X Close

ASSA

Home

Anthropology of Smartphones and Smart Ageing

Menu

The Challenge of Menopause – Daniel Miller

DanielMiller3 August 2018

Photo (CC BY) Daniel Miller

For a project concerned with health and mid-life, menopause is an obvious target. What specifically does an anthropological perspective add, first to understanding menopause and second to envisaging a positive digital intervention? One key anthropological component, which is the comparative perspective, will have to wait until the team completes its research, but from my Irish fieldsite there are many possible insights. The challenge is firstly that no two women have the same experience. Menopause can start in your 30s or 50s. It can be almost symptom-free or have dramatic effects, some of which may never end.

The anthropologist will focus on the way medical issues are inextricable from the social context. The effect can be on close relationships. As a pharmacist told me, Sometimes they come and say ‘I’m ready to kill my husband I think I’m going crazy’ very reassured when you say it could be the menopause”. Or women report that vaginal dryness makes it too painful to have sex. Women have told me that their mothers never mentioned menopause to them, or that they do or do not feel they can discuss the topic with their sister or close friends. Mostly they report that menopause is a topic that can only be broached through jokes. The impact might also be on wider relationships, such as to one’s work: “You might say to your colleague `could you just take over for a moment’ and then not explain why you would disappear, because you had a flush and you needed to remove yourself”.

Then there is the relation to wider medical authorities. Concerns about HRT or addictive sleeping pills may mean they prefer to consult complementary medicine rather than doctors. Knowledge seems to be a complete lottery, where some are well aware of the potential effects on bone density while others have never had anyone suggest this is something they might look into. Listening to women, within an ethnography, also alerts one to the considerable differences in perspective. One woman will give a feminist perspective about the need to rethink menopause as a celebration of a natural process, rather than merely a medical problem. While another, who is undergoing IVF and is desperate to have children, sees nothing to celebrate.

For us, the ASSA team, it is important that this same alertness to the social and wider context should manifest itself as the anthropological contribution towards delivering that will be of genuine benefit. One of the lessons from this research is that we need to see smartphone apps less as autonomous interventions and more as potential hubs. Different women will respond to different levels of information. There are those who are turned off by text and just want visuals, contrasted to those who want to read the medical journals. In my research so far, women have split equally between those who would prefer a discussion forum based on complete anonymity, to those who would only want to discuss these issues with people they can identity and feel some sort of relation to. In making relevant information more accessible all these factors need to be taken into account, but first and foremost comes listening to what a broad range of women say.

 

What is a smartphone?

DanielMiller1 June 2018

Author: Daniel Miller

Photo (CC BY) newkemall

I have spent the last two months in my Irish fieldsite trying to answer a simple question: what is a smartphone? Actually, it’s a fiendishly difficult question. Several older people started our discussion by insisting that the only things they use their phones for are voice calls and texting. Once we looked at the phone in more detail, it turned out that just the most common functions include WhatsApp, maps, voice calls, camera, alarm/time, Facebook, text messages, calendar, weather and news. Once we add a variety of more specialist apps such as sports, music, airlines, banks etc. we easily reach the most typical result which would be that an individual uses between twenty-five and thirty different functions of their smartphone.

In the newspapers, the personalisation of the smartphone is understood as the advances in algorithms and artificial intelligence, which allow smartphones to learn from people and predict their behaviour. But, just as in our previous Why We Post project, for the ethnographer, these corporate developments pale into insignificance compared to the personalisation represented by the diversity of usage that will arise from the way an individual configures this multitude of apps.

Indeed, it may be the personality of the user that comes across most. A man expresses a particular version of masculinity in demonstrating how all his usage is based on need and pragmatism. He mentions more than once how, now his daughter is no longer in Australia, he will never use Skype again. By contrast, a woman, aged 69, has every last detail of her life, from the steps involved in paying each particular type of bill, to the slide decks from workshops she has attended, all carefully classified in nested hierarchies of icons on her iPhone. About the only thing she doesn’t like is the clumsy and intrusive Siri. In both cases the smartphone effectively expresses their personality. Sometimes a particular activity dominates an individual’s phone life; a phone where everything is geared to a retirement spent playing and teaching the banjo, or a phone that contains seven apps all associated with sailing.  It’s not that a woman is addicted to her phone, or even to YouTube per. se., it’s just that she can’t stop spending two hours a day following US politics on YouTube. More commonly the phone will revolve around three or four key activities and concerns such as a combination of family, sports, holidays, and photography.

Working with people in their 60s and 70s, I come to appreciate that they are not elderly, but that much of their life may be devoted to caring for an elderly parent in their 90s. For some of these people everything about the phone is connected with this responsibility of care, whether mobilising family care through WhatsApp, showing pictures of great grandchildren through Facebook, using maps to get to a hospital appointment, employing phone and text to negotiate with the local council and never turning the phone off, because you never know…

An equally important component of what makes the phone is people’s lack of knowledge. An older person is told to download an app, but she has never heard of Google Play and so attempts this action using an icon labelled ‘Downloads’. A man won’t buy a new Samsung Galaxy because it doesn’t have an inbuilt radio and he doesn’t know he can download radio as an app. Many users do not know the distinction between Wi-Fi and data that they have to pay for, so they won’t watch video while on Wi-Fi because they think it will cost them. Many can’t understand that a phone which ‘doesn’t work’, is not a broken phone, rather they just need to go about something in a different way. This is because the smartphone has so little in common with traditions of machines and tools. There is no manual they can actually use. Trying to work out precisely why one 80-year-old finds every little step impossible and another seems entirely comfortable in using these phones may give us many clues as to what, in effect, a smartphone is.

In the newspapers the smartphone appears as the constant development of new capacities – articles about the latest thing you can do with your smartphone are commonplace. For the ethnographer the smartphone is the myriad constellation of new actualities – we strive for an appreciation of what ordinary people create with or cannot understand about these devices.

From smartphones to target phones – By Marilia Duque

LauraHaapio-Kirk26 April 2018

Author: Marilia Duque

Photo (CC BY) Marilia Duque

Helen, a 67-year-old woman, was frustrated when she couldn’t show me all the pictures of her grandchildren that she keeps on her smartphone. “I came here with nothing. It is not safe”, she said. We were talking at a large square where people come to walk and exercise every day. Curiously, the place is also one of the 200 points with free WI-FI provided by the City Hall in São Paulo. Like Helen, many people who I’ve been talking to mentioned that they don’t feel comfortable using their smartphones in public spaces. Most of them agreed it is not safe to make and receive calls or to text on the streets. And they have good reason to be scared.

The number of robberies involving mobile phones represented 65.1 % of all robberies registered by the police in São Paulo in February of this year (percentage over total robberies involving documents, money, and mobile phones). According to the journal “O Estado de S. Paulo”, half of the streets of São Paulo had at least one mobile phone robbery reported from 2016 to 2017. I talked to 60 people in my fieldsite during this month and the numbers are also impressive. More than half of the informants had a smartphone stolen at least once or have someone in their family who experienced this. Because of that, people are creating different strategies to protect themselves and their smartphones in public spaces. For example, Lucy (65) said she would never answer a call on the street: “I just let it ring”. Lilly (67) makes some exceptions: “I take a quick look inside my bag. If it is one of my children who is calling I just go inside one of the stores on the street, so I can answer the call”. Jonas (56) doesn’t have children but accepts emergency calls only after he gets inside some safe space, like a coffee shop or mall. I have found more people who choose to leave their smartphones at home as a strategy to avoid violence: “I won’t risk my life”, one of the informants told me.

Photo (CC BY) Pixabay

People who have never had a mobile phone stolen or who don’t have a relative who did, feel lucky or blessed. Some of them also believe they haven’t been stolen because their devices are too old (they don’t have a smartphone), like one of my informants said: “Nobody wants that. They would probably say to me to throw it away as garbage”. That is not the case of Marcus (60). He already has a smartphone, a two-year-old one. But when I asked him when he was planning to buy a new one, he answered: “The next time someone steals mine”.

When I started my fieldwork, I thought the cost of service and the high rate of illiteracy (24% of the population older than 60 years) could be the two main barriers for the development of m-health initiatives for elderly people in Brazil. But security has became one of the key issue I will need to be aware of from now on. The strategy to leave the smartphone at home, for example, can invalidate two potential functionalities m-health apps can provide. The first is reminding elderly people to take their medicines correctly. According to Silva, (Schimidt and Silva, 2012), 40% to 75% of old people don’t take medicines at the right time or in the right dosage. The second is to contact relatives in case of a fall: one functionality provided by the apps Elderly Help or Mobil-SOS Be Safe, for example (Souza and Silva, 2016). All these advantages can be lost if elderly people just don’t feel safe enough to take their smartphones wherever they go. As one of my informants told me “if you have white hair, you are already a target”.

References:

Silva, R; Schimidt, O.; Silva, S. (2012). Polifarmácia em Geriatria. Revista AMRIGS 56 (2): p. 164-174.

Souza, C.; Silva, M. (2016). Aplicativos para smartphones e sua colaboração na capacidade funcional de idosos. Revista Saúde Digital, Tecnologia e Educação 1 (1): p. 06-19

Infrastructures of Care

LauraHaapio-Kirk19 April 2018

Photo (CC BY) Laura Haapio-Kirk

Someone recently told me about how he encourages his 86-year-old mother, whom he lives with, to use her home blood pressure monitor every day and record her readings in a notebook. He said that doctors had prescribed her medication to lower her blood pressure, which she did not like to take. His solution was to turn to traditional Japanese medicine which he explained is tailored to the individual’s body, rather than western medicine which relies on a universal concept of the body. He was able to track the success of this approach through the home monitoring kit, and now her blood pressure is back to normal. This story reveals how infrastructures of care are made up of various integrated systems – that blockages in the form of non-adherence may reveal alternative routes by which people navigate care and self-care.

I am part of a reading group at Osaka University hosted by Gergely Mohacsi and Atsuro Morita. A few weeks ago we discussed Morita’s recent co-edited volume called ‘Infrastructure and Social Complexity’ (Harvey, Bruun, Morita 2017). He explained that a recent focus on infrastructure in social sciences, indeed an ‘infrastrucutural turn’ in anthropology, is a result of infrastructures becoming increasingly precarious and therefore more visible. Ageing infrastructures are becoming more and more tangible as we bump up against cracks in roads and other markers of decay. Infrastructures are systems that should enable things to flow, whether that’s water, electricity, goods, or people. But what happens when people are disconnected from infrastructures, or for whatever reason the flow is blocked?

Photo (CC BY) Laura Haapio-Kirk

I began to think about how smartphones are integral to navigating many of the infrastructures that enmesh us, for example through maps that visually place you within an infrastructure of roads, or health apps that extend the infrastructure of a national health service towards more individualised care. However, as digital technology becomes more integral to health services will people with limited access (through lack of digital literacy, or affordability for example) face increased marginalisation from infrastructures of care? And how are health professionals to identify blockages in the flow of care before it’s too late for individual patients? In such cases where care is not received, it is not only the infrastructure which is revealed to be vulnerable, but individuals themselves.

A couple of days after the seminar I happened to read a newly published article titled ‘Thinking with care infrastructures: people, devices and the home in home blood pressure monitoring’ (Weiner and Will 2018) in which the authors use the concept of care infrastructure to look at the variety of people, things and spaces involved in self-monitoring using a blood pressure device. Their work reveals self-monitoring as a socio-material arrangement that expresses care for self and for others, as opposed to focusing only on the individual and the device: “Specifically, our analysis has drawn attention to the range of local actors and work involved in the practice of self-monitoring, even in the case of consumer technologies. Through this attention to work, monitoring may also come to be seen as involving not just data, but also care amongst kin, family and colleagues.” My intention for my research was always to look at smartphones as situated within wider practices and things including other technologies and people, but thinking specifically in terms of infrastructure expands my scope and gives rise to questions about how multi-layered flows are connected (or not), ranging from state level, to family based care.

References

Harvey, P., Jensen, C. B.Morita, A. (2017). Infrastructure and Social Complexity. Routledge

Weiner, K. and Will, C (2018) ‘Thinking with care infrastructures: people, devices and the home in home blood pressure monitoring’ in Sociology of Health and Illness 40: 270–282. doi:10.1111/1467-9566.12590.

Thinking beyond health apps – by Pauline Garvey

LauraHaapio-Kirk13 April 2018

Author: Pauline Garvey

Breast Cancer Survivor App developed by Professor M. Kell, Mater Hospital, Dublin, Ireland.

I recently came across an app for survivors of breast cancer. It allows its users to calculate their body-mass index, access nutritional advice, read recipes, set exercise goals and make donations towards cancer research. The app provides a fairly comprehensive guide to health management, but I wonder if it could offer more. Increasingly, the promise of health comes in a surprising variety of packages, and these often exceed a solitary pursuit of nutrition and exercise advice.

The Irish Longitudinal Study on Ageing (TILDA) led by Trinity College Dublin examines the social, economic, and health circumstances of over 8,000 people aged 50 years and older, resident in Ireland. Researchers have found that instead of later years being a time of decline and dependency, older adults make a valuable contribution to society, with many active in the lives of their families and in their communities. The TILDA report suggests, for example, that volunteering is life enhancing as is regular social participation in sports and social clubs. Overall, it finds 60% of adults aged 54 years and over take part in active and social leisure activities at least once per week while 47% participated in at least one of these organised groups at least once per week.

In my fieldwork site, there are groups that meet weekly to knit and chat while sharing coffee and cake. Other groups swim in the sea, go to church, go for bracing walks or gather to engage in litter picks. Many research participants talk of these activities as both building community and enhancing health, activities that are usually moderated through smartphone apps. Some activities that do not seem, on first glance, to be related to health come to be framed as such. For example, one participant in a craft group shared a post called ‘The Health Benefits of Knitting’ (Brody 2016) which argued that the repetitive work of knitting reduces the stress hormone cortisol. Are people joining these groups for purposes of health or fun or ‘community-building’ or for other reasons altogether? Are these distinctions blurred or even relevant for participants? Similarly, WhatsApp is integral to the moderation of these groups, not only in how groups are made but in the types of sociality that they engender, such as in the frequency of online interactions. Continuous online conversations that research participants have on WhatsApp can be experienced as a delight or disappointment, but either way have been described to me as new. These are some of the issues that I’m pursuing in my on-going research.

 

Breast Cancer Survivor App developed by Professor M. Kell, Mater Hospital, Dublin, Ireland, see https://www.materfoundation.ie/news/improving-care-breast-cancer-patients-mater/

Brody, J. E 25/01/2016 ‘The Health Benefits of Knitting’, The New York Times, available online at https://well.blogs.nytimes.com/2016/01/25/the-health-benefits-of-knitting/

The Irish Longitudinal Study on Ageing (TILDA), 11/10/2017 Trinity College Dublin, available online https://tilda.tcd.ie/news-events/2017/1702-w3-key-findings/

“Heal our wounds” Does religious devotion increase with ageing? – Alfonso Otaegui

LauraHaapio-Kirk9 April 2018

Author: Alfonso Otaegui

(CC BY) Alfonso Otaegui

The huge cupola of the Our Lady of Lourdes Basilica is hard to miss while walking through the peaceful neighborhood of Quinta Normal in the western area of Santiago de Chile. Just in front of the temple lays a street market of a particular kind. Street markets are common in Santiago. Some of them are permanent, while some others come up during specific days for a couple of hours and then vanish. Vendors set up tables and plastic roofs and sell the most varied merchandise: fruits, shoes, books, vegetables, bags, fish, used electric devices, clothes and plastic containers. Vendors cry out their offers and some of them even sing. The merchants in front of the temple, however, sell a quite distinctive paraphernalia, more in tune with the ambiance of the place. Yellow candles, brown crucifixes, grey statues of saints, blue bottles for holy water in the shape of the Virgin Mary, red bracelets and pink quartz stones lay next to each other in colorful contrast. Their colors are as varied as their purposes: specific saints (or stones) heal specific ailments or protect against specific evils. The diversity of this pantheon does not distract from what is beyond the market: the impressive open-air temple of the Lourdes Grotto.

This open-air temple, built in the late XIX century, hosts a reconstruction of the Lourdes Grotto, the cave in France where, according to Catholic tradition, the Virgin Mary made a series of apparitions to the 14-year old shepherd Bernadette in 1858. A series of minor displays to the left and to the right of the major shrine tell the story of Bernadette and her many encounters with the Lady. At the center, in the main shrine, a statue of Bernadette can be seen to the left. If you follow her gaze upward, you will find a statue of the Virgin Mary next to the words “Mother of Christ, heal our wounds and increase our faith”. For a couple of hours the shrine is open and people are invited to go in and touch the rock. While a lady at a pulpit reads the story of the apparitions and prays to Mary, people come to the front, piously caress the feet of Bernadette, touch the cave wall behind the altar and then reach a holy water font, where they wet their fingers and make the sign of the cross on their foreheads.

Even though there were people of varied ages, most of them were over fifty years old, not few of them over seventy years of age. They came, they sat for a while and, if the shrine was open, they would go to touch the statue and the wall. To the left of the shrine there is a spring of holy water. People queue –some standing, some on crutches, some in wheelchairs– to bless themselves or to gather the holy water in bottles, a few of which had the shape of the Virgin. The walls demarcating the area temple are covered with marble plaques, of which I counted over 2.000. Some of them as small as a packet of cigarettes, some others as big as a magazine. Some of them ask for help for a specific individual or family. Most of them thank the Virgin of Lourdes for the received favors. Some are as anonymous as to use the initial letters of names, while others have pictures of the beloved person for whom healing or care is asked. On the marble surface further requests and gratitude notes are written in pencil. The newest one was from last month. The oldest one from the first decade of the 20th century. For over a century people have come to this shrine to ask for divine help against disease or unemployment and to express gratitude later on. The high number of elderly people is remarkable. Was it always like this? Did these devoted citizens also come when they were younger? Does religious devotion increase with age? These are some of the questions related to the experience of ageing, healthcare and spirituality I want to answer in the frame of the ASSA project.

Wonder (Grand) Women – by Maya de Vries

ShireenWalton29 March 2018

Author: Maya de Vries

Recently the world celebrated International Women’s Day. In the Arab world, another important date taking place in the same month is Mother’s Day. Not in all cultures is this day still celebrated; for example, in my country, Israel, Mother’s Day turned into Family Day. Instead, it has become more and more popular to celebrate Women’s Day in workplaces, universities, and private organisations. During Women’s Day, special events for women, including lectures given by women, take place and there are lots and lots of discounts on all sorts of “women”-oriented products, an act one can criticize, of course.

In the Palestinian village of Dar al Hawa (دار الهواء), the field site I am conducting research in with the ASSA project, Women’s  Day was also celebrated in a unique form of a special day tour—just for women of Dar al Hawa of all ages—outside of the village as I was told by the women group I joined.

Photo by Maya de Vries, February 2018.

Dar al Hawa is located in the city of Jerusalem. It is not contiguous with the other Palestinian neighborhoods of East Jerusalem since part of it is considered West Jerusalem.

Photo by Maya de Vries, February 2018.

Nowadays, Dar al Hawa has a mixed population of Muslims and Christians and around 13,000 people reside in it. The majority of the village are young, mainly between the ages 21–40. The elder population in the village (61–74) is only 5.38%. The older women in the village do not go out to work, as when they were younger it was not so acceptable that they work; they also do not speak well Hebrew—the dominant language in work places.  Usually, when visiting Dar al Hawa in the morning, you can see women walking around to make run errands, or visit family or friends as happens in the intimate women’s group I have been lucky enough to join. This group of six older adult women meet every Tuesday at 11 am since 2006. Each time, they meet at a different house. They shared with me that they started to meet just to pass the time and that they enjoyed talking together. Usually a few grandchildren, from babies to toddlers, accompanied them,[1] so they could play together.

During their last meeting, I learned (among many other things), how they celebrated Women’s Day.  The entire group went on a day-long field trip to the Sea of Galilee. The trip was organized by the village’s Community Centre and was open to all women of Dar al Hawa, so others joined as well.  I was surprised to learn that the women in the group did not enjoy the trip at all. When I asked why, they explained that the trip was not suitable for their age; it was too long; and they did not have any breaks for coffee and shopping—everything was too fast. They even said that they would not register again for any trips organized by the community center. I thought to myself that they look so strong and vivid to me, so how could it be not suitable for them? Was it only the physical aspect or is was it also other, emotional aspects, such as loneliness or depression that may affect their feeling discontent?

I realized that they act like “wonder grand women as they take care of the entire family, clean the house, take care of their children, their husband (if he  is still alive), and their grandchildren in addition going out on fieldtrips. They also cook for the entire family. It is important  for them, according to their  testimony, to help their daughters and brides with their children, but throughout our conversations I heard other voices saying it is hard for them be with the little ones throughout the day—and that is one of the reasons  they established this group—to be together, with the grandchildren. I also heard that it is not easy to cook for so many people— sometimes twice a day. The tension between their love for the family and the burden they feel comes up quite a lot in their conversations.

Furthermore, the fast and easy communication channels we have today is also an integral part of their lives. All of them carry a smartphone, and they communicate with their families through it, mainly using the WhatsApp app.  They exchange recipes and photos of the grandchildren and give the grandchildren the smartphones so they can watch YouTube.  Nevertheless, although they also enjoy their phones most of the time, they are afraid and anxious for the young generation, as the phone has “stolen their childhood.”

Sitting with these impressive women, I keep wondering if and how their daughters will act when they will be grandmothers. Will they be “wonder grand women” as their mothers are?  I prefer not to take the position of a prophet, but I have a feeling that we are facing a change (as has happened in other places) in the perception of aging. Smartphones and other technologies have a lot to do with it. How exactly is the perception of aging changing? Is it different between men and women? What is happiness for older people today? These issues are what I hope to learn through the older adult population in Dar al Hawa.

[1] There is a shortage in day care institutes of young children, hence grandmother are babysitting quite a lot.