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Long journeys require a courageous first step: A Dream Session with Médecins Sans Frontières

The long journey of migrants, marching onward from danger to hope, is fraught with perils and horrors.

April 25, 2019

This post is one in a series focusing on the second networking group of NetHope members participating in IDEA (Imagine, Design, Execute, Assess), a broad umbrella for digital transformation processes offered to NetHope members through The Center for the Digital Nonprofit. The first IDEA implementation pilot was based on Dream, Design, Deliver, a social impact accelerator developed with Microsoft.

By Jean-Louis Ecochard, The Center for the Digital Nonprofit, NetHope

The long journey of migrants, marching onward from danger to hope, is fraught with perils and horrors.  Now imagine how much more hellacious this journey is for someone in need of regular medical attention.

Even routine treatment many citizens of Western nations take for granted become Augean ordeals. Take Adnan, who needs hypertension treatment, and Benish, who needs maternal care for her baby including routine vaccinations. During the three years their migrant journey will likely last, they will struggle to obtain basic medical services along their route, and expand great efforts and expenses to get them.

The challenges of mobile patients, common to so many migrants, is what Médecins Sans Frontières/Doctors Without Borders (MSF) set up to tackle.

“We know that in the health system there is a power imbalance between patient and provider. How might we re-balance it for patient data?” asked Abiy Tamrat, Medical Technologies Coordinator, at the onset of the workshop.

To work on this challenge, a diverse team of global leaders coordinated by MSF’s Geneva Operational Center, empathized with migrants and care providers and developed journey maps. In this context, journeys are very different from those of migrants.

In design thinking, a journey map is a visual diagram depicting the stages patients and providers go through when interacting with steps in the continuum of care. For patients, this can range from the public health system of their home country, to the medical assessment of their destination nation(s), and in between, receiving services in the care centers of MSF, other NGOs, governments and UN agencies. For providers, it can be managing the stress of high workloads, communicating with traumatized patients with different languages and cultures, and having access to the right medical records. These journeys map the emotional oscillations that people go through, between the positive ones of rescue and relief, and the negative ones of stress and sorrows.

For two intense days, under the facilitation of Theron Kelso and Ryan Risley from Wipfli, more than 20 leaders gathered at the Impact Hub Genève. Microsoft’s Tech for Social Impact, who is sponsoring these workshops, joined in and engaged. As a coworking and innovation space for social entrepreneurs, the Impact Hub is well suited to this design thinking workshop. 


To be successful, design thinking demands that participants be empathetic and authentic, qualities that the MSF team brought in abundance. Together, in small groups we all underwent our own journeys of imagination, with Post-Its and markers in hand, to devise a more positive experience for patients and providers.

As Lao Tzu wrote, “A journey of a thousand miles must begin with a single step.” Like migrants deciding to go on the move, MSF is taking the first courageous step in addressing the challenges of the mobile patient.

Read more about other Dream Sessions:

Dream books have been posted for the following organizations:

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