Set amid volcanic hills, the northern province of Burera is an impoverished area of Rwanda. Before 2011, its 350,000 residents lacked access to adequate health care, living in one of the last Rwandan health districts without a hospital. Today they have one that is an aesthetic wonder. With intricate stone walls fashioned by local masons, the cluster of buildings that make up Butaro Hospital is bright and open, flooded with light and suffused with air from the natural wind paths in the valleys below. In a region with basically no medical infrastructure, Butaro provides 150 beds, a maternity ward and neonatal intensive care unit, two operating rooms, and such basic, necessary services as internal medicine and pediatric care. It cost $4.4 million to build—about $30,000 per bed, compared to the more than $1 million per bed that new US hospitals cost.

A product of the MASS Design Group, a Boston-based architecture firm cofounded by Michael Murphy, AB’02, Butaro melds a modern architectural and social sensibility with lessons from the history of hospital design. That inspiration is particularly realized in Butaro’s open, or “Nightingale,” ward, which forgoes the hermetically sealed design of modern hospitals in favor of a pavilion filled with natural air and light. The buildings of Butaro are connected by outdoor walkways and use natural ventilation instead of air conditioning, creating more sanitary conditions as well as a more beautiful and human-scale setting. The building, said a New York Times op-ed in 2012, “has set a new standard for public-interest design.”

And the hospital’s construction—during which MASS hired more than 3,500 local Rwandans to help build it, training them on site—created a local masonry industry that has become self-sustaining. Taken as a whole, the effects on local health, employment, and the community look to many observers nothing short of miraculous.

Murphy, MASS Design’s CEO, believes that architecture can play a critical role in untangling the cluster of problems that bedevil society, from health care to education to the quality of urban life itself. Designated by the Atlantic as among nine people whom “tomorrow’s historians [will] consider today’s greatest inventors,” Murphy has cultivated his preoccupation with architecture’s relationship to social justice since graduate school. MASS, which refers to itself as a “social enterprise,” is a nonprofit working in typically capital-intensive, competitive architectural markets. Investing its intellectual capital in projects that often don’t seem economically viable—a cholera treatment center in Port-au-Prince, Haiti; the resurrection of deeply depressed American towns—serves two company objectives, offering beautiful, functional remedies to social problems at a local level and proving that such investments can be profitable.

MASS Design’s office is located in Back Bay, at the corner of Boylston and Arlington Streets, near Boston’s Public Garden. The office exudes the low-key nonchalance of a start-up. The wood floors are worn and over the ambient street noises of horns and trucks, the clang of the radiators punctuates conversation. Models of the firm’s larger projects are on display. The front of the office feels sedate and calm, almost uninhabited. The back of the office hums with activity; about 30 people currently occupy the space, most of them working alongside each other.

On a bright, cold morning in November, Murphy and three colleagues, Michael Haggerty, Brendan Kellogg, and James Martin, are discussing their recent work for a symposium led by the Center for an Urban Future. The presentation reimagines New York City’s increasingly obsolete public branch libraries as more vital, well-used spaces. One of MASS Design’s meeting rooms has been turned into a workspace for the project, and dozens of photographs and sketches of four New York Public Library branches and their surrounding communities.

Murphy and his team returned to the lessons learned in Africa and applied them to these economically challenged areas of Brooklyn. The result was, in Haggerty’s words, “south to north”: ideas and practices developed in the resource-poor areas of the global south were brought to bear on the comparatively wealthy neighborhoods of Brooklyn. The study took months and multiple visits, accounting for the “life and rhythms” of the branch libraries, identifying “what stood out as unique, given the characteristics of the surrounding community, the personalities of the staff, and the limitations and potential of the physical building.” That process mirrored the one they followed when planning Butaro: months of immersive research into the community’s needs before plans were finalized. The methodology is as much anthropological as architectural.

In Sheepshead Bay, MASS recommended redesigning the library to emphasize additional cultural events. A Coney Island branch called out for a space to accommodate nutrition and health services.

To be clear, this was merely a design study—MASS received a modest amount of money to think on the library system and then present its findings alongside several other firms at a December meeting with representatives of Mayor Bill de Blasio’s administration in attendance. The potential to contribute to the political discussion about the future of civic amenities in one of the nation’s greatest cities was too tantalizing to pass up. “It fits very well into our work,” Murphy says, “which is how do we use architecture to initiate or instigate significant policy change.”

The majority of the company’s work focuses on the developing world. MASS’s most recently completed projects are in Haiti: a tuberculosis hospital and cholera clinic. As with Butaro, MASS recruited local labor to build the facilities in Port-au-Prince. The new buildings are cast in elegant white and blue, and they employ the Caribbean wind for ventilation and infection control. They’re as beautiful as they are useful.

And their usefulness can’t be overstated.

The cholera clinic, in particular, is a public health feat. In a country where 38 percent of the residents lack access to clean water—cholera depends on dirty water to spread and thrive—MASS designers knew they couldn’t just build a beautiful hospital and plug it into the contaminated wastewater system. To solve the problem, they created a self-contained wastewater treatment system under the building’s foundation, allowing the building to function independently of the infectious Haitian infrastructure.

What animates and unites many of these projects—Rwanda, Haiti, and others—is the desire to take institutions that are widely feared or disregarded and turn them into sources of pride and civic engagement. “The medical facility could be more of a civic amenity, and this could be a future in the US as well,” Murphy says. “Perception of the medical facility has been corroded, it has become one of fear, one of sickness. Patients get sicker when they go to hospitals.”

Murphy challenges MASS Design to reinvent that reality: “What if we could make our health care infrastructure not just reactive but aspirational?”

Murphy grew up in Poughkeepsie, New York, the son of a nurse and a civil servant. He entered UChicago at 18 without a clear understanding of what he wanted to do and was soon “completely swooned” by Renaissance poetry. But even as Murphy wrote on John Donne, he grew fascinated by the built environment around the campus and city. “Chicago is a great laboratory for learning about architecture, and I got really ... intrigued there about buildings,” Murphy says. “I started to catalog architecture as this thing I found interesting.”

The transition from Renaissance poetry enthusiast to architect took some time. First, Murphy “had the great fortune to go on the first study abroad program in South Africa with the Comaroffs.”

Jean and John Comaroff, now anthropology professors at Harvard, spent a storied period at UChicago, and the Cape Town civilization program was a draw for undergraduate students. During his time in Cape Town, Murphy was transfixed, particularly by the neighborhood known as District Six, where it “became clear to me that the decisions around the built environment are always political, or always social, or always cultural. And that architecture is this interface of either, let’s say, disenfranchisement or cohesion.”

Murphy is discussing his past while sitting in one of the small meeting rooms in the MASS office. Cars honk below. A youthful 35, with an easy smile and a quick laugh, he exudes charisma. As he talks he moves in his chair, sometimes leaning back, often gesturing. At one point he starts circling his hands on the tabletop, a kind of wax-on wax-off movement, as a way of working through his thoughts.

Murphy was struck by how, even though formal Apartheid no longer existed, there persisted in areas like District Six a physical boundary— what he calls a “geographic Apartheid”—that kept the wealthy insulated from the pockets of poverty that dot the Cape Town landscape. Once a robust incubator for culture and music, District Six had been destroyed and left to fester in the city, a “massive scar both on the city itself as well as on the social and political history of that community,” Murphy says. “Sometimes architecture is a great manifestation of community cohesion, and sometimes it’s the clear distinction and difference between those who have access to services and those who don’t. That’s a heady way to say something we say often, which is design is never neutral, it either helps people or it hurts people.”

Murphy’s time in Cape Town didn’t have an immediate impact. After graduation he worked several jobs and internships—at Critical Inquiry, the Illinois Humanities Council, a literary agency in Manhattan—before he decided to be a writer. After getting some advice from a Chicago friend turned stringer in Iraq, Murphy returned to Cape Town to write but rushed home when his father received a dire cancer diagnosis and was given just three weeks to live.

Three weeks passed, then six, then four months. Murphy spent the time restoring his family’s 1890s Arts and Crafts home, a project that had been his father’s weekend hobby. It became Murphy’s quest to complete the restoration before his father died, but soon he had recovered well enough to help. “A year and a half passed and he was still alive, in remission,” Murphy says, “and we’d finished restoring the house.” As they sat outside one day, Murphy’s father told him that “working on this house with you really saved my life.”

A sense began to take root that architecture could have more than a social and political impact. It could influence something as personal as an individual’s health. The lessons Murphy drew from the restoration became his inspiration to pursue architecture. When his father, who died in 2007, was hospitalized, Murphy’s visits further shaped his design sensibility. Patients endured an environment engineered for a clinical purpose but blind to its toll on human dignity. Murphy left thinking, “I would love to design a hospital someday.”

Around the same time, Murphy heard Paul Farmer speak. A physician and anthropologist, Farmer is the Kolokotrones University Professor of Global Health and Social Medicine at Harvard Medical School and cofounded Partners in Health. The organization, for which Farmer is now chief strategist, works to bring high-quality health care to places around the world where it’s most lacking.

Murphy introduced himself to Farmer. “Paul said, Where are the architects?” he remembers. “We’re doing all this work and no architects have helped us out. No architects have asked how they can support us.” After reaching out to Farmer by email—and securing outside funding to support himself—Murphy joined Partners in Health in Africa. Soon Farmer invited him to plan the Butaro Hospital. With cofounder Alan Ricks, Murphy started MASS Design. All before Murphy finished graduate school.

There’s the Howard Roark shot,” says Chris Scovel, one of MASS’s directors, showing a photo of Murphy at the firm’s recently completed cholera clinic.

“Oh don’t call it Howard Roark,” Murphy groans. “That’d be horrible. I hate Howard Roark. We’re the anti–Howard Roark.”

Roark, protagonist of Ayn Rand’s 1943 novel The Fountainhead, has become the ur-model of the architect in much of American culture—elitist visionaries who accept no compromise (Roark blows up one of his own buildings during, basically, a pretentious tantrum) and usually work in blissful isolation from their communities.

“I think what makes architecture different than a building is that there is a generative idea,” Murphy says. “Ideally there is a generative idea, which drives decisions of the entire building. And sometimes that idea is completely bankrupt, all right, but sometimes it is about social change.” For Murphy and MASS the generative idea is always social: how can their structures drive social change and empowerment?

“I think for too long we’ve been taught that there’s great architecture and that everything else is just junk. Like, ‘Here, focus on this great architecture and that’s all you should be focused on. And there’s only a few people that can do it, and there’s only a few people that can pay for it,’” Murphy says, hands circling the table. “And that’s a very unjust society. It’s not a society that I want to live in, where a few people get to benefit from this trade that I’ve been fortunate enough to study and learn from. Because I think what [architects] do is a great civic work, civic service."

MASS is currently running about 15 projects, all of them in the spirit of civic service, most in health care or education. They’re building low cost schools that will accommodate up to 900 students each in remote areas of Africa. “You can’t, literally, import any materials,” Murphy says. “Nails,” but that’s about it. A few hours after discussing the New York library project, Murphy met with the US Agency for International Development to offer his thoughts on addressing climate change.

But lately Murphy’s thoughts have been returning to his hometown, which asked MASS Design for help last year. The Poughkeepsie community is economically depressed. Property values are abysmal. What was once a proud downtown is now very much down in the heel, a shell of its former self.

For the past few months, Murphy and his crew have been working with a center that houses nonprofit and social service groups in a century-old school that was hit by Hurricane Irene. MASS envisions the building as the heart of a “three pronged” strategy to revitalize the city.

With the help of a mechanical firm, they’ve worked out a plan to bring in a new boiler system that would save $1 million over 10 years. They also want to transform an industrial watershed next to the building into a pop-up park and turn wasteland into an asset. Finally, they proposed what other “key amenities” would be needed to catalyze broader change in Poughkeepsie.

By cobbling together a series of grants, Murphy thinks they could create a cohort of arts and culture fellows that could “occupy Main Street,” in order to drive traffic to the area and amplify the work of the social service organizations. He hopes such efforts could radically shift perceptions in the long run, contributing to making the town more attractive to other industries eventually.

That’s part of the self-proclaimed “value proposition of MASS”: to pursue what Murphy calls the creation of dignity. “There’s a great dignity that great architecture provides,” he says. Great in ways that are accessible and influential in everyday life—civic-spirited projects, not monuments to a singular vision. “If we don’t focus on that, if we just create basic structures because they’re an orphanage in Tanzania, it’s not enough. It has to actually be great architecture too.”

Michael Washburn, AM’02, is director of programs at the New York Council for the Humanities. He writes for publications including the New York Times Book Review, the Los Angeles Review of Books, the New Republic, and the Boston Globe.