An administration block, 10 single-family houses, and an eight-bedroom dormitory serve the hospital’s staff and their families. Bayalpata delivers low-cost, high-quality care to more than 100,000 patients a year, more than eight times its original capacity. The hospital has two operating theaters for the only two practicing surgeons in western Nepal, Dr. Pawan Agrawal and Dr. Bikash Gauchan. Bayalpata also features the sole dental office in Achham, led by Dr. Rekha Gauchan. Sharon Davis Design introduced rammed earth as a locally available and low-tech construction method, minimizing prohibitive transportation costs and utilizing unskilled local labor.

Local stone was used for foundations, pathways and retaining walls. Built-in furniture, doors, and louvers were fabricated from local Sal wood. A 100kW, rooftop array generates an energy surplus, while insulated roofs, along with massive rammed earth walls, help regulate summer and winter temperatures. Breezeways, clerestory ventilation, and ceiling fans increase airflow, further mitigating summer heat. The campus includes new water management strategies with terraces and bioswales to manage monsoon-driven erosion.

The architecture maintains a vernacular scale through setbacks and gabled roofs. Tall windows frame dramatic views and clerestories provide daylighting throughout all clinical areas. All rooms provide patients with access to outdoor gardens or balconies, and landscaped courtyards offer a sheltered environment for patients and families. Credits: - Ethicons-EWES J/V - Local Architect - Naresh Raj Acharya - Office of Structural Design (OSD) - Structural Engineer - Arun Rimal - XS Space - Landscape Design - Julie Farris - eDesign Dynamics - Waste/Water Engineering - Eric Rothstein - Subedi-Associate J/V - General Contractor - Subeen Man Joshi