November 20, 2019

Meet Designing Shelters for Dignity

Coffee with the Cohort: Meet Designing Shelters for Dignity

I sat down with Elena Clarke and Laila Fozouni from Sasaki Foundation Design Grants project Designing Shelters for Dignity. Their project focuses on the belief that everyone has the fundamental right to safe and accessible housing, though they acknowledge this will take a massive cultural shift and in the meantime many without homes are suffering in dehumanizing and degrading living conditions. Elena and Laila believe design and community involvement can significantly improve the well-being of individuals residing in homeless shelters, at very little cost.

Alicia: I’m so excited to chat with you both today! First, tell me, what was the biggest inspiration behind your project?

Laila: Though I’m not a designer, a significant experience made me start thinking about shelter design. When I was working at a shelter in Boston, I was getting a tour and we walked by the bathrooms, and the bathroom stalls had no doors on them. I was shocked and upset. When I asked why this was the case, I was told this was a safety precaution so people weren’t injecting drugs behind the doors. I was also told it’s a burden on and traumatic for the staff to deal with overdose. Because of all of these concerns, they had to remove the doors. 

For whatever reason, this bothered me for several months: so much so that I changed the focus of my research at the Harvard T.H. Chan School of Public Health to research about injection drug use in public bathrooms. As part of this work, we looked at various design interventions for bathroom stall doors that would promote the safety of those who rely on public restrooms, without degrading them.

I also went to one of the most infamous refugee camps in the world, Moria Camp in Greece, and saw how there are so many overlaps with shelters in terms of design flaws: the space is degrading, individuals lose autonomy, the showers are problematic because they are unsafe for women since they are in dark, secluded areas, et cetera. There are just so many design flaws that make people in these camps and shelters miserable.

Elena: When I was in Italy, it was right around this intense election, and there was a lot of tension. I lived next to a reception center for refugees. I speak French, and a lot of refugees were from West Africa; we talked a lot after they arrived, and they would tell me there was this perception that time and space were stolen from them in having to wait all day at the reception center, feeling lost in the city, like they weren’t important.

When I got to the Harvard Graduate School of Design, I started looking at the social determinants of health as this overlay on the map of the city. You can look at the demographics in the city and the spatialization of these demographics, and if you overlay the health issues that people are having, there is this distinct pattern that goes into the overall framing of everything. If you look at the social, political, and economic exclusions and the way these exclusions affect certain demographics, this is what is creating health issues with certain populations.

This notion is what got me into a hackathon, where I ended up meeting Laila. At the beginning, the organizers asked everyone to pitch an idea, and Laila was talking about the physical aspects of the shelter space; her idea tied into a lot of the work I was exploring, and here we are!

Alicia: What is one of your favorite things about your work specifically on this project? What lights you up as you’re working on this project?

Laila: So frequently with displaced populations, we treat them as if they are helpless and that they need us to serve them in a way. We don’t see them as resilient, which is actually what they arenot vulnerable. I’m really excited about the idea of working closely with people who are experiencing such intense difficulty and having them take the charge on this project by giving them the opportunity and space to have their own agency, as well as identifying what they think they deserve, which in my opinion is obviously way more than what they’re getting.

Alicia: A point you mentioned before that really stuck with me was the fact that shelters had to put doors on the stalls because if someone did overdose, it would be a burden on the staff. Of course that would be traumatizing, but the fact that someone was going through so much that they resorted to injection drug use or possibly lost their life seems to be more of an issue, in my opinion. That just really stuck with me and I think it speaks to your point about giving these populations their own agency and giving them a voice.

Laila: Absolutely. If you ask someone at a shelter, they may say this protocol is meant to protect them from overdosing, as well as to alleviate the burden of overdose on staff. Again, we want to acknowledge how difficult it is for people who are working at shelters, and that it is really traumatizing for people to witness overdose. But we think that there are ways to address both challenges that don’t degrade those who rely on public restrooms and facilities. We want our project to address both aspects of staying at shelters and working at sheltersit’s exhausting and challengingbut I think so often we end up sacrificing the needs and the dignity of these groups of people because it’s easier to just remove the doors so you can see if something happens, rather than implementing all the interventions you can do: including having outward-opening doors, shorter doors, anti-motion detectors, monitoring bathrooms, et cetera. It penalizes everyone who uses public restrooms, not just people who inject drugs. For people who don’t inject drugs and just want the dignity of using the bathroom in privacy, they can’t do that anymore, and that’s just not fair. 

Elena: To your point about agency, I was reading the way shelters and reception centers are described in Italian law, which says they are for persons who cannot autonomously take care of themselves. I think this right here is the issue. Italian law is framing this issue in a way that almost cripples and inhibits people from getting back on their feet. It creates this division of people who can take care of themselvesthose who are in chargeand people who are, according to Italian law, not in control of their lives. That divide is something we want to bridge.

Laila: French philosopher Pierre Bourdieu coined this concept of “symbolic violence” that has been discussed a lot in the setting of injection drug use; it’s where you basically internalize the stigmas of society and see yourself in the way that other people see you. For example, an establishment can take an intervention to install blue lights in bathrooms because it makes it harder to see veins. But these blue lights make it really
dangerous to inject drugs because it is so challenging to do so, and studies have shown that people will still try to inject in these settings out of desperation. Even though they have been shown to increase harms and not really deter drug use, people who inject drugs still believe it’s appropriate for establishments to install these lights, because they themselves think it’s wrong to inject in these bathrooms. That’s the result of stigma; they have this perception that addiction is a moral wrongdoing, and people have internalized that and said “it’s morally wrong for me to be doing this,” instead of saying “I’m suffering from a really serious disease of addiction.”

Elena: In the United States, it is hard to decouple mental health and homelessness; often times the order is mental health issues, then homelessness. After talking to many individuals in Italy, I came to realize they are able-bodied young men in their 20sa lot of them were economic migrants who weren’t getting refugee statusarriving and then getting traumatized as a result of living outside for three to five years as well as getting woken up and beaten by cops. People wind up on the street for various reasons, but being there and the way people treat you is degrading, which takes a toll and makes it tough to break out of something as traumatizing as this.

Laila: People on the street drink alcohol to stay warm, they do meth to stay awake at night so they don’t get assaulted, etc. They develop a lot of habits as a consequence of their experience or to detach from a horrific experience. It’s a chicken and an egg problem. When people are put into this desperate poverty, the outcome is nearly always the same.

Alicia: So, say you go through this and propose design concepts that will be dignifying for people in shelters, and these concepts get implemented, and fears that people have (for example, people using the bathroom to inject drugs) don’t come to fruition, and people are actually treated with dignity and enjoy their surroundings. Are others going to be able to take this model and replicate it in their communities? Does a more dignified design of a shelter exist somewhere that you know of in the world?

Elena: I don’t know that this exists anywhere in the world. I know there are nonprofits who are aiming to empower communities, but unfortunately there is this strange giver-and-taker power dynamic that undermines the whole concept of empowerment and promoting autonomy. If you treat people like they’re going to make a mistake, often times they do; it’s a self-fulfilling prophecy.

Laila: I agree. A lot of these power dynamics are so deeply embedded, but this is an inevitable aspect of the world we live in. We create class and poverty, even in the language we use: homeless versus living outside of a home. 

I’ll also say, in hindsight, this community space that I saw in Greece created a place where everyone was responsible for something. They were treated as humans rather than refugees or people needing to be served. They acknowledged that these people have rich backgrounds. That is a successful model in my mind.  

Alicia: What are the aspirations you have for this project and the impact your work will make on your community?

Elena: Often times people just reproduce what’s already been done because that is the accepted model. They don’t want to critically look at the task or issue at hand and spend the effort to be more creative. The hope would be that all the successful implementations can add up to a new, successful, scalable model.

Laila: If we are able to do this in a cost-effective way and have a dramatic improvement, and collect data on the improvements to the quality of life and to staff burnout, and if we can get the community engaged, it can force community members to reflect on stigmas. How is it that we are allowing people to live like this in the first place, in one of the wealthiest countries in the world? How is someone supposed to have a job when they’re sleeping somewhere as traumatizing and as degrading as a shelter?


If you’d like to connect with folks from the Designing Shelters for Dignity project, please send an email to


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