Architectural historians discussing transnational knowledge exchange have primarily focused on English- or French-speaking or bilateral flows of expertise. This article goes beyond those boundaries to trace the multi-sited design process of a colonial hospital for Europeans built in Coquilhatville, the Belgian Congo. Western hospital typologies underwent multiple typological innovations as they progressed from Brussels to the colonial capital of Léopoldville, and then to the remote town of Coquilhatville. A surprising variety of actors from outside the architectural discipline―administrators, engineers, and especially doctors―impacted its design. To “translate” Western hospital typologies to the tropical climate and colonial racial inequalities, they supplemented metropolitan expertise by drawing on alternative connections provided by the Belgian Congo’s intersectional position within the colonial world. Individual travel experiences, participation in colonial research missions, and direct personal contacts with other colonial administrations all played a role. Uncovering these alternative flows of expertise in the history of Coquilhatville’s Clinique sheds light on how colonial (hospital) architecture cannot simply be reduced to direct bilateral “export.” It was actually the product of a much more complex network of architectural knowledge exchange, so far insufficiently documented by architectural historians, that transcended conventional linguistic and imperial borders.