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Although the work of engineers has contributed enormously worldwide to economic development and quality of life, the unintended consequences of engineers' work also have often caused harm to natural and social systems. Furthermore, the engineers' work is delivered predominantly to developed nations, leaving underdeveloped nations without adequate facilities and infrastructure to build sustainable economies. While these effects have been criticized for at least three decades, the engineering community has struggled with how to respond. Top-down approaches for delivering aid to underdeveloped nations have had questionable results. At the same time, and surprisingly, engineers have not been closely involved in the technical aspects of these aid efforts. What is needed is a new form of engineering project delivery, an approach that meets the technical and social challenges involved in working in underdeveloped communities, but at the same time delivers appropriate and sustainable solutions. A new form of engineering education is needed, one that covers a wide range of technical and non-technical issues, including water provisioning and purification, sanitation, public health, power production, shelter, site planning, infrastructure, food production and distribution, and communication.