BACKGROUND
The first ever studio we had - Design Research to Ideas - was aimed at understanding and practising various methods of design research. We were divided into teams of four and were given the freedom to choose any research question that we would like to find answers to and identify a context where we could do this research on field. We started off with 'waste management' and after a thorough background research, further narrowed it down to one specific type of waste - medicines in households.
PROJECT BRIEF
To understand the awareness and general practices concerning the disposal of unused, unwanted and expired medicines in the form of tablets, capsules and syrups, among the households in Yelahanka New Town, Bangalore.
Team Members
Anuja Powar
Geethu Davis
Mrinalini Majumdar
Riya Sethi
Mentors
Riyaj Isamiya Shaikh
Debjani Roy
Studio
Design Research to Ideas
OVERVIEW
As this was our first attempt at primary design research, our focus was to learn multiple research methods as possible. Hence we conducted two iterations of the same study using two different methods - Contextual Inquiry and Research through Design. For the latter, we used Speculative Design as a research tool to reframe the problem, to open up new perspectives and as a means of speculating how things could be. Later, we used Card Sorting and Affinity Mapping to organise our thoughts and generate insights.
INTRODUCTION
Pharmaceuticals are ideally disposed of by high temperature incineration (above 1,200ºC). Such incineration facilities, equipped with adequate emission control, are mainly found in the industrialised world. But the problem of unused, unwanted or expired medicines occur not only in the industrial level, but also in homes, hospitals, retail pharmacies and care centres. Improper disposal of medicines can cause environmental contamination which leads to health hazards and hampers the balance of our ecosystem. Currently, a high amount of pharmaceutical wastes get dumped into the environment either when disposed as solid waste in landfills or through sewerage into the water bodies. Discarded drugs may come into the hands of scavengers, children or animals if a landfill is insecure. The chemicals in water bodies affect the aquatic life and also work their way back into the food chain. As the safe disposal of drugs is thus a pressing issue of concern, we sought to conduct this study at the grassroot level - to find out the knowledge, general practices and awareness concerning the disposal of unused, unwanted and expired drugs among the households of Yelahanka New Town, Bangalore.
PROCESS FLOW
RESEARCH
Secondary Research
Similar studies conducted in different cities around the globe shows that there are existing gaps and lack of awareness in the disposal practices of unused and expired medicines among the general public. Safe disposal of medications is of high concern as malpractices may lead to harmful consequences such as undesirable effects, prescription drug abuse, overstocking, self-medication, accidental overdose, and even death. In India, there is no regulatory body, monitoring system, or functioning guidelines for the disposal of the expired medicines. The World Health Organisation and the US Food & Drug Administration currently have guidelines on drug disposal. But even then, our country lacks any medicine take-back programmes for drugs that are unsafe to be flushed down the toilet.
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Contextual Inquiry: To gather data from the residents, the method of Contextual Enquiry was selected initially. Semi structured interviews were conducted with residents from different households spread across the town, using a discussion guide as reference. The responses were noted and photographs and recordings were taken after obtaining signed consent from the interviewee. The information was documented in a spreadsheet within 12 hours of data collection and we discussed and analysed the data as a team to develop insights. Even though language and user recruitment proved to be hurdles, we understood the context better through the process and were able to determine the authenticity of the received information on the spot using this method. User statements were observed and insights were generated from possible observations.
Primary Research
Photographs of medicine boxes from various houses that we conducted contextual inquiry in. Expiry dates are not visible when only half a strip is bought or if the part of the cover with the expiry date is peeled off due to use. All the participants got rid of expired medicines from their households, but most of them did not bother about what happened to it after it was "thrown out".
An illegal waste dump on the roadside in 5th phase, Yelahanka New Town, and a zoomed in photograph showing a strip of tablets with one remaining pill in it. Everyone we interviewed was aware that expired or unwanted medicines, if taken in, was harmful. But most of them were not aware of its effects on the ecosystem.
The most common methods of disposal of medicines were through municipal solid waste collection, burying in the soil or returning to the pharmacies. Nobody mentioned flushing the pills even though flushing is one of the accepted methods of disposal for atleast some medicines. Those who returned unused/unwanted medicines to medical stores did so in the hope that it would be useful to someone else and did not bother to return the expired medicines for safe disposal. The image on the left shows the garbage collection area from the only society that we found to have a separate bin for medical wastes, in addition to dry and wet waste. The second image shows that the bin contains other wastes too. But even when some people are making an effort to segregate the medical waste at their household level, the garbage collectors from BBMP who collects this from the society, do not have a separate collection for medical waste and hence the efforts made at the grassroot level do not yield any valid outcome.
Visit to pharmacies to enquire about their disposal practices and checking the sample of medicines that has been stored separately as the expiry date is nearby. Pharmacies return their unused, unwanted and expired drugs to the manufacturers.
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Research Through Speculative Design: As popularised by Anthony Dunne and Fiona Raby, Speculative design thrives on imagination and aims to open up new perspectives on what are sometimes called wicked problems, to create spaces for discussion and debate about alternative ways of being, and to inspire and encourage people’s imaginations to flow freely. Design speculations can act as a catalyst for collectively redefining our relationship to reality. In this project, we decided to take our participants into the future, step by step. We formulated four questions and three sets of responses to choose from, starting from current time to future speculations. The participants were also free to add new responses to the existing lot.
Questions:
What would you do with the expired medicines at home?
What would you do if you are unable to dispose unwanted/expired medicines in your household waste?
You have some non-expired medicines at home, but you do not want them anymore. What will you do with them?
What will you do with the medicines at home on which the expiry date is not visible?
Responses: Current
2019
Discard the medicines in the common household waste
Bury medicines in flower pot or soil
Flush the expired medicines
Crush the pills and throw it away
Discard the medicines in a separate dustbin for medical waste
Use the medicines anyway even if expiry not visible
Burn the expired medicines
Return the medicines to pharmacies
Responses: Near Future
A device that tells you the hazard level of medicine by colour indications and suggest the method for its safe disposal.
2025
An AI powered dustbin that can automatically segregate dry, wet and medical waste by itself.
Return the unused and expired medicines to pharmacies and get rewarded for it.
Follow the clear disposal instructions available on the medicine packaging.
Decontamination bin at home, which will neutralize the hazardous
substances in the medicines.
Responses: Far Future
Medicines are not needed anymore because of progress in genetic
engineering
2040
Medicines do not get expired at all
A device that is a scanner and healer. Its scans the body and detects the disease and determines the cure with the help of AI
Antidotes injected in the body detects and cures all kinds of
diseases
Pills disintegrate into harmless substances after expiry.
Quick prototyping and preparation of colour coded cards to mark responses to the questions during different points in a timeline. Blank cards were also provided to add new responses by participants.
Conducting the activity with participants in bus stand and on park benches. As seen in the picture; we presented the year and the questions (blue cards) and gave them the option cards to choose from, they were allowed to choose multiple number of cards. We also gave them blank cards to fill in their own option which are not present in existing cards. Some image cards were also added later on to provide more clarity for the options given, since text in English was not observed to be the best way of communication. It was observed that participants chose the option most convenient to them, provided the cost of the option need not be considered (especially for futuristic responses).
ANALYSIS
Card Sorting and Affinity mapping were used to categorise user statements, generate insights and subsequently ideas, from the primary research data. As the dataset was rather small, the number of groups and also the number of statements within each group was rather low. Nevertheless, this exercise helped to identify latent relations between user statements. For the Research through Design approach, by observing the variation in the choices of each user for the different levels in timeline, we were able to gather valuable insights into their thought process. Also by probing further into each futuristic choice they made, we gathered more insights into what their expectations and priorities were.
CONCLUSION
A detailed analysis of the research data shows that there is no one solution to the problem. We identified multiple interventions ranging from change in packaging to change in policies. None of the proposed ideas offer a standalone solution, but all or a combination of these can be adopted to ensure that unwanted medical waste is disposed safely in our society.
IDEAS
Medicine take-back programs are a secure and environmentally sound way to dispose of leftover and expired medicines.
Policy level changes to ensure that medical waste is collected separately and disposed safely. Municipal corporations, waste collectors and citizens need to be sensitised about the issue.
The packaging of medicines to provide the correct guidelines for its safe disposal - either as infographics or in coded format which can be looked up.
Government to form national guidelines, legal framework, a regulatory body and monitoring system to ensure safe disposal of medicines.
Expiry date to be imprinted or engraved on each pill to ensure that the date will be visible even when the packaging is damaged or unavailable or lost.
Pharmacy bills to include expiry dates of purchased medicines and a digital copy of it made available to users, if requested, for later reference. However, this idea needs to be studied in detail to protect the privacy of consumers.
In addition to the leftover and expired medicines that are directly discarded as waste, even the medicines that are consumed by us causes the chemicals present in them to pass through our biological system and end up in rivers and oceans threw sewerage, and affect the ecosystem. Hence, it is also important that consumers be responsible to reduce not only unnecessary wastage, but also unnecessary purchase and consumption of medicines.
KEY TAKEAWAYS
• My first encounter with ‘wicked problems’.
• Always treat the context with the respect it deserves.
• Kick my biases away. At least try.
• Simple observations can speak volumes.
• Never fall in love with an idea, always stay a critic.
• Open-ended interaction with strangers can be fun too.
• Probe. Probe. And probe more!
• Stories are important, so listen.
• Envision alternate futures, let the imagination run wild.
• Find connections hidden in plain sight.
• Ideate without any limits.
• Filter. Say no to some ideas, however hard it is.
FEEDBACK FROM MENTORS
Very interesting topic to work on. The experiment for speculation was well designed to initiate probe. In the artefacts documents had some generic pictures that didn’t add much value to the context. More specific images would have been better. The questions formulated in the discussion guide had some leading questions, there is a scope of improvement. A good attempt to conduct contextual inquiry, but there is definitely scope of improvement. The position paper had very good articulation, shows clarity in thoughts and understanding along with retrospection. Overall an interesting outcome of the project.