I'm John Torek. And I'm Danny Sullivan. And you're listening to Speaking of Design, bringing you the stories of the engineers and architects who are transforming the world one project at a time. Today, we'll meet a group of architects volunteering their design expertise to make a difference in the world beyond their day to day
jobs. We'll learn more about one of their projects in India and how they're partnering with a medical technology enterprise to improve health care for an underserved community. A project doesn't actually give back in a single instance. A project has the opportunity or the potential to touch hundreds, if not thousands, if not even tens of thousands of lives over the course of the existence of that
project. And that is incredible in being able to develop societal change or the ability to create more resiliency in a community and to better the lives of other. That's Jason Emery Grand, a design director at HDR. His teams have designed everything from high end modern furniture and small scale fixtures to complex multibillion dollar health care campuses. Jason Emery works in his hometown of Kingston, Ontario, where he took an interest in design at
an early age. I was quite young when I came upon the realization that architecture might be the right thing, and I came from a construction family background. We had a construction family business, and I found myself more and more interested in the design side of that industry. And from there, honestly, never looked back. Early in his career, he landed a position with a local firm that specialized in health care architecture.
So from there, my passion has become quite focused on health and wellness relative to architecture and design. Jason Emery joined HDR through an acquisition, as did several of his colleagues who came from an architecture firm called CU h two a. There, they had been looking for a way to use their design expertise to make a positive impact on underserved communities. Thus, the idea for Design for Others was
born. Design for Others is effectively an entity within HDR that provides pro bono design services for areas in need, and those areas could be anywhere in the world. And our goal is to bring our resources to bear, our skills and talents, to be able to help those in need to be able to achieve either health education or kind of science based
endeavors in their territory. While the work of architects makes a difference in the world, rarely do designers get to stand shoulder to shoulder with the people whose livelihood depends on the very buildings they design. Design for others offers that opportunity to learn from the communities they're designing for firsthand. We pride ourselves in elements of expertise.
We are very open minded, and we wanna make sure that we're working with either people on the ground in the local areas we are working in or even with other partners that can just bring more to the table with us. Design for Others began with two volunteers, and they took on two projects in their first year, a facility in Mozambique to increase disease monitoring and a laboratory in Tanzania to expand diagnostic testing capabilities.
Since that time, d four o has grown to more than 200 volunteers who've completed over 50 projects across 13 different countries. That work has helped communities increase access to health care and education, including projects that expand HIV testing or provide health science education to high school students. With so many communities in need throughout the world, Jason Emery said one of the challenges of offering pro bono design
is selecting projects. And what we mean by that is that we pick projects that have the most impact in the locales that we are working in and have the best potential to get finished. A great idea is wonderful, but without the actual implementation of that idea on the ground, it is just actually sometimes more negative than it is positive. Meaning, with limited resources available, you don't want your volunteers' time to go
wasted. Imagine you volunteered for a project with us, and this project might span six months. You have multiple deadlines by day at work. You're busy. There are a lot of demands on our staff regularly, and you've committed to providing all of this extra effort, obviously, for free. As a volunteer, you have your heart and soul in this project. And six months in, the project all of a sudden just disappears because there never was any real money
for it in the first place. To help evaluate projects, volunteers from d four o have built partnerships with organizations already embedded in local communities across the world. Examples include the Abbott Fund, the National Institutes of Health, and the Centers for Disease Control and Prevention, to name a few. One partnership in particular has been a perfect fit.
Construction for Change, we are a nonprofit construction management company, and we partner with other nonprofit organizations as well as governmental organizations. That's Tim Hickory, director of operations for Construction for Change. Our mission is to build spaces where people can become healthier, better educated, and increase their economic mobility. Construction for Change was founded in 02/2007 by three University of Washington graduates with degrees in construction management.
Their vision, essentially, to create a nonprofit construction company. To date, they've built 55 projects and estimate that their work touches the lives of more than 300,000 people annually. A large number of those projects are part
of the thirty thirty project. When we launched the Thirty Thirty Project initiative, which was a dream of one of our longtime volunteers, Julie Lewis, and then one of our board members, Scott Lewis, and their family to start this initiative to build 30 health care centers around the globe, which would bring access to critical health services to communities that previously didn't have them. The idea was inspired by Julie Lewis's personal story. Julie, she's a
long time survivor of age. She'd been diagnosed with it in '84, I believe. When she was giving her daughter, Teresa, she underwent a blood transfusion. This was before testing for AIDS and before the virus was well understood. It wasn't until a few years later that she even knew that it happened and was given about four years to live at the time, and they didn't know anything really about the disease at
that point. But lo and behold, thirty years later, she because of modern medicine and her access to it and quality medications and services that we have here in The US, she's a driver and, you know, living strong. And so Julian Scott's well known son proposed the 3030 idea to commemorate the milestone. Her son is Ryan Lewis of the duo, Macklemore and Ryan Lewis. And so he kinda said, why do one clinic when we could do 30 to celebrate
the thirty years? Which was when Tim first met Jason Emery Gran from Design for Others. And so right at that time is actually we're launching the thirty thirty project initiative. We were coming into conversations with d four o. And we're like, yeah. If we're gonna do something this big, we need a solid design partner. Like their counterparts at d four o, Construction for Change found that the reach of their work was greater when they partnered with like minded organizations.
We're good at the building side and management side of construction, but you can only do so much with the design that you're given. And so that was an immediate need for us. Tim said the types of projects they build require a special kind of architect. And not just to be able to work with
any architect. There's a lot of architects out there in the world that we're working in resource constraint settings, and context is so important to be able to have design teams that understand that, can adapt to it, have a desire to learn, and to be able to be respectful of the context that you're designing and building in. That was really important to us. So when we met the d four o team, that was kind of an answer to that big gap, that big question that we have.
The new partnership began with a health clinic in Northwestern Uganda that expanded maternity and children's services to a community of 16,000 people. It was really special. So we both played to our strengths, and that, I think, in our first meeting, it was just like, great. Looks like we found our answers to what we've been struggling with both on both sides. Jason Emery said the match went well beyond offering complimentary
services. And within a few days, we realized that it it was almost a marriage made in heaven, if you will, because our wanting to be careful about choosing the right partners, they were very well tooled to fundraise and extremely well tooled to choose and be careful to select the right clients and end user groups, and they were in need of consistent design services that they could depend on. Since that day, Construction for Change and Design for Others have
completed nearly a dozen projects together. And as Construction for Change neared the final project of its thirty thirty initiative, it made perfect sense to work together again. I got a call from Tim Hickory one day, and Tim mentioned this project in Kolkata, which is in West Bengal, just in the Northeast of India, just West of Bangladesh. And we got to know a lot more about what their ambitions were quite quickly.
So iCURE is a leading primary health care provider, which aims to provide affordable and accessible health care to the population in India, primarily. That's Sujay Santra, founder and CEO of iCURE and an Ashoka Fellow. In the last several years, iCURE has treated close to a million patients. We are serving around 9,000,000 population across seven states in India. Before founding iCURE, Sujay had a successful tech career at Oracle,
yet he found himself wanting something more. While I was working, I my work was not able to relate to anything to with my community. And so even though I was very successful in my career, I I could feel that there is a sense of vacuum, within me. And I really wanted to have that urge that how can I leverage my knowledge, my technology for the people who matters the most? Meanwhile, after retiring in 02/2009, Sujay's father began to experience some health issues and went to see a cardiologist.
And when my father went back to our hometown in Krapur, he had some sleep disorders, and he went to a local doctor. And when he came back after six months to see the cardiologist, the doctor said that you have been taught taking wrong medicines for the last six months. So that led me to think that, for people and their families who are sitting on top of technology, if this is the situation, imagine what is happening to millions of
patients who are in the intellect. Sujay was shaken by his dad's experience, which could have been avoided with better communication and coordination among medical providers. While he was home, he shared several train rides with patients, traveling hours from their villages for medical care, putting their own health and the health of others at risk. It was at this crossroads in his life that Suje conceived the idea for iCURE.
His vision was to create a community based holistic health care model by using innovative technology and a hub and spoke system to bring health care directly to patients in rural India. So using a layered model because we know that in India, we don't have enough doctors to the patients. Roughly, for every 2,000 odd patients, we just have only one doctor. So this is how in a three layered architecture model, we are able to provide a comprehensive primary health care to the communities.
And while doing so, we have created the model in a very sustainable way. As he got to know iCURE, Jason Emery Grahn saw how this business model allows health care professionals to connect with patients like never before. What I've learned from iCURE is that they are very nimble. They are clearly adept at understanding
the challenges in their context. And an example being that in their part of the world, the amount of health care servicing required may, in the foreseeable future at least, never actually match the number of medical professionals that will actually enter into the field in that area. So the fact that they thought through this problem in such a creative way was really exciting to us, and we felt privileged that they were asking us to give them a hand to develop one of their prototypical
clinics. Using this model, ICURE has built five hubs, which are essentially small health care clinics. So these clinics are typically the hubs which are physical spaces which we rented out, and it spans from roughly around 800 to thousand to 2,000 square foot of space. Physical doctors, medicines, all the tests being done.
These are fairly small scale clinics that are not only places where patients would go to get services, but there would be also places where the staff would come back from their outreach into the communities to access some of the diagnostics and the data. The spokes of that hub and spoke system are the community health workers. By providing that last mile health care directly in rural communities, they're able to reach about 4,000 additional patients
over a three month period. And the very core element of our model is the frontline health workers. So these health workers are none other than the members selected from the community, mostly the village women who given the smartphone
loaded application. So what they realized was that they could capitalize on technology and, most importantly, make that technology very simple for anyone to use, and then subsequent to that, developing lines of trust in their communities so that they enable key individuals in those communities to be able to use that technology, that they could be able to do a
significant amount of diagnostic testing. By putting mobile technology in the hands of frontline health workers, Sujei's vision is to disrupt the existing health care ecosystem. He's looking to employ telemedicine services to break down barriers between patients and health care professionals in order to improve access to reliable
on-site medicine. Let's say there's a pregnant woman who is in a remote area across the hills, through the jungles, or across the river without any bridges, when the health worker goes and visits this pregnant mother, we give digital health cards to the patients. And when they're scanning that card, automatically all the data of the patient scrolls up onto the phone, and all this happens in an offline mode because the entire data
is captured within the phone. After a health worker visits a patient in a remote village, the spokes reconnect to the hub to complete the analogy. And when the patient's vitals have been captured, let's say, hemoglobin, blood pressure, temperature, and several other EKGs, it tells whether the patient is within the normal range or whether there are any high
risk indicators or not. And if there are any issues once the health worker comes within the Internet zone, this data gets synchronized back to the cloud, and that is made available to the doctors. And meeting with patients and families to then come back to this small facility to literally and figuratively download all of that information, data, and knowledge so that they could build their dataset to better understand disease prevalence
in the region. Sujay calls iCURE a social enterprise with his tech background being at the core. Similarly, we are working with various medical device companies because we understand that for the devices, getting access to the large communities is a challenge to test and see that how, what is the user feedback and experiences and how they would be able to design devices which is which would be affordable in terms of ROIs for, the base enterprises.
Through international partnerships with tech startups, local nonprofits, and research organizations, iCURE's plans go beyond the remote areas of India. While currently serving a rural population of roughly 9,000,000 in India with just 400 health workers, they aim to reach millions more with expansion into other countries. And as we scale up to Vietnam, Indonesia, and few other countries, we aim to reach to close to 25 to 30,000,000 population in
the next two years. However, the immediate future involves building iCURE's newest SuperHub clinic in West Bengal, India, expected to open in 2021, which was where construction for change and design for others came in. West Bengal is an incredible part of the world. It it sits at the foothills of the Himalayas and is prevalent to a significant monsoon season at certain parts of the year. And so the amount of rainfall in that area is quite staggering,
and the water table is extremely high. During high tides, most of the region gets submerged completely twice a day, creating a fragile environment for the heavily migrant population from neighboring states. The new clinic will serve the communities of West Bengal, Viripur, and across the Delta Region and adjacent villages of South twenty four Perganas. In total, about 4,000,000 people. The team of Design for Others volunteers includes Megan Gallagher.
She's a health planner and colleague of Jason Emery who works in HDR Chicago office. So this is a small health care clinic that focuses around technology based solution. Part of what we're doing is to kind of help create a environment that they can pull in, technology within different room types. Megan comes from a family of engineers and was drawn to architecture to blend the technical and creative sides of her mind. After starting her career, she began
to specialize in health care design. I found that once I got into planning and laying out of the departments and spaces that that was actually really interesting. Learning about technology and how physicians and nurses and staff work as well as what patients' needs are. So kind of a blend of problems and coming to one solution that can
create a good environment for everybody. She's had a lifelong passion for volunteering, which made D'Pharo a perfect opportunity to lend her expertise to help iCURE realize a new approach to comprehensive health care. So I'm doing the medical planning for this. So just looking at the different clinic spaces that they need from public spaces down to more technical spaces like X-ray
or dental clinic. The clinic will offer access to general practice, maternal and child health care, eye care, dental care, and telemedicine services. The facility will also be centrally located for seamless communication with smaller clinics. Megan said that in spite of limited resources, working with a socially conscious start up can be liberating as a designer. The interesting thing about projects like this is they're almost less rigid than projects that I'm used to working
on. So it's thinking about health care with what is truly important, to create a healthy space and workable environment for health care workers. So what are the elements that create a good solution for that? Sometimes the solution involves the understanding that the use of space will evolve over time. I think the difference being just trying to approach these spaces with a lot more flexibility, considering sizes and how can sizes of rooms be joined together, and can that create a
different treatment room versus an exam room? Megan's colleague, Paul Howard Harrison, is also volunteering on his first d four o project. Paul's a project designer in Toronto, bringing his own expertise to the project. So I have acted in the capacity of the kind of schematic designer of the project. I came to this project not having a lot of experience in health care, so I work, primarily in the education, science, and technology sector. So it was a bit of an eye opener for me to approach this
really with a blank slate. Paul became immediately interested in design for others when he first met Jason Emery. I was lucky enough on my first day at HDR to take a, I think, three hour train ride with Jason Emery and found it a very interesting proposition that we would be able to kind of apply the skills that we use every single day into projects that don't typically receive this level of technical approach. I I was very, enabler with the idea from the beginning. Paul takes
a data driven approach to design. So I've been involved in computational research and architecture on an academic level for about five years now, and it's tricky to actually apply that in practice, just because, you know, the demands of client and the site, you typically start with a design that is more or less flushed out, and then you might have the opportunity to apply some kind of computational research and fabrication or or detailing later on. Which aligns perfectly
with iCURE's technology based health care model. They've been working with the IBM's big data lab to identify areas of the province surrounding them where they can most effectively deliver treatment. And they're trying to adopt this kind of new technology and mix it with a real boots on the ground approach to pioneer what I think is a really interesting way to deliver health. However, the West Bengal clinic required Paul to rethink how he does research in the
design process. But in this case, the client really wanted to introduce that kind of technology early in the process and really generate the building form itself using computation, which is totally novel for me. So it was a really interesting opportunity to take some of the research that I've been doing on the academic level and applying it to practice. The d four o team recognized the importance of context.
In fact, designing a space that feels like it's part of a community rather than a foreign gift can be critical to members of that community embracing it. In the February, Jason Emery traveled to Kolkata to meet the project team. This gave him a firsthand understanding of the region and how it should inform the
design of the clinic. The livelihood of individuals in that area, the way in which they go about their daily lives, the seasonality of living in that environment, all play into what we call the vernacular of the place, the the way in which they built to satisfy and solve some of those needs. And one of the key things we wanna do with this facility is make sure that it is designed in a way that feels fundamentally welcoming to the people of
West Bengal so it doesn't feel foreign. Those shared cultural insights helped Paul use technology to play a major role. So I wrote an algorithm that mapped out a kind of building based on their needs, so based on their program requirements, and trying to kind of optimize the sun shading on the site in a way that kind of picked up the vernacular architecture that exists there. So all the residential architecture you see in India, the courtyard is quite prevalent.
So the idea was the artificial intelligence research that they're doing would optimize based on the sun and, kind of echo that vernacular architecture as well as acting as a kind of proof for why that architecture works. Jason Emery's trip also factored into the selection of locally sourced materials. So one other piece that's really interesting is because of the high clay content in the soil in that region, they are the brick making center of that entire portion of India in that part of
the world. And so one of the things that we found while visiting and on-site was as prevalent as certain things maybe in North America, brick kilns were literally found within a mile of each other. And when I say a few, I mean dozens upon dozens in the landscape. Which creates a visual identity as well as playing a role in wayfinding
throughout the West Bengal region. And so where in North America, you might find your way through a city by finding the church steeple, in West Bengal, you find your way from town to town by the kiln chimneys. And so what's really fascinating is that definitely created an imprint on us in terms of how we might consider approaching using materials like
brick. Jason and Marni took a number of wonderful photographs, and what really stood it to me was many of the homes that Jason and Marni had photographed had these large piles of bricks outside their houses. And in this area of West Bengal, when you're planning on building a new house, you buy your bricks essentially a couple dozen at a time, and it's the backing of the bricks that is an investment, like a material investment in your
future home. Being respectful of the context and utilizing local resources will help make the new clinic feel familiar to the community. And I thought there was something really interesting in the kind of importance that bestowed on material in the community. And so one thing that was really important for me in the design of this building was that the reverence for material, kind of putting on a pedestal, was really exposed in the
building itself. And and I think that's come through in the way that the building is designed. When Design for Others started, nobody anticipated the ripple effect it would have. Not only did the projects impact the communities they're designed for, d four o projects have also created opportunities for volunteers to utilize skills and knowledge that exercise their creative muscles in different ways.
With different types of challenges derived from limited resources, Megan and Paul said it stretches a designer to think in more nimble ways. I think one of the big differences with this is just the type of technology they are using to administer health care. For instance, I'm thinking of they have a general radiology. We how is that going to be? Is the solution for that seems almost simpler than the type of x-ray room that we would build here, very large and very complicated equipment?
So how can these technology based health care solutions be brought over here and almost maybe make things simpler? One thing I thought was interesting for me with this project was the idea that you don't need to have a high budget project to be high-tech. I think in a lot of architecture, parametric architecture that's been developed over the past fifteen years. There's a real emphasis on kind
of high budget, complicated form making. But I think with this project, it's really established for me that you can have a really high-tech approach, a cutting edge approach even to an architecture that can be extremely low budget, which I think is really exciting. The West Bengal Clinic also has made Paul reflect on how unique cultures and distinct geographies
impact design. I think kind of a similar way, this project has really made me think about the importance of research in the design process and really trying to learn as much as you can about a context or a site, whether it's here in Canada, where I'm based, or in India. And I think it's an approach that really pays dividends no matter
where you are. But all the volunteers agree that most importantly, d four o offers an incredible way to create a meaningful, tangible impact in underserved communities around the world. It's an amazing outlet for desire to help. I have perhaps grown through my career to chase the headlines less and focus on what I hope is very substantive work that can really impact people's lives in
a ver in a variety of ways. I think that can be said about any architecture, but I think here, the work in an environment where the resources are so limited and that impact can be so exponentially great has been just an amazing opportunity. For more information on this podcast, visit hdrinc.com/speakingofdesign. You'll find links to pictures, articles, and more information about this project.
If you like what you heard, be sure to rate us or leave feedback on iTunes, Stitcher, or wherever you get your podcasts. Special thanks to Jack Hirsch for cowriting this episode.