As a lab, we go through a lot of ideas. Some get developed and carried out, while some get shelved. We didn’t want to put good ones to waste, so we’re sharing with you one of our projects that we developed through design thinking, but wasn’t fully implemented. This one, Tahan-tahanan Toys, started with a conversation that I had with my mom, Dr. Marvie Abesamis, who at that time was a Chief at the East Avenue Medical Center (EAMC). She was curious about what Habi was doing and floated the idea that I help her with her own project.
Tahan-tahanan is a halfway house for indigent young patients with chronic illnesses. Located at the basement of EAMC, the facility has residential rooms that young patients and their guardian (usually their mom) can stay in while receiving treatment in nearby hospitals. Some patients stay as quick as one week or as long as one year. They stay for free and the costs are funded by a combination of donations, charity contributions, and the hospital budget. My mom, who was balancing both roles as Chief of Medical Staff at EAMC and Executive Director of Tahan-tahanan, wanted us to help them think of new educational programs for the parents and patients.
Since the beginning, Tahan-tahanan has been a very popular destination for companies and schools to do outreach programs. Celebrities and philanthropists spend birthdays there, providing food for the patients and their parents. Education and Psychology college students perform practicum and research projects. Student organizations and corporations implement feeding programs, donations (food, books, toys), and other outreach projects. The challenge is how to make these outreach programs more relevant to the needs of the patients and parents. While patients and parents enjoy these breaks from the monotony of treatment-waiting cycles, these only provide a temporary break. House Manager Maggie lamented that some organizations do not necessarily have the right attitudes or sincere interest in the patients. “Nagiging party na lang nila, sila na lang nagsasaya”. Some volunteers do not know how to deal with kids with severe illnesses. Ampy, a survivor, said “I don’t want to be seen or treated as if I’m not capable.”
We went into the project, aware of the general outsider-assumption that indigent parents and patients only needed donations. We wanted to dig deeper, and empathize with the parents and patients, to facilitate more meaningful interactions that served their needs.
The challenge is how to make these outreach programs more relevant to the needs of the patients and parents. While patients and parents enjoy these breaks from the monotony of treatment-waiting cycles, these only provide a temporary break. Ampy, a survivor, said “I don’t want to be seen or treated as if I’m not capable.”
Himayin ang Konteksto
We spent a total of 40 hours in Tahan-tahanan, in a span of 2 weeks. Our research process was a mix of observations, interviews with parents, staff, and volunteers, play sessions with children, shared meals, and looking through past photo albums and records of events. As we sifted through our notes and tried to make sense of our insights, it was clear that we wanted to focus on the parents. Most of the volunteer programs focused on the patients, and sometimes the carers tend to be overlooked. As what Ate Maggie told us, sometimes these programs only serve the interests of the donors. This was an opportunity for us to provide more relevant programs for the Tahan-tahanan community. Using our lenses as educators, we came up with two key questions:
How might we make the parents of Tahan-tahanan more informed about their children’s health conditions? The parents generally had differing views about sickness and health. Half still had strong folkloric beliefs, disagreeing with the doctors’ advice and wanting to go to albularyos (folk healers) instead. They blamed their children’s illnesses (ex: brain tumor, Hodgkin’s lymphoma) on paranormal reasons instead of opening up to understand the doctors’ explanations of their children’s conditions. According to the staff, this made it difficult for their doctors to rely on parents as allies for treatment. They were missing appointments, doing away with some medicines, and other behaviors that were not aligned with the treatment plan of their children. Cancer is a tough concept to swallow, moreso understand. But how can we develop ways for parents to be informed enough, so that they can cooperate with doctors and help in the medical treatment of their children?
How might we improve the wellbeing of the parents of Tahan-tahanan, so that they can provide better care for their children? To come to Tahan-tahanan and be full-time carers for their children, they had to drop everything. Some had jobs, some were full-time housewives. But since they moved, their focus shifted. They would spend most of their time waiting: in line for free medicine, outside doctors’ offices during check-ups, in queues for cashiers and medical results. Many felt isolated and alone, commonly labeled as carers fatigue. They get bored and anxious easily. Volunteers who come to do activities with them (Zumba, gospel talks, arts and crafts, storytelling) are welcome, albeit temporary breaks for them. One mother shared her thoughts: “Pag tapos na, balik uli sa dati. Minsan paulit-ulit. Thankful kami siyempre, pero ok rin sana kung may nagagawa kaming iba”. They are indeed in a difficult situation as they didn’t have the support systems that they were accustomed to back home. No husbands, no family, no friends. It sometimes felt like a women’s correctional facility, which was a strange analogy. Their time within Tahan-tahanan was uncertain (as with jail sentences), they were isolated from the real world (forced to stay within a facility), and they felt bored and unproductive.
Ambagan ng mga Idea
It was difficult to put off brainstorming for ideas as we were doing our research, but we had to make sure that we weren’t asking questions for the sake of validating a solution that we had. When we were comfortable with how we phrased our key questions, that’s when we felt we were ready to dive into solution-mode. We looked at similar programs from hospitals and health care facilities. We used the women’s correctional facility analogy to look at their programs. We examined existing initiatives, historically looking at what worked, what didn’t. We also looked at our resources and networks, if we can tap them in some way. Here were some of the ideas we came up with:
- Volunteer pipeline program. A system that allows schools, organizations, private individuals to send volunteers to Tahan-tahanan, in a purposeful way. Currently, Tahan-tahanan only had a rough one-pager of rules for volunteers. The idea was to craft a better onboarding program and sensitivity training for volunteers, to frame their mindsets that they were doing this not to “feel good”, but to serve the needs of the community. We can design a learning experience that would help volunteers look at the patients and parents with dignity and empathy, not as mere beneficiaries of aid. This program would include a clearer monitoring and evaluation element, helping Tahan-tahanan clearly identify the goals for their volunteer program, and document these results for future grants and projects.
- Art therapy classes. Since many parents enjoyed the arts and crafts lessons (more than half would always recall that as one of their favorites), we were interested to explore this idea of art as a means for the parents to process their emotions, deal with stress, and develop support groups. A space that was exclusively “theirs”. This idea involved working with artists and psychologists who have had substantial experiences in this field of work, to try programs that would fit Tahan-tahanan’s specific context.
- Livelihood programs for the parents. After learning that many of them had useful talents such as dressmaking, gardening, or cooking, we thought of highlighting their skills. Through this program, they get to continue the work that they were doing back home, maintaining their sense of individuality and productivity while caring for their children. Pursuing this idea led us to exploring similar vocational education models (such as TESDA), and identifying ways to maximise these as alternative income-generating programs.
Bumuo ng Prototype
We went with idea 3 for our prototype since many parents were keen on learning new skills and using existing skills to make products. They enjoyed the process of learning from the cross-stitch and embroidery classes facilitated by previous volunteers, so we wanted to explore deepening these one-off classes with a longer-term program in mind. We tapped an educator and entrepreneur friend, Ainee Idanan of LaurAin, as a co-designer. She was a pre-school teacher, a maker of hand-made plush toys, and a carer herself, mostly spending time taking care of her mother who has brain cancer.
We conceptualized a toy-making workshop, scaffolding the skills needed to build a plush toy from scratch. The design of the toy was also intentional, a blank miniature human body which the parents can play with their children to talk and learn more about their pain and conditions. The actual prototype was a two-part sample workshop, the second one coincidentally scheduled on my mom’s birthday, which became her modest 60th birthday celebration. Here were some photos of the workshops:
Ipakita, suriin, at ayusin
We learned a lot from our prototype workshops, revealing clear next steps and areas for improvement.
- It was a great community-building activity. In a way, the workshops naturally became art therapy sessions. While we were designing the organs and the human dolls, the parents started sharing their own experiences about caring for their children. According to them, that was one of the few times that they got together and talked about their own struggles and feelings as parents, since they were mainly focused on their children. It was surprising how a simple visual of a human body triggered conversations about treatment, pain, and health. Ainee, who was leading the workshop, also opened up about her own experiences as a carer, making the experience more authentic and poignant.
- The discussions were also peer-learning experiences. Their deep conversations also bled into their notions of health. Fellow parents “corrected” others who believed in folkloric traditions: “Makinig kayo kay doc, wag na sa pamahiin.” It is indeed an assumption that as outsiders, we feel the need to correct misconceptions of others. But the most effective ways are when they discover it themselves, or when they hear it from peers who they trust. This was a great lesson on looking at communities from an asset-based lens, and just facilitating opportunities for these learning moments to happen.
- Really understand the skill level of the learners and the group, and tap into their skills. We came prepared in the toy-making workshop, with basic “how-to-stich” guides and visual aids, thinking that they would need a crash course. While some parents were indeed novices when it comes to sewing, they learned more effectively when they were watching their more experienced peers. Our highly-instructive and scaffolded approach didn’t work as much.
- They weren’t motivated so much about earning income. While the idea of more money initially encouraged parents to participate, it seemed like they weren’t really motivated by it during the workshop itself. They were making the toys for the creative process, for the company, for the novelty of doing something new, and for their children to play with. They didn’t care too much about making “perfect, sellable toys”.
- Not all patients can participate in the toy-making. The ages of the patients vary a lot. Some of the mothers had older children, who were able to help in the toy-making workshop. But for those mothers of infants and toddlers, we had to keep them busy by babysitting them during the workshop. This also presented another improvement for us when implementing further workshops: how to keep the younger children busy to give the mothers their own space and time?
After our two workshops, we planned for another prototype, using service design to create the process of implementing the program, identifying the various touch points of volunteers, artists, and parents. Unfortunately, schedule conflicts and other projects got in the way so Tahan-tahanan Toys was shelved.
Hopefully, by sharing our process in researching and designing this project, we were able to inspire others to do similar Learning Experience Design work outside the school setting. There are many places and communities where learning happens and having more empathy and creativity can definitely bring about more meaningful learning experiences, which in this case, can help save lives.