Helping elderly Moroccans in Amsterdam to understand health issues.

Meet Durya. Durya has a Moroccan background and has been living in the Netherlands her entire life. About one year ago, she got a call from her mother in law, telling her that her father in law did not feel well. He had difficulty swallowing, but it was probably “just the flu”. After arriving, Durya immediately noticed the typical signs of a stroke and they went to the hospital right away. They went to the ER and got more information from a friendly doctor. Friendly, yes, but it was not really effective. Although they did not dare to admit it during the consultation, the elderly couple did not fully understand the complex medical terms and Dutch language. Being brought up in rural Morocco, they believed brain injury and swallowing problems are two completely different things, and figured that the health issues were probably caused by an “evil eye”. Hence, the father in law did not get the medical care he needed, which resulted in an unnecessarily long recovery process.

Client

Cordaan (1 month)

Impact

Two animations about swallowing difficulties, which are used by speech and linguist therapists, families and nurses ever since.

Award

Winner of the CZ Zorgprijs

Health illiteracy is bigger than you think.

Research shows that in Europe, 40% of the population has difficulty understanding information provided by health care professionals. In the Netherlands, health literacy is on average 29%. But this percentage increases when people are uneducated, or when they have an immigrant background. At the same time, Dutch elderly with a Moroccan or Turkish background have a lower health condition than native Dutch elderly do. In other words: How to reach the part of the population that needs good health care most?

Speech and language therapist Homeyra Saiid started an initiative to improve the lack of information on swallowing difficulties for elderly with an immigrant background. Coming to the Netherlands 20 years ago escaping war in Afghanistan, she experienced language and culture barriers first hand. Imagine being in the ER and still processing what just happened to yourself or to your beloved one; not all information from the medical professional is clear. Especially when you don’t speak the language or have insufficient background knowledge.

Does hiring a Service Design agency for an animation sound like a strange decision? Not if you want to be absolutely sure you are making something that works for the viewer.

Service Design and animation.

Homeyra wanted to make a change. She came up with the idea to make an animation film about swallowing problems in Turkish and Moroccan, addressing cultural issues. In just 60 seconds, she wanted to explain the cause of the problem and provide basic health care advice. But instead of hiring an animation studio to do the job, she found us: a service design consultancy. Does that sound like a strange decision? Not if you want to be absolutely sure you are making something that works for the viewer.

Human-Centred Animation.

As a Service Designer, I firmly believe every design challenge starts with listening to your customer. So instead of starting with a briefing, storyboarding and copywriting, we started with interviews. We listened to stories of families, speech and language therapists, nurses, patients and doctors. By default, animations work best when they are short: 60 to 90 seconds. This means we had a restriction of 130–190 words. In other words: the information shown needed to be relevant, easy and practical. What better way to find out what cannot be left out than by asking the viewer.

Put your customer first. Not only in the method, but also in the animation. Mohammed was our main character.

Animation Sprint: in 5 days from research to test.

We used our Design Sprint method for this challenge. We made some iterations in the process, to make it applicable for animation:

Day 1: Expert interviews & research

Day 2: Scoping the problem and copywriting

Day 3: Storyboarding

Day 4: Building a prototype

Day 5: Test and collect feedback

The month after: Creating the animation

The value of testing your prototype.

Just 4 days into the sprint, we tested our initial idea with a prototype test with three families and two experts. Have a look at the prototype. We used Boords (storyboard software) to create a storyboard and asked a friend to do the voice over in Darija, a Moroccan dialect.

Even though the animation was not as smooth and perfect as the finished product, it worked surprisingly well.

We went to the homes of several Moroccan families in Amsterdam and showed them our creation. We immediately discovered what worked, and what didn’t. For example, the animation was too fast and sometimes too complex.

Evil spirits, evil eyes and jins are still associated with medical problems in some parts of the Arabic world. We knew this thanks to the interviews on day 1 of the sprint. So in our prototype, we paid special attention to this topic. In our test every single participant reacted to it! Some laughed, others felt recognised and started talking about it.

Tips and Tricks.

1. Go to the natural habitat of your viewer. It was very insightful to sit in an actual Moroccan/Dutch living room. We noticed that a typical Moroccan couch has a corner, so we used this to give the animation a Moroccan look and feel. We would have never known this if we stayed at our own design office.

2. Testing saves time and money. I have worked at an animation studio for 2 years. One of my biggest eye-openers was the time it takes to make a good animation. Animation is a profession. It takes a lot of time to do it right. So you better be sure what to animate and what not before you start investing time. I made a drawing of a brain visualised like walnuts, but the participants did not recognise it as such. Thankfully we learned this before the animator started, so we could fix it. Validate your assumptions.

3. Keep it short and simple. Cordaan already started on a voiceover text of about 4–5 minutes. Viewers attention generally drops after 60–90 seconds of animation. Serious cutbacks needed to be done. The experts found this hard because from their perspective everything is relevant and important. We helped them a lot. Because we knew what was relevant for the viewer, we knew what was essential.

The result: 2 animations and 1 award.

Using everything we learned during the sprint, we created two animations together with studio Anima. The animations are used by speech and linguist therapists, families and nurses ever since. There is a growing demand for more animation about similar health issues. In December 2019 we won the CZ Zorgprijs and we got the funding needed to continue this initiative! We are looking forward to start making more animations with Cordaan to make an impact in solving health illiteracy.

The brainpower behind this project

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