MASS Design Group (Boston), the Center for Health Design’s 2013 Changemaker Award winner, is building an impressive resume of healthcare projects in devastated parts of the world. Through its work with Partners in Health, the Clinton Health Access Initiative, GHESKIO, and numerous other donors and partners, this young firm is spreading its mission that “design is never neutral; it either helps or it hurts.”

I recently had a great conversation with Michael Murphy, MASS’s co-founder and executive director, in which we discussed the firm’s work and its goals. You can read that interview here and in the upcoming May/June issue of Healthcare Design. In addition, here’s Murphy’s take on how the process of building can improve entire communities, and what architects should be doing to make that happen. Murphy will be on hand in November at the Healthcare Design Conference, where he’ll accept the Changemaker award.

You launched an endeavor called the MASS Design Lab in fall 2012. What do you hope to achieve through this?

 The MASS Design Lab is our initiative to focus on the social capital that surrounds projects. So, in essence, what it’s seeking to address is to reduce the social vulnerability of new infrastructure. Buildings can help people heal, but also the process of building can help people heal. And that—the process—is what the lab is focused on, through research and education.

Explain what you mean by "social vulnerability."

There’s an article in The New Yorker by Eric Klinenberg that was written after [Superstorm] Sandy, which spoke to the notion that buildings are making us more vulnerable, if they’re not being designed well enough. But it’s not just buildings that are failing; it’s communities. If they don’t have social infrastructure—spaces where people can meet, or commercial districts where everyone knows one another—then there’s also increased vulnerability. The article talks about a research study on the Chicago heat wave in 1995 that killed hundreds of people. It examined two neighborhoods that were demographically similar—both low-income, African-American neighborhoods—on the South Side of Chicago. One had one of the highest death rates during the heat wave, and the other had one of the lowest. Why?

The conclusion was that one on the neighborhoods had lost all its social infrastructure, while the other neighborhood had maintained it. And in that space, they were able to find and isolate the people who might be vulnerable to this disaster and seek them out.

This gets to the bigger idea of what the process of architecture is always going to affect, and it’s something that Jane Jacobs [author of “The Death and Life of Great American Cities”] talked about, the social capital of neighborhoods [the belief that social networks of people have intrinsic economic value]. What this example proposes is that there’s great risk if we don’t invest in this or think about that in our design decisions.

The lab, for us, will invest in all of that work: the research needed to prove that social capital has an effect, and making sure that the projects we do are also investing in the sustainability of that community.

Can you give an example of this in your current work?

We learned a lot from this amazing Rwandan engineer, Bruce Nizeye, who started asking questions a long time ago: If we’re going to build [a hospital], why don’t we bring in carpenters and masons, and train them on-site? Why don’t we develop every line and build every piece of furniture and every door and every window on-site? If we can do that, we can build this little artisan craft workshop, and use this as an engine for our economic development instead of just importing material. It’s a financial argument, but it’s also a social capital argument. This is really an economic model for rethinking the building beyond architecture alone. And it’s an important piece of healthcare infrastructure, certainly, but really any infrastructure to focus on the process of building and making it as impactful as possible.

For the cholera treatment center we’re building in Haiti, we’ve invested in training and artisanal craft development. We’re working on the building’s skin system, we’re working on the furniture, and all of the projects are part of this more comprehensive effort.

We’ve hired metal workers in Haiti to develop this highly customized skin system [for the building]. We’re developing it in such a way that we can have as many laborers and metal workers as possible working at it on-site. We want to employ as many people as we possibly can in the community, so they can share the design, as well. There are literally 400,000 cuts on this skin [so] it bends. It will use lots of labor, but also create something seemingly very high-tech.

Obviously, we could just develop a simple, familiar skin system, but that wouldn’t be enough. This is much more invested in the social capital needed to build better buildings.

Does that increase costs?

No, where labor is inexpensive it isn’t necessarily a cost increase. The increase is in our time to design the process. As an example, we also used compressed earth blocks on this facility. We had to learn how to use them ourselves, to bring in a whole training team to teach everyone how to use them. Then we had to develop expertise in how to make them, implement them, and test them. So now, that’s a new technology for Haiti—and it uses earth from Haiti, so we don’t have to import cement and everything else.

We’re using the compressed earth blocks in the cholera center, but now they’re being sought out [elsewhere in Haiti]. People didn’t want to use them at first, but now they think they’re really beautiful. They wanted to leave them exposed, actually, when they saw them go up. Now they’re also being used in a central housing project. There’s now a marketplace for them, and these laborers who’ve been trained can now go and sell them on their own.