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Ageing Actively in Focus

ShireenWalton8 January 2019

Books about ageing are currently in the spotlight. As discussed by Daniel Miller in an earlier blog post from February 2018, philosopher Kieran Setiya has looked at mid-life, from theoretical and practical perspectives. Another more recent work comes from journalist and author Carl Honoré, who in (B)older: Making the Most of our Longer Lives (2018) suggests a rethinking of ageing as a positive feature of the human experience, to be increasingly acknowledged and enjoyed more than ever before in history – a bonus not a burden.

Image (CC BY) Shireen Walton

What these books have in common is a call to shift our thinking about ageing from a negative; to consider the positive aspects of later life, and to rebrand ageing along ‘active’ lines, recalling the European Union’s emphasis on ‘active ageing’. In Italy, a country with the second (after Japan) oldest population in the world, active ageing receives much public policy and media attention. One avenue through which I came in to contact with these initiatives is through Auser, a nation-wide NGO in Italy founded in 1989. The organisation has branches all over the country, and the Lombardy region headquarters is in Milan – located in zone 2 where I am based for my research. Auser’s mission statement is ‘promoting the active ageing of the elderly and enhancing their role in society’ from  an inclsive perspective: ‘addressed primarily to the elderly, but open to relations of dialogue between generations, nationalities, different cultures.’

Auser website (English version)

Attending one of their meetings in Milan in December, I learnt about some of the main ways that ageing is being envisioned; towards skills-acquiring and sharing; a push towards enjoying life through ‘Active Welfare’, a concept the organisation defines as follows:

“Perhaps we will all have to work on building a model of “active welfare” based on financial resources adapted to social needs, built on an integrated system of subjects and public and private interventions, where through informal networks, the State, the Third Sector and individual citizens all work to build the social welfare of people, thus strengthening the concept of community and of social cohesion.”  [Auser mission statement, website]

Auser December meeting, Milan December 2018. Image (CC BY) Shireen Walton

I do not want to detract from these optimistic and significant attempts to combat ageism, but as ethnographer, I have to also investigate, specifically, what possibilities are/could be available to who – locally, regionally, nationally? From the middle-aged Italians in this fieldsite, I hear a great deal about the devastating economic situation in Italy since the 2008 economic crash, which makes the idea of retiring for many seem nigh on impossible, particularly if sufficient structures of in-family care are not in place due to transnational family lives and financial pressures. Active ageing is is also difficult to envisage amongst some of the individuals, families and groups I am working with from countries such as Egypt, Afghanistan and Peru, many of who currently imagine their futures as continuous work(ing). Noor, 45, a schoolteacher from Alexandria, explains how she “hopes my children will take care of me, as I take care of them…if we are together, Inshallah, we will all be fine.” How, I wonder, will her 15-year old daughter take care of her Mother in years to come? What might potential future Grandparenting be like for Noor, as an Egyptian single Mother living in Milan in her 60s?

Image (CC BY) Shireen Walton

Ali, Hazara (44), from west Kabul works a number of jobs, including as a night-time lorry driver. His wife and children are currently in another northern European country with his wife’s family. Ali explained the following: “Of course for the future having money is fundamental, but it is also important if you are a helpful person, and do good things for people; for your family, for your people (Hazara), and for humanity.”

Image (CC BY) Shireen Walton

Noor’s investment in Italy seems to be long-term; her ever-strengthening language proficiency, her children growing up in Italy, attending school and speaking fluent Italian, the death of her parents in recent years back in Alexandria and her own severance from the rest of the family in Egypt means that she feels she is here to stay, intent on growing old near her children. For Ali, currently working in Italy and visiting his family when he can, the geographies of his and his family’s future remains unknown.

My ongoing task then is to consider how people are ageing in – and away from – their homelands, aided by smartphone connections, but in many cases lacking public voice, and/or not involved in many of the dominant culture’s organisations and groups dedicated to ageing, health, and wellbeing. I am continuing to explore about these issues in line with broader conversations about contemporary citizenship, the role of technology, the state and NGO’s, migration trajectories & biographies, and the ongoing categorisation of peoples into strategic kinds of subjects (Giordano 2014). The approach reflects my commitment to studying ageing across cultural lines here in Milan.

References

Giordano, C. (2014). Migrants in Translation: Caring and the Logics of Difference in Contemporary Italy. University of California Press.

Let’s laugh together – by Marilia Duque

Xin YuanWang26 December 2018

Author: Marilia Duque

Marilia (left) with her friend

One year of fieldwork and I must say, I am here laughing alone whilst I remember all the good times I had with my informants. At first I could have argued that most of them were fighting against the stigmas of ageing. On one hand, it means that they were trying their best to hide their physical limitations in order to keep their independence and their autonomy. On the other hand, it also means they were trying to adapt to the model of successful ageing, the image of respectful old people who are healthy, productive and socially engaged. Yes, they are always alert and fighting for their space and that resistance can result in a kind of self-surveillance, with a zero-tolerance with those who try to make fun of old people.
But wait until you are accepted by the group, wait until they feel comfortable with your presence and you will be surprised. They laugh at old people all the time. They recognize their frailties and they make fun of them. I was at an event with old people last week, and an old lady was stealing the scene, dancing with her very long hair, when one jealous old woman whispered to me “her geriatric diaper will fall”. After a while, when the lunch was served and a long queue of old people had formed, one of them said laughing, “where is the senior row? I have priority”. They also make jokes of issues like impotence, lack of memory, deafness, insomnia and their difficulties with technology. They address with humour the amount of time they spend in hospitals, all they have to do to pay their health insurance, how young people think they are stupid and how they feel tired after they have to pretend they were not “that old”.
We shared incredible moments together when they were not old people anymore. They were just human beings facing some difficulties in life and getting old day after day, just like me and anyone else.

Retirement and its malcontent in Yaoundé – by Patrick Awondo

ShireenWalton15 November 2018

Author: Patrick Awondo

The question of retirement in Yaoundé requires first and foremost an understanding of the precariousness of employment and its widespread informalisation across the country, making the idea of retirement per se almost impossible. One of the questions asked by informants is often “what does retirement mean in a country where work is scarce”? Approaching the question of retirement in Cameroon, 3 types of reactions are generally involved.

The first and the most frequent is that “Retirement is not a punishment!” Nearly all of my interlocutors have expressed sentiments such as this at the mention of retirement ; an idea reflecting wider public discourse concerning the retirement of civil servants who have a hard time accepting it, as well as a view from a section of society which views negatively the fact that retirement-age officials are dropping out of duties that should be the responsibility of other younger people.

A second reaction expressed my my informants is to highlight how retirement is necessary, despite the challenges it poses in the context. In discussion, informants raised context as an important factor determining retirement experiences, in a country where only 15% of workers have a payslip. Retirement is therefore a fact that concerns a limited number of people from an official point of view. There is also a notably pessimistic discourse about retirement, especially for those who live and are currently experiencing it. The present moment in Cameroon thus appears to be a complex moment in which the experience of the end of work is combined with a decrease in material resources and precariousness. A final category of discourse highlights the alternative facts that allow us to have a less pessimistic look at retirement. These 3 attitudes and points of view on the retirement can be an entry to initiate a reflection on the way in which this moment of life is expressed in Cameroonian society. Overall, informants in Yaoundé emphasise the ambivalence of retirement.

“Retirement is not a punishment! “

To understand the significance of this popular expression in Yaoundé we must consider the context of work patterns in the country. The labor market in Cameroon is characterised by a high unemployment rate, as well as underemployment[1]. Unemployment is highest among 15-24 year olds (10.3%) and 15-34 years old (8.9%) than among the general population (5.7%). In addition to this, is youth unemployment, which varies with the level of education and is especially higher among higher education graduates (27.1%). Youth unemployment rate is higher in urban areas (15.5%) than in rural areas (4.3%), and is 8.5% for males and 23.5% for females.

In the Cameroonian context, the state remains the largest employer in the formal sector because informal employment is more widely represented, and covers more than 70% of working people. In such a context, the number of de facto retirees is limited insofar as the number of civil servants is itself relatively low, since the State can not absorb all graduates and job-seekers.

Another much more specific issue has been raised in the discussions on retirement in Cameroon in recent years. In 2009, the Association of Public Service Retirees (AREFOP) publically denounced the problems faced by people at the end of their careers along the following lines :

  • the improvement of pensions of retirees in the face of increased purchasing power: “Where have our contributions to the land credit passed for decades?     “How many of us have retired without benefiting from a single honor when they served the nation with loyalty?” Ask the retired officials.
  • Preservation of health insurance
  • The possibility of accessing bank credit etc. «  Why do banks don’t ant to give credit to pensioners at least as far as school advances are concerned? »

These points subsequently led to a media-based controversy over retirement issues. A particular grievance was the long waiting lines in which people came to collect their certificates in the offices of the National Social Insurance Fund (CNPS), the body responsible for social security and pensions. These controversies led to reforms and an administrative reorganization, which reduced expectations and conditions for pensioners’ pensions.

The impossible retreat

 A second series of arguments often mentioned is related to the specific situation of the labor market. Some statistics can help illuminate this issue. In the year 2017, according to the data of the CNPS[1], 7,415 files of Pensions Old Age Disability Deaths were filed during the year and 97,48% were liquidated of which 85,47% in less than 15 days and 8.36% in more than 45 days. The pending files represent 2.04% of the total files filed. The number of PVID beneficiaries is up slightly by 1.6% (from 109,304 in 2016 to 111,006 in 2017). If we consider that Cameroon has more than 23 million inhabitants, of which half active, then 111 006 residents represents a derisory figure. The generic question of retirement as having entailed access to work, and therefore to a pay slip, and later to a retirement pension therefore appears inadequate as a framework for understanding the experience of later life in Cameroon.

The happy few

 There is however an alternative viewpoing about retirement – one which emphasizes its need after long years of “good and loyal” services, and acknowledges the possibility of it being a time for flourishing. This discourse is the result of two categories of informants : people who have worked in a manner that is appropriate for the context, that is, with a regular salary and benefits, and another category of people employed in the formal private sector, who have made a very good living and who have invested in retirement – particularly seen in the field of real estate. Informants mention building several houses for instance, whose monthly rent will be an end-of-career investment. These people are a small group but are a growing happy few retirees in Cameroon who participate in the middle and upper middle-class life style in Cameroon, which is currently expanding, but constitute an overall minority.

Notes

[1] https://www.cnps.cm/images/AnnuairestatistiqueCNPS2017.pdf#page17

Sharing is caring: communities of abundance in rural Japan – by Laura Haapio-Kirk

LauraHaapio-Kirk22 October 2018

Harvested corn. Illustration by Laura Haapio-Kirk

Last week I returned from ten days among the wonderful people of my rural fieldsite in Kochi prefecture. The vibrant green rice terraces I had been mesmerised by back in August are now the colour of gold, and in the fields small pyramids of drying rice are beginning to appear. It is harvest season and I was able to experience first hand, as people kept telling me, how Kochi is truly a land of abundance. I was given bags of chestnuts and yuzu lemons, and large Japanese pears (nashi); people here are adamant about sharing the fruits of their labour. The gifting of food binds the community and is, as one woman told me, important for creating a feeling of wealth without money: “Even if we have no money here in Kochi, we have abundance because we can grow so much delicious food and we love to share it.”

Community is sustained in this small rural town through a number of institutional initiatives, such as group activities for elderly residents, or regular workshops in the town hall, for example for new mothers. But it is also through these informal networks of reciprocal giving that community is made. The building and sustaining of community is especially important to people here because Japan’s ageing and shrinking population is felt most acutely in rural areas. It is not rare to come across abandoned schools which have been repurposed as community spaces, and indeed entire empty villages. Yet, I have also come across another quite different picture – young people and families moving into this rural town in search of a slower pace of life and self-sustainability. I have met numerous families who left behind jobs in cities both in Japan and abroad, to start new lives in a place where they feel safe; both protected by a community that looks out for each other, and as a number of people have told me, far enough away from the site of the Fukushima nuclear disaster of 2011 for the food to not be contaminated.

Akaushi – a famous breed of local cow. Illustration by Laura Haapio-Kirk.

This group of relatively recent immigrants, who have mostly arrived within the last eight years, are active on Facebook community groups where they buy and sell clothing, and post about local events. I have been told that local people are less active on Facebook, but perhaps more reliant on one-to-one messaging through Line. However, I have come across local people practicing traditional crafts who share their work on social media. For example, one woodworker in his sixties who uses Instagram to promote his products has customers as far as Tokyo. He told me “It is important for us to be active online because this is how we can reach the rest of Japan and the world, and show the beautiful things that we make here from nature.” Indeed, one of the first people to move to this community eight years ago blogged about her experience and inspired others to follow her move from urban to rural living. Blogs and social media are one way that people in rural Japan can influence a wider perception of the rural from being depopulated and dying, to re-populated and thriving. Social media also provides an opportunity for local people to build and develop their community in new ways. As my bags of fruit demonstrate, they have always had an extraordinary tradition of sharing.

The challenges of staying active – by Maya de Vries

ShireenWalton25 September 2018

Author: Maya de Vries

10 years ago, in a Russian store at the city center of Jerusalem, I bought an A3 size poster from the communist time, with a drawing of an old lady who looks like a farmer, holding a book. The short text beside her image read: If you stop reading books, you might forget the language.

Recently in my field site of Dar al Hawa I found myself remembering this poster when visiting the elderly club, a central place in my field site, as I observed a variety of practices that aim to keep them sharp and vital.

One of the most challenging problems in the elderly club is to find suitable activities for the members. They need to be activities that both men and women can do; not too physical, because many are suffering from pains in their legs and can’t walk a lot, some have hearing problems, or cannot breath well. Hence, many of the activities are ‘just’ talks – it is easier for them to sit and listen. However, there can still be difficulties in establishing the time and place with lecturers as sometimes they call in the morning of the lecture to cancel. When a lecturer stands them up like this or if there is no other organized activity in the club, their alternative is an independent Quran lesson, which is quite different from the religion lesson that they have every few weeks with the local Iman. They take out larger volumes of the Quran and start reading aloud, each one in his/her turn. Hala, a member in the club who is volunteering in the Israeli welfare department and coordinates some of the club’s activities, leads the reading session and corrects them as they read. It is not easy to read correctly from the Quran,  as ech part has its own chants. The exercise is productive not just of the sense of community but also isa practice which helps stimulate memory (Collier, 2017).

The books were donated by one of the club’s members, and are large in order to make reading easier. From the perspective of our projects work on smartphones, in a site where religion plays a core role in daily life, the small screen of the smartphone poses a problem – even if they are able to change the size of the font. However, people here do find relevant uses for the technology. For example, most of them have downloaded an app that reminds them when to pray during the day.

Quran reading lessons seem to be physically passive, since they take place while sitting. However, praying in Islam is quite a physical experience, as the person praying needs to first take off his/her shoes, following this he/she may enter the mosque and begin praying. Praying also involves all kinds of physical positions such as sitting, leaning to the ground, standing up, turning the head to the side – these movements are frequently repeated. The entire group went inside the mosque to pray, some sat on the floor as is custom, while others who physically cannot get down to the floor took plastic chairs. For almost an hour, they all prayed, regardless of any physical limitations, and in a way, were challenging their bodies through the prayer. It is easy to forget that prayer is far more than just words. It is an immersion of the person physically and mentally within their religious practice, and for older people, it remains the structure to much of their life. So when thinking about the impact of the smartphone on people’s lives, one has to be continually aware of how much, and how, this is mediated by religion.

References:

https://www.medicalnewstoday.com/articles/320377.php 

The place of WhatsApp in the ecology of care – by Marilia Duque

LauraHaapio-Kirk26 August 2018

Author: Marilia Duque

Dr. Gusso uses WhatsApp Business at Amparo Health Clinic (Photo: Marilia Duque)

In 2015 a PwC research report suggested that the Brazilian m-health market would reach $ 46.6 million while a GSMA report forecasted that 45.7 million Brazilians would benefit from mobile health projects (see here). In 2017 the scenario was even more optimistic. According to Statista, Brazil was expected to become the largest m-health market in Latin America with revenues of around $ 0.7 billion. These numbers explain the impressive amount of m-Heath startups and startup Incubators I’ve seen in Sao Paulo (see Eretz.bio, for example). But they don’t explain why after 7 months of fieldwork I still couldn’t find the people who are actually using these m-health apps. Instead, I found an intensive use of WhatsApp among my informants, filling the gaps in communication and making a huge impact on the ecology of care which we address in this project.

For example, every day early in the morning, Ms. M (54) sends a good morning message through WhatsApp to four lady-friends older than her. “It is like volunteer work because I know they are lonely and that message will make them happy and socially connected”, she explained. Ms. D (66) also starts her day sending a WhatsApp message. But in her case, the message is sent to her only daughter who lives in France, as a sign that she spent the night well. She is supposed to send this message every day before 10am otherwise her daughter will call a friend to check on her. “Some people say my daughter abandoned me, but the truth is that she is closer than many of my friends’ children who just live nearby”.

That is the same in the case of Dr. J., a physician who works in Sao Paulo and uses WhatsApp to take care of his 93 year-old father. After having a stroke, his father moved to Dr. J. brother’s house located two hours away.  Dr. J. created a WhatsApp group to talk to his brother and to his father’s caregiver. He gives her all the instructions she needs, and she updates him with information such as what his father ate, how he slept, how much water he drank, how much he exercised and how he was feeling. After a few months, he could tell how improved his father was and he explained how WhatsApp helped him and his family to feel safe and engaged.

Dr. K. also uses WhatsApp to provide care at distance. He works in my field site as a generalist providing ambulatory care to old people. WhatsApp allows him to give orientation about what to do when patients don’t feel well, and he can also ask them to go to his office if necessary. In many cases, he said, he can solve problems providing only care at distance. Dr. K. believes that the simple fact that the patients know they can use WhatsApp to contact him makes them feel safe and comfortable.

WhatsApp is also helping clinics to manage people’s health. Amparo Health, for example, is a clinic that uses WhatsApp Business to connect patients to doctors. The patient pays a monthly fee to have access to low-cost exams and to specialists like ophthalmologists, gynecologists, dermatologists, nutritionists and psychologists. What is new here is that all procedures and exams are coordinated by a generalist, who is available on WhatsApp. Dr. Gusso, the head physician at Amparo Health, explains that because the clinic business model is based on membership, they have no interest in demanding unnecessary exams or appointments. Doctors are paid by the hour and not by performance and that includes time to answer WhatsApp messages during the morning and afternoon. At the end of the day, he said, they are using WhatsApp to provide care at a distance, helping people to stay healthy, to feel safe and to save money. Prevent Senior, a health insurance company, also uses WhatsApp to make patients’ lives easier. In cases where treatments require on-going medication, patients can use WhatsApp to ask for new prescriptions. They can receive their prescriptions at home or they can go to the doctor office to get them, but with no need to schedule an appointment.

WhatsApp is the primary method of communication for 96% of Brazilians with access to smartphones. And among my informants older than 60 years old, that is also the app they use the most. Now imagine what can be achieved if WhatsApp features are explored to make the communication between health insurance companies, doctors, patients, caregivers, family and friends healthier too.

Conducting a health check in rural Japan

LauraHaapio-Kirk22 August 2018

Earlier this month I was invited to help in an annual health check in a rural town in Kochi prefecture. I had wanted to find a rural comparative site to my main fieldsite of Kyoto, so when Dr Yumi Kimura, a researcher at Osaka University, invited me to participate in the health check, this seemed like the perfect opportunity to establish myself in a rural community. I arrived in Kikuyama* on a Sunday afternoon along with my research assistant, Lise Sasaki, and about 50 other researchers, students, doctors, and dentists. The five-hour train and bus journey from Kyoto ran alongside sparkling clear turquoise rivers winding their way through lush mountains.

We were first briefly taken to a scenic spot to view rice terracing; breath-taking luminous green tumbling down the mountainside. But that was the limit of our sightseeing; we soon got down to business. We were expecting to welcome about 300 people to the health check over the next five days so we spent that Sunday afternoon preparing. The health check was to take place in a large hall adjacent to the town’s health clinic. We set up distinct areas for different kinds of medicine and tests, including areas for dentists, cardiologists, gynaecologists, mobility and dexterity tests, dementia tests, driving tests, blood tests, and a space for general practitioners to give consultations at the end of the visit. The area where Lise and I were stationed featured a machine called InBody which we used to measure body fat and muscle percentage.

The machine works by running a small electric current via electrodes placed on the fingers and ankles. Over the course of the week, while we attached and removed electrodes, we had a chance to chat with people about their health. This was a great opportunity to meet a large number of people in a short space of time and to establish myself as a known person to this community. Many were very surprised to see a foreigner, and some even asked to touch my hair, telling me it was the first time they had seen someone with fair hair and skin up close. Given the hectic nature of the health check we were only able to have long conversations with a few people, most were limited to about five to ten minutes. However, we managed to get a sense of the topics that were most insistent and frequently occurring in relation to health: work, food, luck, and community. Identification of these key topics will direct my conversations that are scheduled during my return trip in October, when I am planning to conduct more in-depth interviews and also do filming. Without participating in the health check I feel it would have taken much longer to build up trust with this rural community, especially as a foreigner, but now we have many invitations to visit people in their homes.

I will save a longer discussion of the above mentioned topics for a blog post after my second visit to the site, but for now I will briefly explain why the topic of work appears so pertinent to understanding how health is conceived in this community. Most people we met were rice farmers or foresters, often still working well into their 80s. The foresters had extremely big hands which were often missing fingers, and the rice farmers were deeply tanned from spending their days in the fields. This is hard work which leaves its mark on the body, yet when asked what is the secret to staying healthy and energetic (genki) in old age nearly everyone said that daily work is key. Men and women appeared to be equally committed to farming, while all of the foresters were male. For some farming had been a life-long career, and for others they had taken it up after retiring from other jobs. While the physical nature of strenuous work appears to benefit the physical health of these strong elderly people, I am particularly fascinated by how the sociality of work affects people’s emotional and mental health. Farming requires communication, not only with suppliers and buyers, but also with fellow farmers about how to cooperate and to manage seasonal fluctuations. People also mentioned that they socialise with people who do the same work: a rice farmer will go and have sake now and then with fellow rice farmers in their association. The significance of work for health in later life appears to be about more than staying active or having an income, it seems to be central to maintaining a sense of belonging within a community. I look forward to further exploring this topic, along with the others, in the months to come.

 

Text and Illustrations by Laura Haapio-Kirk

*A pseudonym is used in order to protect privacy.

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