This article collects learnings I made while collaborating as a service designer for BloodLink, at a pilot we ran in India in June 2018.
Blood donation in India
Many countries in the west fulfil their blood demands through voluntary donations. This is not the case in India, where there is not enough blood supply and a significant amount of the blood need is covered with replacement donation.
BloodLink is an Indo-Danish social enterprise. They wish to take the responsibility of finding blood out of the hands of the patient by connecting blood banks and hospitals through digital tools.
The start-up is currently working on a service that connects companies and blood banks to organise donation camps. A team embarked to India to be present at 6 donation camps. As the designer in the team, I was on charge of carrying out intensive research during the camps, ideating on how to increase donor count, frequency of camps and working on new value propositions for BloodLink.
Welcome in India
Indians and foreigners
Being a foreigner researching in India can make some things easier. More often than not, Indians are curious to talk to foreigners and compare how things work in different countries. In this project I have often been perceived as an external, non judgmental figure and this has made it easier for people to speak up. Western candidness can sometimes relax and uptight atmosphere.
Lack of privacy is normal
In this country people are used to having a lot less private space than we do in the West. Literally, spaces in cities are crowded. Indians also can ask personal questions to a person they’ve just met and this is totally acceptable. Typically crucial things, such as warming up and small talk before the interview, having a private space to talk, etc. were just not so important in this context as they mostly are in the West.
Fear of looking and feeling bad
In India people are overly concerned with displeasing others, saving face and being respectful. That is one of the reasons why Indians almost never say “no”. This is crucial to handle when doing research. People will always try to guess what you want to hear and answer accordingly. The researcher needs to be positioned in such a way that they show no personal opinion whatsoever about the subject of research. Conventional feedback gathering just doesn’t work.
Hierarchies and processes
India has a very hierarchical and bureaucratic culture, even hard for Indians themselves to navigate. It is common in organisations to find that the person holding the title for a certain job delegates everything to an assistant person. When researching with employees, it is key to identify who is your real user, regardless of the title, and afterwards correctly navigate the hierarchical structure to get access to the person in question. You can’t just go directly to the person you want to talk to; it is expected that you ask permission to their superior for their time.
Rivalry and mistrust
Superiors in companies need to feel important, so you will often need to interview them just to charm them and get access to their subordinates. Subordinates will not cooperate if they don’t have outright approval from their superiors. And even in cases where they have given approval, if the superior doesn’t like you, or feels threatened in any way, it will just not happen. When researching in businesses, if you’re too acquainted with the subject you’ll be perceived as a menace; if you’re too inexperienced you may be taken advantage of. I find this phenomenon frequent in but not exclusive to the Indian context; I personally have encountered it in many occasions, usually when working with very hierarchical organisations, regardless of the country they’re based in.
A reflection on our methods
I learned to be genuinely economic with design tools and outputs, making sure any efforts polishing a presentation were saved for those things to be shown to the outside of the team. The start-up world is ridiculously fast-paced and superficial, just pick the best cherries to showcase, and don’t bother going to the detail. Nobody cares, just focus on the basics and make them crystal clear.
Researching in a place where you’re not invited
The conventional research tools we use are tailored for design consultancy. They were born and have mostly evolved in that environment; their timings, resources, procedures, match those very specific business circumstances. When it comes to interviews, resistance to this method grows as we move away from this environment.
As opposed to consultancy projects, in a start-up you find yourself needing to do research with organisations and people that often have no direct take in what you are doing. There are many reasons for people’s resistance and they are all logical. In this project I encountered employees that had come to donate due to peer pressure and found it hard to be honest with me. Donors that didn’t understand what BloodLink was and why we asked so many questions. Professionals in the blood sector that were not so sure of our good intentions and feared our competition. People who had their own hidden agenda, making it for us impossible to figure out what was true and what not.
Dropping the notebook
When time came for our last donation camp, I had talked to around 40 people of many different profiles. I had identified many patterns and opportunities. I had also given up on some sensitive topics that the blood bank staff just shied away from. Once at the camp I dropped the notebook and enjoyed casual chatting with the blood bank comrades. Then, at an unusual moment of quietness, the blood bank member I was talking to just opened up. They answered all the questions I had pending, without me formulating them. Looking back, I think it was a mix of several things that made this happen. The trust we had built with this particular blood bank, over several camps and meetings. Their seniority in the field and self confidence, and probably my genuine interest, beyond the research objectives, beyond the project.
Service design fit with the challenge
From a service design point of view, the challenge of improving blood donation in India is a pharaonic one;
- A complex constellation of stakeholders: donors, patients, families, hospitals, blood banks, NGOs, public institutions, CSR & private companies.
- A highly regulated sector, and parallel to it, a big black market that doesn’t follow rules or conventions.
- A shy, mistrustful, hierarchical and wonderfully diverse culture; really complex to grasp.
At the same time, I’ve probably never felt my discipline matched so well the needs of a project. It had all the ingredients that make a service design approach necessary in the first instance. This was very rewarding, since nowadays I see design strategy and service design being used as the Swiss army knife that can tackle any challenge. We can stretch a lot, but no discipline in the world can do absolutely everything.