ABSTRACT
Whether propelled by a peculiarly Western belief in progress and expansionism or by nothing more than the desire to provide a safer and more stable medical environment, most missions progressed from renting and adapting to building anew. Not only did they have to acquire the land, they had to resolve a number of practical and theoretical questions. What was the optimum size, given their location, medical resources, and clientele? Should the hospital be a general one catering for both men and women and providing a range of clinic, medical, and surgical services? Once they had decided to build, the factors to be considered included selection of a suitable site and orientation; the design and layout; the materials, building methods, and style of the buildings. Affecting these decisions were considerations of cost; the local environment in terms of climate and topography; and the availability of water, materials, and craftsmen. The political environment and current attitudes to foreigners could also influence these decisions, as could local reaction to the design and siting of buildings because of their effect on {eng shui }x\'lk.
