An Argentina Hospital's Safe Space For Patient Feedback

An experimental listening booth in Buenos Aires provides people a comfortable space to give honest feedback — alone and in anonymity.

The 'Módulo de Escucha' or 'Listening Module'
The "Módulo de Escucha" or "Listening Module"
Miguel Jurado

BUENOS AIRES — The late Francisco Maglio, the long-time head of Intensive Care at Hospital Muñiz in Buenos Aires, had a saying. "For years we doctors have been at the bedside of our patients. But what we need to do now is be on their side."

It was a view that "Pancho," as he was affectionately known, put into practice while working at the hospital, and that he later developed in books and lectures as head of the Argentine Society of Anthropological Medicine. It's also a vision that, three years after his death, inspired an experimental project spearheaded by his daughter Tuti, who heads the hospital's Institutional Relations department.

The centerpiece of the project is little cabin — a Listening Module, they call it — set up in the Hospital Muñiz gardens. And its purpose is to provide patients a safe place to give feedback about the treatment they receive and their interactions with the facility's doctors and staff.

The module is consciously colorful and could be mistaken for an art installation. But it's also a bit like a confessional, and its purpose is to help patients say what they really feel, without holding back. It is a small, orange cart on wheels, and inside, patients can leave a recording or a written note — alone and anonymously.

The module was designed and is managed by the architects Gustavo Diéguez and Lucas Gilardi (A77 studio), and designers Roger Colom and Leonello Zambón of CoZa, an ongoing creative project.

Francisco Maglio​ believed this approach to patient feedback should replace the traditional interview format. Questioning patients in a hospital could be intimidating, or even become "inquisitorial," he realized. Like judges and policemen, "We doctors ask questions," the late doctor once said. "And all three of us have "uniforms' and can "confine" individuals either as inmates or patients."

As a proponent of holistic treatment, Maglio was well aware that if a medical consultation gets off to a bad start, it can predictably provoke the patient's "resistance."

The designers of the listening cart wanted it to be clearly visible, thus its playful form and color. The design seeks to make the patient comfortable inside, and especially feel sheltered. Particular care was taken to ensure the module could be used by patients with immunodeficiency. The cabin contains a desk and chair for writing by hand, and a recorder in a small console with a single button to start and end voice message recordings.

The outer shell is treated to resist the weather and the cart is mobile like a trailer or vehicle. It can be moved to different parts of the Muñiz gardens, or taken to another hospital.

The inside of the module — Photo: Investigaciones del Futuro/Facebook

After a couple of months, the Listening Module gathered in a good many, worthwhile opinions on patient experiences, sensations and wishes on various levels. These then became part of an exhibition at the hospital's 7th Congress, which took lace last November at the Metropolitan Design Center.

It was unusual venue for a medical congress. More unusual still was that several of the event's presentations mentioned the data and mechanics of the booth, and praised it as an opportunity to rethink doctor-patient relations.

Tuti Maglio also manages the hospital museum and its patrimony, contributing furthermore to the integral healthcare of patients through reading and art workshops. Her father believed illness goes beyond a patient's affected organs, and that healthcare, therefore, should also take a much wider view.

The younger Maglio and the A77 studio have been collaborating for some time now, and the architects have undertaken other projects like lecturing on techniques for video displays inside the museum, or creating equipment using discarded bed parts. And last year, Tuti Maglio created an Art Space in the waiting room of the hospital pharmacy, where patients spend time before receiving medicines.

The cabin was part of this same quest for holistic attention to patients. It was open permanently throughout December, to mark the Art Space's 10th anniversary. In that respect is really is an art installation. But it's a medical instrument of sorts. And it's certainly a curiosity.

Regardless, the purpose of the listening booth above all is to help realize the late Magio's vision of bringing doctors and patients closer together, of helping doctors go from the bedside, as he used to say, to really being on their patients' side.

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How Thailand's Lèse-Majesté Law Is Used To Stifle All Protest

Once meant to protect the royal family, the century-old law has become a tool for the military-led government in Bangkok to stamp out all dissent. A new report outlines the abuses.

Pro-Democracy protest at The Criminal Court in Bangkok, Thailand

Laura Valentina Cortés Sierra

"We need to reform the institution of the monarchy in Thailand. It is the root of the problem." Those words, from Thai student activist Juthatip Sirikan, are a clear expression of the growing youth-led movement that is challenging the legitimacy of the government and demanding deep political changes in the Southeast Asian nation. Yet those very same words could also send Sirikan to jail.

Thailand's Criminal Code 'Lèse-Majesté' Article 112 imposes jail terms for defaming, insulting, or threatening the monarchy, with sentences of three to 15 years. This law has been present in Thai politics since 1908, though applied sparingly, only when direct verbal or written attacks against members of the royal family.

But after the May 2014 military coup d'état, Thailand experienced the first wave of lèse-majesté arrests, prosecutions, and detentions of at least 127 individuals arrested in a much wider interpretation of the law.

The recent report 'Second Wave: The Return of Lèse-Majesté in Thailand', documents how the Thai government has "used and abused Article 112 of the Criminal Code to target pro-democracy activists and protesters in relation to their online political expression and participation in peaceful pro-democracy demonstrations."

Criticism of any 'royal project'

The investigation shows 124 individuals, including at least eight minors, have been charged with lèse-majesté between November 2020 and August 2021. Nineteen of them served jail time. The new wave of charges is cited as a response to the rising pro-democracy protests across Thailand over the past year.

Juthatip Sirikan explains that the law is now being applied in such a broad way that people are not allowed to question government budgets and expenditure if they have any relationship with the royal family, which stifles criticism of the most basic government decision-making since there are an estimated 5,000 ongoing "royal" projects. "Article 112 of lèse-majesté could be the key (factor) in Thailand's political problems" the young activist argues.

In 2020 the Move Forward opposition party questioned royal spending paid by government departments, including nearly 3 billion baht (89,874,174 USD) from the Defense Ministry and Thai police for royal security, and 7 billion baht budgeted for royal development projects, as well as 38 planes and helicopters for the monarchy. Previously, on June 16, 2018, it was revealed that Thailand's Crown Property Bureau transferred its entire portfolio to the new King Maha Vajiralongkorn.

photo of graffiti of 112 crossed out on sidewalk

Protestors In Bangkok Call For Political Prisoner Release

Peerapon Boonyakiat/SOPA Images via ZUMA Wire

Freedom of speech at stake

"Article 112 shuts down all freedom of speech in this country", says Sirikan. "Even the political parties fear to touch the subject, so it blocks most things. This country cannot move anywhere if we still have this law."

The student activist herself was charged with lèse-majesté in September 2020, after simply citing a list of public documents that refer to royal family expenditure. Sirikan comes from a family that has faced the consequences of decades of political repression. Her grandfather, Tiang Sirikhan was a journalist and politician who openly protested against Thailand's involvement in World War II. He was accused of being a Communist and abducted in 1952. According to Sirikhan's family, he was killed by the state.

The new report was conducted by The International Federation for Human Rights (FIDH), Thai Lawyer for Human Rights (TLHR), and Internet Law Reform Dialogue (iLaw). It accuses Thai authorities of an increasingly broad interpretation of Article 112, to the point of "absurdity," including charges against people for criticizing the government's COVID-19 vaccine management, wearing crop tops, insulting the previous monarch, or quoting a United Nations statement about Article 112.

Juthatip Sirikan speaks in front of democracy monument.

Shift to social media

While in the past the Article was only used against people who spoke about the royals, it's now being used as an alibi for more general political repression — which has also spurred more open campaigning to abolish it. Sirikan recounts recent cases of police charging people for spreading paint near the picture of the king during a protest, or even just for having a picture of the king as phone wallpaper.

The more than a century-old law is now largely playing out online, where much of today's protest takes place in Thailand. Sirikan says people are willing to go further on social media to expose information such as how the king intervenes in politics and the monarchy's accumulation of wealth, information the mainstream media rarely reports on them.

Not surprisingly, however, social media is heavily monitored and the military is involved in Intelligence operations and cyber attacks against human rights defenders and critics of any kind. In October 2020, Twitter took down 926 accounts, linked to the army and the government, which promoted themselves and attacked political opposition, and this June, Google removed two Maps with pictures, names, and addresses, of more than 400 people who were accused of insulting the Thai monarchy. "They are trying to control the internet as well," Sirikan says. "They are trying to censor every content that they find a threat".

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