Delle Willett | Arte en la Tierra
Through evidence-based research, health care providers have come to value the restorative powers of nature. Research has shown that exposure to natural landscapes offers stress relief, enhances mood, increases concentration, and offers an improved sense of wellbeing.
Marian Marum, of Marum Partnership Landscape Architecture — which boasts a large portfolio of military projects and nature-based environments for health and wellness — was brought in by the Navy to help design a unique landscape in Balboa Park with healing qualities.
The Comprehensive Combat and Complex Casualty Care (C5) program at Naval Medical Center San Diego (NMCSD) was created to make limb-injury, amputation treatment, and rehabilitation services available to West Coast-based members of the military and their families needing services, which represent more than 25 percent of all service members injured in combat.
Work on the multi-million dollar facility began in November 2006, with the renovation of a 27,000 square foot facility used for physical and occupational rehabilitation.
Re-opened in October 2007, the facility now includes a prosthetics lab, a ‘gait lab’ where patient’s use of their prosthetics is analyzed and evaluated, and a high-tech gym-style physical-therapy room that houses a wide range of cardio and muscle-development machines.
The centerpiece of the complex is a 3,500 square foot outdoor courtyard, designed by Marum.
“When we designed the C5 area, space was limited, so we decided to use the outside as part of our rehab facility,” said Kathy Goldberg, NMCSD physical therapist.
“We went to local rehab hospitals to see what their outdoor rehab training areas looked like, we took suggestions from patients, and we worked with landscape architect Marian Marum to create the area,” Goldberg said.
Converted into an all-terrain area, the courtyard provides service members a place to learn to adapt and work through real-life scenarios. Ramps, stairs and beams allow patients to work on ambulation and balance.
Sand, gravel, river cobble, brick terrains and wood decking simulate surfaces with varying textures and slopes encountered in everyday life, including cobblestone and obstacles such as cast-in-place boulders.
A 30-by-9 foot climbing wall stands as the center’s most iconic symbol of what can be achieved at this unique facility. The wall challenges patients to work on agility, problem solving, and muscle strengthening. Rubber matting at its base offers another real-life texture to be negotiated.
With its enormous stabilizing foundation, Marum said construction of the climbing wall presented a bit of a challenge.
“It was a feat to get it in here,” Marum said. “It has a huge foundation underneath it to keep it from tipping over. It also required the relocation of 60 feet of storm drain.”
Vegetation also plays an important role in this holistic rehab experience. Ferns, flax and colorful shrubs help soften the building foundations and leave the central space open for rehab activities. A single flowering tree was placed close to the activity area, offering a soft canopy of green.
Numerous boulders were strategically placed to enhance the nature-based setting. Brown-colored concrete helps reduce glare.
This green space is surrounded by therapy rooms and offices that benefit from the availability of natural daylight and views of the soft vegetation outside.
“The ability to bring our patients out here, away from a clinical setting, has been very beneficial to their rehab and recovery,” Goldberg said.
—Delle Willett has a 30-year history of designing, writing, and marketing. She is currently PR advisor to the American Society of Landscape Architects, San Diego chapter. She would love to hear from you and can be reached at [email protected].