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published on 29.08.2021

D4E1 - The object becomes

A conversation between Lieven De Couvreur, Katrien De Schepper, Kim Jolie, Alexandre Humbert, Director and Giovanna Massoni, Curator

What is a hospital?
(Lieven) I think a hospital is a place where people enter or gather to solve or help other people considering their well-being, their health. In the first place, primary health needs are served in a hospital. And it's a complex environment because you have all types of pathologies. 

(Katrien) And it's even more complex if you consider the variety of people: there is a stream of sick people that come in with an expectation of coming out healthier. And then you have the stream of visitors and professionals who work here.

(Lieven) And, also important, there are not only healthcare professionals working here, but you also have a big logistics system that makes the hospital work. Food, as well as the cleaning of the hospital, the maintenance. So, it's really a complex mix of healthcare professionals, logistics people and the general public that enter one building. 

How did you start your practice? 
(Lieven) D4E1 really originated when I read about the story of a graffiti artist in New York – it was 10-12 years ago. Tempt One was his name. He was a very famous graffiti artist who suddenly got diagnosed with ALS. In a couple of months, he was paralyzed and he was sitting in his bed. Suddenly a group of people around him, friends and some paramedics discovered a way to let him draw again because that was his most meaningful activity in life. They hacked an optical mouse and made an iWriter device for $40. At the time that was quite impressive, because most iWriter devices were like 10 times more expensive. And actually, that was also the first time that they put the building plans of that design on the Internet and suddenly, you saw that these iWriter's were popping up in India, in Africa. It was amazing to see that there were no designers involved in that process. And it was a very successful product because it was very low-tech, and it had a very high impact on that person. 

That made us think about how we can use the creative capital of citizens better. They also have powerful ideas, and really know the world where they live, so they can very quickly validate what works and what doesn't work. We, as industrial designers, we're trained to always design products for target groups, big audiences. 

Can you explain the importance of an Open Design approach today?
(Lieven) Open Designers say: 'We don't all need the same product. We have the recipe and we can change it according to our needs and location'. That's a very interesting perspective regarding the user-centeredness of products, but also regarding sustainability, because, with Open Design, you can also repair your products very easily. You can’t do that with industrial design products, because they’re made with techniques that, as a normal citizen, you have no access to. And then we started thinking about the perspective and we came into the world of healthcare. And there, you find this very interesting paradox. You have Universal Design, inclusive design, which is a design strategy where designers want to design as human-centred as possible, and they want to do the best they can to make the products very applicable and efficient. But this way, you regularly run into the paradox that somebody can’t use it. So, then we thought: let's start to design from very specific situations, not from target groups. For example, that person is paralyzed, he wants to use his eyes to make graffiti: let's make it on site and make it happen so that it works. Then, by transferring the building plans into the world, we will be able to see how other people react to it, and how they appropriate it in their local contexts. That's a very exciting way to look at design. We are only able to look at it this way for 20 years now because we needed the internet for that. We needed to spread knowledge very easily and we also needed the FabLab machines. That's actually how we started. 

And how do you apply Open Design in your Makerhealth research? 
(Lieven) By making Open Design accessible to nurses, to educators, suddenly you see that people create solutions for problems that we never talked or thought about. It's important that, when we start bottom-up, we can see much better which problems are getting greater support. What do communities really want? Can we connect the patterns much better? Then an industrial designer can tap into that process as we did, and upscale from those patterns. 

(Katrien) Often the word 'designer' or 'industrial designer' makes the wrong connection, because we still usually link it with production, with companies and with more industrial processes. But an industrial designer is more a behaviour, a way of thinking, a way of looking at problems, a way of problem-solving. 

How do you see the future of this practice regarding the number of things that we produce and how do you control that? 
(Lieven) If you look at assistive technology, we have a lot of wheelchairs, crutches made perfectly based on industrial standards, mass production. They are beautiful products. But if you go to the field, and you see that they are not used, for me it's a very big problem. And if you look more on DIY, open-ended products, you see, of course, a lot of products that are a bit inferior, that are not that perfect, but that are used. So, we as designers, have to find the right product in the right place and make sure that it's also connected with the users. Open Design actually also allows you to repair your products. If your product has another purpose, if you design it well, you can dismantle it, you can reuse it, you can make another product out of it. 

What's also interesting in Open Design, is that nine out of ten times, your problem is already solved somewhere else. If you can identify a problem very well, you can also see where somebody else solved your problem but maybe in a different context. I really like Ezio Manzini’s phrase "small, local, open and connected". That's a bit of what we’re trying to do here. 

Going back to the project presented in the movie, looking at the scale of the hospital, the calling system looks like a small detail... It's also a kind of butterfly effect.
(Katrien) You can’t imagine how many layers in the hospital are already involved with this little device: the healthcare professionals who make it accessible for the patient; but also the cleaning department which has to clean the device after use; the technical department which has to repair it or change it; or the logistics department which has to buy new ones if they are broken; and the financial department, which has to pay the bills. 

Can you talk about the way you designed this device? 
(Kim) I wanted to ensure that the patient could reach out for the device to call for help at all times. I think the environment is a big factor as well as the number of people who come in contact with the device. First of all, the object needs to be visible. Then it always has to be reachable. I talked to a lot of healthcare workers, professionals, and nurses: "What do they think, what will work, what won’t work?" It took a lot of work just to make it right because that's the main purpose: if the device falls on the ground, and you can’t reach for it and you want to call for help, you have a problem. Everybody who's in a hospital, who's in a bed, should always be able to reach out for help, at any time.