By Mehera O’Brien
Product designers know how to define, manage, and scale ideas. We have the instinct to imagine the future. We are comfortable navigating ambiguity until a solution emerges, then getting into the practical steps that connect “here” to “there.” It’s a job that requires a critical eye—we spot something a pixel off, we’re trained to give and receive critique—but I believe design is also an inherently optimistic profession. We take a confusing, unattractive, or otherwise fraught experience and we breathe new life into it. We make it intuitive, beautiful, useful. Or we start from a blank slate, from a problem in need of a solution, and intentionally direct it towards a more positive outcome. When we design well, these experiences become part of the everyday habits of the people who use them, maybe even a part of their identity.
In a year as tumultuous and shocking as 2020, what’s a designer to do? So many of us have felt a call to action, a desire to help. Some of us have found a way to engage—I’m inspired by all of you who have. But more often, I’ve witnessed that enthusiasm quickly turning into feelings of insecurity, frustration, or paralysis. I’ve heard colleagues lament: who am I to take this on? Is this even my place? And some of this debate is healthy, especially as we confront issues of racial inequity within the field of design itself. It’s good we’re talking about unconscious bias, or the pros/cons of design research in situations where mostly white, mostly male designers are entering territory predominantly inhabited by people of color, women, or otherwise marginalized groups. But to just check out and say “that’s not my place” isn’t the answer, is it? It leaves the hard problems unsolved. I’ve learned that the conversations we most fear are the ones we need the most. That adversity makes us more resilient, and is often the birthplace of innovation.
I’ll give you an example.
Years ago, New York-based OB/GYN Winfred Tovar—“Freddy” to those who know him—received an emergency phone call from his mother. His cousin was enduring a childbirth emergency in rural Haiti, and access to urgent care was impossible. After a harrowing ordeal, mother and baby made it safely.
That was the impetus for Mimsi, a non-profit serving Haitian women through maternal health services. Traveling between New York and Haiti once a month, Freddy and a team of local staff run a pop-up maternal health clinic for a week. They quite literally load a bus with medical gear and drive from village to village. While the ambulatory team encourages the community to come in, the rest of the team unloads the bus and sets up the clinic stations—administration, triage, lab, ultrasound, prenatal care, pharmacy. They see patients in a seamless flow, then move onto the next town.
The service is filled with challenges, of course. For starters, one week a month isn’t enough. The bus can only travel so far. During the height of civil unrest in Haiti, when UN peacekeepers were on the ground, the service was suspended entirely due to safety concerns. Despite these grim realities, Mimsi has made a significant positive impact. Since the service launched in 2015, it has served more than 8,500 pregnant women and reduced maternal mortality sixteen-fold for this cohort of patients. Freddy didn’t say, “Who am I to fix this problem?” He did what he could, and he’s an inspiration for all of us.
Freddy was working with the incredible team at Dalberg Design, a studio with expertise in global health that co-creates solutions with underserved communities. I had the privilege to collaborate with them while living in Mozambique for several years, and the work we’d done with rural maternal health clinics in Africa provided some analogous context to the issues we’d face in Haiti. Dalberg invited us to join the collaboration because argodesign is a studio with expertise in product innovation. We live by the motto “think by making,” and believe the best way to understand a problem and solve it is to dig into the craft.
With a shared sense of mission, our combined team set to work. We documented a service blueprint, explored technology requirements, defined a research plan, and created a digital prototype.
Then COVID-19 happened.
We considered a number of remote research options and had a workable plan in place when the phone call came. The funding had been pulled. That’s what happens when acute emergencies occur. Maternal health, along with other chronic issues like HIV, malaria, and malnutrition, become deprioritized as resources scramble. The poor, especially women, pay the biggest price.
It was really tough news for the team, but it didn’t take long to come up with an idea: what if we could channel our disappointment over the loss of impacting maternal health in Haiti into an opportunity to impact maternal health right here at home?
We encourage our teams to imagine the future. To not just critique the present, but to speculate on what’s possible and to offer potential solutions. The silver lining of COVID-19, if you can call it that, is a national conversation about the topics we so often ignore: inequitable access to healthcare, racial discrimination, the wealth gap. While we face different challenges than Haiti, we are still far from having a foolproof system in the United States.
First we imagined a literal translation: Mimsi in America. How would it work in the urban streets of New York City, or the remote communities of West Texas? More importantly, did something like that already exist? We collected healthcare innovations from around the world as points of inspiration—the Community Health Extension Worker program in Nigeria, the MomConnect SMS service in South Africa, M-Pesa’s layaway program for farmers in Kenya. But wicked problems need system-level solutions to have real impact, and our focus on a series of borrowed tactics wasn’t getting us anywhere. While the death of George Floyd reignited the Black Lives Matter movement all around us, we dug into desk research to better understand how issues like immigration status, race, and access to healthcare influence the American maternal health landscape.
That’s when it happened—we hit a wall. Overwhelmed by the enormity and complexity of the issues, we asked: who are we to solve these problems? We aren’t doctors, economists, or policy makers. We aren’t specialists in maternal health. We know a few weeks of research can’t rival the expertise of spending years in the field. But we weren’t about to just give up, either, and leave the problem for someone else to solve. So then we asked: what can we do because we’re designers to make a difference?
We call our contribution Maternal Health Futures. It’s a work in progress. We’ve designed a participatory seminar that uses creative storytelling techniques to frame the future and brainstorm potential solutions with a multidisciplinary group of subject-matter experts. Our role will be to facilitate and listen, then give the strongest solutions tangible form and a platform for discussion. We invited Freddy to be our advisor, of course, and together we’re working to identify participants. While we aren’t far enough along to share the results of our experiment just yet, we look forward to sharing more in the future. If it’s successful, we’ll tackle a new topic next year.
“Maternal health—in Haiti, the United States, and many other countries—needs our urgent attention and our collective creativity. I have been inspired by the design approach to problem solving and I know others in the healthcare field will benefit from these techniques. I’m excited to see what we can accomplish with Maternal Health Futures.” — Dr. Winfred Tovar
To be clear, I’m not suggesting designers can solve these problems alone. But we also can’t leave the tough problems to everyone else. Look to your strengths, and let that guide how you participate. I’ll say it again: product designers know how to define, manage, and scale ideas. We have the instinct to imagine the future. We are comfortable navigating ambiguity until a solution emerges, then getting into the practical steps that connect “here” to “there.” If you’re feeling overwhelmed by the world, or if you’re wondering how and if it’s your place to get involved, the answer is yes. The only way towards a better, more resilient future is to design one, together.