I became interested in the power of design in social contexts during a project at my former employer, frog design. Project Masiluleke (or Project M) was organized by Pop!Tech, frog, and MTN, an African mobile phone operator. Project M was designed to help stop the spread of AIDS in KwaZulu-Natal, a South African province with about 10 million people, including an estimated four million who are HIV-positive and 400,000 who will develop AIDS each year.Dugger, Celia. "South Africa Is Seen to Lag in H.I.V. Fight." July 20, 2009. (accessed October 1, 2011).
Only 500,000 people have been tested for the disease and know their status, and of the 200,000 people in treatment, close to 40% will abandon the treatment program within two years.
In many ways, the societal norms of the country were more difficult to overcome than lack of test kit accessibility, the interdisciplinary team routinely noticed during initial research. During an interview, one resident explained, "I don't want people to see me standing in queues. I want it to be private and secret." Another said, "I wouldn't visit the clinic because of the undignified way health care workers handle the issues of patients." A third explained, "People are so afraid to go to the clinic." Because complex issues of privacy, sexual identity, and fear stood in the way of desired, healthy behavior, the solution needed to address them along with the biological spread of the disease.
Research also showed that an estimated 80% to 90% of South Africans have access to a mobile phone. So the designers developed a system that uses mobile messaging channels to raise awareness of the disease and directly link to HIV counseling and other support services. The designers embedded health care messages in "Please Call Me" messages (PCMs), a type of free messaging in Europe and Africa that is used primarily in poor communities. These PCMs arrived discreetly on personal phones.
In the first three days of Project M's message distribution, the National AIDS Helpline received 5,000 calls a day, three times its usual number.Yale School of Management. Project Masiluleke: Texting and Testing to Fight HIV/AIDS in South Africa. n.d. (Accessed November 14, 2011).
After frog launched Project M, I started wondering why more of our work wasn't focused on efforts like this; this was just one small project in a sea of otherwise standard, traditional design work. I quickly came to realize that, despite the well-intentions of nearly everyone at the company, and despite the large-scale positive evidence that the work was actually doing what it was supposed to, and despite the massive and positive PR the company received, it was a simple question of economics. frog—owned by a company named Aricent, which in turn is owned by a "leading global investment firm with deep roots in private equity", is expected to produce a certain amount of money every quarter. Project M wasn't making money, and while it wasn't losing money either, it simply didn't compare to the profitability of a large corporate engagement.
This begs the question: if, at an extremely creative, well intentioned, and supportive company, Project M is the exception and not the norm, how can this type of work possibly have a chance?
I think the answer is in social entrepreneurship.