In an article for DWA on Participatory Design, designer and researcher Byron Qually explores some of this increasingly popular methodology’s unintended impact and consequences; as well as the question of who it is that has the right to claim ownership for design in a co-design process.

Here we take a look at an architectural project in Rwanda where the designers spent an intensive period of integration in the user-community to understand their health needs, and the contextual and environmental issues impacting on them. The result is a hospital design that includes innovative, cost-effective design modifications that promote access to health care while preventing the spread of prevalent communicable diseases. The project also provided skills training and employment opportunities for the local communities and catalysed public investment in infrastructure that improves communication and access between this rural district and the opportunities in the capital city.

DWA celebrates an inclusive, participative and collaborative ethos in designing WITH end-users, and would like to invite you to join the conversation on design practices in majority world contexts, and their [potential] impacts. Please share your views and insights on the projects we post here and write about or alert us to others on the continent.

“Empathic Architecture” is the term used by Mariska Shioiri-Clark, and explained in her TEDx  Stellenbosch 2011 presentation on the design methodology used when she helped design a new hospital for the Burera District of Rwanda. As a first year M.Arch student at Harvard’s Graduate School of Design, Shioiri-Clark co-founded MASS Design Group with fellow students after hearing a talk on the provision of health care in developing countries by Paul Farmer of the organisation, Partners in Health. Farmer, a Harvard alumnus, was persuaded to include the architecture students as designers on Partners in Health projects and MASS Design Group was established.Its mission is to use design in the service of social equity. Shioiri-Clark’s particular thesis rests on the need for a close identification between the designer and user-community. She took a sabbatical from her studies to live in Burera for a year during the early design phases of the Butaro Hospital project.

Being embedded in the user-community helped reveal its primary health concerns and a perspective on how the design of existing health facilities could be improved to counteract health risks. For example, until the students who made up Mass Design Group’s early design team collaborated on the Rwanda project, they were unaware that tuberculosis remained a killer disease in developing countries. The typical design of health facilities in the region exacerbated the effects of the disease by creating the conditions for highly drug-resistant strands to develop. Interior corridors served as congested waiting rooms where airborne diseases were easily spread. Early design interventions therefore included removing all corridors and replacing them with doors to wards from external verandas. In addition, attention was paid to improving ventilation through eliminating all air conditioning systems and taking advantage of the mild climate to install clerestory openings, larger windows and oversized ceiling fans for constant cross ventilation.

While design innovations have improved health provision and ameliorated the potential health risks in poorly designed facilities, the project also had further social impacts on the Burera district. Nearly 4,000 people were trained and employed on the construction of the project, boosting the local economy and creating a legacy of skills in the region.

The approach for this project was seemingly one of co-creation rather than participatory design. Primary design decisions appear to have been reserved for the architects, based on interviews with health workers, while the community was used to implement embellishments. This approach may have been due to a combination of things, like the apparent scarcity of architects in Rwanda and the complexity in applying a participatory design methodology to high risk projects, such as health care, where specialists are required to mitigate unforeseen complications. Therefore it appears local communities, rather than participating in the design decisions, were used as a research sample in order for the architects to understand what designs might be appropriate, and, interestingly, to apply indigenous craft and building techniques.

MASS Design has gone on to attract a catalogue of sponsored social projects in developing regions around the world, but their commitment to Rwanda and the African continent remains in tact. Co-founder Michael Murphy expresses a vision for architecturally driven social change throughout Africa and the creation of “a local community of designers from the ground up”. In a country with a population of 10 million people, where the tally of architecture firms is evidently less than ten, his vision is a bold one. But members of MASS Design are already involved in working to realise it. Two of the team lecture in the relatively new Department of Architecture at the Kigali Institute of Science and Technology. MASS is also involved in other projects in Rwanda including a 200-unit housing development in the eastern area of Rwinkwavu, a school in Kigali, a bicycle shop, and a book on medical infrastructure in areas with limited resources.

The views expressed in this video are entirely the views of the speaker  and are not necessarily those of DWA or its associates.

All images sourced from www.massdesigngroup.org