The region is among Nepal’s most inaccessible and impoverished, with high rates of childhood malnutrition and maternal mortality. The Tatopani Hospital expands access to affordable healthcare services with a special emphasis on maternal health. The Hospital is organized as three interconnected volumes around a canteen and central Healing Garden with native plantings and views to the Karnali River valley. The facility’s emergency, out-patient, and administrative departments are located on the west side of the site with easy access to the entry, parking, and drop-off.

An in-patient department, surgery, and maternity ward are located to the east for privacy. The Hospital takes advantage of its one-acre site’s moderate, south-facing slope by earth sheltering against the north and opening toward the south for maximum solar gain. Sterilized spaces and service spaces are located to the north where windows are kept to a minimum and the adjacent soil can stabilize indoor temperatures. To the south, tall windows in occupiable spaces such as the clinical offices and in-patient and maternity wards — angled to increase solar exposure — provide expansive views out to the valley and allow in sunlight to passively warm the interior.

Interior rammed earth shear walls and concrete floors act as thermal masses, storing the energy of the sun and heating the interior overnight as outdoor temperatures drop. High clerestory windows bring sunlight deeper into the interior, reducing the need for artificial lighting and lowering energy usage.