For over forty years, the Italian architect Fabrizio Caròla, impassioned by Africa since his first voyage in 1972, has built buildings in the form of domes, cupola or arches. Constructed for the most part on African soil respecting traditional Nubian building techniques, his projects seek to address the needs of disadvantaged populations in a sustainable manner. The expansion of the Kaédi hospital in Mauritania (1984), resembling at its start the orthogonal plan dating bake to the colonial era, is an example of Caròla’s approach, constantly searching for a symbiotic relationship between the subject and location while always being respectful towards local culture and lifestyle, especially in this case, when the patient’s family needs to stay in close proximity during their hospitalization. In order to achieve this, the architect divided the plan into several groups of circles centered around the patients rooms creating spaces for their loved ones to reside. He uses an ancestral compass construction technique, allowing the building of cupolas in raw or cooked earth bricks, without lead mesh or machines. All achieved by employing local labor and using materials from the surrounding areas, taking care to preserve any local traditional craftsmanship techniques. An advocate of architecture without an architect, Caròla prefers to build “signs” with a primary goal responding to human needs.