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Antimicrobial Resistance: The Need for Arts and Humanities

Victorian print of cholera-infected water pump
'Death's Dispensary': a Victorian print of a standpipe with cholera-infected water

In 1842 Edwin Chadwick was commissioned to inquire into the state of public sanitation. He concluded that:

'medical officers consider [death by disease] to be most powerfully influenced by the physical circumstances under which the population is placed - as external and internal condition of their dwellings, drainage, and ventilation'.1

Only 12 years later in 1854, the physician and a founder of epidemiology Dr John Snow, having used novel approaches in studying the outbreak of cholera, established that cholera outbreaks clustered around a specific water source (a water pump in Broad Street in Soho, London).

These examples of Chadwick and Snow demonstrate how built environments and human behavioural patterns have had a direct impact on the spread of disease and public health.

Although the challenges faced today are significantly different, the need for investigation into public health challenges such as Antimicrobial Resistance (AMR) from an arts and humanities perspective continue to be vital.

In under two weeks, the cross-council AMR call closes. The AHRC's Design Fellow, Professor Paul Rodgers, tells us why it is still vital for the arts and humanities to be involved in the discussion.

"I have been involved in a number of projects over the last four to five years that have concerned the health and wellbeing of people," Prof. Rodgers tells us. "In particular, my work has focused on developing disruptive design interventions in health and social care contexts. I have explored the concept of truth in mobile health platforms, challenged pre-conceived ideas surrounding what people living with dementia are capable of, and investigated the demanding role of carers".

Photograph of Prof. Paul Rodgers
AHRC Design Fellow Prof. Paul Rodgers

We asked Prof. Rodgers how design has played a crucial role in the improvement of human health.

"One example that springs immediately to mind is the design of Maggie's Centres, built in the grounds of NHS cancer hospitals throughout the UK", Prof. Rodgers said. "Maggie's Centres provide amazing practical, emotional, and social support that has been shown to improve the physical and emotional wellbeing of people living with cancer, and their families and friends. The UK Government's Department of Health has described the work of Maggie's Centres as an example of best practice."

"Another example is the new  GHESKIO Tuberculosis Hospital, designed by MASS Design Group", continued Prof. Rodgers.

Completed in 2015, the GHESKIO Tuberculosis Hospital located in Port-au-Prince, Haiti, replaced the multi-drug-resistant tuberculosis (MDR-TB) facility, which was destroyed in the devastating earthquake of 2010.

"MASS Design Group are a not-for-profit organisation based in Boston, Massachusetts, USA. The GHESKIO hospital will provide TB patients who are still being housed in temporary tents with an effective and dignified place to stay for the duration of their long-term treatment. The GHESKIO TB hospital's simple but effective design methods of passive ventilation and infection control will be used to reduce in-hospital transmission of TB in this high-risk population, as well as reduce energy costs for the facility."

Maggie's Manchester
Maggie's Manchester, designed by Norman Foster, opened in May 2016

"There are many other examples where designed products, systems, services, and environments are improving human health and wellbeing. Crossick and Kaszynska's recent report Understanding the Value of Arts and Culture: The AHRC Cultural Value Project (2016) has highlighted a number of art and design projects where significant improvements in health and wellbeing have been achieved through the creation of enhanced healthcare environments, designed interventions to improve social inclusion and mental health2, and the benefits of engagement via co-design processes for older people and those living with dementia3".

As was understood by Victorian health researchers like Chadwick and Snow, clearly the AMR challenge is not just one found in medical establishments to be tackled by medical professionals.

"In my opinion," said Prof. Rodgers, "researchers based in the arts and humanities can bring different and valuable perspectives to the challenges commonly found in medical establishments. In particular, the tools and approaches used by design researchers can offer much to AMR challenges. This includes the creative, analytical, highly visual and practical ways of working such as co-design endeavours, model-making, scenario-building, and prototyping that design researchers commonly use. Design researchers bring excellent analytical skills, and they also possess valuable synthesis abilities. That is, the skills in being able to visualise and model future visions, and evaluate and test these effectively."

Rounding-off the case for arts and humanities in the AMR challenge, Prof. Rodgers drew to a firm conclusion.

"Design is crucial to all aspects of modern life. It has always aimed to make the industrialized world both human and habitable, as well as to generate a better quality of life within artificial environments. Design permeates everything that we do. In terms of its genesis, design has always been deeply concerned with all parts of contemporary life: with economy as well as ecology, with traffic and communication, with products and services, with technology and innovation, with cultures and civilization, with sociological, psychological, medical, physical, environmental, and political issues, and with all forms of social organization.4"

"Design needs to be at the core of any research pursuit aiming to tackle the major AMR challenges we currently face."

Interested in applying? Find out more about the call 'AMR in the Real World: The Indoor and Built Environment' call here.


1. Chadwick, E., Report on the Sanitary Condition of the Labouring Population and on the Means of its Improvement, London: May 1842

(Retrieved from:http://http://www.deltaomega.org/documents/ChadwickClassic.pdf)

2. Daykin, N. and Byrne, E., The Impact of Visual Arts and Design on the Health and Wellbeing of Patients and Staff in Mental Health Care: A Systematic Review of the Literature, Centre for Public Health Research, University of the West of England (Retrieved from: http://eprints.uwe.ac.uk/4829), 2006.

(Retrieved from:http://eprints.uwe.ac.uk/4829)

3. Rodgers, P.A., “Designing with People Living with Dementia”, Proceedings of the 3rd European Conference on Design4Health 2015, Sheffield Hallam University, UK, 13 - 16 July 2015, ISBN 978-1-84387-385-3.

4. Rams, D. et al., ”The Munich Design Charter”, Design Issues, Vol. 8, No. 1, 1991, pp. 74 – 77.

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