Butaro Hospital opened in January 2011, where Partners In Health and the Rwandan Ministry of Health could provide healthcare to the community of Burera--a region that once lacked access to a single doctor. MASS partnered with Partners In Health and other global health experts in the process, seeking to create a more holistic model of architecture that addresses target health outcomes, as well as the sustainability and resiliency of the region's broader healthcare system.MASS worked with thought leaders in the U.S. and Rwanda to develop effective strategies to affect health outcomes, including patient and staff flow and natural ventilation. Through eliminating interior corridors and implementing large-radius fans and louvered windows, the hospital reduces airborne disease transmission and provides a template for other high-exposure, resource-limited settings. MASS championed patient-centricity and defied traditional ward structures by shifting beds from the perimeter to along a central half-height wall to increase privacy as well as allow for increased natural ventilation and views of the Rwandan countryside. A clear wayfinding system directs patients at all levels of literacy with bilingual, color-coded signage.Beyond the physical building, Butaro Hospital's collaborative construction process built job capacity. Instead of importing equipment and foreign construction teams, MASS hired the local community and made use of local materials in order to both deliver appropriate and sustainable design and stimulate the local economy. The volcanic rock that littered the farmlands was once considered a nuisance; MASS taught new masonry techniques to turn the material into an opportunity for craft and beauty. The design and coordinated construction reduced the project's cost to roughly two thirds of what a hospital this size would typically cost in Rwanda, as well as gave community members marketable construction skills. The process brought community ownership, dignity, and new capacity in both architecture and healthcare through a building that will continue to educate, employ, and empower.