically, procedures that were once available to limited countries are now developing
in emerging economies, with some services offered at a lower cost. To bring into context, the
country has untapped potential in the field of medical and wellness tourism, yet people from
all across the world have been coming to the country to avail of their treatments. The
Department of Tourism cites a cost analysis that indicated how the country has been offering
a wide range of modern medical services at a more competitive price.
e) Through social media and the internet, citizens all over the world are given information on
looking for health providers that offer comparable qualities at a lower cost. To bring into
context, high value medical travelers are one of the factors that medical services are looking
to expand all across the country, particularly in Cebu.

While these trends identified three years ago are still relevant to date, the country is expected
to exert unprecedented impact on global and regional developments through a different perspective
on the current health and environmental trends brought about by the COVID-19 pandemic and the
alarming issue of Climate Change. As part of the Philippine Development Plan for 2017– 2022, the
strategic framework to achieve the AmBisyon Natin 2040 includes Health System Improvement,
Regional Development, and Learning Continuity as one of the few mentioned sectors that the
government must be focusing on.

The goal of this study in approaching these health and environmental trends is to improve
the healthcare system of the country while pursuing efforts to combat the environmental issue of
climate change through proposing establishments and infrastructures, since it has been stated in the
Philippine Development Plan 2017–2022 that the current administration is looking to increase
spending for infrastructure from 4% of the country’s GDP in 2016, to a 5.5% increase in 2021, and
going back to a 4.5% by the end of the current administration’s term in 2022. In response to these
frameworks, this study aims to propose a one–stop medical tourism complex located in the South
Road Properties, Cebu City, a place where a boom of infrastructures has started.

1.3 Problem Statement


The medical tourism industry in the Philippines is not developing well in comparison to its
neighboring countries with more advanced equipment and more investments in the healthcare
system. However, this doesn’t hinder international and local patients from getting treated with the
current medical advancements within the country, because of three factors: (1) the healthcare
facilities available here costs less than other countries; (2) the country is also a popular tourist
destination among the Southeast Asian region; and (3) the infrastructural developments and medical
innovations are exponentially rising in other provinces outside from Metro Manila, specifically in the
province of Cebu.

This study aims to address two highlighted trends– the emerging Health Trends brought
about by the global pandemic and the Environmental Trends brought about by climate change–, in
the health tourism industry through the planning and design of a proposed One–Stop Medical
Tourism Complex Development that includes buildings and spaces for residential, commercial, and
public mixed–uses.

1.4 Architectural Goal


To develop and design a flexible, resilient, and quality One-Stop Medical Tourism Complex in
Cebu City, consisting of residential, commercial, and public mixed-use buildings and spaces, that
gives thoughtful consideration to its purpose statement, environment, sustainability practices, and to
global prevailing issues of climate change and inevitable outbreaks.

OBJECTIVES:
1) To contribute to the projection of climate change and impacts on the field of architecture.
a) Creating passive design strategies to improve resilience to hazards.
b) Conduct a vulnerability assessment to ensure that buildings are not at a high risk of
being affected by climate change.
c) Consider the use of renewable energy to promote carbon zero, as envisioned in the
2050 commitment.

2) To provide a community with affordable and long-term housing solutions.


a) Developing and demonstrating new fully automated manufacturing lines for
multifunctional modular renovation elements
b) Reduce consumption of home energy and water.

3) To improve the healthcare system for more functional, fast recovery services for the users.
a) Discuss the importance of integrating “safe hospital” and “green hospital” concepts
into hospital planning and design.
b) Examine and assess architectural designs in relation to hospital operations and
functions.
c) Explore the critical aspects, principles, and practices involved in planning and
designing a hospital, its utility systems, and facilities.

4) To promote the usage of mass transportation rather than private automobiles among the
general public.
a) Helps cities to reduce traffic congestion and the overall level of pollution
b) Reducing the use of gasoline and other vehicle consumables.
c) Promotes to a faster access to desired locations.
1.5 Purpose and Significance

This study seeks to develop a medical tourism complex that will change people's perceptions
of a one-stop medical complex with mixed-use buildings for residential, commercial, and public-use
zones and how the next generation will utilize them. As a response, this study focuses on proposing
architectural solutions for the future inhabitants of Cebu City.

For the community in the South Road Properties area, this medical tourism complex will
complement the existing commercial and public-use buildings by providing residential and
institutional spaces.

For the guests and tourists of Cebu, this medical tourism complex will encourage
international and local visitors to spend their vacation within the province as it has a variety of
reliable and modern medical facilities where they can run to in cases of emergency, and it has a
variety of commercial spaces to enjoy in their leisure time.

For the economy of the country and of the province, this medical tourism complex will aid in
the stability of the economy by aiming to be an internationally accredited medical facility through its
accessibility to the Cebuanos, its reliability of medical advancements, and its affordability to the
common masses.

For the medical tourism industry, this one-stop medical hub will supplement the existing
medical facilities in the country by being another institution that promotes the health and wellness of
its people within an affordable price range in comparison to the other neighboring countries, and by
providing a wide range of services within a small locality.

1.6 Scope and Delimitation

The research will primarily concentrate on the design and planning of the Medical Health
Complex that has residential, commercial, and public-use spaces, which will include architectural
working drawings as well as a site development plan. However, these plans and drawings will be
developed by architecture students without any medical or engineering consultants. Another limiting
factor of this study is that these plans and drawings are constructed within a short period of time, so
additional comments and suggestions for the implementation of the proposed development is highly
encouraged for the future researchers.
1.7 Related Studies

As one of the top leading medical tourism destinations in the world, Singapore has boosted
its economy with its private hospitals investing in exceptional medical services, state-of-the-art
technological innovations, and highly trained doctors and professionals, and has boosted its
healthcare system with the public and private institutions investing in highly flexible, resilient, and
responsive work environments.

The Khoo Teck Puat General Hospital in Singapore has optimized a total building
performance approach that does not merely focus on how they can effectively treat problems with
human health, but also gives importance to how they can be a healing environment that encourages
people to care for their health. Being the most biophilic hospital in Asia, this healthcare institution
considers aspects such as water and energy efficiency, environmental protection, and indoor
environmental quality so that they could bring about optimal levels of visual, spatial and thermal
comfort, and a high level of indoor air quality (Medical Tourism Magazine, n.d.). This medical tourism
complex development has become a destination spotlight in Singapore with the concept of “a
hospital in a garden” and “a garden in a hospital” since it has relatively low healthcare costs, modern
healthcare technology, and quality assuring doctors, while relatively focusing on the perceived
beauty of the environment, the self-reported well-being of its patients and surrounding residents, and
the awareness of nature. As an observation to how the general public responded to this approach in
the medical industry, the head architect of the Khoo Teck Puat Hospital, Jerry Ong, boosts of how
members of the public visit the hospital on a regular basis where not only patients come in with their
health-related concerns, but also people coming in to jog and exercise, to eat healthy and cheap
breakfast options, and to study. “The hospital no longer caters just to the sick. It caters to everybody,
even the healthy.” (Ong, 2017)

The National Centre for Infectious Diseases (NCID) and the Ng Teng Fong Centre for
Healthcare Innovation (CHI) have optimized design approaches and solutions that are not only
internationally recognized for its high levels of sustainability and urban integration, but also
advocates wellness and human centric approaches through their transformative abilities in resolving
design challenges brought about by the COVID-19 pandemic. In balancing the needs for health
safety and business continuity, the healthcare ecosystems of these institutions focused on how their
facilities would be designed to meet changing operational needs brought about by inevitable global
circumstances. The focus of their design requirements heavily relied on two key factors for their
healthcare design: (1) flexibility, and (2) capacity. Counteracting possible damages done by the
pandemic, Ar. Jerry Ong and Ar. Saurabh Bhagra designed and implemented healthcare facility
models in planning for crises. Using the infrastructure shared by the NCID and the Ng Teng Fong
CHI inside the medical complex of the Tan Tock Seng Hospital, the Pandemic Scenario Planning
embedded these facility models in its design and operations to meet the changing operational needs
needed for the future HealthCity Novena Masterplan. Pre-pandemic, the NCID functioned as a
high-end facility of special cases of infectious diseases, while the Ng Teng Fong CHI functioned as
an education and training center for healthcare. During the pandemic, the NCID was transformed as
an extension of the Tan Tock Seng hospital since it had underground access to the medical facility,
and the Ng Teng Fong CHI kept the healthcare community resilient as it allowed training
development for the frontliners and integrated planning of operations. “NCID was built to be ready to
adapt and respond to outbreaks of new and emerging infections, while being safe for both the staff
and its patients. While the Ng Teng Fong CHI was built for the future to cater to changes in
healthcare needs.” (Soh, 2020)

Adapting Singapore’s success in the medical tourism industry and in the healing environment
industry, a proposed complex in the Philippines that promotes the overall health for its people and its
environment would be beneficial to its developing economy, particularly in areas with a recent
economic boom that unfortunately lacks in quality healthcare institutions, such as Cebu City. A
one-stop medical tourism complex in Cebu City that would not only focus on treating and
health-related issues but would also focus on encouraging its people to care for their health through
consciousness and engagement with their environment would be crucial in revolutionizing how
stakeholders and the general public responds to a healthcare system that promotes healthy lifestyles
and sustainable practices, even in the midst of a global pandemic.
CHAPTER TWO
METHODOLOGY

2.1 Introduction
This study focuses on the importance of identifying and integrating the dimensions of
architectural design, post-pandemic response, and climate change response. A combination of these
methods will allow for more holistic evaluation of the benefits to the urban development and open
space planning of the South Road Properties Area in Cebu City. In conceptualizing and building
places that integrate people and nature– especially in response to the impact of climate change
depends and in response to the impact of a pandemic–, four factors of focus were identified: (1)
healthcare, (2) flexible spaces for national emergencies, (3) affordable housing, (4) technologies to
adapt against climate change.

2.2 Research Design

This study would be adapting applied research through obtaining qualitative data and
non-experimental procedures.
As an applied research, this study aims to look at the current problems of the medical tourism
industry and the on-going developments within the South Road Properties area, and how a proposed
medical complex development would supplement a solution to these problems.
In obtaining qualitative data, this study utilizes current user experience of other global and
local medical facilities that has greatly influenced the medical tourism industry of their country or
locality
Using non-experimental procedures, this study optimizes the limited time in proposing
solutions within the allotted time for the current medical facility status of Cebu City and for the design
of a development that complements existing buildings in the SRP area.

2.3 Design Problem


As the state of Climate Change continues to worsen, an increasing number of institutions are
launching programs and initiatives to assist in mitigating its effects and reducing negative
environmental impacts. Global reports indicate that the world has already reached a "critical point,"
where various human activities have increased global warming to the point of changing climate
patterns and endangering all forms of life.
Cebu city is vulnerable to climate change and has some of the country's most polluted air.
Due to its growing population, the city is facing transportation challenges as a result of its reliance on
private vehicles rather than public transit. The increasing of population growth that resulted as of the
most overpopulated cities in the country. Prior to the problem, population growth indicates an
increase in the number of households per family. This results in an increase in the demand for
housing development—which may be associated to energy and water consumption. Open space
feature such as streetscapes, walkways, and vegetation have become less of a priority, which are
also the primary issues that users must address. Due to the pandemic, the limitation of healthcare
has gotten worse. Hospitals became unwelcome and uninvited, resulting in patients being unable to
receive assistance. Implementation of new room spaces for COVID patients is mandatory.
These different problems are ways to solve for a better environment, to establish
sustainability, and to fight climate change without risking future generations' ability to meet their
needs.

2.4 Technical Lot Description


CHAPTER THREE
RESULTS

3.1 Research Design Solutions


The study has gathered user experience data from related developments on medical
complexes and developments. Adapting Singapore’s success in the medical tourism industry, the
researchers will take into account the approaches used in the different medical facilities and complex
developments from a neighboring tropical country. This study will use (1) Biophilic Design
Approaches and (2) Blue-Green Infrastructure Methods to address the on-going health and
environmental problems being faced in this research.

3.1.1 Biophilic Design Approach


Focusing on the medical complex being a “healing environment,” the proposed medical
tourism complex will be looking at the elements of its form, space, and urban landscape to be
explicitly related to the overall wellness of human-beings. Through a biophilic approach in design,
the study will be focusing on five parameters to strengthen the environmental quality, human health,
and efficiency.
(1) Sight: visual stimulation and access to the surrounding and built environment;
(2) Smell: selection of tropical scented plants in green areas and courtyards;
(3) Sound: audible ambient noise from falling and flowing water;
(4) Diversity: diverse variety of tropical floral and fauna within the area; and
(5) Community: ease of access to varied facilities within a singular public-use space;
This approach will most likely focus on the productivity of human habitats and environments,
in terms of energy needs and waste flows into its micro to macro fauna, while encompassing the
building's materials, structure, and program. With a biophilic design within the development,
consistency with the immediate environment inside and outside the building's façade will be
observed throughout the design. As a result, these characteristics will healthily and visually
communicate habitability for a desirable, comfortable and health promoting design.

3.1.2 Blue-Green Infrastructure Methods


To be a complex development that caters to the future residents while addressing the issues
of a post-pandemic environment and of an inevitable climate change, the proposed medical complex
will be focusing on planning infrastructures that are liveable, sustainable, and resilient. Blue-Green
Infrastructures focuses on three elements, namely (1) the Blue Imperative as for the water and
hydrology, (2) the Green Imperative as for the greenery and ecology, and (3) the Red Imperative as
for the people and communities. Through a total building performance approach in ensuring an
energy performance with that of a green hospital, the study will be focusing on four aspects to
determine the overall quality of the development as a post-pandemic response in mitigating the
effects of climate change.

(1) Water and Energy Efficiency


(2) Environmental Protection
(3) Indoor Environmental Quality
(4)
Looking at these factors, this proposed complex will be able to bring about the optimal levels
of visual, spatial and thermal comfort, and a high level of indoor air quality.

3.2 Technologies and Innovations


As a high density urban development aimed at serving people living in the present and in the
future generations to come, it is crucial to adapt new methods of sustainability that will be flexible
and resilient enough to combat similar situations with a global pandemic and to mitigate the harsh
effects of climate change in the environment to be built.

3.2.1 Ecosystem integration in the drainage system

Diagram on the integration of ecosystem with the drainage system

Modern urban structures will have to counteract the current conventional solutions of the
wastewater management and drainage system within the facility. Instead of adapting the typical
sewage system where drainage areas are extruded from the ground level, the complex will mimic the
natural environment in mountain areas where downhill water flow is slowed down by natural
vegetation and other landscaping elements.
Application of ecosystem to the drainage system

3.2.2 Thermal and visual comfort in the facade systems


The proposed medical tourism hub will propose a design that redirects sunlight in a more
comfortable design, considering the area to be near the sea with minimum surrounding buildings to
give shade and comfort to its residents. Awnings with elements of vertical landscaping will be
implemented to protect patients and residents from direct, bright sunlight, and to redirect light to the
ceilings of the rooms to enhance the overall brightness of building interiors, conserving and
preserving energy use.

Achieving visual and thermal comfort within spaces

3.2.3 Renewable energy for utility systems


In response to the issue of climate change, this medical tourism hub would aim to be one of a
certified LEED sustainable building within the city. Solar panels would be installed in a creative way
for the landscape to complement the goal of a garden within the medical hub, such as a shade for
benches and outdoor areas, and an overhead roof in parking areas. These solar panels will then
supply the energy expenditure needed in the hospital, including the HVAC systems inside the
buildings, and the optional ceiling fans for large areas outside the facility.
Connection of solar system panels to the main electrical panel

3.2.4 Air quality management in the health environment


To complement the sustainability practices adapted in the proposed one-stop medical hub, air
filtration systems will be added to minimize air contamination and air infection, considering that the
area is along a road where high-speed vehicles will be passing through. Carbon dioxide and
monoxide sensors will be used to track the air quality passing through the development.

Air Quality Sensors and how it works

3.2.5 Waste and Water Treatment/Management


Using blue-green infrastructure methods, the medical tourism complex aims to reduce the
consumption of potable water and to utilize the waste water accumulated from the development. In
reducing consumption, recycling rainwater will be adapted through using rain sensors installed in
wide surface areas that has a potential to be a large catch basin for the development and through
irrigation systems in the public-use areas that helps supply for the landscaping needs of the
vegetation around it. In utilizing waste water accumulated in the development, a pneumatic waste
conveyance will be adapted to ensure that the waste coming from the hospital is hygienic and safe to
be dispersed in the local sewage system. This will minimize potential human contact with
contaminated wastes, reducing risks of infection.

Rainwater Harvesting System

Pneumatic Waste Conveyance System


3.3 Proposed Spaces
3.3.1 Medical Facility Zone Spaces
● Admitting and Social Service Office ● Administrative Service
● Business Office - Waiting Area
- Billing - Information, Reception and
- Cashier Communication Area
- Budget and Finance - Public Toilet
(Male/Female/PWD)
● Medical Records Section
- Staff Toilet (Male/Female)
● Office of the Chief of Hospital ● Emergency Room
● Office of the Chief Nurse - Waiting Area
- Toilet
● Office of the Administrative Officer
- Nurse Station
● Office of the Chief of Hospital - Examination and Treatment
● Office of the Chief of Clinics Area with Lavatory/Sink
- Observation Area
● Personnel Office
- Equipment and Supply Storage
● Staff Toilet Area
● Prayer Room - Wheeled Stretcher Area
● Laundry and Linen Office ● Outpatient Department
- Sorting and Washing Area - Waiting Area
- Pressing and ironing Area - Toilet
- Storage area - Admitting and Records Area
● Maintenance Office - Examination and Treatment
- Work area Area with Lavatory/Sink
- Housekeeping area - Consultation Area
- Motorpool and ambulance ● Surgical and Obstetrical Service
parking area - Major Operating Room
● Parking Area for Transport Vehicle - Delivery Room
- Sub-sterilizing Area
● Supply Room - Sterile Instrument, Supply and
● Waste Holding Room Storage Area
● Dietary - Scrub-up Area
- Dietitian Area - Clean-up Area
- Supply Receiving Area - Dressing Room
- Cold and Dry Storage Area - Toilet
- Food Preparation Area - Nurse Station
- Cooking and Baking Area - Wheeled Stretcher Area
- Serving and Food Assembly - Janitor’s Closet
Area ● Nursing Unit
- Washing Area - Semi-Private Room with Toilet
- Garbage Disposal Area - Patient Room
- Dining Area - Isolation Room with Toilet
- Toilet - Nurse Station
● Cadaver Holding Room - Treatment and Medication Area
with Lavatory/Sink
● Central Sterilizing and Supply Room ● Intensive Care Unit
- Receiving and Releasing Area - Nurses' Station with Work Area
- Work Area with Lavatory/Sink
- Sterilizing Room - Medication Preparation Area
- Sterile Supply Storage Area - Toilet
● Obstetrical Service - Patient Area
- Delivery Room - Dressing Area
- High Risk Pregnancy Unit - Equipment and Supply Storage
- Labor Room with Toilet Area
- Sub-sterilizing Area/Work Area ● Primary Clinical Laboratory
- Sterile Instrument, Supply and - Clinical Work Area with
Storage Area Lavatory/Sink
- Scrub-up Area - Pathologist Area
- Clean-up Area - Toilet
- Male Dressing Room and Toilet ● Radiology
- Female Dressing Room and - X – Ray Room with Control
Toilet Booth, Dressing Area and Toilet
- Nurses' Station/Work Area - Dark Room
- Wheeled StretcherArea - Film File and Storage Area
- Janitor's Closet with mop sink - Radiologist Area
● Neonatal intensive Care Unit (NICU) ● Pharmacy
- Nurses' Station Work Area with
Sin
- Newborn Care Area
- Breastfeeding Area with
Lavatory
- Treatment Area
- Viewing Area

3.3.2 Residential Zone Spaces


● Studio Type ○ Living Space
○ Main door ○ Toilet and Bath
○ Open plan for bed, living area, ○ Kitchen and pantry
dining area ● Family Type
○ Toilet and Bath ○ Main door
○ Kitchen and pantry ○ (1) Master Bedroom
● Loft Type ○ (1) Bedroom
○ Main door ○ Living Space
○ Open plan for bed, living area, ○ Dining Area
dining area ○ Toilet and Bath
○ Toilet and Bath ○ Kitchen and pantry
○ Kitchen and pantry ○ Balcony
● Dual Type ● Utility Room
○ Main door ● Amenities
○ (2) Bedroom ○ Pool
○ Gym
3.3.3 Commercial Zone Spaces

● Perimeter Spaces for Lease ● Interior Spaces for Lease


○ Open Commercial Space at ○ Open Commercial Space at
least 90sqm least 70sqm
○ Own entrance/exit ○ Comfort Room
○ Sidewalk Seating ○ Office Space
○ Comfort Room ○ Supply Room
○ Office Space ○ Utility Area
○ Supply Room ● Space for temporary stalls near
○ Utility Area public-use zones

3.3.4 Public Use Zone Spaces


● Rooftop Gardens
● Amphitheater
● Mini Public Library
● Exercise Park

3.4 Site Analysis


CHAPTER FOUR
DISCUSSION

4.1. PRINCIPLES OF DESIGN


In applying these solutions to the proposed one-stop medical tourism hub, this study
will be adapting Peter Calthorpe’s principles of designing and building better cities for the future. In
projecting the population to move in urban areas by the year 2050, the center for designing current
infrastructures that ought to withstand and mitigate the effects of a post-pandemic environment and
climate change should be on the vitality of communities.

(1) Preserve. To maintain natural ecologies, agrarian landscapes, and cultural heritage places in
order to promote the complex and make it a tourist destination. This will help to improve the
beauty of the complex by preserving ecologies and rural landscapes. It will also demonstrate
how the project can be completed without affecting natural ecologies.

(2) Mix. Although mixed use is already prevalent in city design, Peter Calthorpe argues that
creating communities with mixed income, mixed age groups, and diverse-land use must
remain a focus. By fostering such a diverse environment, we will be able to better integrate
diverse groups and minimize inequity amongst individuals.

(3) Walk. To create a walking environment and a neighborhood on a human scale. This is done
to enjoy the people in the complex as well as to limit the use of vehicles; there’s no great city
that you don’t enjoy walking in (Carbonneau, 2020). We don't go to places where walking is
nearly impossible since it's not fun. This is the conclusion reached by the urban planner in his
exposé. Why not make walking easy and fun everywhere else, just like we do when we are
on vacation?

(4) Bike. The bicycle is the most efficient mode of transportation available. Many instances of
well-planned cities revolve around the use of bicycles. Copenhague and Amsterdam are two
excellent examples of such towns in Europe. Nonetheless, this system can be installed
practically everywhere in the world. Bicycles were formerly an essential mode of mobility
throughout Asia. With the rise of the self-driving car and its less expensive counterpart, the
powered bike, the bicycle has fallen behind. Initiatives, such as the Chinese government's
new laws encouraging the use of bicycles in cities, will become more common, and for the
better.
(5) Connect. The aim behind this notion is to build a network of streets that will allow multiple
routes to go to the same location rather than a single route. Furthermore, those routes must
be varied, giving a variety of streets rather than just one. As a result, individuals will be able
to use various modes of transportation (walking, biking, and public transportation) to go to the
same location.

(6) Ride. We need to invest more in public transportation. It is the only viable option.
Autonomous automobiles will not solve our problems. In reality, they will produce more traffic,
and thus more VMT, than the alternative. As a result, in order to curb the growth of this
industry, we must give individuals alternative options. The goal is to make public
transportation the first option when walking and bicycling aren't viable options.

(7) Focus. To build a diversified transit path, we must use a variety of modes of mobility, such as
bicycles, public transportation, and autonomous vehicles. The position that each will take
must be determined by their wealth. As a result, green modes of transportation will be
prioritized both on our streets and in our minds.

4.2. LEGAL CODES AND ORDINANCES

4.2.1. Republic Act No. 1096 | The National Building Code of the Philippines

RULE VII. Classification & General Requirements of allBuildings by Use/Occupancy.

SECTION 701. Occupancy Classification. As a one-stop medical tourism hub, mixed building
occupancies are being used in the development. These are the following classifications: (1) Group A
– Residential Dwellings; (2) Group B – Residentials, Hotels and Apartments; (3) Group D Division 2
– Institutional; and (4) Group E Division 2 – Business and Mercantile.

SECTION 703. Mixed Occupancy. The buildings within the complex should conform to the
standards stated in the classification above, and should have accessories that do not occupy more
than 10% of the basic area. An occupancy separation must also exist and must be protected by a
fire-assembly of the researcher’s chosen rating.

SECTION 704. Location on Property. The buildings within the complex should be connected
to a public space, yard, or street on its sides, and must have a building footprint that is subjected to
the firewall requirements of each of the identified classifications, such as a residential condominium.
SECTION 705. Allowable Floor Areas. The buildings within the complex should comply to the
allowable floor areas stated for each classification identified.
SECTION 707. Maximum Height of Buildings. The buildings within the complex should
comply with the determination of the building height limit according to its use and occupancy. The
minimum required for off-street parking provision stated in Table VII.4. should also be followed in
consideration for the maximum height of buildings.
SECTION 709. Requirements for Other Group Occupancies. The buildings within the
complex should comply with the reference table for determining the building bulk and the
development controls.

RULE VIII. Light and Ventilation.

SECTION 803. Percentage of Site Occupancy. The buildings within the complex should
comply with the reference table for determining the Maximum Allowable Percentage of Site
Occupancy (PSO), Maximum Allowable Impervious Surface Area (ISA), Maximum Allowable
Construction Area (MACA), Minimum Unpaved Surface Area (USA), and the Total Open Space
within Lot (TOSL) with reference to Type of Land Use Zoning of the chosen lot.
SECTION 804. Sizes and Dimensions of Courts. The buildings within the complex should
comply with the minimum setbacks for the proposed facility and should acquire an open space to
provide maximum light and ventilation into the building.
SECTION 805. Ceiling Heights. The buildings within the complex should comply with the
minimum requirements of providing a habitable room through adapting a minimum ceiling height of
not less than 2.40m and through the following conditions– (1) for buildings with more than one
storey, the first storey should have a minimum ceiling height of 2.70m, the second storey should
have a minimum ceiling height of 2.40m, and the succeeding storeys to have an unobstructed
head-room clearance not less that 2.10m above the finished floor; (2) for buildings with natural
ventilation, a minimum ceiling height of not less that 2.70m should be adapted; and (3) for
mezzanine floors, a clear ceiling height of not less than 1.80m above and below the level should be
implemented.
SECTION 806. Sizes and Dimensions of Rooms. The buildings within the complex should
comply with the minimum requirements of providing a habitable room through adapting minimum
horizontal dimensions with the following essential spaces– (1) for habitable rooms, an area of 6 sqm
with a least dimension of 2m; (2) for the kitchen, an area of 3 sq.m. with a least dimension of 1.5m;
and (3) for the bath and toilet, an area of 1.20 sq.m. with a least dimension of 0.9m.

SECTION 807. Air Space Requirements in Determining the Size of Rooms. The buildings
within the complex should comply with the minimum air space requirements of the following zones
and spaces– (1) for the school rooms, an area of 3 cu.m. with a 1.00 sq.m floor area per person; (2)
for workshops, factories, and offices, an air space area of 12 cu.m per person; and (3) for habitable
rooms, an air space area of 12 cu.m per person.

SECTION 808. Window Openings. The buildings within the complex should comply with the
minimum of 10% of the room's floor area, such as windows must open directly to a court, courd,
public street or alley, or open water courses. Each room intended for any purpose that is not
equipped with an artificial ventilation system as defined in this code must have windows.

SECTION 809. Vent Shafts. Ventilation or vent shafts must have a horizontal cross-sectional
area of at least 0.10 square meter for every meter of shaft height, but not less than 1.00 square
meter in any circumstance. The minimum dimension of any vent shaft must be 600 millimeters.
Skylights, unless the entire vent shaft is open to the outside air, must have a net free area or fixed
louver apertures equal to the maximum needed shaft area. A horizontal duct or intake shall open to a
street or court at a location below the lowest window opening. A minimum unobstructed
cross-sectional area of 0.30 square meter and a minimum dimension of 300 millimeters are required
for such a duct or inlet. At the respective extremities of the duct or intake, the openings must be at
least 300 millimeters above the bottom of the shaft and the street surface or level of the court.

SECTION 810. Ventilation Skylights. The buildings within the complex should comply less
than the required windows replaced. This should be equipped with louvres and movable sashes that
has less than open area, or provide similar artificial ventilation.

SECTION 811. Artificial Ventilation. An artificial ventilation system shall be installed in rooms
or spaces housing industrial or heating equipment. The equipment used for artificial ventilation must
meet the minimum air changes specified in Table VIII.4.
4.2.2. Republic Act No. 9514 | The Fire Code of the Philippines

SECTION 7. Inspections, Safety Measures, Fire Safety, Constructions and Protective and/or
Warning Systems. Comply with inspection requirements, safety measures for hazardous materials,
safety measures for hazardous operations and processes, and fire protection features such as
sprinkler systems, fire alarm systems, fire walls, emergency exits, shafts and/or means of egress for
smoke and heat, and roof vents.

4.2.3. BP 344 | The Law to Enhance Mobility of Disabled Persons

BP 344 contains the requirements for the accessibility of different individuals with or without
special needs. BP 344 helps in achieving a barrier-free facility that will be freely and safely by
everyone. It also provides the necessary measurements for ramps and other parts of the structures
that will be used as access to fully function and use the facility. The detailed measurements are also
listed from gradients and sizes of ramps, staircases, curb cut-outs, handrails, etc. that will be used
by users to avoid accidents and delays.
CHAPTER FIVE
CONCLUSIONS AND RECOMMENDATIONS

5.1 Introduction

Generally throughout the country, current issues on infrastructure development in today’s


situation are also challenged by the news about climate change and the post-pandemic environment. For
the environmental issue of climate change, one of the main culprits for it is the pollution coming from
vehicles. There are a lot of vehicles in the Philippines, which causes traffic every day. Some roadways in
the Philippines lack bike lanes, emphasizing the importance of the vehicle instead of encouraging the use
of bicycles as a mode of transportation that can also help our environment and reduce pollution. Using
bikes and mass transportation can be a healthier alternative to use rather than using your own vehicle as
it can help you to exercise regularly and it can help reduce the pollution. For the health issue of a
post-pandemic era, one of its main culprits is the poor planning of flexible and resilient spaces in times of
crises and state emergencies. The commercial spaces and residential spaces in the complex could be
converted to extended medical facilities during emergencies, counteracting the lack of spaces and beds
in hospitals in the current problems of the pandemic.

To conclude the proposed concepts and ideas for the one-stop medical tourism hub, the
researchers will be summarizing the solutions and technologies to be integrated in the design.

5.2 Summary of Design Solutions

Mixed-use occupancy has a law requirement regarding space requirements, such as general
provisions, standards, and zoning. Moreover, implementing rules and regulations focuses on
developing and adapting standards and requirements for the design and construction of buildings
and other structures. Construction types should be classified or identified to determine which
construction type to use. Permits for fire zone requirements must be checked and granted based on
the type of construction to ensure the structure and its occupants are safe. By then, light and
ventilation are recommended to ensure comfort and an appropriate building design. The building's
public streets and pedestrian projections are within the property line and will not extend beyond.
Electrical and mechanical regulations should be planned with the assistance of allied professional
electrical engineers prior to their implementation. Lastly, prefabricated structures must be subjected
to special tests to determine their stability.
Along with the provisions and laws, sustainability is also important in making solutions to the
design. Designing this development in terms of principles and practices in fighting climate change
should make changes for future purposes. Implementing tangible ways to combat the climate crisis
to state not only for the natural environment but also for sustainable development. Cebu City’s
ecological problems such as topsoil erosion, groundwater and seat water pollution, air pollution and
excessive garbage are clearly tragic environmental issues. Addressing these issues through
sustainable design and the use of renewable energy will ensure their viability in the future.

Integrated Technologies and Innovations in the development


APPENDIXES
ACKNOWLEDGMENTS

We are grateful to the Almighty God for spiritual direction and for making us strong through all
of the hardships and trials that we have faced. We are especially grateful that He has supplied us
with good health, wisdom, and well-being.

For Ar. Francisco Epe, our dearest Design adviser, who has become our mentor by sharing
all of his thoughts, experience, and expertise. Furthermore, for providing us with direction and
checking during the duration of the research.

We, the study's researchers, would like to convey our heartfelt gratitude to the following
individuals who assisted, supported, and significantly contributed to the establishment of this design
project.

To our cherished family, who has given us the strength and support we need to complete this
research to the end of the project, and who is always there for encouragement, and spiritual. This
project would not be possible without their help.
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