At Design that Matters, Timothy Prestero is bringing together hundreds of bright-minded students, professionals, and social entrepreneurs, to collaboratively experiment and design breakthroughs in areas such as infant health and literacy. You may have heard of some of their projects (you can see them above), like Firefly, a cheap way to treat infant jaundice; the Kinkajou projector, which brings media to the developing world; and the NeoNurture incubator, designed to run off common car parts. We talked to Prestero about how his program manages to keep creating these design innovations.

Can you describe the collaborative process that you built and how it works?

Design that Matter's collaborative design process yields world-class design results at a fraction of the commercial cost through the efficient application of intellectual and financial capital. DtM leverages over $8 in donated time and materials from our corporate and academic partners for every dollar we spend. In this way, we are able to address what the Rockefeller Foundation recently described as the chief barrier to design for social impact: affordability.

We have structured our collaborative design process such that participants are motivated by self-interest as much as altruism. For academic partners like MIT and Stanford, DtM "design challenges" serve as curriculum materials in existing university courses, engaging students in real-world problems while helping faculty to meet university accreditation requirements in "capstone," or experiential-learning, courses. These design challenges boost student engagement. Of his experience with DtM, one faculty member reported, "this was the first course in 17 years of teaching in which nobody dropped the class."

In the case of our corporate partners, like IDEO, SolidWorks, and Optikos, companies donate in-kind resources and take advantage of staff "white-space" (paid, but un-billable hours) to allow employees to volunteer for a DtM design project. According to our corporate partners, time spent on a DtM project boosts staff retention, builds staff skills through exposure to what we call "minimum resource design," and provides an opportunity to demonstrate corporate social responsibility.

The lessons DtM has learned in aligning our social mission and the individual goals of our volunteers and their host institutions gives us unique access to a vast reservoir of talent and enthusiasm. Our partnerships with academia offer a "view over the horizon" for technology trends. Access to university and industrial facilities spare DtM from the need for costly hardware investments. DtM is, in a sense, building a "virtual company" by identifying best academic programs and corporate partners for different needs within the product design process, in fields as diverse as ethnography, design, engineering, manufacturing, and business development. We are able to tackle a broad range of global issues, with projects completed in health care, education, microfinance, and renewable energy.

Since DtM's launch in 2003, almost 1,000 students and professional volunteers have participated in the creation of dozens of new products, three of which have reached implementation in the developing world. The DtM project experience is, for many volunteers, their first exposure to problems faced by people in poor communities. For some high-empathy students with a sense of personal responsibility for the state of the world–students who often have trouble connecting with the university curriculum–the DtM project was the first time they got an "A." DtM alumni are embracing their role as citizens of the world, and many have realigned their life trajectories to focus on careers in the social sector.

This is the latest post in a series on generosity, in conjunction with Catchafire.

Why is it critical to understand the on-the-ground realities in hospitals and developing countries before beginning the design process?

The lesson here is that a medical device designed for an American hospital includes all kinds of assumptions that fall apart in a developing country. If the goal is helping people, I've learned that there's no such thing as a "dumb user," there are only dumb products. When you focus on outcomes, you can't blame people for using the product "wrong"; you have to figure out how to make it hard to use "wrong"; or rather, how to make it easy to use correctly.

A big issue: The difference between the "cost to buy" and the "cost to own" a medical device. Plenty of international aid programs focus on donating medical equipment to hospitals in poor countries. Unfortunately, eliminating the "cost to buy" doesn't solve the problem. According to a study conducted by the Engineering World Health group at Duke University, up to 98% of donated medical equipment in developing countries is broken within five years. There are issues with paying for regular maintenance, locating appropriate spare parts, even with training users. Affordability is important, but I've learned that product cost usually isn't the most significant barrier to social impact.

I've learned that appearances matter. Our partner MTTS has created an amazing suite of technologies designed specifically to treat babies for poor countries. They're robust and inexpensive, and they work. They've treated 50,000 babies in Vietnam. The problem is, as they scale to new countries, they're finding that every doctor and every national health bureaucrat in the world has seen on TV–they know what medical equipment is supposed to look like. It sounds crazy, it sounds dumb, but there are hospitals that would rather have no equipment than stuff that looks cheap. I've learned that if you want people to trust the device, it has to look trustworthy.


These are some examples, but you get the point. It's absolutely critical that we understand the context, the user and the needs of all of the key stakeholders before starting the design process. In a sense, you have very little chance of getting the right answer, until you start asking the right questions.

When did you realize that your career as a designer would be focused on giving back?

At one of my first job interviews during my senior year of college, a representative from the auto industry described a chilling future: "We're designing a car, that car is going to have a radio, and that radio will be attached to the dashboard by four screws. Son, those four screws will be your job." I fled the industry for the Peace Corps and I never looked back.

Tell us about one up-and-coming social good designer we should be watching.

Michael Murphy and the team at MASS Design Group are doing remarkable work in adapting the principles of design to the creation of context-appropriate architecture in poor countries. Their work at Butaro Hospital in Rwanda shows a remarkable sensitivity to the location and the needs of both the hospital staff and the patients.

Who inspires you most with their generosity?

I can think of a number of great writers whose generosity and influence have made me a better person–patient, generous, and humble humanists like Thomas a Kempis, Samuel Johnson, Flannery O'Connor, and Shusaku Endo. What drives someone to sit at their desk for years attempting to hammer out an explanation for complete strangers about how to live a good life?

Really, the best model I can think of for true generosity is two people walking on an icy sidewalk, one slips and the other reaches out to catch them on instinct. Not waiting until they've validated that the person is somehow worthy of their person-catching skills, or that they can catch the person without risk of harm to themselves. Not waiting until they've issued a press release about the catch they're about to perform, not waiting for the film crew to set up to witness and record the act. Generosity should be unself-conscious, and its own reward.

In my life, I've witnessed countless examples of this kind of generosity, in acts big and small, and I've spent my career trying to measure up.