Introduction 

The pandemic has put our health into sharp focus and nurturing collective welfare has become one of the crucial challenges regarding our cities. This research is examining the post-pandemic spatial network of collective well-being beyond the city boundaries, while sustainably activating architectural heritage in Sweden. 

Once recognized as instruments for healing, sanatorium buildings represented a visionary response built in times of crisis. Strategically located in specific landscapes, where nature could provide the best health conditions, nowadays many are left to decay. 

By focusing on both their architectural and cultural-historic significance in relation to the necessities of post-pandemic cities, the question this research aims to investigate is - how can these buildings and their landscapes once again serve the well-being of the wider population? Could they become the new sustainable typologies of housing / working / coexisting in order to create new neighborhoods?

Post-pandemic Typologies of Well-Being

In the times of the coronavirus pandemic, the way we collectively perceive health has been reshaped on two main levels. On one side, we have become more aware of the state of illness- by reading about the symptoms of the virus infection, checking ourselves if we are ill, or being ill. On the other, we have experienced how our behavior could prevent us from becoming ill - by wearing masks and keeping physical distance from others. The first aspect of behavior refers to the traditional definition of health as the absence of illness, and the second one to prevention, or in wider terms, well-being.

According to the World Health Organisation, health is not defined anymore as the absence of illness,  but as “a state of complete physical, mental and social well-being”.¹ This redefinition of health is to include correlations between social, psychological, and medical aspects, besides access to medical treatment. This approach takes into consideration a wide set of actions related to the quality of the built environment. 

Health and well-being are therefore symbiotic, and long-term solutions are more appreciated than just instant treatments. A healthy society reduces the increasing pressure on health services, and thus integrating well-being aspects into designing our homes, neighborhoods, and cities is an important potential that architects and planners are given. 

In this regard, Koen Steemers, Professor of Sustainable Design and Head of the Department of Architecture at the University of Cambridge states:

New Nature - Architecture in Charge of the Well-Being

Historically, health as an aspect of architecture has received little attention, and its existence  was within the boundaries of designing ‘healthy buildings’ - buildings that are not going to make its residents ill. That was a result of the effects of environmental characteristics such as overcrowding, noise, air quality, and light. There is a shift in recent work towards establishing a more holistic awareness of the role of architecture in health. 

In the post-pandemic context, architects and urban planners should take part in creating an environment that will nurture collective well-being. The health crisis could be used as a chance to put emphasis on the necessity of new typologies that are going to nurture two key elements of our well-being - feeling good and functioning well. This research is going to focus on the creation of built environments that not only contribute to physical health through ergonomics but also affect our emotional comfort. 

Tracing the Sanatoriums in Sweden

Sites with specific environmental benefits, historically recognized as instruments that powerfully affected the mind, senses and emotions, unique by many features, were sanatorium buildings and their surroundings.

A sanatorium was a type of medical facility that mainly isolated and treated patients with tuberculosis. Around one hundred Swedish sanatoriums were built during the last quarter of the 19th and the first half of the 20th century, scattered throughout the country’s finest landscapes. 

Sanatorium locations were carefully selected and strategically chosen in the places where the climatic conditions were considered fruitful for the purpose of healing. In order to enable the prevailing ideals of care, these buildings were mainly positioned on high altitudes, close to forests, lakes, sea-side locations, or sometimes an agricultural landscape. As such, they were the opposite to the city's dust, overcrowding and noise, but still remained connected by means of transport. Even if they were not in a close vicinity to the city, they represented its extension, and a crucial part of its infrastructure of health and care. 

Before the discovery of a pharmaceutical cure, architecture in alliance with nature was considered the basis for the standard therapy. With the advent of antibiotics, and the possibility for curing tuberculosis, the treatment in sanatoriums became obsolete, leading to the ultimate end of their typology.

Since the formal closing of the last sanatorium, the future purposes of such buildings were never a subject of strategic overall plan. Over time, some of the former sanatorium buildings were independently converted into general hospitals, or into different types of hotels and apartments, while some were left to decay, reaching the condition where inevitable repairs are needed.

Research Goals: Towards a New Identity

The main goal of this research is to map, document, analyze and evaluate the means of systematic reactivation of unused former sanatorium buildings in order to accommodate post-pandemic well-being typologies. The analysis will bring out the architectural principles on which the sanatoriums were initially designed, in order to revive the healthy environment within such locations. Additionally, it will focus on sustainable development by reusing and remodeling as architectural tools, instead of building new structures. Furthermore, the project will introduce a set of activities and scenarios in order to create new neighborhoods of well-being.

The specific goals are used to define activities following each phase of the report:

- to research and outline the well-being typologies in the context of the pandemic
- to research the history by bringing together historical records of the former sanatorium buildings, including defining its architectural features, archival documents, physical analyses, and knowledge about the building’s performance over time
- to research targeted buildings and propose a tailored plan of activation for each of them
- to open a dialog with residents of the cities, in order to gain information about the needs of the future users
- to create a long-term strategy for decision-makers, contractors, and users with regards to investment possibilities
- to make a research report, reach out to the general public, and initiate the dialog about the project

In the long run, the research serves as a starting point for future developments that could benefit the residents of the cities and the collective well-being.

Methodology

The project will be split into two phases: the research and the reaching out phase.

The methodology of the research phase of the project is going to proceed within two frameworks: theoretical and practical.

The theoretical framework represents the starting point of the project and it includes the research of the post-pandemic typologies, and the historical framework of the former sanatorium buildings, as well as their current state. The practical framework involves site visits, specifically chosen case studies and interviews. Together, the theoretical and practical frameworks represent the base for the creation of the set of proposals for future developments, which will be compiled in the form of a report.

The reaching out phase is the final phase of the project, which will be realized in the form of public presentations and panel discussions.

Case Studies

Three in-depth case studies will be executed based on the following criteria - the typology of the surrounding nature, its location, the lack of development plan, and the overall architectural values. The architectural values concern the quality and the state of the existing structure, the spatial capacities, the building’s transformation potential, and the cost-effectiveness of reuse. The case studies could consider sites with different typologies of surrounding nature (e.g. by the lake, at different altitudes, or deep in the forest), providing a platform for analysis of how different types of nature affect well-being.

Based on the current analysis, the following examples could represent the case studies, but the final selection would be made after the detailed theoretical and archival research phase of the project:

Hålahult sanatorium, Örebro
Built 1900, located in central Sweden surrounded by forest,
20km from the city.
Consisting of one main building and two summer pavilions.

Sandträsk sanatorium, Norrbotten
Built 1913, located in the north of Sweden deep in nature by a lake,
40km from the city.
A new bigger building was added in 1927.

Hällnas sanatorium, Västerbotten
Built 1904, located at an altitude of 273m above sea level,
70km from the city.
A new bigger building was added in 1951.

Conclusion

If we manage to incorporate new collective needs into our built environments, while respecting the existing qualities of historic sites, we can manage to move our society forward in a unique, contextual, and sustainable manner.