In response to a nationwide call to action from the US Agency for International Development (USAID), the Centers for Disease Control and the White House, RISD and Brown students and faculty joined forces with Boston’s MASS Design Group last Saturday to participate in a full-day workshop aimed at using design in the fight against Ebola. Organized by RISD Architecture Critic Nathan King—director of research at MASS—with support from RISD’s Office of Research, the impromptu session established 10 interdisciplinary teams to work on design prompts such as: ‘How might we improve the ability to rapidly construct emergency treatment centers?’ and ‘How might we better equip healthcare workers in hot environments with sufficient protective gear?’
“This challenge indicates that the response community recognizes that design has the potential to heal,” King explains, “and that the Ebola crisis is not solely a medical problem.” The goal, he adds, is to brainstorm “actionable” solutions to the problems healthcare workers face in Liberia, Sierra Leone and Guinea (where the outbreak is centered) and then share them with global leaders via the OPEN Ideo platform.
The workshop began with a short presentation by MASS Design Cofounder and CEO Michael Murphy about hospitals his team has designed in response to other communicable diseases, such as tuberculosis (Rwanda) and cholera (Haiti). “A building is a system that may actually affect the health outcomes of patients,” Murphy notes.
Ebola is different from the diseases he has faced in the past in that it’s communicated via bodily fluids, meaning it’s neither airborne (like TB) nor water-borne (like cholera). That said, the outbreak in West Africa has a lot in common with situations Murphy has seen before. Medical staff is extremely limited, electricity to support mechanical ventilation and other equipment is spotty at best and government response thus far has focused entirely on short-term solutions versus long-term investments in African healthcare systems.
“We are witnessing what will no doubt be the largest investment in West Africa that we’ll see in our lifetimes,” King notes. “But what will remain when the crisis is resolved?”
Even as students spent the day brainstorming, government agencies were working to erect 17 Ebola Treatment Units (ETUs) in Liberia and to train soon-to-be-deployed medical workers in safety protocols developed by Medicine Sans Frontiers. Local ER doctor Noah K. Rosenberg, who is preparing to travel to Liberia in December to care for Ebola patients, demonstrated the proper technique for getting in and out of protective gear—a process that takes about 30 minutes in the field and allows medical staff to work with patients for roughly 45 minutes before they run the risk of overheating in the bulky, fully sealed suits.
“Donning and doffing the gear creates high-risk moments for medical workers,” Rosenberg notes, “and there are lots of opportunities for human error that can lead to infection.” Although the virus dies in seconds without the presence of water, there are still many unanswered questions about how many times gear can safely be cleaned and reused and how to best handle contaminated gear—questions posed in the design prompts workshop participants used from USAID’s website.
There are also multiple variations of the suit being used in the field—goggles as opposed to safety glasses or face shields, for example. All of these options make healthcare workers look alien, however, which frightens patients and their families, and inhibits good communication between patients and practitioners.
When Rosenberg completed the demonstration, students broke into assigned groups to discuss these and other key design opportunities. With mortality rates ranging from 60–90 percent, questions about how to engender hope came up repeatedly as did the need for home care options in communities facing overpopulated treatment facilities, social strategies for decreasing the stigma associated with the disease and safe protocols for locating and burying the dead.
“During crisis it is easy for empathy to be overshadowed by urgency,” says King. “As designers, we have the power to make something better.”
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