The award-winning Bendigo Hospital showcased last year for the inaugural Open House Bendigo and again this year. The result of the Victorian State Government’s $630 million-dollar project, the largest regional hospital in Victoria is well worth a visit, even though hospitals aren’t usually on the tourist circuit.

Over the last few months, I’ve had more interaction with the Victorian health system than I’d like because friends and close family members have needed serious surgery or other procedures. As a consumer health representative, I’m always interested in the ‘where, when and how‘ healthcare is delivered as well as any outcomes so I was determined to see Bendigo Hospital this year during Open House Bendigo.

The Bendigo Hospital Project’s much-lauded design includes therapeutic gardens and harnesses the healing power of inclusiveness and nature to deliver world-class healthcare facilities in a welcoming, holistic, and positive environment.

 I can assure you ‘seeing is believing’…

The project a Private Public Partnership between Exemplar Health and the Victorian Government and involved collaboration and consultation. The contract hands the hospital back to the government in 25 years.

Is this a pathway for the future of providing public hospital care?

Medical technology and expertise can detect and treat disease earlier, replace or heal damaged body parts, and extend life expectancy – but it all comes at a ‘dollar’ cost.

Students of history know the difficulties experienced when Medicare was introduced and the ongoing battle to retain it. To fund or even establish a universal healthcare system opens the proverbial ‘can of worms’ in Australia. Maintaining public health systems is costly financially and in political terms, because there are those ideologically opposed to the idea of government completely funding anything.   

And ‘bean-counters’ must be satisfied.

Australia’s two-tiered health system of public and private services already stretches government dollars and there is an underlying reluctance or suspicion of change from most people – especially radical change – private-public partnerships may be the compromise we need to have.

The design, organisation, and management of hospital buildings evolve at a slower pace than medicine and treatments because bricks and mortar and technological equipment require huge investment and often relocation. Expanding existing facilities may not be possible and any new site can meet community opposition or the shortcomings of political expediency.

The Bendigo Project united three existing sites. From the beginning, the architects, design team, and landscape architects OCULUS collaborated and consulted to join the various precincts through a series of connecting paths and diverse landscaped gardens, where staff, patients, and visitors could move or sit in communal and private spaces.

The scale, colours, and proportion of the built form of the hospital reference Bendigo’s distinguished heritage buildings, while establishing a strong sculpturally, formed civic element creating a more friendly and human scale.

Dja Dja Wurrung & Chinese Gardens

There is a designated area for the Dja Dja Wurrung respectful of their needs and Chinese gardens reflect the cultural diversity of the region since colonial times. The green infrastructure ensures trees and plants are inside the building as well as in gardens outside. 

Mainly indigenous plants are used but also non-indigenous to mirror the history of gardens in the Bendigo area – special plants that may have been introduced or cultivated by colonial settlers.

Tree bark was an important resource for the Dja Dja Wurrung People and was used for the manufacture of a number of different articles such as canoes, shields and coolamons (bowls). Trees like this one, bearing the scars from bark removal can still be seen in many parts of the Country and are an important reminder of the Dja Dja Wurrung presence in the landscape.

When you enter Bendigo Hospital there is a sign that reads ‘ We are proud to acknowledge Dja Dja Wurrung as the Traditional Owners of this Country’ and at the entrance to the Aboriginal Support centre/gathering place, there is a framed Possum Skin Cloak by the artist Jida Gulpilil with the following explanation:

The creation of a Djaroon – Possum Skin Cloak to Dja Dja Wurrung people is a direct link to our past and connection to our physical and spiritual world today – it continues our healing, forever telling the stories, customs, beliefs and culture of our people. The Djaroon creates warmth and is shared with others for healing, health and wellbeing.

The Mootchung (wattle seed pod design) represented reflects the practice of seasonal food cycle collection and movement. It is high in protein and can be cooked or eaten raw like green peas. The wood of the tree is used to make the implements for hunting and gathering other bush-foods and medicinal plants that build strength and connection to country.

Our belief, which has been passed down over 2000 generations is that our spirits and physical presence were created to encourage and support all peoples health and wellbeing, through health support, education, mutual respect and understanding: we should never disconnect from that objective as a universal community.

Jida Gulpilil 2016

 

The privacy of the Aboriginal Support area, the secluded garden with a fire circle for smoking ceremonies and meetings were designed with consultations to meet the needs and cultural sensitivities of those who use the services.

The impression of tranquillity and quietness is strong, also the smell of eucalyptus leaves. The furniture and building features made with natural materials blend into the landscape to create an inclusive and beautiful space.

The Chinese Garden with its central Pomelo tree surrounded by seats for rest and contemplation is also distinctive and beautiful.

The plaque in English and Chinese reads:

88 

Number 88: Representing abundance, prosperity, good health and family unity.

Pomelo trees are an important symbol in Chinese culture. To the Bendigo Chinese, this is a ‘tree of life’, and pomelo tree leaves are made as an offering to the decorative Chinese dragon at many special ceremonies. This tree was propagated by Russell Jack AM, from trees grown from seed by his mother, Gladys Ah Dore in Elmore during the early 1900s. A donation from the Golden Dragon Museum of Bendigo this tree is a living reminder of the growing contribution the Bendigo Chinese community has made to Bendigo Health for more than 100 years.

Nature Invited Inside

This recently finished hospital impressive in many ways and it was a joy to be shown around the place by one of the Oculus architects and a representative from Exemplar Health. Both women were exceptionally generous in the details they provided,  answering every question, no matter how repetitive. 

Yesterday, I received a list of all the plants and trees used in the incredibly stunning gardens because many of us requested it.

This list for the precinct is nine pages and as Joan from Exemplar Health stated in the email ‘a live document, changing over time as we work with our horticultural staff to maintain the gardens and see what is thriving (or not!) in each area.’

When I walked through the gardens and entered the hospital, first impressions were unlike any hospital I’ve ever visited. I say this as a positive, not a negative. Inside the building was even more stunning than the magnificent garden area outside where you’d expect to see rows of parked cars.

The entrance, airy and light with abstract paintings and sculptures by internationally renowned, Daylesford based artist Esther Stewart contributing to the positive ambience.

 

Stewart explores repetition and composition through colour and line. the intricate hand-painted wall painting references decorative arts, crafts and flowers from the Bendigo region. Inspired by the symmetry and formal geometry of Bendigo’s famous gold-rush era architecture.

The wall-painting features architectural elements drawn from German-born, Bendigo architect William Vahland’s ornate structures, as well as from the historic Victorian threshold tiling found in domestic and civic buildings in the Bendigo region.

Bendigo’s native flowers, Shrubby Dampiera, Sweet Bursaria and Rosy Heath have been incorporated into a repeated pattern through the piece. These decorative elements contrast with solid blocks of joyous colour, the palette of which has been inspired by the work of artists Agnes Goodsir and Emma Minnie Boyd, who were amongst the Bendigo ArtGallery’s first female acquisitions.

The elaborate wall work is a complementary counterpoint to the feathered natural light and earthy materials of Bendigo Hospital’s internal street space, providing a human warmth and local familiarity to the important new civic space.

You notice the trees growing inside the building and can’t resist checking if they are real or artificial.

Everywhere you look there is shrubbery and this green infrastructure has a remarkable, immediate, beneficial effect. The restorative power of gardens is documented here in an article written in 2015  for Frontiers in Psychology, after a study about the benefits of formal or informal gardens.

At Bendigo, there are three full-time gardeners over the three sites, plus contractors at particular times when seasonal changes may demand extra maintenance.

Our guides told us that the design of the ceiling in the entrance area was influenced by the way light filtered through the tree branches. The architects altered their original design and materials accordingly. This openness and flexibility apparent throughout the project and staff and patient input were given high priority.

We walked through the ground floor of the hospital and learned about the landscaping, soil depth, microbes, plant needs, tree needs, light and sunshine available, the reason for rainforest trees. 

When choosing plants they had to consider allergies, if plants were poisonous and could be ingested, if plants, seeds, branches, stones in rockeries could be weaponised. The mental health and dementia area have their own closed-in and safe garden.

Each floor has its own garden/rainforest – wherever you are receiving treatment there is a view to the outside world and access to plants and fresh air closeby. On the lower floors, canopy trees offer privacy from upper storeys and balconies.

We walked through the Cancer Centre and several other departments, each decorated in a specific colour scheme with artistic backdrops reflecting the seven shires that make up Bendigo. An aerial photo of some aspect of the shire enlarged behind the reception desk while chairs and other furniture complement the main colour.

When looking at the Cancer centre, one of the volunteers told me her husband was treated at the hospital and died in the hospice. I appreciated her volunteering because her grief would still be raw. 

The Treatment and Chemotherapy Rooms look out onto gardens, which help you relax and take your mind off what is happening but for some procedures ‘staff and patients have to remember to shut the blinds,’ she said with a smile. Patients can see out but people sitting outside can also see in!

I told her that when I was going through chemo at Cabrini Brighton, they had scenic landscapes hanging on the wall and I used to stare at one of a beach, close my eyes and pretend I was in Samoa! My daughters waited in a nearby cafe until I was ready to go home but at Bendigo, support friends could sit and relax in one of the lovely courtyards.

An Interesting Segue

Last year the Cancer Council of Victoria chose Bendigo to launch a national campaign tackling obesity and cancer – a campaign claimed to be a world first.

• Targeting ‘toxic fat’ around internal organs, the campaign revealed sugary drinks contribute to obesity and being above a healthy weight is a preventable cause of 13 types of cancer, including breast cancer.
• Sugary drinks, including soft drinks, sports drinks, sugar-added juices and milk are the single biggest source of sugar in our diets.
• 98% of Australians are aware obesity is a risk factor for type 2 diabetes and heart disease but as few as 40% know about its link to cancer.

Bendigo Health BANNED all sugary drinks being sold within its precinct – a great initiative for the sustainability of our health resources!

We want people to realise that they could be drinking their way towards weight gain, obesity and toxic fat, including their risk of many types of cancer.

Dr Sam Harris, consultant medical oncologist

It can’t be overstated how important a relationship with the outside world is when recovering in hospital. To be able to access natural beauty with its promise of new buds, leaves, and flowers contributes a promise of healing.

Central to the landscape architectural approach was the idea of connections and kindness… delivering high-quality public spaces, streets and edges inviting use and respite.

Key Outcomes & Sustainability Pluses

• Design using evidence-based & biophilic design approaches
• nearly 50 green roofs, roof decks, balconies & courtyards (some accessible), nearly 20 mental health courtyards and an Aboriginal Services Garden (part of closing the gap initiative).
• the largest green roof in a hospital project in Australia
• the hospital’s green roofs reduce glare and heat island effect, improving acoustics and thermal performance.
• a 770panel 200-kilowatt solar photovoltaic panel array generates clean energy power
• annual reduction in greenhouse gases of approximately 300,000 kilograms of CO2
• the hospital roof can harvest and store more than 300kL of potable and no-potable rainwater in this drought-prone region
• recycled water systems supply landscape irrigation, toilet flushing and heat rejection systems.
• green infrastructure has been incorporated combining water sensitive urban design and structural soils and increased biological diversity.

Not surprisingly Exemplar and Oculus have won a string of awards for Bendigo Hospital, the latest only recently: the Prize for the Civic Landscape by the International Federation of Landscape Architects.

Other awards include:

• Premiers Sustainability Awards, winner Regional Recognition Prize
• PCA Victorian Development of the Year
• Good Design Awards, winner Architectural Design
• AILA Sir Zelman Cowen Award Public Architecture
• AILA National prize Civic Landscape

Robots In Use

While listening to our guides some hardworking robots glided along a designated corridor on a walkway above us.

The robots looked like large silver boxes to me.

The robots made in Germany (Siemens) operate on a small platform/trolley that can be raised. They deliver food and linen after being loaded by humans. The robots operate in a special corridor and lift reserved for their use, taking the items to the wards to be distributed by nurses or other staff.

The robots take themselves into a storage area to be recharged and when you consider all the repetitive movements and effort required to lift clean or dirty dishes and linen, having a machine to do it makes sense.

Further Improvements Transform Bendigo Health

The transformation of Bendigo Health is amazing considering in 2012, some buildings were deemed non-compliant after failing to meet fire-safety standards.

The Victorian Government promised $60million last year to fit out the old hospital building, demolish towers at the Anne Caudle Centre, and complete the redevelopment of Bendigo’s hospital precinct.

Stage three of the hospital’s redevelopment brings together allied health services, including physiotherapy, social work, speech therapy, prosthetics and orthotics, clinical psychology and neuropsychology.

People recovering from illnesses and injuries will have good rehabilitation services and support close at hand when the new rehabilitation centre is complete by 2023. Work will start in 2021, this enables current services to move with minimum disruption before towers are demolished.

This stage is not part of the private-public partnership that delivered the first two stages so it will be interesting to see if the greening continues!