Monthly Archive: September 2015

How Working in Home Automation Inspired One Developer to Rethink Smart Tech

Twist by Astro LED light bulb and speaker

How smart is the smart home if nobody can understand it? That’s the question that drove Shaun Springer to create Astro, a lighting and audio startup that believes smart home solutions should be as simple as screwing in a light bulb. 

After working for one of the biggest names in home automation left Shaun Springer feeling frustrated by the industry’s inefficiences and high cost of entry, he set out to create hardware solutions targeted to urban apartment dwellers. Astro’s first product, Twist, an integrated AirPlay speaker and LED light bulb, is currently available for pre-order. 

At Dwell on Design NY, Springer will join Ted Booth of Honeywell User Experience and Honeywell Connected Home for the conversation “How Smart is the Smart Home, Really?” on Sunday, October 4 from 11:45 a.m. to 12:15 p.m.

Get your tickets now to join us for three days of stimulating conversations and exhibitions. For more info, and a full list of our panelists, visit this page at

How U.S. Cities Are Making (and Spending) Money

Mayor Rahm Emanuel’s 2016 budget includes a $543 million property tax increase over four years to help with billions of dollars in pension and other municipal debt and repair Chicago schools’ low credit rating. (AP Photo/Christian K. Lee, File)

The fiscal health of U.S. cities continues to improve since a post-recession low of 2010, but revenues still aren’t growing fast enough. According to the new 2015 City Fiscal Conditions report from the National League of Cities (NLC), despite three consecutive years of growth, city budgets are still feeling the effects of the recession, and revenue bases are still below pre-recession levels.

Still, the report says that 82 percent of finance officers say that their cities are better able to meet the financial needs of their communities in 2015 than in 2014. (In its annual report last fall, NLC cited “cautiously optimistic” municipal money managers.) Ending balances have reached pre-recession levels, even if revenues have not.

“This level of optimism amongst finance officers is the highest since the inception of the survey and reflective of widespread, incremental improvements amidst an on-going slow and long recovery,” according to the report.

The increase in ending balances is a sign of smart planning. Conservative estimates show that revenues likely won’t return to precession levels until 2024, and more generous estimates have revenues bouncing back by 2020. Neither of these dates looks promising for a total recovery before the next recession hits the U.S., which economists estimate will occur around 2018.

According to the report, revenues increased 1.3 percent in 2014 and are anticipated to grow .31 percent in 2015, not enough to offset the expenditure increase of 1.5 percent in 2014, with continued growth anticipated into 2015. Here’s a look at where the revenue is coming from and where that money is going:

(Credit: National League of Cities)

Currently, the most constraining factors on city budgets are infrastructure needs (48 percent), employee pensions (38 percent) and employee healthcare benefits (36 percent). It may not be news that America’s infrastructure is in desperate need, but the NLC makes sure to note that half of America’s cities identified “infrastructure” as one of the three most challenging issues facing cities.

(Credit: National League of Cities)

And just how bad is the pension crisis? Across the board, the NLC report predicts more challenging times ahead for cities — though some, like Chicago, are being hit harder than others. Chicago Mayor Rahm Emanuel, of course, has pushed for a steep property tax hike.

Overall, according to the NLC, municipalities may be in an better position to manage difficult circumstances, but they could still use some help.

“Simply because they are able to manage under difficult circumstances does not mean that it will be easy, or without consequence,” the report notes. “In the years ahead, as cities continue to navigate their roles as fiscal stewards, stronger state and federal partnerships will be critical to enabling the fiscal choices that will allow cities to grow, innovate, and propel our economy forward.”

Can 19 Types of Plants Clean Some of America’s Dirtiest Water?

(AP Photo/Mark Lennihan)

Brooklyn’s Gowanus Canal, known as one of the dirtiest waterways in America, a place where scientists sampling the water once found gonorrhea in the murk, is currently playing host to something a bit prettier.

A new “floating island” was launched recently in the canal in an attempt to clean the water. Landscape architect and urban designer Diana Balmori calls the project “GrowOnUS,” and the island includes 19 plant species living in metal culvert pipes filled with plastic bottles.

Fast Company reports the structure is layered with bamboo, woody plant material, water hyacinth rope, shredded plastic, coconut matting and oak cork. The structure should act as a sponge that will filter the water, distilling it and collecting it into a reservoir underneath.

Balmori and the Gowanus Canal Conservancy received a $20,000 grant to make the project a reality. “We think of this as being a productive farm that could serve to feed into farmers’ markets and into restaurants,” Balmori told Fast Company.

(Credit: Balmori Associates)

Perhaps the Gowanus Canal should be viewed more as a proving ground than a gross pool. After all, the floating island isn’t the first fascinating de-polluting solution that’s been proposed.

“We picked the hardest,” Balmori told the Wall Street Journal. In other words, if this works there, it could probably work anywhere.

Artist Evan Hecox covers new ‘Terrain’

Evan Hecox is covering new ground in his exhibition 'Terrain' which opens this week at Andenken Gallery in Amsterdam. American artist Evan Hecox is on the move, from his base in Denver, Colorada in the United States to the Netherlands. He’ll be covering new ground, first headed to his exhibition Terrain that opens this week at Andenken Gallery in Amsterdam, and then continuing on an inspirational journey to Utrecht courtesy of The Jaunt.

Inside the Dollars and Cents of Cleveland’s Latest High-Speed Internet Investment

(Photo by Rob Sinclair)

“Rust Belt cities were shrinking markets, not growing markets,” Lev Gonick says.

The former chief information officer at Case Western Reserve University, in Cleveland, is talking about how, more than a decade ago, the city’s economy was in such bad shape in the de-industrialized-Rust Belt era, that Gonick couldn’t find anyone from whom Case Western could procure a super-high-speed Internet connection. Not one incumbent provider was willing to make that kind of investment in the Cleveland market, Gonick says.

So Case Western and a number of the other large, publicly funded institutions in town, including healthcare institutions, the regional transit authority, public broadcasters and others realized the only way to be sure that they had a digital future was “to chart their own destiny,” Gonick says. As Next City has previously reported, they created their own 100 GB network.

“We took a bet it could actually be a catalyst for Cleveland,” he adds.

Thirteen years and 2,400 miles of fiber-optic cable later, the community’s collective vision got sweet validation earlier this month — in the form of a $50 million private investment in that super-high-speed network they built.

The bigger picture reveals how a community-owned asset has grown up. In a post-industrial Rust Belt, it’s also a Cinderella story with several possible precedents set along the way.

First, the basics: The network started out as a nonprofit known as OneCommunity. With Gonick as CEO, it was a model of cross-sector collaboration.

“It was a unique approach that came from a lot of entities that don’t often talk to each other, agreeing to work with each other,” says Christopher Mitchell, director for community broadband networks at the D.C.-based Institute for Local Self-Reliance. “I alternate between wondering how come we don’t see it more often, and wondering how it happened even once.”

OneCommunity had equity built in from the outset. They sought out universities, schools, hospitals, local governments and other large nonprofits, institutions with a public mission, as their initial customer base. The whole point of the network was to give local Cleveland-area businesses and local governments a competitive edge by keeping a key cost — their monthly Internet bill — relatively stable and affordable.

“If they could start it on their own, they could get together and get that rock-bottom rate,” Mitchell says.

As the network grew, demand started to percolate from customers outside their original mission-driven target market. They eventually accessed seven different kinds of capital to build what became a $200 million fiber-optic network. Online donors. Foundations. Partnerships with universities. Federal stimulus dollars. Bonds issued by the Medina County Port Authority helped build the network. They were among the first to take advantage of federal new markets tax credits. A grant from the U.S. Economic Development Administration allowed OneCommunity to upgrade part of its network, allowing Cleveland to become the first U.S. city to offer 100 gigabit per second commercial Internet, the fastest in the country.

As creative as OneCommunity got, and as quickly as they grew, demand for fiber-optic bandwidth grew faster. The deal flow, the need to raise capital, the day-to-day operations took them further and further away from the work of the nonprofit.

“It led us to fundamentally revisit the business model and ask the question, as a nonprofit chartered in the state of Ohio and as a federal nonprofit to build out the digital economy of Northeast Ohio and assess the community technology needs, was actually owning and operating the network the be-all and end-all of that activity?” Gonick says. “It was the right moment to return to our core mission to grow the digital economy, of which the infrastructure is a critical but insufficient condition.”

OneCommunity and its stakeholders agreed in 2013 that the time came to create a for-profit subsidiary, which they dubbed Everstream, to handle the network business.

“In some ways it was ‘be careful what you wish for,‘” Gonick says.

They didn’t anticipate how much demand there would be once they launched into the for-profit space. Cellular service providers became a huge source of demand — they needed big enough “piping” in the ground to connect the proliferation of cellphone towers to the internet. Your Internet might be wireless for you, but that latest cat video has to travel through the ground somewhere before it gets to you. Regional sports teams, big downtown law firms and financial institutions all came knocking on Everstream’s door.

It was only a matter of time before Everstream took on a large investment in order to meet all that demand — and that’s what transpired this month. With a $50 million infusion of capital, OneCommunity becomes a minority owner in Everstream, with a guaranteed share of revenues as well as two seats on the Everstream board of directors.

Two big risks weighed on the decision to pursue the investment.

The single largest risk, Gonick says, was being able to communicate to community stakeholders why they were taking on the transaction at this time. They had to take time to ensure buy-in from their existing core customers of local governments, universities, healthcare groups, large nonprofits and others.

Second, was finding an investor who could fully understand and appreciate just how complicated OneCommunity had been as a nonprofit network operator. Seven different kinds of funding sources went into building the network, some of them with strings attached — particularly the federal sources of money.

“Could we find an investor prepared to get educated on just how complicated we were and still see their way to the opportunity to ultimately see the rate of return they wanted to realized?” Gonick explains. They did, in the form of Boston-based M/C Partners and investors advised by the Private Equity Group of J.P. Morgan Asset Management.

As a result of the deal, Everstream is moving forward as a standalone organization.

“This transaction allows OneCommunity to leverage the fiber network as a catalyst for growth and an asset upon which to shape a civic agenda around community and business technology priorities in Northeast Ohio,” said Gonick in a statement announcing the transaction.

In terms of the worlds-colliding overlap from nonprofit to for-profit, Mitchell says, “I don’t think I have seen a nonprofit spin off a for-profit network company before. We have not seen a lot of nonprofit networks. A lot are co-ops. A lot are government owned and operated, due to necessity and the ability to access inexpensive capital via bonds to build them.”

When I asked Gonick if Everstream might get certified now as a B-corporation, he said it’s up to their management. Everstream’s incoming CEO is Brett Lindsey, the heretofore COO of OneCommunity.

Notably, there was a flavor of community economic development in Lindsey’s statement when the deal was announced: “This transaction also means more jobs in Cleveland, investment in the network and opportunity for our local partners,” said Lindsey.

Iconic Artist Wendell Castle Talks Contemporary Furniture Design at Dwell on Design NY

Above Within Beyond bronze sculpture by Wendell Castle

“Above Within Beyond” is a bronze outdoor sculpture that was displayed at Friedman Benda’s show “Gathering Momentum” in the spring of 2015.

On Friday, October 2, at Dwell on Design New York, Dennis Miller will moderate a discussion with three industry leaders—designers Wendell Castle, Donna Feldman of Dmitriy & Co., and Jiun Ho. Titled “Contemporary Furniture Design: A Dynamic New Era,” the session will be held at 2:45 p.m at Skylight Clarkson Sq in New York City.

Wendell Castle has been a sculptor and designer for more than four decades. An influential artist, his work has led to the development of handcrafted, modern designer furniture as a major art form. His bold pieces are crafted from rare and beautiful hardwoods, plastics, veneers, and metals. Click through the slideshow to glimpse some of his whimsical creations.

Get your tickets now to join us for the show. For a full list of panelists, see this page of Dwell on Design New York’s website.

Shop Houzz: Modern Goth (46 photos)

A modern goth home isn’t just filled with completely ornate black decor — that would be full-on gothic. And it isn’t just black decor mixed into lighter spaces; that would be more Scandinavian. Modern goth is a devilishly good blend of gothic or very traditional decor and furnishings with clean modern…

Art and Heritage Are Key to Creating Strong Cities That People Want to Live In

Visitors look at Rembrandt’s “The Night Watch” in the Rijksmuseum in Amsterdam. (Photo by David Lichtneker)

Sponsored content from AkzoNobel Art Foundation. from rural areas to live in cities. According to China’s State Administration of Cultural Heritage, more than 900,000 villages have disappeared in the past 10 years as cities prepare for the influx, with high-rise buildings, huge street blocks, industrial parks, multi-lane highways and shopping malls dominating the cityscape of cities from Beijing to Shanghai and Chengdu.

These changing demographics come with a high cultural price. Since 1990, more than 1,000 acres of historic alleys, traditional quadrangle houses and street shops have been demolished in Beijing alone, accounting for 40 percent of the city’s central area. And it’s not just a Chinese problem: Our heritage is at risk of being wiped out in cities throughout the world, for a multitude of reasons and with far-reaching consequences beyond that simply of the physical loss of objects, art or buildings.

But let’s take a step back and ask ourselves first: Why aren’t we protecting our heritage? I believe that, the trouble is, heritage does not really have an owner. Our post-Second World War culture of subsidizing art, culture and architecture has created a negative situation in which, as civilians, we no longer feel responsible for maintaining our collective cultural heritage. This development is compounded by the shrinking civic budgets to support the arts and culture in the wake of the 2008 economic crisis, particularly in Europe. For example, between 2012 and 2013, Dutch government funding for arts and cultural programs dropped 22 percent.

Through AkzoNobel’s Human Cities Initiative, we are trying to redress the balance, encourage citizens to be proud of and embrace their local heritage, and help preserve the places, spaces and objects that make our cities unique. For example, through the AkzoNobel Art Foundation — set up to create an outstanding contemporary art collection for tomorrow’s generation — we open our art spaces up to local communities in and around our sites and offices. It offers people a chance to engage with amazing works of art and inspires them in a way that only art can.

Heritage is not, of course, just about conserving the past; it is also very much about the present and the future. In a 24-hour, always-on digital world — in which people prefer to order their groceries online, rather than venture to their neighborhood stores (according to PwC, almost 6,000 U.K. stores closed in 2014) — local communities are being eroded and people are losing touch with those around them. Art, culture and heritage can bring people together once more, instilling in people a sense of pride and belonging.

More practically, heritage can also help pay the bills. In fact, making it to the UNESCO World Heritage list can increase per capita income by more than 10 percent in certain regions, according to data from the International Monetary Fund. In Amsterdam, where AkzoNobel recently helped with the restoration of the Rijksmuseum, tourist numbers have jumped to 2.45 million, making it the most visited museum in the Netherlands in 2014.

Heritage also attracts talent. Take a look at this year’s Monocle Quality of Life survey — which ranks the top 25 cities in the world that are considered to be the most attractive places to live — and you will see clear trends connecting the success of the winning cities, from Tokyo in first place, to Copenhagen, Vienna, Stockholm, Munich and Zurich among the rest. Yes these cities embrace innovation and enable citizens to reap the full benefits of 21st-century living, but they also put a lot of effort into preserving their historical assets, creating “real” but relevant places where people want to live, work, invest and raise a family.

So the next time a city or government thinks about cutting its culture budget, I would urge them to seriously consider the many additional benefits of having a strong physical and cultural heritage. They will certainly find the consequences go beyond the past and stretch far into the future.

6 Homes with Underfloor Radiant Heating

Outdoor fenced dining porch area in Brooklyn, New York

Adrian Jones lived in his top-floor loft in Brooklyn’s Williamsburg neighborhood for nine years before renovating. For a bachelor set designer, the 2,500-square-foot space was perfect: plenty of room for his studio and collections of books and art, big windows affording city views, and exposed brick tagged with graffiti. When the door to the deck is open, air flows unhindered from the kitchen to the living room. Garrick expanded the apartment’s radiant heating and added a high-efficiency Fujitsu Halcyon ductless forced-air system for cooling. The radiant-heating system’s pipes and gauges hide in a closet.



Photo by Kevin Cooley.

2015 MacArthur “Geniuses” Work on Poverty, Inequality, Jobs

LaToya Ruby Frazier is among the 24 MacArthur “Genius” fellows, class of 2015 (Credit: John D. & Catherine T. MacArthur Foundation)

The newest MacArthur “Geniuses” were named yesterday. Each year, the MacArthur Foundation selects fellows for $625,000 grants, with the intent of helping everyone from problem-solvers to artists pursue their own creative and research projects. Of this year’s 24 new grantees, here are some whose work has a particular focus or impact on cities. (MacArthur also provides funding support to Next City.)

Matthew Desmond is an urban sociologist at Harvard University whose work has focused on the impact of eviction on the lives of the urban poor and its influence on racial and economic inequality. His Milwaukee Area Renters Study looks at the intersecting world where landlords, local government, city police and renters meet.

Desmond has a new book coming out next year, Evicted: Poverty and Profit in the American City, that tells the story of eight families that are living in poor neighborhoods in Milwaukee and struggling with crime, drug addiction, disabilities and paying the rent.

The researcher spoke to the Harvard Gazette after MacArthur’s announcement.

Tackling what he called “some of the most morally urgent questions of the day” is Desmond’s goal. …

Desmond said that the so-called “genius grant” couldn’t have come at a better time. His teaching and research focus on urban sociology, poverty, race and ethnicity, organizations and work, social theory, and ethnography. He … is beginning two projects. One will continue his work on housing, looking at eviction on a global scale, and the other will examine the child welfare system.

Juan Salgado (Credit: John D. & Catherine T. MacArthur Foundation)

In Chicago, grant winner Juan Salgado is the president and CEO of Instituto del Progreso Latino. He helps immigrants navigate the working world in the U.S., and the Institute’s reach has grown to a national scale, providing technical assistance to similar groups in California, Texas, Minnesota and Indiana.

According to the Chicago Tribune, Salgado’s main goal is to help low-income workers carve a path to higher-paying jobs through education.

“In our work, you do the mission to achieve the mission,” he told the Tribune. “You need resources, and you need an audience of people who understand the work you’re doing. At the end of the day, you want to make as big a dent in the world as you can. This (award) means more people are going to know about the dent you’re making.”

Photographer LaToya Ruby Frazier has focused much of her work on the decline of Pennsylvania steel town Braddock, outside Pittsburgh. Portraits of the city as well as herself and her family seek to capture the social inequality and historical change in light of environmental changes, economic downfall and healthcare problems in the region.

Kartik Chandran (Credit: John D. & Catherine T. MacArthur Foundation)

Environmental engineer Kartik Chandran works on how the harmful environmental impact of wastewater can be mitigated with certain microbes. In addition to engineering source-separation sanitation in rural Ghana, he is also developing training opportunities for engineers in the city of Kumasi, and testing a project that makes biofuel from sludge.

Patrick Awuah founded Ashesi University College in his native Accra, Ghana, after working at Microsoft in the U.S. Beyond implementing studies in technology and engineering, Awuah also helped set Ashesi apart by creating an honor code for ethics, the first of its kind in any African university.

Ta-Nehisi Coates is a journalist whose work focuses on race and racism in America. Last year, he wrote “The Case for Reparations” for the Atlantic, which focused on the history of discriminatory housing policies in Chicago.

Why Houston’s Politicized Drains Could Be Any City’s Drains

Cars stranded on a flooded section of Interstate 45 after heavy rains in Houston (AP Photo/David J. Phillip)

From giant alligators to cannibalistic humanoids, horror movies have long promised that the contents of our sewers will catch up with us. But outside Hollywood, mayoral hopefuls should worry less about fanged clowns peering out of their gutters and more about the gutters themselves. It’s election season and municipal politicians beware: Your drainage infrastructure is out to get you.

Case in point: Houston.

Houston, as I wrote in August, is a place where the phrase “controversial drainage initiative” is a thing. Houston’s drains — and the crusade to fix them — haven’t just made an appearance at the Texas Supreme Court, they’re also helping to guide November’s election. And because the controversy surrounding them involves so many familiar players in the Annals of Crumbling Infrastructure, from a history of deferred maintenance to an allegedly misleading ballot initiative, Houston’s drains today could be all our drains in years to come.

The story starts on November 2, 2010, with the 51-49 approval of the Proposition 1 charter amendment. According to city documents, that vote OK’d the creation of a “dedicated pay-as-you-go fund for improving and maintaining streets and drainage.” Funding sources would include development impact fees, property taxes and a drainage fee that would collect a minimum of $125 annually.

It’s that drainage fee that has Houston on the hot seat. But first, a word about the vote on that ballot initiative.

In 2009, the American Association of State Highway and Transportation Officials (AASHTO) co-released a report with the transportation research group TRIP. Using Federal Highway Administration data, researchers published a list of pavement conditions in urban areas with more than 500,000 residents. Twenty-nine percent of Houston’s roads were found to be in poor condition. Of the 75 metro areas listed, it ranked among the top third for that unflattering title.

The drainage system built into those roads needed work too. In short, as Mayor Annise Parker recently told NPR affiliate WBUR, the city had multiple decades of deferred maintenance “coming home to roost.”

Officials hailed the vote that established the program now known as ReBuild Houston as a way to fund that maintenance. And according to Janice Evans, chief policy officer for the Mayor, it’s doing just that.

“The program has resulted in millions of dollars of completed projects since its inception earlier in Mayor Parker’s administration,” she writes in an email. “Without it, the city would be hard pressed to finance these necessary improvements.”

The controversy, which has recently taken the form of Supreme Court case 13-0047, concerns the language presented to voters in 2010.

Soon after the vote, a group of petitioners filed suit asserting that the ballot had been misleading. Central to their argument was the fact it hadn’t described the drainage fee, even though published city documents and media reports did. That missing information, they claimed, made it “impossible to discern the extent of the new financial burden on Houston property owners.”

Andy Taylor, of Andy Taylor & Associates, the petitioners’ legal representative, did not return my calls to his office and cell phone. But in June, Supreme Court judges affirmed his clients’ argument, stating that by “not describing the nature of the drainage charges, the ballot language omitted a chief feature of the proposition, thereby violating the common-law standard governing ballot clarity.”

According to Evans, the ruling won’t affect whether the city keeps collecting a drainage fee — a statement that some have questioned. Whatever happens, the lawsuit has cast a long shadow on this year’s election. City Council Member Stephen Costello, who helped pass the initiative that would become ReBuild, is now running for mayor. And that particular piece of history isn’t doing him any favors, at least with conservative opponent Bill King.

All of these pieces, from the history of deferred maintenance to the allegedly misleading ballot, are specific to Houston. But it’s impossible not to view them against national data and headlines from other cities. Texas has built more highways and bridges than any other state, but will fall $170 billion short of its maintenance needs over the next two decades, according to an investigative dive by McClatchy DC. And, as I’ve covered before, across the U.S., we’re statistically terrible at fixing our infrastructure, usually opting to build more instead.

In other words, Houston isn’t so unique. Watch out mayoral hopefuls. Your own controversial drainage initiative could be just around the corner.

Quick Tech Fixes Can’t Solve All Healthcare Problems

(Credit: Kilimanjaro Center for Community Ophthalmology)

Often, public attention gravitates to simple fixes to large-scale problems — with reason, as such solutions are appealing, and sometimes they work. But a recent flurry of projects is supporting health through complex packages of solutions, including an organization supporting vision in Africa, a tech project in South Asia and even part of America’s Affordable Care Act.

In global health and development, is complexity the new simplicity?

Peter Courtright thinks it is. He’s one of the founders of the Kilimanjaro Centre for Community Ophthalmology, a project that just won the prestigious Antonio Champalimaud Vision Award for innovations in eye care. Since 2001, he and his collaborators have been expanding the capacity of healthcare facilities in sub-Saharan Africa to address patients’ visual health.

The help is sorely needed. Like people everywhere, Africans often experience worsening vision with age. Along with this issue comes a range of visual disorders in excess of the ones that trouble Western people: loss of vision from undiagnosed diabetes, for instance, and trachoma, an infectious disease that causes the eyelids to turn inward and blind the eye. (The latter has been eradicated in most countries outside of sub-Saharan Africa.) As is the case with most healthcare specialties, Africa has far fewer providers than are necessary to treat all people who need care.

KCCO (and the partners with whom it shared the prize, the Seva Foundation and Seva Canada) isn’t alone in attempting a fix for the problem. But their approach differs from the simple fixes — like adjustable glasses or a smartphone-mounted eye-testing device — that global health projects sometimes offer. While those can generate a positive impact, KCCO’s collaborative Kilimanjaro Project instead provides a multipronged program that aims at increasing care by increasing the capacity of existing African clinics.

“We don’t provide clinical care,” Courtright says. Instead, the project encompasses research, training, technical advice and evaluations meant to help existing healthcare facilities provide better eye care to their patients. The project’s wraparound approach can allow a neat complement to simpler innovations, as it can theoretically move useful tech solutions to the right place and right population at the right time.

“We do look at it as a comprehensive model,” Courtright says.

KCCO’s approach to providing care might be unique among sub-Saharan African visual health projects, but it is not unique in healthcare worldwide. In America, for instance, the changes triggered by the passage of the Affordable Care Act included a massive gamble on a concept called ““care coordination.”

The method, invented by Sri Lankan-American physician Rushika Fernandopulle, aims to reduce healthcare spending by better managing chronically ill patients with high costs. To address the complexities these patients experience — often a mix of long-standing disease, acute social stresses and difficulty navigating an inefficient healthcare system — Fernandopulle constructed a team of dedicated practitioners to collaborate with each patient. These providers, termed “care coordinators,” try to remove every hurdle blocking a patient’s best health outcomes. The end result is often healthier, happier patients and lower expenditures. (Disclosure: In the past, I’ve worked on care coordination projects for Illinois Medicaid.)

Care coordination, like the KCCO model, is simple only in that it unites a huge and varying array of problems under one large umbrella. The model is out of step with the trending, simple tech approach to solutions, like a $100 laptop held up as the answer to an insufficient education for millions of children. Courtright says, “People want to hear simple stories,” and notes that it’s sometimes been a block to KCCO’s development.

Yet, as KCCO’s prestigious award suggests, complexity might be the new global vogue. Earlier this year, former Microsoft programmer Kentaro Toyama published Geek Heresy, a kind of confessional-cum-manifesto about technological solutions to global problems. Identifying himself as a “technology addict in recovery,” Toyama builds his conclusions around the five years he spent researching and implementing technological innovations for global development in India.

The book doesn’t discount the value of simple fixes, some of which are undeniable (many people in Kibera, a slum in Nairobi, Kenya, for example, wouldn’t mind having a smartphone and an emergency number to call). But, using an example of an organization called Digital Green that worked by combining new technology with high-touch, person-to-person communication, Geek Heresy agitates against believing overly simplistic, one-note fixes — what Toyama calls “packaged interventions” — are enough.

“What isn’t a packaged intervention?” he writes. “The caring attention of a good teacher. Citizen participation in a protest march. The capable execution of a vaccination program by a well-managed healthcare system ….” Even the best technological solutions, he concludes, must be implemented by embracing “the importance of heart, mind, and will.”

Courtright agrees. “Unless you have good leadership or the potential for good leadership and team management in place, you can throw in all kinds of money and not get much out of it,” he says. By promoting human wisdom and connection, “We help places become productive and to expand their service selections.”

The Champalimaud Award committee believes in the value of the approach. But does a person in need agree?

At least one does. I met 34-year-old Michael Kazala on a street corner in downtown Nairobi, where he was sitting on an upturned bucket and cradling a guitar. With his head tilted towards his instrument, it was hard to see his face. But when he looked up, his eyes – one socket empty, and the other bearing a cataract-blinded, rolling eyeball – were striking.

“I lost my sight from the measles,” at age 10, he said. Bright, upbeat and not lacking in ambition — he’d like to tour the U.S., he said, playing clubs — Kazala was nonetheless badly hobbled by the aftereffects of a disease that could have been prevented with a cheap, simple technology: a vaccine.

Only complexity would make up for its absence. Living in the street, he relied on the sole job he could do, blues busking. He could readily list the help he needed, including comprehensive medical care, disability assistance and support in securing housing. But he said the healthcare system continued to offer him little.

What he was describing seemed to encompass both simple technologies and the wise implementation of them; the back-on-your-feet effort of care coordination; and the comprehensive approach to visual health that the Kilimanjaro Project helps primary care clinics provide. “Everything,” Kazala said, summarizing his needs in the simplest possible terms.

Smiling into the twilight he could not see, he said it once more for emphasis: “Everything.”