IN 2006 a 26-year-old architecture student, Michael Murphy, approached the global health pioneer Paul Farmer after a lecture at Harvard. Mr. Murphy asked which architects Dr. Farmer had worked with to build the clinics, housing, schools and even the roads he had described in his talk. An aspiring social entrepreneur, Mr. Murphy was hoping to put his design degree to use by apprenticing with the humanitarian architects aiding Dr. Farmer’s work. But it turns out, those architects didn’t exist.
“I drew the last clinic on a napkin,” Dr. Farmer told Mr. Murphy.
Soon after, Mr. Murphy flew to Rwanda, where he and a few other students, including Alan Ricks and Marika Shioiri-Clark, became Dr. Farmer’s architects. Mr. Murphy lived in the country for over a year while the Butaro Hospital, which laborers built with local materials, was designed. Now, a site that was once a military outpost is home to a 150-bed, 60,000-square-foot health care center that served 21,000 people in its first year and currently employs 270, most of them locals in an area with chronic unemployment.
The Butaro Hospital is a breathtaking building with intricate lava rock walls made of stones cut by Rwandan masons, and it is full of brightly colored accent walls and breezeways bathed in light and air. Deep-green flora blossom everywhere. For the 340,000 people who live in this region of Northern Rwanda, the project marks a literal reclamation: an area that was once a site of genocidal violence is now a center for state-of-the-art medical care. Healing happens there. An unmistakable grace permeates the place.
Building the hospital under the auspices of the nonprofit MASS Design Group (MASS stands for a Model of Architecture Serving Society), Mr. Murphy, Mr. Ricks and Ms. Shioiri-Clark relied on Dr. Farmer’s theory of a “preferential option for the poor.” The idea — adopted from liberation theology — is that the poor deserve the best quality intervention because they’ve been given the least by luck and circumstance. The students’ naïve audacity, coupled with Dr. Farmer’s wisdom and experience, resulted in a building that has set a new standard for public-interest design.
It used to be that young people with humanitarian aspirations went into law or medical school or applied to Teach for America or the Peace Corps. But today, increasing numbers of the most innovative change makers have, like Mr. Murphy, Mr. Ricks and Ms. Shioiri-Clark, decided to try to design their way to a more beautiful, just world.
This new breed of public-interest designers proceeds from a belief that everybody deserves good design, whether in a prescription bottle label that people can more easily read and understand, a beautiful pocket park to help a city breathe or a less stressful intake experience at the emergency room. Dignity may be to the burgeoning field of public-interest design as justice is to the more established public-interest law.
Careful listening is an integral part of this human-centered approach to design. IDEO.org — a nonprofit spinoff of the premier design and innovation firm IDEO — has made radical listening its hallmark; IDEO.org associates observe and grill would-be clients and sites with so much rigor that they could easily be mistaken for anthropologists. An IDEO.org team assigned to redesign sanitation in Ghana, for example, spent weeks slogging from home to home asking families intimate questions about their bathroom habits before they began designing a system that would safeguard against cholera and other waterborne diseases.
The relatively young field of public-interest design already faces a crisis: interest in human-centered design far outpaces the formal opportunities. Over 500 people applied for the four spots in IDEO.org’s fellowship program this year. The Enterprise Rose Architectural Fellowship is one of the few opportunities for aspiring architects to work on affordable housing and other development projects in poor communities; the program, which lasts three years, has 12 spots. The San Francisco-based Code for America trains and then dispatches two dozen self-proclaimed “tech geeks” to cities where they design new ways for city leadership and citizens to be in conversation, improving their communities.
Despite the scarcity of opportunity, there are already vivid examples of what embedded designers can do to improve and enrich people’s lives. One Enterprise Rose fellow, Theresa Hwang, served as a liaison between the nonprofit Skid Row Housing Trust and a professional design firm, Michael Maltzan Architecture, as they worked on a new housing complex for formerly homeless and disabled people in Los Angeles. The Star Apartments, now under construction, promise to be far more congenial and pleasant to inhabit than the soul-killing concrete towers of traditional public housing projects. The 97,000-square-foot complex consists of a dozen cantilevered cubes, wrapped in brilliant white stucco and integrated with 15,000 square feet of outdoor areas, art studios, a running track and other communal spaces. The finished project will provide 102 housing units.
Though unemployment is widespread among designers and architects, there exists a world of products, places and processes in desperate need of redesign. Imagine if designers — uniquely trained to listen and observe, and to improve the way things function, feel and look — were, like the Enterprise Rose fellows, embedded in schools, community centers, nonprofit organizations, health clinics, religious institutions and government offices, where they could experience community needs and behavioral patterns firsthand.
The need for designers — and their ingenuity and interest in beauty and functionality — is not limited to Africa, India, Haiti or other far-flung places where architects and designers are commonly called upon following natural disasters. People who struggle to maneuver strollers and wheelchairs in and out of urban transportation systems or work in a deadening sea of suburban office complexes share the same basic need for enlivening, dignifying design. Anyone who has recently visited a local motor-vehicles office most likely knows about the need we have in mind.
Mr. Murphy had a surprising insight about how much the developed world has to learn about good, human-centered design from the developing world. After finishing the Butaro Hospital and returning to the United States, Mr. Murphy said, he was struck “at how over-designed most hospitals are here — yet there’s little natural airflow, a lack of color and craftsmanship, and few outdoor spaces to take a deep breath and gain some perspective.”
When faced with a poorly considered, dehumanizing product — be it a dingy women’s center, a mountain of unnecessary bureaucracy or assembly instructions for a new product that make you feel inept — it is a failure of design. The bad news is that no country, rich or poor, is immune to bad design; the good news is that we can all learn from one another.
But we have to advocate for it and many of us, until now, simply haven’t realized that we deserve better. We couldn’t imagine the alternative. But once you see what good design can do, once you experience it, you can’t unsee it or unexperience it. It becomes a part of your possible. The public-interest design movement is counting on it.