Paimio Sanatorium as a Monument of Healthcare Architecture

The building completed in 1933 as Paimio Sanatorium has become an international key monument of healthcare architecture. It was not only an outstanding building when completed, but it has been preserved well within the field. The rapid development in medical sciences and on the other hand expectations and needs required in building facilities has brought constant refurbishments and large-scale interventions to the hospital buildings in some 20 to 30 years cycles. In many cases only the exteriors or qualities in city scape, if even those, has retained.

The sanatorium was also of key importance to the international career of architects Alvar and Aino Aalto. Together with Viipuri Library, completed two years later, it gave the Aaltos an international profile. Finnish architecture was not only the receiver of influences from outside.
The building, constructed on the basis of their win in an architectural competition resolved in 1929, was ground-breaking. A tuberculosis sanatorium was particularly suitable for a building which followed the tenets of the new Functionalism, where bold concrete structures and state-of-the-art building services were inseparable elements of architecture and practicality. Aalto designed the interior colour scheme, including the yellow floors in the main staircase, the colourful walls in the corridors, the dark ceilings in the patients’ rooms and the orange balcony rails, in conjunction with the decorative artist Eino Kauria.

The entire building complex, grouped together in several parts according to use, was constructed in accordance with Aalto’s philosophy, right down to the smallest details of the furniture. As far as the loose furniture was concerned, good many items designed specifically for the sanatorium were used, as well as standard products which were already available. According to the idea of standardisation, which belonged to the spirit of the times, these items were also planned for use elsewhere - for example, many of the light fittings ended up in the catalogue of the Taito metalworks. The pieces of furniture became key products for Artek, which was founded in 1935. The bent plywood “Paimio chair” in particular has become an international design icon. On the other hand, the famous three-legged stool, which is the same age as the sanatorium, was not included in the first phase of the furniture supplied by the Otto Korhonen furniture works. The furniture in the patients’ rooms was dominated by tubular-steel construction, soon to be spurned by the Aaltos.

An operating theatre wing designed by Aalto’s office was added to the main building in the late 1950s and new staff living quarters were erected nearby in the 1960s. The sinuous, serpentine row of shared flats in the middle of the pine forest, known to the inmates as the ‘Hall of Vipers’ (Kyykartano), brought a new form of accommodation to the area.

With the advent of antibiotics, tuberculosis could be cured and ceased to be such a terrifying disease, so the sanatorium was gradually converted into a general hospital from the early 1960s onwards. After Alvar Aalto’s death in 1976, his office, Alvar Aalto & Co, was in charge of alterations, under the leadership of architect Elissa Aalto from 1976 until 1994; since 1996, design work has been carried out by LPR Architects.

Over the years, the buildings have been altered considerably, but the key characteristics of the architecture and much of the original furniture have been preserved. In recent years, hospital functions have been transferred elsewhere and a new use has been sought for the building, the current use as children rehabilitation is in balance with the significance of the site.

Yet the communal owner, the Hospital District of Southwest Finland, needs no longer the building and wants to give up the complex. The bidding competition in 2018 resulted no selling nor reuse, but the Alvar Aalto Foundation got alerted and an international appeal was collected.

The Ministry of Education and Culture and the Ministry of the Environment ordered a report to study the future of the site, which was completed in June 2019. It proposes that the Hospital District of Southwest Finland, the central government, the Alvar Aalto Foundation and the City of Paimio establish a foundation to administrate the sanatorium. The organizing of the foundation is currently going on.

Alvar Aalto foundation completed in 2016 a thorough building historical survey and a Conservation Management Plan mainly funded by the “Keeping it Modern” initiative by the Getty Foundation. Thus, the National Board of Antiquities and other stakeholders are well prepared for the future discussions of the reuse and feasible alterations. With all the challenges and unsolved questions, the future of the landmarking building seems stable.