Manuela Aguirre and Jan Kristian Strømsnes
Designing for Dignity
The Oslo School of Architecture and Design (AHO)
Designing for Dignity
Designing for Dignity is a service that addresses a sensitive issue in a very human centered yet professional way.
The broad involvement of all stakeholders in the design process has brought to the project an inclusive and multilateral perspective.
The project finally combines users-staff interaction and space lay out in an original and innovative way.
Designing for Dignity
A holistic spectrum of system interventions that support the needs of a Sexual Assault Survivor (SAS) throughout their medical and legal care. We analyzed a SAS's journey from their personal perspective and compared that to the perspective of other stakeholders in the system, such as nurses, social workers and police. From understanding the complexity layered in the different problems, we co-created system interventions that responded to the most critical painpoints identified. The solutions addressed new ways of collecting DNA evidence in a less invasive manner, ways of facilitating difficult conversations and service and architectural guidelines for Sexual Assault Centers (SAC).2. The Brief: Summarize the problem you set out to solve. What was the context for the project, and what was the challenge posed to you?
We chose to work in the field of sexual violence because it is a complex wicked problem under-addressed in almost any culture. We started with an open brief and used Systems Oriented Design (SOD) and GigaMapping to find a design opportunity within this field. When we started, we were petrified by sexual assaults that occurred in the streets, but soon realized that the problem was much deeper than that. The sexual crimes that are addressed by the media are not representative of the whole sexual crime landscape. When the perpetrator is a stranger the survivor has little or no compassion for that person and reporting those crimes is in many cases the most common thing that happens. However, what happens when the perpetrator is the father of your children, or your teacher or friend? When the perpetrator has a close relationship to the victim it becomes much more difficult to speak about it. We set ourselves to understand the emotional and psychological needs of SAS and compare those with the needs of the medical and legal care teams. Since report rates are so low, the problem is not properly defined and metrics are not reliable. We wanted to create a service that has relevance in a field with almost no representative statistics. Our goal was to make an impact through a comprehensive user need understanding of the landscape and create systemic interventions that could have the biggest effect using as little resources as possible.3. The Intent: What point of view did you bring to the project, and were there additional criteria that you added to the brief?
Our brief always started open so we were constantly battling between a divergent exploration and narrowing down when key opportunities were identified. Since we used a systems design approach, we analyzed the landscape from multiple perspectives making seemingly unrelated elements relate. We did an extensive visual mapping of the system that not only showed hundreds of design opportunities, but it also displayed people's journeys through the different service touchpoints, their roles and the equipment they used throughout the different spaces. Just by the power of visualization, the service providers saw their job in a whole new dimension. They were able to understand how their job played a role in the larger context and this facilitated many conversations between different key stakeholders. These giant system visualizations were the starting point for people to believe in the power of service design within their field and enabled people to co-create solutions for the common good. We organized a workshop where we presented painpoints as opportunities and SAS sat in the same table together with the police, nurses, social workers, doctors and designers. For the first time these people were empowered to make a difference collaboratively (according to their feedback). That was a huge satisfaction for us and from that moment on we understood that our roles as designers shifted and became a way of facilitating those expert points of views and orchestrating their ideas, fears and aspirations in a tangible way through system/service interventions.4. The Process: Describe the rigor that informed your project. (Research, ethnography, subject matter experts, materials exploration, technology, iteration, testing, etc., as applicable.) What stakeholder interests did you consider? (Audience, business, organization, labor, manufacturing, distribution, etc., as applicable)
We had a rigorous design process that was divided into four stages: Research; Ideation; Prototype; Deliver. The Research phase started with extensive mapping of the prevention and response landscape where we identified the key stakeholders involved. We had one-to-one interviews with anybody we could get a hold off -from insurance companies to volunteers, to the Police Intelligence department and the Norwegian Crime Prevention Councils-. At first we had a lot of resistant for using design as a way to approach challenges related to sexual crimes, but after they met us and we did mini workshops with them, they had a clearer picture of the assets of having a service design approach and became experts of delivering insights to the project. We explored all the sides of the challenges by contrasting the perspectives from the prevention side to the response side. Usually the stakeholders involved in the prevention landscape tended to see the big picture while the people at the response side work with particular cases every day, so they were more detailed and user insight oriented -which enriched our understanding of the particular needs of SAS. We chose to focus on the medical, social and legal care teams as our service providers and SAS as service receivers. After understanding their painpoints, challenges and aspirations from their individual perspectives and mapping that out in a very visual way to create a common dialogue, we invited all of these stakeholders to a common workshop to co-create solutions that can address the common good. This was a breakthrough moment in our process. They had never faced problems as opportunities and that instance was very meaningful, specially for SAS - they were sitting in the same table as their legal and medical care team that addressed their case having a constructive dialogue and understand their own individual perspectives and try to come up with solutions for the whole. We, as designers cannot take credit for the ideas that were collectively created, but just creating that space for constructive multi-perspective dialogue was unique. There were three main topics addressed in the workshop. How to make the evidence-collection process more dignifying? How to make SAS have transparent information about the process and gain back control? How can we understand the SAS's journey as a whole and redesign Sexual Assault Centers to meet the service providers and the SAS needs? The architectural guidelines for Sexual Assault Centers (SAC) were communicated to the architects in Oslo that are in charge of building the new SAC in 2014. The first iteration of the Safety Blanket was provided to the Social Workers and they used it with an SAS. That experience gave us valuable insights for the second design of the Safety Blanket. The material for the Education System was co-created with the service providers during the whole Research phase. The different iterations of the GigaMap and Journey Map became the baseline content for the Education System.5. The Value: How does your project earn its keep in the world? What is its value? What is its impact? (Social, educational, economic, paradigm-shifting, sustainable, environmental, cultural, gladdening, etc.)
The anonymous questionnaire with 106 women from our school in Norway and many of them feared to walk alone at nights and designed their own prevention mechanisms. 5.7% of the women questioned revealed that they had been directly affected by sexual violence. This fact shocked us and determined us to try to make a real impact. The process during the project was definitely a paradigm-shift for the social workers, nurses, doctors, legal care teams and SAS. For the first time they could approach their challenges as opportunities as we created a space for constructive dialogue and co-designing to occur between them. The real impact of responding to sexual crimes with dignity has two major effects: the first is that by making this problem relevant you can make it easier to talk about it and decrease the taboo around sexual crimes. The second effect is that by making it easier for SAS to go through the medical and legal care process you can increase the number of people that reach for help. By increasing statistics and reducing taboos you can actually start quantifying the problem and more resources can be put place to address those challenges.6. Did the context of your project change throughout its development? If so, how did your understanding of the project change?
We redesigned the services delivered by the legal and medical care providers for SAS after an acute assault. The touchpoints in the service responded to the current painpoints we identified in the SAS's journey through the response system. The first and far most crucial touchpoint was the very first interaction SAS has with the response system. Today that touchpoint consists of receiving paper bags from the care teams for SAS to introduce their hands in to capture and store any DNA evidence that might be left. In response to this, we designed a safety blanket that can be used by care providers in any crime case that involves victims to store safely their dna evidence in a way that can also give comfort and support. This blanket has a material that can adhere to DNA while embracing the victim with anonymity. After this first crucial touchpoint of the blanket - and the script for service providers, we touched upon the different instances at the Sexual Assault Center. A private waiting room, customized education packed in an anonymous folder with a journal to start writing down feelings and several tools for social workers, nurses and police to facilitate conversations and explain the types of examinations and the difficult legal decisions SAS have to make.7. How will your project remain economically and operationally sustainable in the long term?
We identified the leverage points by first having a thorough research phase and in parallel keeping a concept track visualized through a Systems Intervention Map. This became the space where we documented all the concepts identified when investigating the prevention and response field to sexual crimes. The Systems Intervention Map housed hundreds of concepts of different nature. Choosing randomly from it would not have made a systemic impact. That is why we contacted again all the stakeholders and invited them to be part of the solution co-creation process. In the workshop, several issues were highlighted and analyzed from their own lens - having the whole in mind. These issues were around facilitating shared decision making for SAS and helping them gain back their control. The challenges discussed were mainly around the painpoints in the response process. The service interventions chosen for the response system were inclusive - they were co-created from multiple perspectives from both the Service Providers (medical, legal and social) and the SAS (receivers of the service). It was a consensus that we would achieve the biggest impact by orchestrating and sequencing the main leverage points within the service and a particularly interesting one was the first touchpoint. This first touchpoint in the service became the interaction between an SAS and the safety blanket (responding to a huge painpoint today). The safety blanket was the entry door to a whole response system that has been underutilized and trust is a big part of the issue. The following touchpoints became tools that could facilitate difficult conversations and make the whole response journey feel more transparent. One of the most important conversations that arose from the workshop was the word "control". SAS lose control over their decisions and their body during the assault, so all of the design interventions in the mix had that insight in mind. We designed multiple touchpoints, from the first and most important one to enter the system- to the information that is handed off after the medical process is done and it is time to go through the legal journey. When designing for the space at Sexual Assault Centers, we were inclusive of the different roles, intentions, aspirations and underestimated needs the different service providers and receivers valued.