Safe Niños: Holistic Healing Environments at Concepcíon Campus

Global Health
Social Entrepreneurship

Project Brief

Building upon the conceptual and installation work accomplished in previous Safe Niños studios, this Designmatters studio in the Summer of 2023, challenged interdisciplinary ArtCenter students to co-create with long-time partner COANIQUEM – a nonprofit pediatric medical facility that provides free treatment to young burn survivors across South and Latin America – to design holistic healing environments for a rehabilitation satellite campus in Concepcíon, Chile, the second largest city in Chile.

Students spent time with staff, patients, and the families of COANIQUEM as well as in the Concepcíon facility. Students toured local cultural landmarks of the Biobio region, extremely important to the Mapuche, the indigenous people. Students returned, and in teams, ideated holistic solutions that addressed the needs of all stakeholders and the local community to affordably transform the ordinary building into a place of learning, empowerment and healing.

About Burn Patients and Latin America

Every year, more than 6 million children across Latin America are victims of burn accidents. In Chile alone, 100,000 burn accidents occur, with the majority involving children under 5 years of age; burn injuries are the third cause of death in children under 15 years old.

About 90 percent of burn accidents for children happen at home, even with parents present. Youngsters are burned by hot liquids, open fires, electrical fires, fireworks, and hot elements from heaters and irons. Recovering from a burn – whether small or large – can be painful and often involves extensive follow-up care that can take decades. The process is extremely stressful since many families live in faraway underserved communities.

For survivors and their families, a burn represents a psychological, emotional, and physical scar that changes everyone for the rest of their lives.

“When I talk to parents and children when they are with specialists, I see the children looking, touching and feeling what you have created. I encourage you to continue what you do. This relationship between COANIQUEM and ArtCenter has been life-changing for so many. COANIQUEM has a before and an after – and it’s all because of you.”

Karina Zalavari Palma, COANIQUEM

About COANIQUEM

Since its inception in 1979 by Dr. Jorge Rojas-Zegers, COANIQUEM has cared for more than 100,000 children suffering from devastating and life-altering burn injuries; children and families travel to the Santiago, Chile facility from South American countries and the Caribbean Islands. Because of partnerships and international support, COANIQUEM can offer their services at no cost to families, many who live in poverty.

COANIQUEM treats 8,000 patients annually, with survivors and families living on the facility grounds from weeks to months as they undergo treatments and therapy sessions. The main campus is located in a Santiago residential neighborhood and is accessible by public transportation. Taking a holistic approach, COANIQUEM combines medical attention, restorative healing, and comprehensive rehabilitation programs to treat physical and psychological scars. Trained professionals from a wide range of specializations are part of the COANIQUEM facility: medical doctors, registered nurses, physical therapists, occupational therapists, psychologists, social workers, and music therapists. Teachers at the on-site school ensure that children of all ages who are undergoing treatments keep up with their education.

Since 2013, COANIQUEM has partnered with ArtCenter to create design opportunities that welcome and reassure patients and families; many elements have been installed onsite and are used across additional media platforms.

Research and Project Development

To have a deep understanding of the work and culture of COANIQUEM, students traveled to Santiago, Chile to learn in-person how this nonprofit serves young burn victims and their families. Students had opportunities to meet staff, patients, and parents and hear first-hand what COANIQUEM means to them, especially families who were staying at the on-campus housing, the casabiertas.

Time spent at the main Santiago campus allowed students to observe the current design elements of the Healing Tree (a Safe Niños project from 2016) and how that backstory informed the design to provide patients with a better understanding of the treatment processes. ArtCenter students volunteered in the waiting room, playing and interacting with children. Some stayed at the casabieritas. All absorbed the culture of Chile by touring the capital city’s landmarks, including a stop at one of COANIQUEM’s successful thrift stores, another previous Safe Niño’s project.

Prepared with these experiences, students traveled south to Concepcíon to experience the current facility (the physical building) but also to meet the staff and the patients/families. Since students were divided into four teams, each group had a specific design focus, yet all teams worked together for one holistic final presentation. The four groups included: the backstory inspired by the Healing Tree, the physical layout of the upper story space, casabierta housing design, and creating child-friendly play items.

Instructors infused discussions with the principles of social impact design, showing how design starts with empathy and understanding the human connection, and how co-creation involves designing WITH not FOR the partner. During this research phase, students were encouraged to also look for key opportunities that would provide the most impact in their design-thinking.

As they spent time on this campus and interacting with staff and patient/families, student teams were advised to consider: What do you want to learn here? What will help you back in California?

Their time in Chile also included exploring the surrounding Biobio region and learning about the indigenous Mapuche people; their culture is dependent on the natural world and that connection is necessary for healing from any trauma. Students learned firsthand how incorporating the natural world of Chile into their projects would be valuable.

A workshop with COANIQUEM staff was very informative; students asked about their needs and their on-the-ground experiences which could point a direction for improving their work environment. Interventions, they learned needed to address outside room noise and provide privacy. Teams then brainstormed initial thoughts for their designs, remembering all they have seen, felt, and heard – and how their ideas could uplift and extend the COANIQUEM experience at this location.

Before they left Chile, teams presented their research insights and suggested areas of opportunities to explore; input and comments from the stakeholders gave the students concrete direction for continuing their ideation. It was the beginning of a co-creation process for COANIQUEM and this next cadre of ArtCenter students.

“I think this project was a balancing act. We had to be very resourceful with the decisions we were making, because it is a nonprofit, with a limited budget. We took that to heart and created interesting solutions that would feasible and doable. This made the project more challenging and interesting.”

Venkatesh Akkineni, Spatial Experience Design student

From Field Research to Concepts

Back at ArtCenter, students reflected on what they discovered from their research, especially the holistic philosophy of COANIQUEM and the interconnections of support and recovery. For this studio, ‘holistic’ took on deeper meaning. Four student teams would work together as one unified project; each team would have their own priorities and responsibilities but would be part of one conceptual presentation. Communications between teams would ensure that the project would have one singular voice of design and direction.

Teams set down their objectives and reviewed their priorities: address the needs of the patients (as children and teens), families, and staff by helping empower children; assisting staff with better patient connections; and to create housing to feel like their own homes and communities.

Some post-trip research insights included:

For kids:

Kids arriving with trauma and treatments can be scary; wound dressing room is the scariest part of the treatment.
Kids don’t know the Healing Tree Story since it’s not introduced throughout the treatment.
Pretend play can help kids in overcoming fear of treatment; kids are generally interested in their own healing process. Some treatments are long, and kids can get bored.
Kids enjoy interactive tools.

For teenagers:

Feel like they don’t belong since the space is focused on young children.
Prefer being on their phone rather than interacting with spatial elements.
Music and outer space are favorite topics.
The causes of their burns (engaging in Tik Tok Challenges, e.g.) are different from younger kids.

For parents:

Feel a lot of guilt; think burn accidents are their fault.
In waiting rooms, they are too tired and often don’t pay attention to what children are doing.
Want to understand the treatment and healing process.

For Mapuche:

Nature plays a role in healing.
Proud of culture and want to share it with the world.
Family-oriented.

For staff/everyone:

Introduction of The Healing Tree story is needed.
The Concepcíon campus needs a space where Mapuche families can relax any time of the day.
Space restrictions point to creating multi-functional spaces.
Staff needs a way to connect and distract kids who are fearful.
Create motivation/incentives for kids to continue healing.

“This was my first time collaborating with others and it was hard to let go and trust. Once I did, my amazing team constantly surprised me. That’s a valuable lesson: let go and let other people be involved in my creative process.”

Kelsey Hawthorne, Spatial Experience Design student

Teams considered the feedback they received from the staff at Chile; they sketched out possible next steps and considered how they could integrate their team with the whole group. A journey map of how a patient is introduced to the facility was created from the viewpoint of children, teens, and parents. A strategic direction was formed, along with illustration style and color palette. Teams noted additional research that they would need to accomplish. Students relied on research they conducted on the ground in Chile, such as their sketches, notes, photos, and memories.

A big challenge was for the Story Team to generate the animal characters, story tone, and relationship to Mapuche culture; all important information other teams would need before moving forward. Storytelling needed to dovetail with the actual paths that patients encounter in the facility. The Story Team established the burn treatment rooms/experiences with magical components – an animal, a relatable ecosystem, an associated value/emotion and how all connected.

Teams ideated on how their design could appeal to a child’s senses: what can be touched? Heard? Seen? Students delved into how using sensorial design can effectively tap into a child’s cognitive learning.

Student teams offered up their design thinking for stakeholder and COANIQUEM feedback at a virtual Concept Presentation. Suggestions were positive and kept the students on track moving forward. Comments included: “Think about what small children who are too young to read. How will they understand the story?” “Keep exploring the concepts of AR and VR especially since they are embraced by teens.” “Search for solutions with games.”

In only a few weeks, student teams would be making their Midterm Presentation.

“All of you put your heart, your empathy and your care into this project. The work we do with COAQUIEM can support the physical and emotional healing of patients and their families. You are bringing your skills as designers to help others. It took 14 short weeks to learn something brand new and now we all feel like we are part of one big happy family.”

Penny Herscovitch, Spatial Experience Design faculty

Designing with empathy

As part of their research, teams examined how other organizations – hospitals, museums, etc. – create a welcoming sense for children in their design. A field trip to the UCLA Mattel Children’s Hospital demonstrated how wall illustrations livened up hallways and positively engage patients who would be coming in with various traumas and fearful emotions.

Teams were confronted with a variety of interesting challenges: the Casabierta Team needed to come up with a temporary and cost-effective design since COANIQUEM would be renting the next-door space for their patient lodging. The Toy/Playful Treatments Team decided that the Psychology Room would be a location for an item that could be a conversation tool since children are often shy to talk about their feelings – a playful distraction could open up a child for engagement.

All teams needed to consider that the weather in Concepcion is often rainy and gloomy. Beyond the practical aspects of keeping mud to a minimum inside the facility, teams realized the need to brighten up hallways and rooms with art and incorporate effective lighting and room staging. Student teams prioritized spaces, decided what current elements would stay without any reworking – and what needed to change.

Midterm Presentation

Teams displayed their conceptual design at the Midterm Presentation where representatives from COANIQUEM flew from Chile to be in attendance. ArtCenter faculty, Safe Niños alum, and other stakeholders also listened to the presentation and provided feedback, observations, and suggestions. “Take your very good ideas and make them more functional.” “Have something new and different each time a child comes to the clinic.” “I’m so happy with your work.” “How can you produce more surprises in each space, especially for repeat patients?”

The excitement and acceptance of their direction propelled the students to refine and expand their projects. Teams crafted 3-D models, book mock-ups, floor layouts, and toy prototypes for their final presentation. The Casabierta Team connected with a local Chilean modular system company that took their designs and created technical blueprints and details of which models to rent or buy. Teams also considered the design of furniture and furnishings, the color, size, and materials for all age groups and accessibilities.

“What you do is really important, not only for children, but for us. We work in a better place because of you.”

Karina Zalavari Palma, COANIQUEM

Final Project Outcome

Guests from various departments, Safe Niños alum, and others arrived at the Designmatters Studio where renderings of the Healing Tree animal characters are featured on the door and walls. Inside the room, models and small intricate prototypes are displayed on a table; prototypes of light toys were on a nearby wall. In the corner, the Chilean flag added to the festive mood of the bilingual presentation. COANIQUEM members joined the presentation via Zoom. Each team started their presentation with team members describing their favorite memories of their time spent in Chile.

Outcomes

Healing Tree Story/Characters and Values

Anggie Arivia, Stella Chen, Fabiola De Candido. Skyler Su

Taking its cue from the original vision of the Healing Tree, the Concepcíon storyline weaves in regional animals and magical moments which allow children – and parents – to be familiar with the treatments and to give a sense of empowerment and comfort.

The Healing Journey begins at the birth of the BioBío River, an important tributary of the region, and will end at the Healing Tree. Spatial, physical, and digital imagery will correspond to these story beats. Soft color block style will be used and will appeal to both children and teens. Window decals can filter the outside light creating rooms with a more intimate and private feel – especially on the first floor rooms and entrance.

Additionally, an interactive digital map of the animals and the journey in the waiting room will introduce and welcome patients and visitors. BioBío River imagery on walls of the hallways serves as the connective element, and ‘Easter eggs designs’ – mini LED screens embedded to the wall with motion graphics – are ‘hidden’ for children to discover.

Each room will be assigned an animal guide that embodies the characteristics of the treatment and its values.

Surgery (mountain lion jumping over a waterfall) “Be brave”
Garment Fitting (puda in a tree forest) “Be different”
Physical Therapy (rabbit in a lagoon) “Be active”
Psychology (mice talking to each other) “Let’s talk”
Social Services (penguin family) “Let’s stay together”
In addition to room wall graphics, many rooms will also feature imagery on the ceiling, important for those treatments that require patients be on their backs. Also, to be more attentive to the needs of teenagers, the Wound Dressing rooms (with peacock as animal guide) are split into two design concepts – for children the design will be fanciful and bright, while the room for teens will feature subtle abstract colors and shades.

The Concepcíon Healing Tree storytelling concepts can be incorporated into three physical handout tools – a story kit, a tree book, and a coloring sheet.

Designed in a tree-like shape container, a sturdy cardboard kit is opened to display a colorful place for imaginative 3-D play. A story/sketchbook and map of the BioBío River is folded out depicting the animal regions. The kit also features a back shelf with individual cubbies; children can ‘collect’ small felt Healing Tree animal figurines – handmade by local Machupu artists – and manipulate them on the map.

To appeal to older kids and teenagers, the cover and each page of the storybook features an NFC card underneath that can be activated by a cell phone. This will present the corresponding animal in an augmented reality, a new way to interact with the characters. Story kits can be sold at the COANIQUEM thrift stores, can be given as rewards for patients, and also to thank COANIQUEM partners.

Another physical item is a Tree Book, a children’s board book style, which uses hard paper covering and is shaped like the Healing Tree. Inside story pages include a map and coloring areas. Each book only has six pages, and children can receive the next one in the series once they have finished a particular treatment. Finally, a cost-effective coloring sheet folds out into a map and tells the Healing Tree story. This zine-like item can be directly printed on tabloid size paper and cut and folded into a coloring book. Children can receive it at the front desk.

Spaces

Kelsey Hawthorne, Jingxin Liu, Doreen Zhang

The design of the second floor space addresses practical needs but also promotes a sense of homelike belonging. Nature elements are integrated for a sense of calm and familiarity. Concepts considered construction costs along with removing some non-load-bearing walls to create larger spaces which can serve multiple functions.

A therapeutic garden invites guests to plant a small seed and, over the course of their treatments and visits, to watch how it grows and flourishes. In the waiting room, a wooden tree with spreading branches umbrellas an activity area of vibrant wall colors and animal designs. Window decals let in natural light and tree panels are PET felt for noise control.

The nearby school room incorporates lightweight furniture that can be easily moved around as needed. Doors can be closed during private lessons, or opened so students can play with children in the waiting room. The quiet zone invites parents and children to enter into a replica of the ruka, a traditional hut-like structure of the Mapuche. Here, people can rest and talk quietly. There are various sizes of rukas, one is wheelchair accessible and another has a built-in playpen. Rukas are designed to be made from wood and be easily assembled and installed. For more privacy, fabric with traditional Mapuche patterns can be wrapped and snapped from the inside.

In a corner, two private rooms are set aside for families in the Mapuche culture who traditionally do not spend the night outside of their home. One room is for small children and the other for teenagers. The casino (cafeteria) is designed for multiple functions. It can be easily divided into two rooms or be configured into a meeting space. Overall, indirect lighting can improve the current light conditions and brighten up dark spots. Lighting fixtures are made with PET felt to reduce noise.

Casabierta

Venkatesh Akkineni, Cheng Cui

A lodging facility that feels safe and relaxed, COANIQUEM casabiertas are more than dorm rooms, they continue the healing process. The overall theme will be water as healing, connecting, and relaxing. The layout design, envisioned on nearby leased land, needs to be modular and temporary as well as sustainable for government grants. The current site has four trees with two entries: from the clinic (north) and street (south). In addition to common areas, there will be eight dormitory rooms, all large enough to be wheelchair accessible, and each with separate washrooms.

Families enter the building at a reception station and walk down a hallway where imagery of a large colorful horse near the river represents 'descansa' or 'rest well.' The reception station leads to two common areas: one is relaxed, the other active. Both spaces have an adjoining kitchenette and dining area where guests can enjoy meals, cooked by COANIQUEM staff, and snacks in a communal setting.

The calm Lagoon Courtyard common area features a sky dome above and abstract imagery of flowing water on the walls. Poufs are placed randomly around the room where guests can have one-on-one conversations or singular reflective moments. The larger courtyard common area is under an expansive translucent dome where guests can view the sky above. Guests can rest on a long S-shaped lounge seat across from a mural of a boat on a river – imagery that corresponds to a play boat in a corner space. Children can enjoy imaginative play in the wooden boat; a wavy lighting pattern is projected on the wall giving the illusion of being on the water.

At the end of this courtyard is the school classroom which has its own entryway out into the community; neighborhood kids will be welcomed here for afterschool programs. Toys are arranged on round tables, and colorful mats feature animals from the Healing Tree. Another entryway opens into a calm space with a variety of cushions for sitting or stretching out, diffused lighting, and soft music from a hidden speaker. Down a nearby ramp, guests can walk outside to discover a small but powerful outdoor garden filled with fragrant lavender and other herbs.

Interior lighting design creates warm and cozy environments. Spaces can be made to appear larger using indirect light. The casabierta will have sustainable elements (solar panels, local material use, rainwater harvesting) and will also generate on-site energy (groundwater for heat generation, roof turbines). The Chilean modular system company Techo Fast can provide modules that can be rented or purchased, a very cost-effective route.

Toys

Bob Guo, Doris Tao

To counter the possible memories of the burn trauma and fear of unknown treatments (which can last up to an hour at a time) playful additions can distract a child’s mind to the once again joys of creative play. Healing Tree animals will be reconfigured to be whimsical wall lighting objects. These natural wood creations will decoratively light up a space and can be turned on by clapping hands which also changes colors.

In the Wound Dressing room, the peacock body shape will have shafts of illumination that creates shadowy “feathers” on the wall. Creative designs of penguins and mice depict unique light and color patterns in their “lights.”

In the Psychology Room, a lighted object becomes a tool for the specialist as a conversation starter with children. The storyboard has an illuminated surface and drawing area. Children can choose the mood and background and add to the story with markers. To answer the question, “How are you feeling today?” children can spin a wooden plug on the top of the storyboard that reveals different emotion faces of a mouse.