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CONTEXT OF THE PROJECT
Design Brief
How might I build trust in the Indian Systems of
Medicine (ISM) amongst its potential and current
users in urban India
Many of the ‘alternative’1 approaches to healthcare in modern
India2 consider the physical and spiritual human body3 as being
connected. They look at health in a holistic manner, indicating that
diseases are symptomatic of greater imbalances in a person’s
lifestyle4. On the other hand, allopathy looks at the human body as
a combination of separate, often unrelated biological parts that
can be “fixed” or “replaced” by breaking them down to their most
fundamental ingredients (Hankey 2010). Today, the average Indian
consumer of healthcare services finds themselves torn between
these radically different “religions of health,” with few existing
systems to support an integrated approach that values the unique
benefits of each system of medicine.
1 With reference to Ayurveda in the given reference material, but also applicable to the other Indian Systems of Medicine.
2 ISM, the once traditional and indigenous modes of healthcare.
3 Or in certain cases, such as in Pranic Healing, even the entire universe is considered part of one’s “energy body”.
4 Physically, mentally, or emotionally.
5 With reference to both people and institutions in this case.
The National Health Policy of India asserts that ‘focus on sensitizing
practitioners of each system to the strengths of the others’ is
important in the development of the nation’s integrative medical
capabilities. ‘Further the development of sustainable livelihood
systems through involving local communities […] will also be
supported by this policy.’ Hence, there is seen to be a national level
need to bring emphasis to the unique values of ISM as a means of
balancing the overwhelming focus being given to allopathic
systems. This is to be done through interventions at the local scale,
working together with the local communities of the region to build
sustainable systems of trust in ISM, and thereby in integrative
practices of medicine.
Until recently, the doctor-patient relationship was seen as having an
implicit and unquestioned dynamic of mutual trust. Evidence that
doctors have acted against patient’s interests has brought a shift in
these dynamics of trust. Today, with the cultural rise in the value of
autonomy, and the ease of access to information, including a pleth-
ora of medical information online that patients can consult, a new
paradigm of “calculated trust” is emerging in patient-doctor interac-
tions. This means that the patient is considered a partner in their
healthcare choices, and ‘trust may no longer be blind trust’
(Gopichandran 2013).
Through initial research, the aspect of trust in relationships5 (Simp-
son 2010, 264) has been identified as a key factor in the building
and sustaining of systems. When it comes to building a system that
has integrated two other subsystems, trust between the subsystems
is important in ensuring that the system works smoothly. Hence, the
identified design brief6 is approached through a set of frameworks
derived through existing theories on: trust in relationships and
research on the perception of ISM in the urban Indian context.
Both of these together help to detail the essential concepts under-
lying trust systems in ISM. The different aspects of the context that
ISM is placed in, in today’s urban India is presented through nine
key themes7. These outline the area of exploration and grounds for
this project, further leading to some essential questions to be
addressed through this project. This set of frameworks and key
themes will together serve as a guide for further enquiry and work
on the design challenge as defined in the brief. ISM is seen to be
especially effective in treating chronic illnesses. This makes ISM all
the more relevant to the urban Indian context, given the growing
influence of urban lifestyles on chronic and non-communicable
diseases. Hence, the proposed system or service could highlight and
accentuate this unique benefit of ISM over allopathy to the poten-
tial and current users of ISM. This would provide a fair share of
focus on ISM’s unique values and thereby enhance the chances for
effective integration of these systems of medicine into the Indian
healthcare system.
In terms of the user’s economic demographics, systems and services
that reach out to the lower-middle class of society8 would create a
“trickle-up innovation” effect on the systems of trust in ISM. ‘... These
reverse innovations9 are an important opportunity for learning and
building capacity for leading change that has the potential to
optimize resource use while also finding innovative approaches to
deliver health services in a cost effective, sustainable manner.’
(Snowdon 2015) The lower-middle class¹⁰ make up a large section
of India’s urban population, much larger than what is referred to in
general as the ‘middle-class’ population, and this would be an
opportune section of the population to build personalised systems
of trust in ISM through in-depth research and appropriately
designed systemic interventions.