Can Human-Centered Design "Fix" Humanitarian Aid?

JULIA TAYLOR KENNEDY: You're listening to Impact from Carnegie Council. I'm Julia Taylor Kennedy.

With the rise of social enterprise and corporate social responsibility in the business world, and more efficiency and impact measurements in the non-profit world, one of the trends we're tracking on the podcast is how global business and global society borrow ideas and methods from one another. This week, we're looking at an approach that was developed in the business world that's proving hugely effective in humanitarian work. It's called human-centered design. And some say it might work even better in the social sector than it did in large corporations. We'll get back to that later.

But first, let's start with a definition.

JOCELYN WYATT: What we mean when we say "human-centered design" is really that it's an approach to creative problem solving.

My name is Jocelyn Wyatt. I'm the co-lead and executive director of IDEO.org.

JULIA TAYLOR KENNEDY: When it comes to human-centered design, IDEO is the gold standard. The consulting firm popularized the methodology by designing products in a new way for large corporations. Among its claims to fame: designing the first-ever Apple mouse. In 2011, the firm founded its non-profit arm, IDEO.org, the organization that Jocelyn Wyatt runs today.

JOCELYN WYATT: We started with the objective to apply human-centered design to tackle poverty-related challenges around the world.

JULIA TAYLOR KENNEDY: For example, IDEO.org recently worked with the global health organization Marie Stopes International. They wanted to design a better solution that would encourage teenaged girls to use contraception in order to decrease unplanned teen pregnancies.

JOCELYN WYATT: We started off doing this work in Zambia, and spent a lot of time with teenagers trying to understand their wants and needs and aspirations and desires; and really figure out what they were hearing about contraception, who they were learning it from, what were some of the things that they were scared of, or what some of the barriers that were preventing them from seeking birth control options. We also spoke with their boyfriends and their parents and teachers and community leaders to really understand what the community's perceptions were around sex and around birth control.

JULIA TAYLOR KENNEDY: IDEO discovered health clinics weren't geared towards teenage girls.

JOCELYN WYATT: The clinics were called family planning clinics. If you're a 17-year-old girl who's having sex, you're not thinking about planning your family. Oftentimes, even if the girl would go into the clinic, she would be treated with sort of disdain by the health care workers, saying "You shouldn't be having sex. You're not married yet. You're not old enough to be having sex." Then that would make the girl never really want to return to the clinic again. It was also really challenging for the girls.

When they heard about the contraceptives, the health care providers would oftentimes focus on some of the side effects. Instead of talking about some of the benefits of the different types of contraceptives, they would talk about all the challenging elements to them.

JULIA TAYLOR KENNEDY: After gathering all of this research, IDEO.org's team set about designing a solution. First, they decided girls needed to be able to learn from one another to better communicate with their peers about reproductive health and contraception.

JOCELYN WYATT: We designed a whole communications campaign called the Divine Divas, which was really about making contraception aspirational and helping girls make the right choices about the type of birth control that would be most suitable for them.

JULIA TAYLOR KENNEDY: IDEO.org also re-vamped the look of the clinics themselves.

JOECLYN WYATT: We use playful language. We use bright colors that are really attractive to young girls.We use girls to connect with other girls. We have younger nurses who really are excited about working with younger girls and are trained to do so. It was just a whole flip in terms of the orientation. Instead of this being for mothers who are looking at birth-spacing or contraceptives to stop having children, we really focused on young, sexually active girls who weren't yet ready to start families.

JULIA TAYLOR KENNEDY: In this first clinic they worked with, IDEO.org is seeing significant results. Before they came in, the clinic really had no teenaged patients.

JOCELYN WYATT: We're now seeing between 12 and 15 a day enter the clinic. That's been going on for the last nine months or so. Of those, we're seeing about 82 percent are actually leaving with contraceptives.

JULIA TAYLOR KENNEDY: The steps IDEO.org followed in this Zambia project were guided by its parent company's methodology for human-centered design. The methodology starts with ethnography in the field.

JOCELYN WYATT: We do observations and interviews. We meet with people in groups and spend time following them around in their daily lives. We do this to really get a great sense of what their real wants and needs are.

JULIA TAYLOR KENNEDY: This helps IDEO's researchers come up with opportunities for new designs and solutions, once they've identified unmet needs.

JOCELYN WYATT: We then go through a process of ideation where we brainstorm and come up with many different solutions to the particular challenge that we have identified.

JULIA TAYLOR KENNEDY: After they have a challenge to solve, they come up with the rough prototype of a solution and test it in the field.

JOCELYN WYATT: From there we then bring them back out to the communities, get their feedback on those prototypes, and then work to refine and resolve some of those issues with them to get those prototypes into concepts that are ready to be pilot-tested and rolled out with those communities.

JULIA TAYLOR KENNEDY: The idea of human-centered design is to understand points of pain, and then tweak a given solution to find something appropriate for the community IDEO.org aims to help.

JOCELYN WYATT: It really is about co-designing with communities. Instead of a process where we sit in the U.S. or Europe or wherever we are and design solutions or programs for people in other countries, this is an approach which embraces them and makes them creative problem-solvers along with us.

With the human-centered design approach, what we're doing is trying to figure out what are solutions that people really own and embrace so that those solutions will then be sustained and carried forward by those communities, rather than seeing that in so much of development work that after the project is funded for a few years it no longer continues because it was never really implemented by the local community.

JULIA TAYLOR KENNEDY: If human-centered design works as well as Wyatt says it does, it could solve an enormous problem that has long plagued the global development community. Every few months, it seems, there's an article that exposes a poverty-alleviating solution that's gone wrong: a cheap new cook-stove that no one likes to cook on, a more sanitary toilet that no one uses, or a water pump that is harder to work than the original. Often, the reason these well-meaning solutions fail is lack of contextual knowledge by the organizations trying to implement them in the developing world—or a lack of buy-in from the communities where they're trying to put these solutions in place.

BRUCE NUSSBAUM: The core of design and, I would say creativity to a large degree, is really empathy. It's understanding what's meaningful to people. I'm not really talking about what their needs are, I'm talking about something deeper.

My name is Bruce Nussbaum, and my title these days is mentor-in-residence at NEW INC, which is New Museum's new incubator.

JULIA TAYLOR KENNEDY: Nussbaum has written and thought about human-centered design for more than a decade, first as an editor for BusinessWeek, later as an author and professor at Parsons School of Design. He hasn't always had a rosy view of design thinking—mostly because he saw it applied poorly in large corporations a few years ago.

BRUCE NUSSBAUM: Design firms really focused a lot of their efforts on large corporations, and large corporations are focused on efficiencies. They get their values not so much from creating new things, but from pulling cost out of older things.

JULIA TAYLOR KENNEDY: Nussbaum saw the design methodology's openness to new ideas, trying and failing and tweaking, and deep research that is at the root of design thinking, start to fall away in the corporate context.

BRUCE NUSSBAUM: And instead of being playful and exploratory and focused on discovery and empathy, it had become a step-by-step process that business people thought they could simply apply and generate the creativity and innovation that they really wanted, that would give them great value.

It didn't work out. It really hit a wall and companies like Procter & Gamble that had been great design thinking champions began to move away from it, because it wasn't delivering the kind of really powerful changing innovation that it had promised.

JULIA TAYLOR KENNEDY: As Nussbaum reported on design consulting and design in large corporations, he found the efforts falling flat.

BRUCE NUSSBAUM: Designers began telling me the truth about success rates. It boggled my mind. The success rates were, in fact, extremely low. Companies were hiring them to do things and it wasn't really working out.

JULIA TAYLOR KENNEDY: And so when human-centered design methods started entering the humanitarian sphere, Nussbaum warned his industry colleagues to proceed with caution. He had worked in the Peace Corps early in his career, and had seen how tone-deaf solutions can be when they come from a Western perspective.

BRUCE NUSSBAUM: The risks are, you don't know what's meaningful. We're all creatures of our own culture, our own demographics.

JULIA TAYLOR KENNEDY: Nussbaum thinks one example of a Western idea gone awry in the developing world was the initiative One Laptop per Child. It sought to bring low-cost laptops to children in developing countries.

BRUCE NUSSBAUM: In the realm of non-profits, it was a really great idea, and beautiful aesthetics, a great interface, the best people I know in terms of good hearts were involved in it, but it was a complete disaster. Not only was it not meaningful to people in India and China and elsewhere, it threatened them.

The whole concept of dropping millions of laptops directly into the laps of children, bypassing the school system, bypassing the teachers, bypassing the governments basically, bypassing the parents, was crazy, you know? It was probably crazy in our culture, certainly crazy in countries that are very sensitive to Western imperialism.

JULIA TAYLOR KENNEDY: With that backdrop, Nussbaum worried that design thinking in humanitarian work would also be seen as a new kind of Western imperialism. And he had early evidence to back up his fears.

BRUCE NUSSBAUM: I was out in Asia at a design conference and people were talking about how harnessing design for humanitarian purposes was a really good thing, and the people in the audience—it was an Asian audience, I think it was in Singapore—were grumbling about, "Who's this person to tell us what to do? Does this person even know what our problems are?" There was a lot of grumbling, and most design conferences are full of goodwill. They're full of people feeling they can do good things and they're all in together, and I was really struck by that.

JULIA TAYLOR KENNEDY: A couple of months later, Nussbaum heard something similar at a presentation at Parsons, where a mix of experts were discussing the possibilities of human-centered design in the developing world. Participating in the discussion was an Indian businessman who invested in an Indian design firm.

BRUCE NUSSBAUM: A woman got up—I can't remember who she was working for, but it was something like Acumen and IDEO and Ashoka—she got up at the end of it and said, with a great deal of enthusiasm, "We're all going to get together, we're going to solve this problem, and I'm working on a project with all three of these wonderful organizations and we're going to get this job done."

There was a little American enthusiasm, and it was fine with me, but the Indian businessman got really angry and he said something to the effect of, "You know, there might be an Indian solution to this problem, and you ought to think about that." And it just stopped the whole audience.

I thought what's going on here? Did he just get pissed off because he's sensitive to India's whole imperial history?

JULIA TAYLOR KENNEDY: And so Nussbaum wrote a column for Fast Company in 2010 to raise his concerns about neo-imperialism and how it could creep into humanitarian design. He wanted to warn his colleagues that a new methodology and optimism aren't sufficient to solving the tough problems facing the world.

BRUCE NUSSBAUM: You really have to understand that your physical presence may alienate people because of history in culture, and so I wrote this warning, basically: "Be careful." Good intention is not enough. Youthful intention is not enough. You have to be very careful about the sensitivities of people and also spend a lot of time knowing what's meaningful to them. Don't assume that you do know what's meaningful to them.

The warning about humanitarian design being perceived as the new imperialism shouldn't stop anyone from doing humanitarian design and trying to do the good stuff, it should just—you know, take a moment and make sure you know what's meaningful, you're partnering up with the right people, that things are in alignment as much as possible before jumping in.

JULIA TAYLOR KENNEDY: The column set off a firestorm of responses from proponents of humanitarian design. Nussbaum took a lot of heat for criticizing a methodology that does seek to be more inclusive, to more deeply research the population that will be using a new product.

JOCELYN WYATT: I would say I don't think that's fair criticism. I think that our approach is really about being integrated and working with communities.

JULIA TAYLOR KENNEDY: At IDEO.org, Jocelyn Wyatt and her team work with local community members during early research phases and as they test out different prototypes in the market. They also seek on-the-ground supporters when they roll out new products, to serve as evangelists and encourage others to adopt these products. And yet . . . Wyatt says there is one piece of Nussbaum's fear of excluding local ideas and expertise that continues to be a struggle.

JOCELYN WYATT: I think one of the real challenges, especially in Africa, is there's been a lack of design education. And so what that's meant is that it really hasn't been possible to hire local designers in order to engage on these challenges. One of the things that we're really taking on at IDEO.org is, "How do we really build a cadre of trained African designers to really tackle these challenges in their local communities and with these local organizations?"

JULIA TAYLOR KENNEDY: Other humanitarian design organizations are also working to hire local talent onto their teams.

SUSAN OGUYA: I am Susan Oguya, a designer at Dalberg Design Impact Group.

JULIA TAYLOR KENNEDY: Dalberg Design Impact Group, or DIG, is a New York-based social enterprise that works with global non-profits to design solutions that take cultural context into account. Susan Oguya is one of a few designers the firm has hired in the countries it's working to help. She's based in Nairobi, Kenya.

SUSAN OGUYA: Especially in Nairobi we've seen an increase of foreigners coming in trying to incorporate the locals because they believe that they understand the market better. I have seen design companies actually having local offices within Nairobi, so for example as DIG opening an office in Nairobi so that we could actually understand what is happening on the ground so that we can understand clearly what are the particular needs for this business and what are the particular needs for the user.

JULIA TAYLOR KENNEDY: Oguya initially thought her career would be about inventing cool new tech products in a lab, and then bringing them to market. But after she started her own company about five years ago to develop better solutions for rural farmers in Kenya, she attended a seminar in a tech incubator that completely changed her approach.

SUSAN OGUYA: We realized it's not about coming up with cool products, but it's about users actually implementing this product in their day-to-day activities. That's when you had to change our whole strategy, instead of sitting behind the desk and coming up with products we had to interface with those users, face to face, and actually understand their needs or their pain points, and see how we could actually create products for their needs.

JULIA TAYLOR KENNEDY: After dabbling in more user research, Oguya went back to school in Italy to become further educated in human-centered design. Now, at DIG, she is excited to work alongside designers both in Kenya and in the developed world to make products more user-friendly.

SUSAN OGUYA: When I came back I met a colleague of mine now at DIG, and what I realized is that they had the same vision and mission that I had for this community, which is to help organizations or even individuals who are building products, to actually come up with a better innovation or strategy on scaling that product or innovating that product.

DEBBIE AUNG DIN TAYLOR: You just can't helicopter in and bring in design thinking. If you're not rooted in the culture and the context, and you don't have proximity, it's really hard to design, no matter how much empathy you have.

My name is Debbie Aung Din Taylor, and I'm co-founder of Proximity Designs.

About 98 percent of our staff are Burmese, so we're a very, very local organization in that respect. We're a hybrid and we tap about 10 foreigners working with us, but we have international networks and partners, so we tap international expertise and are tied to the outside world.

You need both. I think you can't be just local these days, and you can't just be international these days. I think you need to be hybrid in order to be effective.

JULIA TAYLOR KENNEDY: Taylor is originally from Myanmar, but before founding Proximity Designs, she had many years' experience with organizations like the World Bank and UN Development Programme, in other countries and in Myanmar itself. She also lived for several years in the United States. But in 2008, Taylor was in Myanmar, looking for a new way to really drive impact with rural communities in her very remote, insular country.

DEBBIE AUNG DIN TAYLOR: I was doing more policy-related work and looking at the economy and saw that villages were very isolated and using—farmers had ancient technologies; backbreaking drudgery every day, and just because they didn't have access to basic products and services.We needed an approach that was not the traditional aid model, because that wasn't an option. I also knew that we wanted to have a different relationship with the people we were trying to help—rural people—and not one of a charity recipient or an aid beneficiary, but a more equal relationship with a customer, where you pay attention to their needs and aspirations and are held accountable by them.

JULIA TAYLOR KENNEDY: So, she started experimenting with human-centered design, and eventually founded Proximity Designs. It's a social enterprise that develops new tools for farmers. The firm is truly integrated into its community.

DEBBIE AUNG DIN TAYLOR: We have a salesforce of about 120 people who are travelling to villages all the time and they're doing road shows, introducing the product, so they're face to face with our rural customers, and they get a lot of feedback there. We have a distribution system that includes mom and pop dealer shops, about 150 dealer shops throughout the country who carry our products. We get feedback from them, and then we also have a network of several hundred agents who are product users themselves, and they're like your Tupperware agents or your Avon ladies. They have used the product themselves and benefitted from it, so they work in their own locale of five to six villages in promoting the products themselves. It's a very intimate kind of relationship with customers that we try to foster among our staff.

But at the same time, we very much have our eye on the macro picture, because we work at scale. For any given year, we have 75,000 new households that are adopting and buying our products.

JULIA TAYLOR KENNEDY: Proximity Designs has introduced some life-changing solutions to farmers in Myanmar. One of the biggest challenges these farmers face is the time-consuming prospect of watering their crops.

DEBBIE AUNG DIN TAYLOR: A farmer might have been watering their half acre plot of vegetables by hand, and by buckets, hauling 200 times a day these 40-pound buckets of water on each shoulder. That's hours of drudgery a day.

JULIA TAYLOR KENNEDY: To help with water distribution, Taylor and her team first designed a treadle water pump, which looks a little bit like a stairmaster. It's way more efficient than using buckets because it employs leg strength to more quickly distribute water throughout a field. But Proximity needed to design this pump in a way that would work for farmers and that they would quickly adopt. On this first project, Proximity partnered with Stanford University's design program to learn the right methodology for working closely with end users. Tweaking their model after the product had initially launched proved really important.

DEBBIE AUNG DIN TAYLOR: So we had these metal pumps originally and saw that farmers liked them to be more portable, and easy to install, and so we worked on a model that was more like an IKEA snap-and-go model that had this bamboo and was very easy to transport and set up. That was one model we came up with, and that sold very well.

JULIA TAYLOR KENNEDY: But Taylor and her team kept hearing from their customers that a $40 metal pump was a little too expensive.

DEBBIE AUNG DIN TAYLOR: We all thought metal treadle pumps were what farmers wanted, because farmers wanted durability, but they want affordability also. It was all based on feedback, and that's how we came up with a plastic one, and said well, let's just try a plastic one, and we developed a $20 plastic foot pump, which is pretty radical. It's our bestseller right now.

JULIA TAYLOR KENNEDY: After introducing the treadle pump, Proximity Designs got more ambitious, bringing drip irrigation to Myanmar for the first time.

DEBBIE AUNG DIN TAYLOR: People in North America use it, companies use it—advanced companies—but they have running water and motorized pumps, but in Myanmar people are off-grid in the rural areas, so we had to design a drip system that would operate with no electricity, just very low pressure, and so we designed a 250 gallon water storage tank that would work with our drip irrigation, and that's been, also, a huge breakthrough.

JULIA TAYLOR KENNEDY: At her social enterprise, Taylor sees results she never saw in her years as a development consultant.

DEBBIE AUNG DIN TAYLOR: They can double their incomes easily by growing more and by having better water control and better crops—yields—and have time to do other things around the house or generate income in other ways. It's pretty dramatic, and each family is unique, and each family has a different story of how their particular circumstances changed as a result of better income, and so that never gets old.

JULIA TAYLOR KENNEDY: She sees these irrigation systems truly changing the lives of her customers.

DEBBIE AUNG DIN TAYLOR: Think of your own life: You can think of a product you can't live without and that has dramatically increased your efficiency, daily, and I think that's the same thing. With a lot of our products, customers have an attachment to it, which is what we want to see.

JULIA TAYLOR KENNEDY: Taylor isn't sure how quickly design thinking might be adopted in some of the bigger aid organizations globally. She thinks they might put up process roadblocks similar to the ones Nussbaum saw in big corporations when they tried to implement human-centered design. But as things stand, Nussbaum is back on the design bandwagon.

BRUCE NUSSBAUM: I think design and all the things that go with design are much better suited to start-ups and to smaller non-profits and to the solving of specific challenges. I just see it all the time when people bring the power of design to both starting up a company or starting up an NGO or utilizing the power of design within these organizations. And I think those are the spheres, the start-ups and non-profits, where I think design is really everywhere. The rate of success, which is so low in corporations, is much higher. It's like 20, 30, 40 percent, maybe 50 percent, as opposed to 3, 4, 5 percent.

The lines between business and non-profit are evaporating. I would say within the start-up community, the tech community and the non-profits, that's absolutely true, and you see people moving back and forth all the time.

All of this is a good thing. I think design is in fact what lubricates it, brings people back and forth. It's the same methodology and same approach. Many of the same values that you find in the start-up, small business community that you find in non-profits, so this is all a very good thing.

Design got stuck for a year or two in its focus and its methodology and now it's just blooming. And it's wonderful. This moment—I've written this several times, in the' 90s especially—this is the moment of design. This is yet another moment of design and what design can bring to the world.

JULIA TAYLOR KENNEDY: Thanks for listening to Impact from the Carnegie Council. A special thanks to our production team, Amber Kiwan, Terence Hurley, Deborah Carroll, Alex Woodson, Anna Sophia Young, and Matthew Sacco.

I'm Julia Taylor Kennedy. You can find out more about this podcast at carnegiecouncil.org. You can also find us on policyinnovations.org, on iTunes, or wherever you download your podcasts.