MSF Makes — Solutions without Borders
A design-doing approach to help MSF support & scale new ideas
About MSF’s Innovation Approach (in 2018)
Médecins Sans Frontières (MSF) is a huge organisation with staff from 148 nationalities, working on delivering healthcare in conflict zones and in countries affected by endemic diseases. Operating 478 projects across 70 countries, MSF provides life-saving medical care in conflict zones, natural disasters and epidemics. Responding to humanitarian emergencies in remote/hard to reach settings with limited readily available resources necessitates continuous inventing. MSF-born medical innovations include Cholera Camps (service), MSF Logistique Kits (service/ product), Plumpy Nut (application of product) and more recently Missing Maps (part of founding group) & Mapswipe (app).
Organizational growth has increased the internal capacity to design new products and service. Japan, Sweden, Nairobi and Geneva are host to dedicated innovation units. Innovation advisors are placed in Paris, London, Brussels and Geneva HQ’s.
In Feb 2018, we were selected to develop a new approach to democratise innovation. Our brief was to design a new digital space for field challenges to be solved creatively by field staff.
Our Process (6 months)
We conducted research over 22 weeks in 5 phases in London, Amsterdam, Ethiopia and Kenya. We followed a multi-stage problem-solving process with each phase focusing on one stakeholder group’s needs and operating contexts at a time. Stakeholder groups included field staff to innovation units and advisors. Each round of ethnographic research result lead to insights, brought to life by a new rush of sacrificial concepts coalescing into a final proposal and recommendations.
Typically a field trip for a project like this would be scheduled early on, as early as week 2. Security constraints &protocols prevented this which led to the visit being in the flag end of the project & combined with alpha testing.
In order to step into the busy lives of the 40,000 + MSF staff, we began collecting images of daily tasks and associated objects such as doing the laundry, spreading a community health message and this evolved into a set of 70 images providing a visual framework for us to think about the breadth of MSF innovation!
During our user interviews, we learnt about field-grown DIY projects like a non-electric fridge, manual phase selector and how one can estimate population from an aerial map without GPS information. We realised that innovation in the form of DIY projects was valued highly by Head of Missions since there was the possibility of quick implementation associated with them, unlike long term innovation projects. This and other considerations informed our alpha prototype, which had 3 sections:
- Blueprints — where step by step instructions or ‘recipes’ for an innovative solution was shared (modelled on Instructables).
2. Exchange — A visual forum where staff could share task-specific problems workarounds and ideas (for better cross-pollination across the 400+ projects) inspired by the card deck
3. Feed — Curated content from projects across the world, selected to share quick DIY solutions, popular posts & innovation/funding specific news.
We designed all 3 sections to work in low bandwidth areas and even offline.
While testing in Kenya and Ethiopia, the card deck helped start & be specific quickly about problems, workarounds and ideas experienced by diverse project teams & co-ordination officers eg: neonatal & maternity teams at Gambella Hospital, IT and hospital management advisors in Addis.
Over 8 days our app and website received 216 unique visits. Staff found “Blueprints” were a tangible example of innovations and they wanted to see more of them!
“…there are many many things which are small innovations which need to be on there as well.”
Johnathan, Logistics Team Leader, Gambella Hospital
In the “Exchange” section we collected over 51 submissions. Half of the ideas proposed via exchange had the potential to be quickly prototyped and experimented with the existing skill set at the project (electricians and general logisticians work alongside medical staff in MSF). This became our biggest insight.
The Big Insight
MSF field teams had all the pieces of the puzzle for a good innovation project: a) the problems had immediacy & were defined, b) staff were highly motivated to solve said problems & c) equipped with the technical skill sets to implement a solution. Finally, d) there were ideas abound. The only problem was access to hard to find materials like electronic components etc since MSF deliveries are 4–6 month apart! If lightweight materials & timely support could be provided, in-field rapid prototyping had the potential to become an incredibly effective way to make ideas tangible early & iterate.
To experience what it is like to prototype in the field, we developed a quick clean file holder, and a hospital wayfinding system with MSF project staff in Gambella.
In addition, the Gambella hospital electrician (Yisak) had a strong idea for which we did not have equipment for prototyping. There was an extreme shortage of blood which was compounded by the intermittent electricity (temperatures cannot be maintained in the safe zone). Yisak wanted to make a blood bank alarm which sent an SMS to the watchman in case temperature went above 6°C so that he could check the power or turn on the generator. In order to test remote support, we sent materials for an Arduino based blood bank alarm to be assembled by Yisak. Our package ran into custom issues, which ended up being a big learning experience.
This and other experiences and insights were captured as design principles for the portal :
- Increase cross-pollination by sharing hidden knowledge of makeshift ‘solutions’ and workarounds from the field.
- Help make ideas real quickly by supporting field prototyping
- Accompany large innovation projects with open source templates or tools rather than reports ( eg a tool for making sustainable power generation choices while setting up a project)
- Build on the existing diversity & skill set in an MSF project
- Standardise templates for known design issues faced by field sites (patient workflow improvement workshop)
Recommended Innovation Approach
After our field visit, we consolidated our insights and proposed MSF Makes — Solutions without borders. We recommended the development of three key ideas :
1. Virtual Prototyping Desk / MSFTeams (Make More)
HQ based service for field staff with ideas; via which they are sent supplies and given timely remote support for in-field prototyping, iterations and testing.
2. Blueprints / MSFSolutions (Share More)
Movement-wide wiki for DIY solutions/ workarounds written by field staff, and modelled on Instructables, to encourage MSF’s existing maker culture & reduce duplication
3. MSF Partner (Connect More)
A Marketplace for beta products/service owners to connect with field missions for testing and scaling.
We imagined a space where innovation ventures ranging from services like NFI voucher programs to products like Arduino Blood Bank Alarms and Charcoal Fridges could be supported side by side, in the field. If every innovation team could support one field project a month, there could be 80+ service/product prototypes tested in the field every year. Real feedback from the field could guide decisions to scale up.
One year on, We still think this approach can lead to massive cross — organisational transformation in the most cost-efficient way possible! Next up, we will be sharing the details of a workshop we conducted with field staff.
Do let us know your thoughts via comments below or reach out on twitter @hetcodesign
