Three Decades of Design at Aga Khan University

In 1971, His Highness the Aga Khan commissioned the planning and design of a new teaching hospital, together with a medical college and school of nursing, on the outskirts of Karachi, Pakistan. Completed in 1985, the Aga Khan University (AKU) has become the premier academic medical center in Pakistan. In 2006, the hospital was accredited by the Joint Commission International for achieving and maintaining the highest international quality standards in healthcare. AKU graduates approximately 150 nurses and 350 physicians each year. Today, the campus is the hub of an integrated health delivery network that delivers care to one million patients annually.

The AKU hospital complex was conceived as an integrated complex of buildings, verandas, and courtyards, providing a rich continuum of experience from exterior to interior. Far from being an object building, the architecture forms a sequence of interlocking, “interiorized” outdoor rooms that are intended for particular patterns of use. Some courtyards are designed for private contemplation. Others define shaded outdoor waiting areas where patients’ families hold vigil for loved ones undergoing surgery. These richly textured landscaped spaces, which incorporate reflecting pools and fountains, produce a pleasant microclimate in contrast to the formidable climate of Karachi. They provide respite for patients, their families, caregivers, and students, prefiguring the healing gardens that are prevalent in hospital design today.

Long-term vision
The initial campus provided approximately one million square feet of space for hospital, academic, housing, and service functions. Ten years after opening, the campus began to feel the pressures of evolving approaches to healthcare delivery and new research initiatives, triggering several master plan iterations to guide campus growth. These master plans have produced a series of new buildings and courtyards built over the past 18 years, representing approximately 600,000 square feet of new space. Some of these buildings are infill additions and expansions to the original complex; others represent the initial phases of new sections of campus development. All of them have been designed and constructed to extend and elaborate the original architectural vocabulary of the campus.

It is nearly impossible to distinguish between the original complex and the various infill additions and expansions, due to the consistency of the architecture (tectonics and materials) and how gracefully the original buildings have aged and endured. Perhaps the most important transformation has been the maturity of the landscape. The courtyards, now with fully-grown trees and lush vegetation, have achieved their fullest expression. The landscape today plays a spatial role in the experience of the campus, supporting and enhancing the experience of the architecture.

Photography: © Warren Jagger, ©Ayesha Vellani, © Paul Warchol