Project Masiluleke (which means "lend a helping hand" in Zulu) is using mobile technology to tackle the worst HIV epidemic in the world in KwaZulu Natal, South Africa, where infection rates are more than 40 percent. Broadly speaking, Project M consists of two parts. The first component, a mobile phone–based platform, is being used to get the word out about testing, and also to provide information and counseling when needed. The second component consists of an HIV testing kit (above) designed for use in the highest risk communities with minimal oversight or instruction from HIV educators.
The testing kit harnesses a much broader national effort to transform South Africa's attitudes and treatment of the epidemic. As a metaphor for self-knowledge as well as an individual testing tool, the kit acts as a physical instantiation of the larger effort and a rallying cry for advocates within their communities. I was lucky enough to be involved in the design of this second segment of the project.
Synthesizing the results of on-site research and insight gathering in Kwazulu Natal, leveraging the cultural knowledge of our local advisers and stakeholders, and later concept testing revealed to us that the context in which the kit would be used provided both limitations and opportunities for the carton design and OOBE. Research told us that for this effort to become successful, the test kit would have to be mostly homegrown with local and respected advocates, be very cheap to produce, designed in a sustainable fashion and walk a fine line between being a utilitarian medical and desirable consumer product.
Designing for the medical category reinforces that the product itself is just a singular moment in a much larger story. Any medical device exists as a node in a much larger patient experience, pre- and post-treatment, and HIV tests are no different. Because HIV is such an emotional subject matter, and for South Africans in many cases literally a life and death experience (with 50 percent HIV-positive populations in some areas), sensitivity and empathy have to be highest on the list of prerequisites for any product in this category. Thus, in the case of the test kit we were designing a point in time where the tester has already come to the conclusion that testing is necessary (and trying to push that moment forward to a point where the test-taking isn't too late for treatment) as well as a gateway into a secondary test, more information and continued treatment. The OOBE, all of the language within the kit (in Zulu), and the physical design of the carton are all designed to hint at that continuum; there is no elaborate start to the process, nor is there a hard stop, the final step in our OOBE is the first step of the next series of actions.
We leveraged different technologies to address the need to tackle the process of testing and coming to grips with the results. Our sense was that the testing moment would be one of introspection and thus should be completely controllable by the tester. We didn't want to either confuse or alarm testers unnecessarily during what is already an extremely stressful event. South Africa has extremely high cell-phone adoption rates, and so we were able to create clear linkages between the carton itself, which provides high-level steps to take a successful test, and the phone, which can be used to call for deeper understanding about testing, or to speak to another human about the results. A pocket-sized brochure containing helpful phone numbers and next steps gives testers a sense that the schedule is theirs to decide and not dictated by others.
As we saw with the Lego OOBE example last week, every package or carton consists of a number of different elements. In this case, the packaging for Project M was conceived of as being as simple as possible. Inside, a brochure offered instructions for use and post-testing prompts, and the testing elements included a swab, solution and solution holder (above).
The outer carton consisted of three parts: a folded and tabbed sheet of cardstock with instructions on one side and a call to action and high-level instructions on the other, and two pulped paper end-caps.
As a rule, at frog, we try to create products that cause as little harm to the environment as possible, and the image of thousands of plastic end-caps littering the streets in townships all over South Africa was one we couldn't stomach, so we made sure that all of the parts in the kit could be recycled. The end caps serve double duty within the OOBE, first to hold the carton together and then to serve as a support for the testing vial during the test itself. Each of the elements is designed to have a life beyond testing, if the person testing wants that; otherwise everything can be torn up and thrown away.
When designing the OOBE for the testing kit we looked deeply at the larger production and manufacturing experience. As a result, all of the parts were designed to be locally produced and manufactured, flat-packed and shipped to individual communities then assembled based on need. By leveraging local populations in the fabrication process we hoped to empower individuals to take action and create a sense of responsibility in the testing experience; that people would feel it was their responsibility as a member of a small community to know their status and perhaps encourage others to test. In some ways the carton acts as a Trojan Horse; it works on its own as a test, but its real value lies in that it's a view into the much larger community-driven effort underlying it.
Project M was a wonderful project to work on. It has been great to see the response the project has gotten in the design community but more importantly that it's been well received in the communities for which it's designed. It's a great case study for culturally diverse and geographically disparate people working together. Without the help of engaged people on the ground in South Africa, community organizers and the communities themselves, as well as designers in NY and SF, it wouldn't have been successful.
Nick de la Mare, a Creative Director at frog design San Francisco, has spent his career designing digital, physical and experiential systems.