Preparing small notes and changes often becomes the responsibility of consumers in India – based on what I have experienced so far, which is different mentality compared to Japan or Korea especially. If you only have 100 or 500 rupee notes, be prepared for delays in getting your changes back, or even the risk of not being able to buy what you want. I cannot yet find a pattern with which this happens. It just happens. I experienced it so far at: office canteen, food court at the flower show, street vendors, high-end grocery, or entrance fee to an exhibition. If this happens at general stores, I might be offered to buy more products that would fit the corresponding amount of the lacking change.



It so happened when we were driving to Tamil Nadu. One of the highway tollbooths gave a piece of chocolate instead of one rupee coin. It is a witty solution, but I consider it a misdirected effort: getting candies ready instead of one rupee coints. Other more fair and sustainable solutions are abound, however perhaps they might be just slightly out of reach to those who work at the tollbooths.

Many countries utilize RFID cards at high way tollgates, ranging from free passes with which cars can simply drive through the gates, to transportation or credit cards. Replacing cash transactions alone can speed up the process of passing through the tollgate.



This tollgate in Seoul, on the way to Incheon airport, had 3 card scanners each accommodating the different height of the driver seat. Designers must have gone through several options before deciding on this solution: A stronger scanner? Material and manufacturing cost of the machine? Off-the-shelf components available on the market? Ergonomics of the driver reach on different vehicle types? Maintenance cost? Variations in the usage contexts where the scanner should be installed and used?





Cash is an incredible medium that has lived through centuries in human lives to facilitate exchange of values. Any attempts to replace cash were accompanied by the heavy investment in the infrastructure over a long period of time, such as transaction terminals that suit various contextual and business requirements. Similar to any communication technology where the real value is in exchanges among people, it could move very slowly till the minimal size of ‘majority’ starts to get equipped with the tool and people get convinced that there is a clear benefit for conversion.

This slow change, in turn, could also result in intermediate technology solution in order to accommodate the existing human processes. For instance this signature pad has become a very common tool at the checkout using credit cards in South Korea. This replaces a printed receipt for getting the customer’s signature for the shop to keep. The credit card payer signs on the pad and gets the final receipt with the signature captured on the pad printed on it, typically in low resolution. This allows the shop to keep the transaction record electronically, which simplifies the process of bookkeeping. Is this working better than ‘Chip & Pin’, requiring a 4-digit personal code with IC chip embedded on the card as is widespread in UK? Advantages and disadvantages are different between the two methods, but I guess that’s beside the point. South Koreans opted for a technology solution that produces an equivalent outcome to an existing process: a printed receipt with personal signature, while being able to record the data digitally at the same time.





The signature pads I have tried invariably made me write my signature distorted or cut due to the inadequate feedback and lack of personal calibration (I was not exactly given a practice run either), or simply I started with the wrong size for the given space. So most of the times, I get a receipt with my signature printed too small, too big, unrecognizable, or incomplete. Does this matter? In theory yes, but in practice no. People have embraced the ineffectiveness, the defect of the technology tool because it still allows them to comply with the existing rule and process to a degree.

In India, I sometimes have to hand over my credit card to my driver (yes, I have to rely on a driver to live in Bangalore) for transactions. First time I got the receipt with no signature, I asked him “Don’t I need to sign this?” His answer was clear and simple as he started the engine: “Anyone can sign.” A similar attitude, but a different behavioral solution from the South Korean example.

Will either of these solutions prevail in the future? I would say yes, until the evidences of failure becomes apparent to the majority. We are, after all, humans who embrace mistakes and learn from them. But still – can we really design for adoption, abuse, appropriation and degeneration? Is it a matter of trying, an attitude? This is an increasingly relevant topic for my work these days. If you are involved in designing an infrastructural service that will have to transcend time, space and a large body of population, the cost of ‘we will iterate the design after we deploy it and get the feedback’ can be huge, if not leading to the failure altogether. It becomes critical that the patch tests of contextual validation trigger a wide variety of scenarios to consider, for policy creation, changing the existing process (gradually), training personnels, and establishing the word-of-mouth concept propagation message – including the potential ‘myth’.





Bonus: The new equipment invested is a chance to add on other features. The highway tollgate receipt comes with advertisement and coupons; POS system with the signature pad often comes with a screen facing customers that play ad videos.

A signage for warning the danger of HIV and promoting the use of condoms, found across in Uttar Pradesh.



Getting condoms however may not be an openly accepted behavior. In rural health centers, they try to distribute condoms for free, but people may not visit the center while others can see. One solution to the problem is to place the condom dispenser outside so that people can take them whenever they feel comfortable.







I wish smart bollywood stars could do more on sexual education in India, given their influence and what they are selling, even though the reality in India is still quite harsh.

Posters and drawings on the walls of primary health centers in India. If you want to get an idea of the seriousness of the matter to educate and treat the local population, you can have a look at the comparison of top 10 causes of death between the developed and developing countries.

Can you design a poster so convincing that the beholder would change the attitude, or get motivated for proper treament or prevention? I am no graphic designer, but this presents a good challenge for those of you who are.













on a different note: my new team, Nokia Research Center India worked on a mobile service pilot called Health Radar, a reporting system for malaria outbreaks in 2009. this is no graphic design work, but it dealt with how we can change the existing practices of information dissemination and assimilation. changing the existing and forming new habits are the most challenging part of making the new practice work, which is to happen to various people involved throughout the whole process. in the next decade or so we hope to see the top 10 causes of death list in the developing countries will see a dramatic change.

A good maternity care is the foundation of a healthy society. While traditional wisdom still prevails in communities with little influence of modern technology and services, it does not always offer the best possible solutions available.

One of the challenges that primary health centers (PHC) in rural India are facing is to make people be aware and trust the medical services that they provide. Offering a substantial amount of cash & a maternity package (pictured below, containing all the basic goods needed for a new born baby) to give birth in the PHC is an exemplary effort to attract such population to the advanced medical service.



I have experienced maternity indirectly through people around me. But not much when it comes to the real realm of parental responsibilities. In January, I had a chance to visit government-run health centers in Udupi district in South West India. As an unexpected byproduct of the visit, I learned a great deal about maternity healthcare.
The printed material for the maternity care fascinated me (to be honest, I don’t know what material is available in other countries). This government issued maternity education and record keeping material design is very visual so that literacy level does not matter much in using it. In any case, all the materials come available in the local language of the region.





The record for vaccination needs to be kept by the family for at least 5 years, depite it being just a mere piece of paper. It acts both as a record keeping tool as well as reminder for the future visits or activities.

Field workers, called asha (accredited social health activist) are vital for rural healthcare in India. While the majority of population lacks an official identity, these field workers walk the ground on foot, visiting house to house for families that they are responsible for and get all the needed information manually to update the records back in the office. They are also the mobile networks to disseminate information, mediate communications, and educate residents on health. Tey are the mobile healthcare enablers, where both families’ and doctors’ mobility is compromised due to the lack of vehicles, roads, or time. Above all, they are the human and humane keys to open the suspecting hearts to the potentials of modernized, unfamiliar services.

If you look at the whole of healthcare as a service, you will see a lot of parts that can be improved dramatically by implementing technology solutions replacing the existing roles of people’s manual work. More often than not, service designers should really try to foresee whether the partial replacements would become a sustainable part of the whole organic process.

A bigger part of the total cost of implementation in getting technology solutions into existing processes is often about changing the human practices after all, ranging from re-training staffs and users, to political and social policies. How will roles of asha’s change in the coming years? What would be the crux of their role that would remain stronger than before? Where should the first investment of changes be?





I deeply thank doctors at the primary health centers, who opened the doors for us and took their valuable time. And the Manipal University staffs who kindly guided us.