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The power of co-design

Something we value, and consistently promote in our team, is the involvement of people who use the products and other stakeholders in the design process. But what would it look like if they actually became part of the design team?


This restrospsctve look back at a important project with MSF explains the power of involving people in the process

We collaborated with Médecins Sans Frontières (MSF) on a 3-week mini project, which proved to be an interesting and fruitful experiment co-designing solutions with our clients.


Photo: Anup Ravi / MSF

Photo: Anup Ravi / MSF

Josie Gilday is a UK trained nurse who has worked globally with MSF, bringing emergency medical aid to areas where natural disasters, military conflict, or epidemics have struck at the heart of a community.

As a Technical Logistician, or 'Techlog', Anup Ravi's role is to support people like Josie, and to ensure that all the equipment and other resources required for a project are functional and in the right place at the right time.


Photo: Jana Brandt / MSF


Wherever Josie and Anup go in the world, they are likely to be making use of the MSF standard off-road vehicle: the tank-like Toyota Landcruiser. Because of the nature of MSF's work, these vehicles are multipurpose and a dedicated, fully equipped ambulance is a rarity. As a result, Medics like Josie will often have no defined place to hang their patients' IV fluids on route. The go-to solution is to fashion an ad-hoc harness from a surgical glove or piece of cord, wrap it around the IV fluids, and fix it to an interior feature of the vehicle. Failing that, they may find themselves holding it aloft for the duration of the journey, or tasking a colleague with the same. As a Technlog, Anup has been on the end of such requests on more than one occasion.

Idriss shows us the interior of a multi-purpose Landcruiser and demonstrates some of the issues surrounding the IV Fluids.

With first-hand experience of this situation, Josie and Anup made ideal co-designers in seeking to create a comprehensive, longer-term solution that could be standardised across MSF missions. The project, funded by an MSF innovation fund, was headed up by Fearsome's Nils Aksnes, whose responsibility was to guide Jose and Anup through our design process and the tools we use for market-led development. The 3-week phase of work was kicked off when the team met up in Brussels for a close-up look at the Landcruisers and some valuable input from the project's originator, Idriss Ait-Bouziad (MSF UK). The resultant role-playing exercise, involving some bumpy rides around MSF's grounds, provided key insights and laid the foundation for development work.

Josie and Nils discussing the IV fluids in a well equipped MSF ambulance Landcruiser. Josie explained that she had never seen one of these in the field and that she was used to multipurpose vehicles.

Photo: Fearsome

Photo: Nils Aksnes / Fearsome


Back in Glasgow, the scene was set with a mock-up of the Landcruiser interior, and our resident patient, Susie. On their arrival the MSF team members were surprised to discover that their first task was not to dream up potential solutions, but instead to dig deeper into the problem and map out the factors involved.

The mocked up Landcruiser in the studio, with Susie playing our patient.


For Josie and Anup, whose jobs requires rapid problem solving, this methodical approach - and indeed the whole project - was a departure from the everyday and highlighted one of the joys of co-design, which is the exchange of process and experience (J and A share their feelings on this in their own blog series on the MSF site).



“We realised the initial ideas we had had on day one of the project had all been scrapped because of all the extra information we’d gathered. The reasons for that previous week-and-a-half suddenly became clear, thank god!”
— JOSIE

For the Fearsome team, who are used to reaching out to stakeholders, the opportunity to work with them everyday was rewarding. A clear benefit is the rapid progress that can be made when members of the team can readily access their own very relevant experiences, as well as making direct contact with their colleagues in the field via video conferencing or social media.



At the end of the third week, and a succession of prototypes, a solution was presented involving 3 custom components - to be integrated into the Landcruiser - and 3 components that could be readily replaced by materials found in the field, should they break. The team also created a roadmap for further development of the design, which includes a series of in-field trials. Another benefit of working so closely with MSF on this project is that those people who would carry out these trials have already been initiated into the process. This sense of ownership creates a momentum that is harder to find in a typical product development scenario. The project, including our Landcruiser mock-up, was be featured in the MSF Scientific Days in London.



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