A Hospital for the future: Planning for Montserrat’s growth

Waste building currently under construction by SES.

The recent contract signing for Montserrat’s New National Hospital marks a major milestone in a transformative project that will deliver a modern, resilient healthcare facility for the country. This initiative, led by the Government of Montserrat in partnership with Article 25 and the Foreign, Commonwealth & Development Office (FCDO), will provide a state-of-the-art hospital designed to meet the island’s long-term needs.

As Honourable Dr. Ingrid Buffonge, Minister of Health for the Government of Montserrat, highlighted: "A building is just a building. What makes it a hospital is the people that will work there."

This principle has guided the development of the new hospital, ensuring that it is built with and for the healthcare professionals and patients it will serve.

Overcoming the challenges of remote construction

Building a hospital on an island with limited resources presents unique challenges. Montserrat’s remoteness means that materials, equipment, and expertise must be carefully coordinated to ensure a smooth construction process. The existing hospital, Glendon Hospital, has operated out of a former primary school, following the 1995 volcanic eruption that devastated the island. The new facility will finally provide a purpose-built solution to meet the demands of modern healthcare.

Reliable power is essential for any hospital, but it is a particularly pressing issue for Montserrat. Frequent outages can pose a serious risk, especially for critical medical equipment. One CT scanner, for example, requires as much power as an entire hospital wing. As part of the minor works, robust power solutions, are being implemented to ensure medical services remain uninterrupted.

Additionally, the new hospital will feature an on-site oxygen generation facility. Currently, all medical oxygen is imported, which creates vulnerabilities in supply. The new system will provide Montserrat with a self-sufficient and sustainable oxygen source, significantly improving healthcare resilience.

Sustainability and resilience at the core

Montserrat is highly vulnerable to extreme weather, particularly hurricanes and tropical storms. The new hospital is designed to withstand these challenges, incorporating hurricane-resistant structures and seismic protection to ensure it remains operational during emergencies.

Beyond resilience, the project prioritises sustainability – using locally appropriate materials, reducing environmental impact, and integrating efficient construction practices. In doing so, it actively supports seven of the 17 United Nations Sustainable Development Goals (SDGs), in particular ‘Good Health and Well-being’ (SDG 3) by improving healthcare access; ‘Industry, Innovation, and Infrastructure’ (SDG 9) by strengthening essential services, and ‘Climate Action’ (SDG 13) by enhancing disaster preparedness and sustainability.

Waste management is a key consideration for the new hospital. As part of the project’s minor works, a new incinerator building is being built with local contractor Steel Express Services, to safely dispose of clinical waste, improving healthcare standards on the island. There are also ongoing discussions about reducing single-use hospital equipment where possible, with items cleaned, processed and sterilised for reuse in the Central Sterile Supply Department (CSSD).

A partnership-driven approach

Local partnerships are also central to the project’s success. The Government of Montserrat has worked closely with Article 25 to ensure that the hospital meets NHS standards while being adapted to the specific needs of the island. Community engagement has been a priority, with hospital staff involved in planning every detail, from clinical workflows to the placement of electrical outlets in offices.

Logistics on the island require careful planning, as only a handful of shipments arrive each month, and any delays can impact the project timeline. To help mitigate this, the appointed contractor, CIE, brings valuable regional expertise and operates its own barge and transport network, ensuring more reliable access to materials.

Designed for Montserrat’s future

With a current population of 4,200, the hospital has been designed for a future capacity of 12,000, reflecting the government’s long-term vision for repopulation and economic recovery. The volcanic eruption of 1995 led to a dramatic reduction in the island’s population, but with strategic investments in infrastructure, Montserrat is steadily rebuilding.

Article 25’s Site Architect, Mark Webb, who has been working on site since November 2024, comments:

"Montserrat is unlike anywhere I’ve worked before. Despite its similarities to other Caribbean islands, it has a distinct history, culture, and set of challenges that require a tailored approach. The complexity of logistics, procurement, and infrastructure on the island makes this project unique, but it also highlights the resilience and determination of the people here. Understanding these constraints has been essential in ensuring the success of the new hospital. It’s a privilege to contribute to a project that will have such a lasting impact on Montserrat’s future."

Despite its challenges, Montserrat remains a stunningly beautiful and culturally rich island. Important national events such as the St Patrick’s Festival, which temporarily triples the island’s population, highlight the potential for tourism and economic revival. The hospital project is a crucial part of this broader recovery strategy, providing essential healthcare services that will support community growth and attract new residents.

A collaborative effort for a sustainable future

The success of the Montserrat National Hospital project underscores the importance of collaboration.

By working in close partnership with the Government of Montserrat, Article 25 and its collaborators are ensuring that the island’s healthcare future is secure. This project stands as a testament to the resilience and determination of Montserrat’s people, demonstrating how strategic planning and international cooperation can overcome even the most complex logistical and infrastructural challenges.

With construction now underway, Montserrat is one step closer to a hospital that will not only serve the immediate needs of its residents but also support the island’s long-term growth and resilience. This is not just about building a hospital; it is about building a future.