Design-led Solutions for Humanitarian Aid

How Pivotal worked with the Humanitarian Innovation Fund to develop a guide for applying lean and user-centered design far beyond software.

Authors: Ellie Ereira & Aly Blenkin

As we set off from the London Pivotal office, wielding paper rollups of giant wall printouts, a colleague asked where we were going. We replied, “we’re going to Oxford to run a workshop on user-centered design (UCD) methods for building toilets in refugee camps during rapid onset emergencies.” His quizzical reply? “That sounds like a great cause, but… aren’t we a software company?”

It’s a fair question. Of course, the answer is yes — Pivotal’s mission is to transform how the world builds software. At Pivotal Labs we’re all about solving problems. Reducing risk, iterating to eliminate waste, and placing the user at the centre of the product or service is the best way to do that. And the tools and practices we use can be applied far beyond digital products.

The problem with toilets

When an emergency — such as conflict or floods — results in mass movements of people, latrines need to be built in refugee camps. Typically the toilets are constructed very quickly in the effort to manage the high influx of people. Unfortunately, the toilets often are left unused because they’re built in a way that doesn’t take into account people’s needs and sanitation preferences.

Toilets and sanitation are a basic physiological need. Imagine you are used to a certain way of using a toilet and then are forced to adopt new sanitary practices in the midst of coping with a natural disaster, while your primary concern might be finding enough food, not sanitation. This is a problem that refugee camps face every day. For example, some refugees are used to squatting rather than sitting or gender-specific toilets rather than communal. Or maybe they only use the toilets in the daytime because at night they are scared. All of these situations result in people finding alternatives because they don’t feel comfortable using the latrines, and the result is that people in the camps end up practicing open defecation. This is the core of the problem, as it leads to the spread of diseases and tragically, often deaths. Studies have shown that illnesses related to unsafe excreta disposal can account for up to 50% of fatalities during an emergency.

The Humanitarian Innovation Fund (HIF) recognized this as a major problem, and decided to run a challenge for non-governmental organizations (NGOs) in partnership with Oxfam, an international confederation of charitable organizations that aim to alleviate poverty around the word, and Science Practice, a design and research company that helps organizations design problem-led funding initiatives. The challenge asked for proposals to use rapid community engagement and user-centered design methods to encourage new behaviors, and figure out how to build latrines that end up getting used. To help the NGOs shape their proposals, HIF held a 2-day workshop, and brought Pivotal Labs in to facilitate a session on user-centered design.

UCD workshop

Oxfam provided context for the workshop to help frame the problem we wanted to address: A typical refugee camp, for example in Sub-Saharan Africa, could have a population of over 200,000 people. It’s possible that people have to walk for several days to get there. Camps are often set up in existing villages that are overwhelmed by the sheer numbers of refugees, and don’t have the infrastructure to cope. When people arrive they often settle anywhere they can find shelter, such as in school grounds or wastelands. There might be existing public latrines in the local school, market, or hospital, but often they are in a very dilapidated state even for the existing population. Frequently the majority of the refugees are women and children.

We started off with mapping out the eco-system and stakeholders, before narrowing down to focus in on the users. Once we identified the most vulnerable people impacted by this scenario, we created empathy maps of specific types of people, such as: young mothers, children, the elderly, and people with disabilities. The different personas helped us create storyboards or user journeys to consider all of the touchpoints for interacting with the latrine. As part of building empathy for our personas, we also acted out the service. Getting people to pretend they’re on a journey to use the toilet was awkward at first, but the idea was to imagine yourself in the shoes of the users. Lastly, we covered prioritization of assumptions and lean experiments, to explore ways to validate quickly and eliminate risks early on. Here are some of our key takeaways from the workshop:

Leave the comfort zone

For most of the participants, UCD was a new way of thinking about the problem. In most cases, the latrine is designed for the average person, which in reality is nobody. Thinking about who are the most vulnerable people impacted by this problem and then designing solutions to meet their needs requires a mental shift. Building empathy for these vulnerable groups was a way to highlight and communicate some of the major problems that these people face on a daily basis. The workshop participants, had a lot of experience working in refugee camps, thus they already have a lot of empathy for these marginalized groups, but this was the first time they started to visualize those insights, as a way to drive creative solutions.

Act it out

Along with visualizations, we also wanted to build empathy by physically acting out the experience. Oxfam had brought with a few of the physical parts of latrines that teams were able to use at props when acting out how the different personas would use them, such as the slab and lid.

During the acting it out exercise, one team realized that they hadn’t thought about the fact that their persona would need to lift up the lid of the latrine with their hands. This was something they knew their user, based on the empathy map they had made, would not feel comfortable doing. They then had to get creative and think of new ways to lift up the lid without touching it.

Embrace time constraints

One of the downsides of any workshop is never having enough time. It would have been impossible to share all of the different tools and UCD methods in the workshop in just a few hours, so we created a UCD guide that explains how to use these techniques in the humanitarian context. The guide is a step-by-step approach to getting the most out of the activities and how to use them in the field. The guide highlights techniques such as how to conduct user research, actor maps, empathy personas, 2×2 prioritization, and service design map.

Speak the same language

On the second day of the workshop, Oxfam led a session on monitoring and evaluation (M&E). The humanitarian and development sectors use tools such as logic frameworks (also known as logframes) for measuring the impact of an intervention. This involves identifying the outcome you are aiming to achieve, which can be thought of as the high-level goal motivating the project. You then think about what activities you can do — or outputs you can create — that you think will bring about this goal, based on a theory of change. You then think up some key performance indicators (KPIs) to measure these outputs, to see how well you’ve achieved the change you wanted to affect.

While workshop participants spent time thinking about their own logic frameworks, we worked with them to develop the theory of change using a lean hypothesis framework — something we use at Pivotal with our clients to identify goals, as well as hypotheses we might want to test. For example:

• We believe that internally displaced peoples (IPDs)
• Have a problem with practicing safe excreta disposal in camps
• We can help by using community engagement methods to test and iteratively build latrines

Small changes can have big impact

You have to be able to check your assumptions while understanding context. While it might have made sense to think of new locations for the latrines themselves, the truth was we were limited by health standards that were in place for good reasons. But there were other ways to provide value. For example, participants talked about a case study in Nepal that identified simple additions to the latrines that were easy and cheap to test, such as adding hooks to the doors so that people could hang their bags there. Another example is varying the height of the locks on the doors, so that both adults and children are able to use them.

A balanced team is still key

At Pivotal, we believe that a balanced team, with joint responsibility and accountability across disciplines is key to success. During the workshop, we found that this is definitely still the case when implementing our methods in a humanitarian setting.

Incorporating iterative approaches and identifying opportunities to test low-fidelity prototypes can be more complicated outside of the realm of software, especially when you’re working in an environment where people’s health, safety, and wellbeing are at stake. It was great to see that one session of the workshop was dedicated to ethics, discussing the issue of balancing the importance of testing at small scale before rolling out while meeting refugees’ needs quickly.

Where we go from here

Rethinking how to adapt our design tools to the humanitarian context was certainly a challenge. But having the opportunity to work on something that could ultimately affect people’s lives for the better was inspiring. We had really positive feedback from the workshop participants, and we felt incredibly lucky to have had the chance to contribute to the meaningful cause of making refugee camps cleaner and safer. Introducing practitioners working in humanitarian aid to lean and HCD methodologies can help make aid more effective, by reducing risk and therefore waste. It’s hard to imagine a sector where efficient spending is more important, and we’re excited to see these tools applied in real projects that the workshop participants will be running over the next 12 months.

We at Pivotal will be following their progress, and sharing the learnings with the wider product and humanitarian community. This is just the beginning of bringing HCD to this sector, and we hope NGOs and aid agencies will see the benefits and will start applying HCD to their own programs.

About the authors

Ellie Ereira is a Senior Product Manager, and Aly Blenkin a Senior Product Designer at Pivotal Labs in London. Before Pivotal, Ellie worked at the World Bank where she supported startups building clean tech solutions. Aly has a masters in Transdisciplinary Design, which led her to social impact work in tech at Thoughtworks.