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" When a magnitude 7.0 earthquake rocked Haiti last year, 80 percent of the buildings at Grace Children&amp;#039;s Hospital in the capital, Port-au-Prince, toppled. Grace&amp;#039;s inpatient ward, which provided care to more than 300 children each year with tuberculosis, HIV and other ailments, was condemned and demolished. As much of Haiti&amp;#039;s critical infrastructure crumbled after the disaster, the hospital pushed on by stringing up tarps outdoors and salvaging old cribs and beds so it could continue helping patients, including those sickened by cholera, the first outbreak in the nation in decades  Around the same time the quake hit, a Massachusetts-based organization called Containers2Clinics (C2C) and its partners were busy overhauling two 8 x 20\u2013foot shipping containers into a maternal-care clinic. Founded in 2008, the nonprofit was based on the idea that these easy-to-move industrial containers could take on a new life as boxy hospitals-on-the-go, boosting healthcare access in remote areas of developing nations, particularly for children and women. The prototype container-turned-clinic was slated to go to Bani in the Dominican Republic. But when C2C learned about the destruction at Grace Children&amp;#039;s, the company made a course correction and sent that first clinic to Haiti, where it helped Grace care for thousands of patients. Given shipping containers&amp;#039; reputation for sturdiness and longevity\u2014not to mention their sheer ubiquity\u2014it&amp;#039;s not surprising that eco-minded engineers and designers have been transforming the utilitarian steel boxes into all sorts of spaces, including DIY wet labs and cozy vacation homes. Crews battling forest fires have hauled them into the field as makeshift bunks. Retrofitted containers are increasingly proving useful in disaster relief; they have also have caught the attention of agencies such as FEMA and the Red Cross. But retrofitting an old, dirty steel box into a sanitary mobile clinic requires innovative design, precise fabrication and a fondness for using every last square inch of a tight space. To make it happen, C2C turned to Anshen + Allen Architects and to Stack Design Build, a construction service firm adept at retrofitting containers. The firm&amp;#039;s portfolio includes the aptly named Box Office, a three-story complex in Rhode Island made from 32 recycled shipping containers that, among other things, serves as Stack Design Build&amp;#039;s headquarters. &amp;quot;We got a layout of the two shipping containers, and some very basic schematics and plans,&amp;quot; Andrew Keating, principal and co-founder of Stack Design Build, says. Shipping containers aren&amp;#039;t the most forgiving material to work with\u2014space is limited and incorrect cuts are costly. And because mobility is the clinics&amp;#039; key feature, the building specs had to stay within the &amp;quot;ISO Envelope&amp;quot;\u2014precise dimensions set by the International Standards Organization that allow containers to be neatly and securely stacked for shipping. So before putting plasma cutter to steel and busting out the welders, Keating and colleagues plotted out every detail, down to the angle of the exam tables. &amp;quot;When it comes time to take tool in hand and make a cut in a shipping container, there&amp;#039;s no hesitation,&amp;quot; he says. To make an entire clinic fit into two shipping containers, the first had to include two exam rooms, similar to a doctor&amp;#039;s office. The second container needed to be a small pharmacy and laboratory, equipped with a refrigerator, microscopes and basic diagnostic equipment. The original sketches Keating received didn&amp;#039;t include mechanical space, so his team needed to create a place within the already tight confines for basic electric and plumbing systems. The solution: Build a small partition near the far end, just in front of the shipping container&amp;#039;s front door, and then sandwich the mechanical guts of the clinic into that space. This setup ensured easy access for maintenance without interrupting the flow of the clinic; doctors and patients enter and exit through doors cut in the middle of the containers.  Making room for the electronics was only half the challenge. Because C2C intends to send these clinics to remote locations, Keating built the electrical system to handle irregular power flows and pull power from a variety of sources. &amp;quot;I think the electrical system is one of the best parts of the prototype. We came up with a system that would allow the clinic to be powered from absolutely any source available\u2014local grid power, any kind of generator, or any nearby house panel,&amp;quot; Keating says. &amp;quot;The proto was shipped with this long heavy-duty cable that extends from the clinic to whatever the power source is going to be, and some twist-lock connectors that could plug into anything.&amp;quot; The specs for the prototype called for no air conditioner, either, and Stack Design Build was acutely aware that a steel box sitting in the Haitian sun would heat up quickly. To keep the clinic cool, Keating&amp;#039;s team applied a 2-inch layer of closed-cell spray-foam insulation before putting up easy-to-clean walls made from fiberglass reinforced panels. The team also added through-wall fans powered by photovoltaic panels and passive ventilation to keep the air moving. Keating and company applied a few coats of highly reflective white paint and built a custom canopy. The operational C2C prototype arrived in Port-au-Prince at the end of 2010. Kathleen Flemming, C2C programming director, says Grace Children&amp;#039;s Hospital&amp;#039;s staff has used the shipping-container clinic to care for nearly 4500 patients in the roughly eight months since then. Patients receive primary and preventive services, including vaccinations, pre- and postnatal care, infectious disease testing and treatment, and nutrition counseling.  With its first mobile clinic a success in Haiti, C2C is scaling up. The organization is scouting locations and securing partners for future clinics. To increase production, C2C has begun working with Allied Container Systems, one of the largest providers of prefabricated containers in the world. Lee Hayes, a project manager at Allied who oversees the C2C work, says the second clinic will be similar to the prototype, though there will be a few tweaks, including air conditioners.  Allied is scheduled to finish its first container clinic for C2C in the coming months, which will go to Haiti. But Hayes says demand for retrofitted containers is growing across the board. Allied\u2014a major supplier of containers for the military\u2014has been approached about retrofitted operating rooms and even large-scale housing developments. And though C2C is focused on bolstering healthcare infrastructure in developing nations, and not necessarily disaster relief, its work with Grace Children&amp;#039;s Hospital shows that container clinics can quickly go where they&amp;#039;re needed.  Considering that more than 42 million containers moved through U.S. ports last year, the raw material is available. And we certainly know how to move them. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.popularmechanics.com/science/health/a6750/shipping-container-clinics-could-be-the-future-of-mobile-hospitals/>