Langa, South Africa: Context
Located just outside of Cape Town, Langa is South Africa's oldest black township. Like many of its kind established during apartheid, its dense layout and limited infrastructure continue to shape daily life today. Narrow pathways, uneven terrain, and areas inaccessible to motor vehicles make transportation particularly challenging, especially for the community health workers who travel throughout Langa to provide in-home care.
These geographic realities have been the driving force behind the mobile and portable REACH stretcher project developed through MIT D-Lab over the past several years. By enabling healthcare workers to transport patients and medical supplies more effectively, the project seeks to improve access to care while remaining practical for the environment in which it will be used.
Our team and goals
This iteration of the stretcher began in Spring 2026 as a class project in MIT’s D-Lab: Design (2.722J /EC.720). Taught by Ankita Singh and Eliza Squibb, the team consisted of Marco Arias II (MIT '26), Pauline Vien (MIT '27), Kayode Dada (MIT '27), Michelle Lam (MIT '27), and Ruben Stephen (MIT’27), and culminated in the prototype we eventually brought to the township.
In June, a different lineup carried the prototype the rest of the way: trip leader Maddie Johnson-Harwitz brought Kayode Dada, Marco Baisch (MIT '29), Jaiden Cadotte (MIT '29), Luke Johnson (MIT '29), and me (Ruben Stephen '27) back to Langa to finish assembly and hand the stretcher off to the community that would use it. We were all students in Spring 2026 D-Lab classes, some of us in D-Lab: Design and others from D-Lab's newest class, Introduction to Engineering Design for International Development, taught by D-Lab Founding Director Amy Smith, Martha Thompson, and Matthew McCambridge.
The project: co-design across time
Our prototyping team built upon the work of students in four previous D-Lab teams, each of whom contributed to the stretcher's iterative development through prototyping, testing, and community feedback. Rather than beginning with a blank slate, we continued a design process that has evolved over multiple years alongside our partners in Langa.
Based on feedback gathered during previous deployments, our primary design goals were twofold.
- First, we developed an attachment that allows the stretcher to be towed behind a bicycle when not carrying a patient, reducing the physical effort required to move it between locations.
- Second, we designed a lightweight shade structure to provide additional protection from the sun during patient transport. Throughout the spring semester, these features were prototyped and refined before being brought to Cape Town for testing with community members.
Understanding Langa: stronger together
Beyond the engineering work itself, one of the most memorable aspects of our time in Langa was seeing how deeply collaboration is woven into the community.
Organizations throughout the township demonstrated how shared resources and strong local partnerships create opportunities that extend far beyond their primary missions. At Mzansi Restaurant, meals were paired with performances from local musicians, creating a space that celebrates both food and culture. At the Langa Bicycle Hub, bicycle repair operates alongside educational programming and community initiatives that serve residents of all ages.
This same spirit of collaboration was evident throughout our project. Community organizations, healthcare workers, manufacturers, and local leaders each played a unique role in moving the project forward. Rather than existing independently, these partnerships reinforced one another, making it possible to accomplish far more collectively than any one group could alone.
Project partners
The success of this project depended on collaboration with organizations throughout Langa and Cape Town.
The Langa Bicycle Hub served as our primary community connection, helping coordinate outreach, facilitating conversations with residents, and providing insight into how the stretcher could be integrated into existing transportation networks.
Our healthcare partners at Kete Impilo shared their day-to-day experiences providing care throughout Langa. Their feedback helped us evaluate design decisions through the perspective of the people who would ultimately use the stretcher most frequently.
We also partnered with GM Technologies, where Greg and Michael worked with us to manufacture components of the updated design. Their expertise highlighted the importance of designing not only for functionality, but also for manufacturability, durability, and long-term maintenance.
Finally, Shonaquip shared their expertise in adaptive mobility and assistive technology. Their experience designing equipment for challenging environments provided valuable feedback that informed our thinking around comfort, ergonomics, and long-term usability.
Beyond the prototype: deployment systems
One of the most valuable lessons from this trip was that successful engineering extends well beyond the prototype itself.
During community feedback sessions, we repeatedly heard stories about government-issued motorbikes that had been introduced to improve healthcare access but ultimately saw little use. Although the technology itself was sound, community members explained that the program had been implemented without adequately involving the people expected to use it. As a result, the solution never became integrated into everyday practice.
Those conversations reinforced the importance of designing alongside community partners throughout the entire development process. Our healthcare partners at Kete Impilo, who navigate Langa's streets every day while caring for patients, continually provided practical feedback that shaped how we evaluated our own design decisions.
We also visited GM Technologies, a local manufacturing company led by Greg and Michael, where we saw our university-built prototype translated into a professionally manufactured product. The visit highlighted another important aspect of engineering: designing not only for functionality, but also for manufacturability, durability, and long-term maintenance. Creating a successful prototype is only one step; ensuring that it can be built, repaired, and sustained locally is equally important.
Looking forward
Testing the updated design with community members provided valuable direction for future iterations of the project. One suggestion we heard repeatedly was to expand the shade structure beyond its current design, creating a tent-like enclosure that would provide more complete protection from both sun and rain during patient transport.
Like the teams before us, our goal was not to produce a finished product, but to move the project one step closer to a long-term solution. By building upon previous work, testing ideas directly with users, and documenting feedback for future teams, we hope the next generation of D-Lab students can continue refining the design alongside our partners in Langa.
More information
REACH (Reliable Emergency Access to Community Health)
Building reliable emergency access in Langa, South Africa, Blog post | Jun 05, 2025 | Michela Galazzi and Madeleine Johnson-Harwitz, Massachusetts College of Art and Design ‘25
Improving emergency transport in Langa, South Africa, Blog post | Anna Duncan ‘25, Jack Grier ‘25, Avani Narula ‘25, Annica Lam ‘26, Michela Galazzi and Maddie Johnson-Harwitz
Contact
Libby Hsu, MIT D-Lab Associate Director of Academics
Maddie Johnson-Harwitz, REACH Co-Founder