Norton Sound Regional Hospital

This medical and wellness center—designed to serve the healthcare needs of northwest Alaska’s native tribes—integrates state-of-the-art medical technology within a calming, culturally relevant environment.

The Norton Sound Regional Hospital is the first comprehensive medical and wellness center to serve the healthcare needs of the Inupiat, Siberian Yupik, and Yup’ik people of the Bering Strait region of northwest Alaska. The facility, which opened in 2013, supports a system of satellite clinics in 15 coastal and island villages accessible only by air or boat. Devoted to the needs of the people, the hospital and its design address the intersection of vulnerabilities that the local tribes experience—from cultural and health threats, to the multiplicative effects of climate change. Mahlum served as design architect in partnership with Kumin Associates in Anchorage, which served as architect of record.

The Critical Access Hospital is the first in the nation to be designed for ownership and management by—as well as service to—native tribes. To learn about the values, traditions, and challenges facing community members, the project team traveled throughout the hospital’s 44,000-square-mile service area to meet with individual village leaders, tribal elders, and clinic staff. While some challenges varied between tribes, many were very similar: several of the native languages are vulnerable to extinction, which is accompanied with the fear of losing their culture; the influences of Western diet and substance abuse—as well as the increased difficulty in hunting traditional prey because of loss of sea ice—have promoted obesity, diabetes, and other chronic diseases; and the limited sources of clean water are being contaminated by the melting permafrost, which exposes populations to the harmful chemicals previously trapped in the frozen soil.

The elders’ stories highlighted a community under radical threat to its culture, traditions and health. The hours of interviews resulted in the creation of a book of poetry and images entitled Moon of the Bird Sling, which references the Inupiat, Siberian Yupik, and Yup’ik words for the month of April—the time when the migrating birds return. The deeply personal stories informed the architects’ design of a healthcare facility that not only serves the community with the best equipment and technology but also reflects the unique culture and environment of the Bering Strait region and its people.

As a result of this outreach, the design focuses on integrating state-of-the-art medical technology within a calming, culturally relevant environment. Comfortable waiting areas and wide stair landings provide spaces to wait or chat with neighbors, while signage includes local dialects spoken by the diverse population of the service region. Views of the vast landscape and sea from all patient rooms and public areas promote healing and general well-being for patients and their families, who are deeply tied to the experience of nature in all parts of their daily lives.

The design focuses on integrating state-of-the-art medical technology within a calming, culturally relevant environment.

Paintings and sculptures evoke strong themes from the region and its culture and provide visual wayfinding cues. A local Native art consultant traveled across the region to select individual pieces from each village to tell a part of their story. Aerial shots of each village and community are also hung throughout the hospital.

Providing complete care

Comprehensive inpatient and outpatient services are housed under one roof: surgery, enhanced diagnostic imaging, obstetrics, advanced dental care, a pharmacy and physical therapy. The hospital includes an emergency room, offices for public health nursing, laboratory services, and 18 in-patient rooms. It also features an 18-bed wing for elderly nursing care, with a salon and spa. By offering this variety of services, patients and elders can stay closer to home and family during illness, recovery or death. Previously, access to this level of care required two-hour flights to Anchorage, which are often delayed due to severe weather and further postpone medical treatment.

The 144,000-square-foot hospital is located on a gently sloping site on the outskirts of Nome, Alaska. The building’s west wing houses three floors of clinical and administrative space. Bands of windows along south-facing public circulation routes and waiting areas fill the spaces with views and daylight. The two-story east wing houses in-patient bedrooms above diagnostic services and the emergency department. The public entry joins the two halves; a full-height glass stairway creates a landmark for the hospital while marking the on-grade entry.

“Our facility really is beautiful and we are so lucky,” says Angela Gorn, president and CEO of the Norton Sound Health Corp. “The hospital is a huge benefit for the nearly 10,000 residents who live in the Bering Strait region. It helps people of the region avoid the high cost of having to fly to Anchorage.”

Accommodating the place

In addition to treating the medical needs of the local people, the building contributes to climate change adaptation and mitigation. The building is elevated to maximize wind scour under the building to help preserve the permafrost, much of which is thawing under today’s warming conditions, and limit environmental degradation. The foundation uses thermal piling to further protect the permafrost.

Furthermore, the hospital's design combines several systems to protect against the elements while increasing energy efficiency. Triple-pane windows guard against heat loss while allowing in generous daylight regardless of seasonal light variation. Optimizing Alaska’s naturally low-angled sunlight to deliver natural light throughout reduces the energy load of the building. With 8 percent of greenhouse gases in the United States deriving from the health sector, these—among other strategies—help ensure that hospitals concurrently promote patient and environmental health.

About the author: Anne Schopf, FAIA, is design partner at Mahlum. She provides inspired leadership across the firm’s healthcare, student housing and education studios to ensure the firm’s vision of creating healthy and sustainable communities. Under her leadership, Mahlum was recognized with the 2014 American Institute of Architects Northwest and Pacific Region (AIA NWPR) Firm Award. Anne currently serves on the Advisory Group of the American Institute of Architects’ Committee on the Environment.

A version of this showcase originally appeared on APHA’s Public Health Newswire.

Image credits

Norton Sound Regional Hospital - hero

Ken Graham Photography

Norton Sound Regional Hospital - image 2

Ken Graham Photography

Norton Sound Regional Hospital - service map


Norton Sound Regional Hospital - broken ice


Anne Schopf, FAIA - Nome, Alaska