Architecture that's built to heal

Every weekend for as long
as I can remember,

my father would get up on a Saturday,

put on a worn sweatshirt

and would scrape away the squeaky
old wheel of a house that we lived in.

I wouldn't even call it restoration.

It was a ritual --

catharsis.

He would spend all year scraping paint

with this old heat gun
and a Spackle knife,

and then he'd repaint where he scraped
only to begin again the following year,

scraping and re-scraping,

painting and repainting.

The work of an old house
is never meant to be done.

The day my father turned 52
I got a phone call.

My mother was on the line

to tell me that doctors had found
a lump in his stomach --

terminal cancer she told me,

and he'd been given
only three weeks to live.

I immediately moved home
to Poughkeepsie, New York

to sit with my father on death watch,

not knowing what the next
days would bring us.

To keep myself distracted,

I rolled up my sleeves

and I went about finishing
what he could now no longer complete,

the restoration of our old home.

When that looming three-week
deadline came and then went --

he was still alive --

and at three months,

he joined me.

We gutted and repainted the interior,

at six months the old
windows we refinished

and at 18 months the rotted porch
was finally replaced.

And there was my father
standing with me outside,

admiring a day's work,

hair on his head,

fully in remission,

when he turned to me and he said,

"You know Michael,

this house saved my life."

So the following year I decided
to go to architecture school.

(Laughter)

But there I learned something
different about buildings.

Recognition seemed to come

to those who prioritized novel
and sculptural forms,

like ribbons or ...

pickles?

(Laughter)

And I think this
is supposed to be a snail.

Something about this bothered me.

Why was it that the best architects --

the greatest architecture,

all beautiful and visionary
and innovative --

is also so rare,

and seems to serve to very few?

And more to the point,

with all of this creative talent,

what more could we do?

Just as I was about to start
my final exams,

I decided to take a break
from an all-nighter

and go to a lecture by Dr. Paul Farmer,

a leading health activist
for the global poor.

And I was surprised to hear a doctor
talk about architecture.

"Buildings are making
people sicker," he said.

And for the poorest in the world,

this is causing epidemic-level problems.

In this hospital in South Africa,

patients that came in
with say, a broken leg,

to wait in this unventilated hallway,

walked out with a multi
drug-resistant strand of tuberculosis.

Simple designs for infection control
had not been thought about

and people had died because of it.

"Where are the architects?" Paul said.

"If hospitals are making people sicker,

where are the architects and designers

to help us build and design hospitals
that allow us to heal?"

That following summer I was in the back
of a Landrover with a few classmates,

bumping over the mountainous
hillside of Rwanda.

For the next year I'd be living in Butaro,

in this old guest house which was
a jail after the genocide.

And I was there to design and build
a new type of hospital

with Dr. Farmer and his team.

If hallways are making patients sicker,

what if we could design a hospital
that flips the hallways on the outside --

makes people walk in the exterior?

If mechanical systems rarely work,

what if we could design a hospital

that could breathe
through natural ventilation

and meanwhile reduce its
environmental footprint?

And what about the patients' experience?

Evidence shows that
a simple view of nature

can radically improve health outcomes,

so why couldn't we design a hospital

where every patient
had a window with a view?

Simple, site-specific designs can
make a hospital that heals.

Designing it is one thing,

getting it built we learned
is quite another.

We work with Bruce Nizeye,

a brilliant engineer,

and he thought about
construction differently

than I had been taught in school.

When we had to excavate
this enormous hilltop

and a bulldozer was expensive
and hard to get to site,

Bruce suggested doing it by hand

using a method in Rwanda
called "Uba day hay,"

which means "community works
for the community."

Hundreds of people came
with shovels and hoes,

and we excavated that hill

in half the time and half
the cost of that bulldozer.

Instead of importing furniture
Bruce started a guild

and he brought in master carpenters

to train others in how to make
furniture by hand.

And on this job site,

15 years after the Rwandan genocide,

Bruce insisted that we bring on
labor from all backgrounds,

and that half of them be women.

Bruce was using the process
of building to heal,

not just for those who were sick
but for the entire community as a whole.

We call this the locally-fabricated
was of building, of "low-fab,"

and it has four pillars:

hire locally,

source regionally,

train where you can,

and most importantly --

think about every design decision

as an opportunity to invest in the dignity
of the places and where you serve.

Think of it like the local food movement
but for architecture.

And we're convinced
that this way of building

can be replicated across the world

and change the way that we talk about
and evaluate architecture.

Using the low-fab way of building,

even aesthetic decisions can be
designed to impact people's lives.

In Butaro we chose to use
a local volcanic stone,

found in abundance within the area

but often considered a nuisance by farmers

and piled on the side of the road.

We worked with these masons
to cute these stones

and form them into
the walls of the hospital.

And when they began on this corner
and wrapped around the entire hospital,

they were so good at putting
these stones together

they asked us if they could take down
the original wall and rebuild it.

And you see what is possible.

It's beautiful.

And the beauty to me,

comes from the fact that I know
that hands cut these stones,

and they formed them into this thick wall

made only in this place
with rocks from this soil.

When you go outside today
and you look at your built world,

ask not only what is
the environmental footprint --

and important question --

but what if we also asked,

what is the human handprint
of those who made it?

We started a new practice
based around these questions

and we tested it around the world,

like in Haiti,

where we asked if a new hospital
could help end the epidemic of cholera.

In this 100-bed hospital,

we designed a simple strategy

to clean contaminated medical waste
before it enters the water table,

and our partners at [La son trag...]
are already saving lives because of it.

Or Malawi,

we asked if a birthing center

could radically reduce maternal
and infant mortality.

Malawi has one of the highest rates
of maternal and infant death in the world.

Using a simple strategy
that we replicated nationally,

we designed a birthing center

that would attract women
and their attendants

to come to hospital earlier
and therefore have safer births.

Or in the Congo,

where we asked if an educational center

could also be used to protect
endangered wildlife.

Poaching for ivory and bush meat

is leading to global epidemic,
disease transfer and war.

In one of the hardest
to reach places in the world,

we used the mud and the dirt
and the wood around us

to construct a center

that would show us ways to protect
and conserve our biodiversity.

Even here in the US,

we were asked to rethink

the largest university for the deaf
and hard of hearing in the world.

The deaf community,

through sign language,

uses the power of visual communication.

We designed a campus

that would awaken the ways
in which we as humans all communicate,

both verbally and non-verbally.

And even in Poughkeepsie,

my hometown,

we thought about old
industrial infrastructure.

We wondered,

could we use arts and culture
and design to revitalize this city

and other rustbelt cities
across our nation,

and turn them into centers
for innovation and growth?

In each of these projects
we asked a simple question,

what more can architecture do?

And by asking that question

we're forced to consider how
we could create jobs,

how we could source regionally

and how we could invest in the dignity
of the communities in which we serve.

I have learned that architecture can be
a transformative engine for change.

About a year ago I read an article

about a tireless and intrepid
civil rights leader named Bryan Stevenson.

(Applause)

And Bryan had a bold architectural vision.

He and his team had been documenting

the over 4,000 lynchings
of African Americans

that have happened in the American South.

And they had a plan to mark every
county where these lynchings occured

and build a national memorial
to the victims of lynching

in Montgomery, Alabama.