In Langa, South Africa, stories of hardship in accessing medical care are common—and often heartbreaking. Ambulances are scarce, roads are unpaved, and care often arrives too late, or not at all.
As Industrial Design students at MassArt, we cross-registered for a course at MIT D-Lab in February 2024, where we launched REACH (Reliable Emergency Access for Community Health)—a partnership with Lebogang Molete of the PHELA Foundation aimed at improving emergency medical transportation in underserved communities.
Alongside an MIT student team from the D-Lab: Design class, we began designing an all-terrain stretcher to safely transport patients to clinics. We continued REACH as our senior thesis, diving into research on South Africa’s townships, healthcare system, and existing products.
With support from the MassArt Foundation, we traveled to Cape Town in January 2025 to meet with community members to understand these challenges firsthand. More than an emergency transportation solution, REACH is a community-driven initiative to help build sustainable healthcare infrastructure in South Africa’s townships.
Community-centered solutions: the Bike Hub and Langa Township
Our first stop was a meeting with Mzikhona Mgedle, the founder of Langa Bicycle Hub. The team took us through Langa by bike, explaining the different areas and terrain of the township and the existing infrastructure. We saw homes constructed with rusting tin sheets, old planks of wood, and other found materials, with no access to clean water. Biking from these areas to the local medical facilities gave us a real understanding of the area’s barriers to accessing care and how the system wasn't set up to serve those living in lower infrastructure areas. With narrow dirt roads riddled with potholes and broken down cars, it was apparent that ambulances wouldn’t be able to access those deeper into these settlements.
We also met with Yvette Andrews, the Clinical Program Coordinator for Langa, who dedicated time to helping us understand the unfiltered realities of healthcare in many of South Africa’s townships. She introduced us to the coordinator of Langa’s 42 community healthcare workers, who act as the first level of care. They gave us a tour of their small wellness center, and the insight we gained during this visit went beyond what our research from the previous semester had taught us.
The heart of innovation: Shonaquip Warehouse and test facility
During our stay, we also met up with a fantastic organization, Shonaquip SSE, a local enterprise that builds assistive mobility devices and enables the inclusion of children with disabilities and their families across Southern Africa. Shonaquip’s founder, Shona McDonald, invited us to tour the manufacturing facility, meet the design team, and shadow a technician during their clinic day.
At the warehouse, we were able to see first-hand the iterative designing and testing processes required for customized assistive devices. Spending time with Shonaquip’s head of design, we learned about the development of each of their products, and the importance of balancing affordability with functionality.
Shonaquip’s clinical team shared insights drawn from years of field experience assessing patients, fitting them to the proper devices, and educating on usage and repair. The clinical team members knew each device inside and out, and were able to point out where common failures occurred, what areas required the most maintenance, and even the psychological barriers most prevalent in patients and communities surrounding medical care.
Clinical and field insights
We were able to accompany the clinical team on a maintenance and repair off-site to a non-profit facility that provides 24/7 residential care for children with severe intellectual and physical disabilities. We spent the day shadowing and assisting the clinical team as they assessed each of the children’s wheelchairs and identified their needs. We observed how the team connected with the caregivers to ensure their feedback was heard and they understood how to properly operate the wheelchairs.
For the clinical team, this was a regular day of outreach, just a routine part of their job, but for us, it was a moving look into the benefits of dignified care and proper equipment. We ended the day scribbling down notes, sketching new ideas, and brainstorming.
Merging design and real-world use
The REACH Stretcher aims to bridge the existing emergency healthcare gap by providing a mobile, highly portable stretcher that can be stored at central hubs within the township. This will allow patients to be transported safely and efficiently through dense, uneven areas to either an ambulance waiting on an access road or to a clinic.
We’ve developed a stretcher that is both rugged and easy to maintain, designed with locally sourced materials and bicycle parts, allowing it to be repaired and adapted using tools and skills already present in the community.
Next steps for the REACH Stretcher include:
- Manufacturing and Assembly: Building the stretcher in Cape Town using local resources and manufacturers.
- Field Testing: Working with Community Health Workers and residents to evaluate the stretcher in everyday use.
- Co-Designing the System: Creating a plan for training, deployment, and integration into Langa’s emergency response network.
- Exploring Expansion: Traveling to Johannesburg to connect with healthcare partners for future implementation.
Looking ahead
Our time in Langa reinforced the importance of designing with communities, not for them. Our project is as much about systems and relationships as it is about hardware. By working with Shonaquip and the local bike hub, we aim to not only build a product but also help lay the groundwork for a sustainable emergency care infrastructure that can scale to other townships.
We’re looking forward to our return to Langa this summer with a team of mechanical engineers from MIT D-Lab, to build our prototype on-site for the Langa community to field test, and to explore opportunities to scale. Stay tuned for additional project updates.
About the authors
Michela Galazzi holds a BFA in Industrial Design from MassArt. Her work is grounded in human-centered design, with a focus on creating thoughtful, end-user-driven solutions for complex real-world challenges.
Madeleine Johnson-Harwitz holds a BFA in Industrial Design from MassArt. She is particularly interested in design for humanitarian purposes and in the transformative power of design education.
More information
Contact
Libby Hsu, MIT D-Lab Associate Director of Academics