X Close

ASSA

Home

Anthropology of Smartphones and Smart Ageing

Menu

The Full Moon on WeChat — by Xinyuan Wang

By Xinyuan Wang, on 10 October 2019

fig. 1

11 am, UK time, 13th September, in China it’s already early evening. Mrs. Tong (59), one of my research participants in Shanghai, sent me a WeChat animated sticker of a bright full moon surrounded by three joyful bouncing bunnies, saying ‘Happy Mid-autumn day!’ (fig. 1) This is just one of hundreds of stickers, emoji, short videos, or animated albums to do with the full moon or moon cakes that circulated among friends and family members on WeChat, the dominant social media platform in China (fig. 2) on the day of Chinese mid-autumn festival.

Falling on the 15th of the 8th month of the Chinese lunar calendar, the mid-autumn festival, or the ‘moon festival’, happened to be 13th September this year. Untouched by ‘western’ superstition surrounding Friday 13th, my WeChat profile ushered in the warmest greetings and festival wishes from a wide range of WeChat contacts from China many from my Shanghai field site which I left this June.

Mid-autumn festival is said to be second important national festival next to the Chinese New Year. Traditionally, on the festival day, family members gather to offer sacrifice (e.g. moon cakes) to the moon, appreciate the bright full moon at night, eat moon cakes, and express affection and sentiment of missing toward family members and friends who live afar.

Well, ‘live afar’ probably will be redefined as Mr. Huang (75), another research participant in Shanghai, said as a goodbye wish: “Even living in the same city, friends meet on WeChat. Live near or afar, it matters much less once you are on WeChat. So see you on WeChat.” Mr. Huang is indeed right. Three months after leaving the field work, I still feel deeply involved in the loop of neighbours’ gossips or the troublesome relationship of mother and daughter-in-law. I constantly get updates about the daily quarrels between the cat living on the 15th floor and the dog on the 20th floor, the routine exercises and activities in the old people’s home 5,700 miles away from London, all thanks to WeChat.

Back in London, my colleague Marilia asked me whether it was difficult to leave the field site. I shook my head: it is not difficult, it is simply IMPOSSIBLE. It may very well be the same case for other anthropologists in the age of smartphone: we meet people on social media, be it WeChat, WhatsApp, Twitter, Instagram, or Facebook, so that even if there is an end to the field work, there will be no full stop to the constant connection with people from the field site online.

How long will the full moon appear? Wine cup in hand, I ask the sky… Why then when people part, is the moon often full and bright? People have sorrow and joy; they part and meet again. The moon is bright or dim; it waxes and wanes. Nothing in history has ever been perfect.” Those melancholy words written on a mid-autumn festival 900 years ago by the great poet Su Shi, still influence nowadays Chinese people’s interpretation and aesthetic appreciation of the moon.

Every year, on this particular night, the bright full moon conjures the collective hallucination of ‘togetherness’ among Chinese people: no matter where you are, we are looking at the same moon, and we are bathing in the same moonlight together. Almost millennium ago, clever ancient Chinese have created the ‘mega-symbol’ moon to visualize and mediate the affections in long distance. Problem solved.

fig. 2

Alas, the perfect solution doesn’t work in the face of ‘time difference’ caused by really long distance in the ‘global village’. When my Chinese friends admired the full moon at night, I hadn’t even finished the first coffee during the day. However, before I saw the full moon on the sky, I had been bathing in the moonlight on WeChat during the day. One tends to think the full moon in the sky is more ‘real’ than the full moon on WeChat, but, is it? Would the moon in the sky be the same moon had it not been wrapped with the poetic imagination of ‘togetherness’ from generation to generation in China? If it is all about the shared imagination within the specific group of population, then the moon on WeChat shared among Chinese people is definitely more ‘real’ than the moon in the sky of the unlucky Friday the 13th.

Sometimes I am wondering, had poet Su Shi lived in today’s world, on the grand mid-autumn festival, whether he would still ask the sky for the full moon, holding the wine cup high, or, would he be equally satisfied by sending the full moon on WeChat, holding the smartphone tight.

 

50 colours of menopause – reframing the ‘age of despair’. By Maya de Vries and Laila Abe Rabho

By Laura Haapio-Kirk, on 30 September 2019

Authors: Maya de Vries and Laila Abe Rabho

Photo (CCBY) Maya de Vries. Activity at the senior’s club: colouring pine cones.

Right from the beginning of the ASSA project, one of the main topics that we discussed was menopause. Although menopause is less of a taboo, and people talk about it much more in the al-Quds field site compared with some of the other ASSA sites, it took a us a while to be able to speak with informants about this sensitive topic. We discovered that for many women speaking about the physical and mental ramifications of menopause is still not easy to do and they tend to be shy and even embarrassed by it. It was only recently, after a year spent at the field site that gathering information about menopause became easier, mainly because women felt more comfortable to open up.

Research about menopause in al-Quds is rare. However there is some research about this issue focusing on the West Bank. In the article Age of despair or age of hope? Palestinian women’s perspectives on midlife health (Hammoudeh et al., 2017), authors depict the perception of menopause among Palestinian women in the West Bank who were born between 1960-1975. They clearly say that they had no access to Palestinian women in Jerusalem due to political and security problems entering Jerusalem from the West Bank.

The term used in Arabic in medical literature and discourse to describe menopause in the West Bank and in al-Quds is the ‘age of despair’ (sin al-yaas). However, in Hommoudeh’s article this term was unpopular with the women interviewed, and they preferred not using it. Similarly, in al-Quds, women that we spoke with in Dar al-Hawa, do not like to use this term. They are familiar with it, but do not wish to use it when talking about themselves, since it is not describing them correctly. The word despair is not relevant for them and perceived as negative, whether they are married with children, widowed, married with no children, or never married. They simply do not see themselves as in despair; for them it is very strong word, that does not describe their daily life.

The women we interviewed knew that they are in their midlife, but midlife for them means much more than just menopause, which carries negative associations. Many women articulated a positive view about midlife and ageing as a natural process that is part of life. Midlife, is considered to be an age of peacefulness and wisdom in the Holy Quran. The ‘age of despair’ is not mentioned; the term to describe older people is ‘old in years’ (Kbar fi al-Snin or Sheikhoukha, referring to old people, but they tend to see their age as an advantage because of increased life experience.

While talking with the women in al-Quds we found out that they talk about menopause in private and intimate situations such as meetings with girlfriends or with other women from their family. In such occasions, they talk more about the various physical symptoms characterising this age, such as – hot flashes, tension, incontinence, lack of sleep and more, and less on the mental issues that might appear. Some said that they were sure that these symptoms will pass with no need for medical treatment. They thought menopause is natural thing, and temporary. What was interesting to hear is how they refer to the term ‘menopause’, and what are the alternatives they are using instead.

In Yasmin’s (42) interview she referred to menopause as the ‘safety age’, when there is no chance to get pregnant.

yes, I have heard about it, there is another term that is used as an alternative to menopause and it’s the safety age. I know many women relatives and friends that reached this period of their life, but they never said that they were going through it (menopause). I think that this term is wrong, because there is no age that stops women.

Abeer (58) called menopause in a different name, considering it as ‘maturity age’, while referring not just to physical consequences of menopause, which are usually negative, but also to a better self.

I have been through the menopause period, I consider it maturity age, in this period women feel that they are able to take decisions by themselves, she feels that she is strong, she lives her life the way she wants, before the menopause her life was different.

Tagreed (60) sees menopause in contrast to what it represents. For her, the role of the women as grandmother is significant:

I don’t know, maybe when women reach this period her role in life ends, on the contrary, I believe that they are wrong because in this period her role becomes even more important than before, she takes care of her grandchildren, her children get married, she takes care of everything, and all the family depends on her. They think that if her period stops, that she is no longer able to become pregnant, her role in life ends. In contrast, in this period she takes care of her grandchildren, and her children depend more on her.

Tentatively, we can say that the term ‘age of despair’, is no longer relevant, and the concept of a novel, ‘golden’ prestige age is rising now. Our guess is that there are plenty of reasons for this shift, mainly because medicine is progressing and leisure activities are more commonly pursued. We will continue exploring how the digital environment impacts on this change; this still is an enigma for us, as many of our informants are not using digital devices, or health apps heavily. Some do not even carry a smartphone.

Interestingly, just as the term ‘menopause’ is being reframed, the same is happening also with the term ‘old’, as many in al Quds refrain from using it as it might be considered insulting. Many times, we see the word “seniors” instead of old, switching the word out of respect. A small example of the change in discourse can be seen in the new WhatsApp group opened two weeks ago by the coordinator of the seniors’ club under the name ‘The group of the golden age club’. The previous WhatsApp group, which is now being abandoned by its members, was called ‘The group of the older people of Dar al-Hawa’. The ‘golden’ age highlights the possibilities this age, despite menopause, can offer. Is this reframing simply concealing what is really happening in this age? Or due to various changes in the modern world, is ageing is coloured in gold? So far the al-Quds’s field site tells us that ageing is changing, and if you are financially secure, yes – you can experience the ‘golden age’.

 

 

Mobile Money & Elder Care from Kampala – by Charlotte Hawkins

By Shireen Walton, on 22 September 2019

Calling and mobile money are the most ubiquitous uses of mobile phones in the Kampala fieldsite. This connects people to their relatives across distances, allowing people to check on family or request assistance. Mobile money is often lauded as an example of adapting technology to requirements ‘from below’ (Pype, K., 2017), offering financial flexibility and connection (Kusimba et al., 2016: 266; Maurer, 2012: 589). With 33 mobile money vendors in the low-income neighbourhood where fieldwork was conducted, it is the most convenient and accessible platform for saving and transferring money.

Various people in Godown explained how they provide for their parents and relatives in the village without visiting them as “you can send money on the phone”. People sending money take cash to an agent, who arranges the transfer to the recipient’s phone number via their mobile.  Whilst relatives living in rural areas may be able to grow their own food, money is necessary for other amenities, transport, school fees, hospital bills, and burial costs. As one woman explained, if she wasn’t sending her parents money, they would have no other source of income; recently, her mother had a stomach ulcer, so she sent her money to go to hospital.  And from the perspective of an elder in the village in Northern Uganda, “life’s easier now with phones”, as they are able to communicate family problems with relatives in the city and mobilise necessary funds. This also exacerbates the burden of care for urban relatives. A local councillor in Godown explained how he bought his sister in the village a smartphone in order to make communication easier between them. But he actually finds the connectivity has made life “a bit harder” for him, as it has increased his obligation; when people have problems, they can immediately let him know and he’s expected to find money for them. Before, news of a death could take a week to reach him, by which time he may have even missed the burial and the accompanying financial obligations.

In a survey of 50 respondent’s phone use, only 3 people said they had not used mobile money in the past 6 months. Those who had used it sent and received money 3 times a month on average. We asked them about the last 3 times they had sent or received mobile money, who the person was, the amount and reason for remitting. Of 130 recorded remittances, the average amount sent was just over 200,000ugx, ranging from as little as 10,000 to 10,000,000ugx. Mostly, remittances were sent or received from siblings (28%), parents (12%), friends (11%),  and customers (10%). Sometimes people had deposited money for themselves, using their phone as their bank. The greatest proportion of remittances (28%) were for ‘help’, which could include money for upkeep, food, ‘pocket money’ or gifts. This was followed by remittances for health purposes (25%), which could include hospital bills, medicine, transport to hospital and surgery costs. 6 of these transfers were received or forwarded by the respondent in a chain of remittances, for the purposes of supporting older relatives. For example, one respondent had received 200,000ugx from her daughter, in order to help her take her mother in the village to hospital; or another who received 30,000 from their Aunt for their grandmother’s hospital bills. Perhaps the older person was unable to receive the money themselves, or perhaps other relatives weren’t trusted to pass on the money.

As economic anthropologist Bill Maurer notes, mobile services such as mobile money are appropriated within existing communicative networks (2012: 593). These instances of phone use demonstrate how mobile phones can provide a platform for intergenerational care between the city and the village. This works against a pervasive academic, public and everyday discourse about the declining social position and experience of older people in Uganda and Africa more broadly (e.g. Nzabona and Ntozi: 2017; Nankwanga et al., 2013; Van Der Geest, 2011; Oppong, 2006; van der Geest, 1997), often associated with broader contextual shifts, such as the urbanisation and technologization which have necessitated and facilitated mobile money practices. Research participants often lamented the Westernisation, increasing materialism and individualism, of the younger ‘dotcom’ generation exposed to outside influences. But in these everyday instances, ‘dotcom’ technologies are also shown to up-hold family support and obligation towards older relatives, despite greater distances between them.

References:

  • Kusimba, S., Yang, Y., Chawla, N., 2016. Hearthholds of mobile money in western Kenya: Hearthholds of mobile money in western Kenya. Econ. Anthropol. 3, 266–279. https://doi.org/10.1002/sea2.12055
  • Maurer, B., 2012. Mobile Money: Communication, Consumption and Change in the Payments Space. J. Dev. Stud. 48, 589–604. https://doi.org/10.1080/00220388.2011.621944
  • Nankwanga, A., Neema, S., Phillips, J., 2013. The Impact of HIV/AIDS on Older Persons in Uganda, in: Maharaj, P. (Ed.), Aging and Health in Africa. Springer US, Boston, MA, pp. 139–155. https://doi.org/10.1007/978-1-4419-8357-2_7
  • Nzabona, A. and Ntozi, J. (2017) Does urban residence influence loneliness of older persons? Examining socio-demographic determinants in Uganda. Unpublished
  • Oppong, C., 2006. Familial Roles and Social Transformations: Older Men and Women in Sub-Saharan Africa. Res. Aging 28, 654–668. https://doi.org/10.1177/0164027506291744
  • Pype, K. (2017) ‘Smartness from Below’, in What do Science, Tehcnology and Innovation mean from Africa? eds Clapperton Chakanetsa Mavhunga. MIT Press
  • Van der Geest, S., 1997. Between respect and reciprocity: managing old age in rural Ghana. South. Afr. J. Gerontol. 6, 20–25. https://doi.org/10.21504/sajg.v6i2.116

Digital Social Participation: Cases from Milan

By Shireen Walton, on 9 September 2019

Photo (CY BY) Shireen Walton

Social participation is among the most significant factors linked to health and wellbeing later in life. As a variety of studies have shown, loneliness (both social and emotional [i]) is one of the most pressing issues of ageing. Individuals, of all ages and backgrounds seek roles, a sense of belonging and purpose, but these needs becomes particularly pertinent following retirement, in ‘empty nest’ contexts of family members having moved away, or in conditions of limited physical mobility

One question we have been exploring in the ASSA project is what might be the significance of digital social participation, or rather, social participation that is facilitated by smartphones and digital practices. My ethnographic research in one inner-city neighbourhood in Milan reveals how smartphone practices play a significant role in facilitating social participation amongst a range of individuals and groups, helping to combat issues associated with loneliness and physical/social isolation, via on– and offline practices.

To illustrate with a couple of examples.

Ugo, 75 is a retired engineer lives with his wife, Anna, 70, a retired schoolteacher, on the 5thfloor of an apartment building where they have lived for the last 30 years. Due to a severe spinal condition that affected the use of his legs, Ugo hardly ever leaves the house. A combination of technologies, the Internet, historical fiction books, and daily interactions with his wife make up his social world where he spends the days in a wheelchair at home. From the moment he wakes up in the morning until he goes to bed, Ugo is connected to the Internet via the house WiFi. Ugo uses his smartphone primarily for communication with the wider social world – he wears his smartphone round his neck in a well-worn, knitted phone case that Anna had knitted for him a few Christmasses ago. Through WhatsApp, Ugo enjoys receiving photographs from family and friends. At one point, Ugo was added to a WhatsApp group of the apartment building that was set up by one of his neighbours, a Peruvian woman called Angela, as a communication porthole for residents of the building. Before long the group transformed ‘from below’ into a forum of sharing, posting, commenting, celebrating, via emojis, memes, screenshots, even poems. While Ugo is not active overly himself on the group, the messages he receives on his phone, in addition to wider notifications such as the news, bring him a certain pleasure throughout the day, making him feel connected to a certain buzz of being-in-the-world where his physical conditions had otherwise gradually removed him from.

Ugo also uses WhatsApp to communicate with his (family) doctor.  In one instance, Ugo had a rash that had developed on one of his legs. The first thing he thought of to do was to take a photograph of it on his smartphone and send the image to his doctor on WhatsApp. This led to a kind of informal digital consultation between the two. “We are close”, Ugo explained. “He (the doctor)is like a son or nephew to me. With WhatsApp we are like family – I know he is never far away if I need anything, which comforts me. From time to time he will ask if he can pop round to see me on his way home.”

In a different example, Rosalba, 69, originally from the region of Abruzzo in central Italy is a retired secondary school teacher. She lives with her husband (75), a retired electrician, and their dog. Rosalba found the adjustment to full-time retirement a difficult transition, and missed the sociality of her professional role and buzz of school life. She soon sank into daily routines within the home; household chores, shopping, cooking for her and her husband, a few outings. But without real purpose, Rosalba found herself drifting through the days and weeks. Before long, her home space became a kind of benign ‘prison’, and she found herself feeling suffocated by emotional isolation and loneliness. One of Rosalba’s former colleagues from her school who she sees regularly at the supermarket recommended that she should come along to a women’s choir that meets once a week in the neighbourhood. Rosalba found aspects of the choir refreshing and stimulating; the multi-cultural and cross-generational aspect resembled what she had experienced at work at the school. The choir’s WhatsApp group, in particular, was extremely active. The women share photos, videos, song lyrics, emojis full of hearts, flowers, shooting stars, laughs, cries, thumbs up and down, amid a broad repertoire of digital-visual expressions of emotion. After a year, Rosalba found that she had discovered a new lease of life through the choir and its associated fora of sociality, including the WhatsApp group. The stream of messages that flows between the women and the immersive, ‘affective community’ it forms, comforts Rosalba in her day-to-day life, and she became to feel less alone throughout the days. Retirement now feels like something Rosalba can participate in and even shape, as she begins to carve out spaces for herself and her need for collectivity. She has developed her singing voice in expressing powerful and politically and emotionally-loaded lyrics of defiance, human solidarity, sisterhood, in a range of languages and dialects, and this empowerment appears to have seeped into other aspects of her life, including how she participates more actively in her social relationships, and in trying out new hobbies such as walking groups. Ageing and retiring with smartphones has been a gradual but creative and rejuvenating experience for Rosalba, and digital communications have facilitated and boosted her social participation.

For others in the neighbourhood, digital social participation can be an important way of participating in community life for other reasons. Angela (45) is from Lima, Peru. She lives with her husband and their 12-year old son in the same apartment block as Ugo mentioned above, working as a part-time teaching assistant in one of the local public schools. Angela describes her life with her family as ‘quiet and closed’. She is not particularly sociable or confident in public settings, and some of this she attributes to a difficult background and upbringing in the low-income neighbourhood her family lived in in Lima. She is particularly concerned about street crime and violence and the safety of her son growing up in Milan. Although she is reasonably active during the day between her job, the food shopping, and taking care of the family at home, Angela avoids going out at night. Through digital forms of engagement however, Angela has enhanced her social participation in the community in a manner she feels comfortable with – from the comfort and safety of her home. She participates enthusiastically on the apartment block WhatsApp group she set-up for neighbours in the building – sharing friendly messages and greetings on festive days – and is a member of various groups tied to her son’s school such as parents’ groups on WhatsApp and Facebook, which keeps her both informed and feeling involved. When one of her Peruvian friends recommended a weekly women’s sewing group, Angela joined and became an active participant on the WhatsApp group. The social worlds contained within Angela’s smartphone constitute some of the main sources of Angela’s present social life. Her social participation is both offline and online, but is most frequently played out via the smartphone.

Engaging socially in digital forms can be important in a variety of contexts and at any age. Although the politics and practices of inclusion/exclusion via digital practices are far from simple matters, requiring delicate critical and contextual attention, my research in Milan highlights how smartphone-facilitated sociality can modulate experiences of loneliness, isolation and/or social exclusion amongst a range of people, including older adults and migrants in the city, forming an overall central part of how socialities are crafted in this context.

References:

[i]  De Jong Gierveld, J. & Van Tilburg, T. (2006). A 6-item scale for overall, emotional and social loneliness: Confirmatory tests on survey data. Research on Aging, Vol. 28 (5): 582-598.

 

Ageing, Retirement and Activities in Yaoundé – by Patrick Awondo

By Shireen Walton, on 29 August 2019

During my 16 months of ethnographic work in Yaoundé, I have been investigating the process of ageing in the digital era. As part of the research, I spent time with middle-aged people, but also retired older persons in order to try and obtain a clear understanding of their daily lives and routines The interviews, therefore, always included exploration of informants’ activities.

The daily activities of my research participants can be divided into 3 categories. There are those related to professional work for people still in service or who are forced to continue producing either to survive or to help their families. Then there are the activities that could be described as routine for retirees for those who no longer work and enjoy a retirement pension. These activities vary between associative and community involvement, commitment to civic life, sport and religious engagements. Finally, there are activities related to the displacement of living spaces that retirement imposes. In this sense, the “return to the village” is a major fact although complex to grasp. In Yaoundé, there is indeed a real tension between the ideal to return to the village, the materiality of life in these often rural areas with their deficiency in basic infrastructures and the relative comfort to which survey participants are accustomed. This makes this ideal an ambivalent reality.

Overall, informants are concerned about the occupation of their time in a practical perspective fulfilling several functions: first, a routine function capable of filling up days that can be long and boring, especially if they live alone or without immediate family present or nearby. These routine activities are thus varied and embrace the playful dimensions of life, for example watching television. It can also include participation in community life, religious and various activities. In this same fun life, the uses of the smartphone and other similar devices like the laptop should be considered. There is no clear break between these internet-related activities, for example watching and sharing videos and those related to television. Then, there are the “productive” activities, which the participants in the study consider as generating some benefits for themselves and for their close relatives.

A 64-year-old retired woman, a former primary school teacher organises an informal crèche in her home to “help neighbours who have young children who do not know what to do”. These children from the neighborhood are grouped with her grandchildren (3 in total), which her 3 sons and 3 daughters entrust her regularly when they are busy. It is an activity underlines the informant, « that allows to extend her work but also to help her family because the nurseries for children are expensive in Yaoundé when one is lucky to find one near home. “; this dimension of dual utility is fundamental for this informant as for other people met. Admittedly, the mobility and health variable and the financial capacity to sustainably extend activities such as this informant are needed.

Finally, there are a range of activities related to physical and mental health, and to the maintenance or construction of a social and community network. Staying active to stay healthy is the watchword for study participants, especially among public sector retirees and former formal sector workers. In this area, walking, sport, outings and meetings within sports groups that extend to associative activities (tontines), volunteering, and strong community participation are central. However, it is necessary to take into account the complexity of the life trajectories of individuals, and to keep in mind that there is not always a clear cutoff between being retired and the cessation of activities. Just as the retirement activities are not to be considered as exclusively new or in complete disruption to the professional life of the participants in the study.

Applying ethnography to digital health aims; challenges and opportunities – by Charlotte Hawkins

By Laura Haapio-Kirk, on 10 August 2019

Author: Charlotte Hawkins

Photo (CC BY) Charlotte Hawkins

How can a holistic ethnographic understanding of ageing experiences, particularly related to health mobile phone engagement, contribute to an mHealth initiative and improve the accessibility of health services and information through mobile phones? This applied challenge in the ASSA project has initiated partnerships with digital health practitioners in most of our fieldsites – in particular, with collaborators working within existing phone practices. This aligned with our early finding across the fieldsites, that mobile phones are commonly used for health purposes, but through communication on apps evidently most popularly used, such as calls, Facebook and WhatsApp. In Kampala, I worked with The Medical Concierge Group (TMCG), a medical call centre founded by Ugandan medics to improve the accessibility, affordability and quality of healthcare. They offer a 24-hour toll-free phone line, SMS, WhatsApp and Facebook access to a team of doctors and pharmacists and have 50,000 interactions each month. At the time of fieldwork, they were in the process of researching the development a psychiatric call line, or ‘telepsychiatry’. This early stage of service development meant that TMCG were interested in and able to accommodate holistic ethnographic insight in their considerations.

Ethnographic insights included systematic information on 50 low income research participants’ existing mobile phone and mobile health practices as relevant to accessing TMCG services. For example, access to airtime and data is intermittent, with a tendency towards regular low-cost subscriptions. This suggests that calling or using the internet could be inaccessible to users at least once a day. Furthermore, 54% of participants had made health-related calls in the last month, and 27% of their previous three remittances were for health purposes, which confirmed an existing propensity to use mobile phones to support family health – but only across their own network of friends and relatives. Interviews with 50 respondents encountered during the wider ethnography also offered TMCG feedback on mental health perceptions, experiences and help-seeking preferences. These interviews were predominantly with older people, mostly older women, who would not typically opt to engage with research on mental health, and yet who represent an advisory position within their family or community. This also included interviews with health workers, including psychiatric clinicians at the local government hospital, and private health clinicians within the fieldsite. Research showed that treatment for mental illness was perceived to be unavailable, costly, or stigmatised. Often respondents said they prefer to handle mental health problems through prayer or counselling within their community, with hospital treatment sought only once problems become severe. This suggested that optional, confidential, accessible or community-based mental health services could be useful for low-income people in Kampala, if advertised accordingly.

Initially, the wide-reaching interview responses were considered thematically, from causality to treatment seeking, and condensed into representative quotes for presentation back to the team. More recently, alongside the team, these themes have been expanded to inform a draft publication in psychiatric journals, which TMCG hope to use seek further funding. We also hope to further disseminate findings in accessible formats amongst other digital and mental health service providers in Kampala. As familiar to many applied medical anthropologists, translating interpretive, subjective and relativist ethnographic information within positivist, objective and universalist medical paradigms brings challenges, such as risking that complex human experiences and perceptions are reduced into ‘practical’ or digestible concepts (Kleinman, 1982; Scheper-Hughes, 1990). However, this assumes that the health practitioners and their discipline are not open to understanding their patient’s everyday realities, which has not been the case in this instance, perhaps reflecting a particular affinity between anthropology of digital health – appropriation of phone based health services is entirely dependent on their relevance and usefulness for their target populations.

The on-going collaborative process has also highlighted what anthropology might learn from the research and writing processes of health disciplines, for example: ensuring findings are widely disseminated and thus accessibly written; avoiding anecdotal, emotive or biased claims; and ensuring that quantitative statements, “many people said xxx”, are qualified and backed-up. The collaboration has  also confirmed that the flexibility of anthropological research and richness of qualitative insight potentially has much to offer health programmes, to ensure their contextual relevance. In ethnographic research, we have the privilege of time, which comes with in-depth insight, and familiarity with the community – time and understanding which we can offer usefully to other audiences. The data provided can perhaps confirm a hunch of a practitioner from the area but can also surprise them. When documented and publicised, the data encourages practitioners to both tailor their approach, but also allows them to share the specific requirements of their target population, encouraging others to do the same – or hopefully even to offer funding to support them.

 

REFERENCES

Scheper-Hughes, N. Three Propositions for a Critically Applied Medical Anthropology. (1990) Social Science & Medicine 30 (2): 189-97.

Kleinman A. The teaching of clinically applied medical anthropology on a psychiatric consultation-laison service. In Clinically Applied Anthropo1ogy: Anthropologists in Health Science Settings (Edited by Crisman N. and Maretzki T.) Reidel. Dordrecht, 1982.

 

Health and Ethics – by Pauline Garvey

By Laura Haapio-Kirk, on 1 August 2019

Author: Pauline Garvey

The current advertising slogan for Gaelic Sports Clubs is ‘Where We All Belong’. The girl is shown holding a hurl for the sport called camogie. Gaelic sports including camogie for women and hurling for men have a huge national following, all-Ireland finals easily fill the national stadium with 80,000 spectators.

 

Why is it important to be active, or is it important to be active in specific ways? In recent years there has been mounting focus on health and wellbeing, as evident in the launch of the ‘Healthy Ireland Framework’ (2013-2025) a Government-led initiative that aims to enhance the population’s health. In this initiative health is presented as a public good, of individual and social concern. In the face of troubling temptations that arise with modern lifestyles the launch of this framework explicitly carries an ethical imperative: individual health, it asserts, affects the quality of everybody’s life experience. It is for the collective good to maintain one’s health. The approach recommends that the way to enhance wellbeing is less by focussing on the negative and more by highlighting what one can do to stay well. It recommends, in other words, a focus on the positive instead of the retribution of a poor quality of life that comes with bad behaviour.[i]

Often such initiatives focus on activities. From my fieldwork with middle-class Dubliners I have learned that staying well and being healthy is often talked about as routinised and collective in nature. People gather to walk, run or do yoga and the group aspect is an essential ingredient in the diverse efforts to stay healthy. When people talk of ‘activities’ they are often referring to group activities rather than solitary ones. Lots of keep-fit activities like walking or running can be done alone, yet they seem to be more successful when done with others. Respondents who attend tai chi classes might attend with a friend, and even if they don’t join these groups to extend their social networks they seem to prefer them to following a YouTube course online. This is interesting because it implies there is an added feel-good factor to the demonstration of healthy living beyond the benefits that come with social interaction. It is not just about being healthy, I suggest, but pursuing health in the company of others carries an added benefit in a cultural context where consensus is highly valued.

Younger respondents who have children report emphasis on mindfulness in schools where the health and wellbeing of children and young adults is couched as a social and spiritual category as much as a physical one. The National Council for Curriculum for example states that in ‘health promotion, health is about more than physical health and wellbeing. It is also concerned with social, emotional and spiritual health and wellbeing.’[ii] What we are seeing therefore is an interesting blurring of health, ethics and even spirituality to the degree that it is difficult to discern their distinctions.

 

References:

[i] A Framework For Improved Health and Wellbeing 2013 – 2025, available online https://assets.gov.ie/7555/62842eef4b13413494b13340fff9077d.pdf)

[ii] The National Council for Curriculum and Assessment. https://curriculumonline.ie/getmedia/007175e5-7bb7-44c0-86cb-ba7cd54be53a/SCSEC_SPHE_Framework_English.pdf

‘Ikigai’ – what is your purpose in life? By Laura Haapio-Kirk

By Laura Haapio-Kirk, on 25 July 2019

Photo (CC BY) Laura Haapio-Kirk.

I went to meet Wada san* on his land in the heart of the mountains of Tosa-cho, where he grows the plant sasaki, common in Shinto ceremonies and used to decorate altars. He keeps ducks who help him to take care of his rice by eating weeds and harmful insects, and by fertilising the rice crop. He knows the paths and trees in his forest as well as a city person would know the streets and buildings of their neighbourhood. School children often come here to learn about nature and see how we can work with it, such as by making beautiful things out of wood, or healing ourselves with plant remedies. He told us that the plants that are able to grow and thrive here in the mountains, growing up through other vegetation, have the strength to survive and therefore when you eat them you too gain some of that vitality. Along with my research assistant Lise Sasaki and two friends, we spent several hours walking and talking together about happiness and the things in life that give a sense of purpose, in Japanese termed ikigai. While this is quite an abstract term, Wada san was able to explain his ideas through vivid analogies to the landscape that surrounds him.

“What is happiness? Human being’s happiness… I’ve heard that it is health. But after that, its whether or not you find the job you want to devote your life to. I have lived through many jobs and have picked up skills throughout. Now I use those skills to do what I do, my passion. My life story, my life history is written in the mountains, and is remembered by the mountains. Working in an office, once you retire someone else will take on your job. But in this rural area the trees I have planted will grow and remain here, and the trees will be cut down and I will plant them again. It will be a cycle. Not only that cycle, but here – (shows us the rings of a cut tree) you can see how much it has grown, how much it has lived. The trees, even if they are chopped, they will live on as someone else’s house or in another form. It reincarnates as several things. Trees live once in the mountains, giving us oxygen and giving to us our life. And it lives that way. But in its second life, it is transformed into our homes, giving us comfort. We can’t see the oxygen, but it produces it – let’s say it was living in the mountains for 50 years and then it was chopped down and lived as a house for 50 years. Then it has lived for 100 years.”

Wada san explained that trees, like humans, are naturally wild, but that with the right kind of nurture they can find their way in the world. He said that when we are becoming an adult we have to choose our path in life and our role in society – trees are the same. For many people I have spoken to the idea of ikigai is linked to the satisfaction you gain by fulfilling your role in society, especially when you see your positive impact on others. Whether through making delicious bean paste sweets and sharing them with people, or in taking workshops to become a better teacher for your students, people agree that one element of ikigai is about trying your best in serving others.

Everyone has a different definition of ikigai. For some people it refers to dreams and ambitions, such as pursuing a career as an artist, for others it is about doing daily activities which align with one’s interests such as learning English, or for others it is more about the thing in life that you could not live without, such as your children. For some people it is about enjoyment of life, for others it is about the fulfilment of obligations, and some people are in between – a sense of ikigai can come in both difficult and joyous moments and it is more about an underlying feeling of immersion in life.

The English translation of “purpose in life”, it seems, is completely inadequate for understanding the broad range of meanings that ikigai can have in Japan. In England we often talk about life dreams, or working towards goals that we want to achieve. But it seems that people here think about life purpose in a more subtle way, through trying your best day-to-day and being fully present in whatever you are doing. Wada san explained that we must live in the now, rather than waiting for happiness in the future. I think this is an important lesson for us all, especially for people living hectic city lives far removed from the cycles and rhythms of nature. We can often get caught up in our to-do lists and anxieties rather than being fully aligned with our passions and the flow of life.

Human beings are always worried, human being all have anxiety. If your passion wins over, you’re okay. If anxiety takes you over, you can’t take a step. You think life and death are far apart? They’re next to each other. You can die anytime you know? It’s up to you whether you stay anxious or live to the fullest, with passion.” 

Thank you to Wada san for sharing your time, wisdom, and inspiring passion for nature with us.

 

*Wada san is a pseudonym because this man preferred to remain anonymous.

Pandora turned 70 and she just opened the box again. By Marília Duque

By Laura Haapio-Kirk, on 3 July 2019

Photo (CC BY) Marilia Duque.

Author: Marilia Duque

I am packing up to leave my field site after a 15-month ethnography with older people in Sao Paulo. One thing I learned is that a smartphone is not smart by default. Most of the time, especially for older people, a smartphone could be a stupid little thing that releases a new set of problems they now have to deal with, just like a Pandora’s box.

The character of Pandora can be perfectly represented by a 70-year-old lady I met who just received her box in the form of a gift from her son. This pandora’s box contained many gifts: a telephone, camera, calendar and computer and they were all hidden inside a Samsung Galaxy phone. Pandora’s husband warned her: “You should never turn this on. We are not supposed to steal technology from the youngsters”. Pandora then left the smartphone inside its box for weeks until she found out she was not invited to her old school annual reunion. The explanation they gave to her? “It was all set up through our WhatsApp group, dear”. In a mix of rage, sorrow and curiosity, Pandora immediately opened her smartphone’s box and turned it on.

As in the Greek myth, our Pandora also released some plagues and devils she now has to deal with. In her case, she faced fear, low self-steam, and anxiety. She first experienced fear of breaking the device, fear of being charged for something she was not using, and fear of erasing something important, like the pictures of her youngest grandson’s swimming competition. She then experienced a lost of self-esteem because her smartphone’s display was set to sleep after just 30 seconds of inactivity and she just didn’t have the proper time to think about what to do before the screen turned off. And when she asked her son for some help, he simply had no patience to explain to her what was happening. Instead, he took her smartphone from her hands, reset the sleep mode to 5 minutes and gave it back to her saying “it is intuitive, even children are supposed to learn how it works”.  Pandora still doesn’t use her smartphone to its full potential, but a friend from her church has downloaded WhatsApp for her. She has finally joined her old school friends’ group and also her charity group, her meditation group and her family group. Now Pandora experiences anxiety because she has to manage so many messages that just keep coming without interruption. Pandora doesn’t understand that the connection is on 24 hours a day, 7 days per week, but she can choose not to be.

Curiosity was what made Pandora open her smartphone’s box and turn it on for the first time. But it is also curiosity which is the only thing that can save her. With curiosity (and with a little help from her friends), Pandora can dig deeper into her smartphone until she finds a solution – ‘hope’. It is hope that was left remaining in Pandora’s box. She will make ten mistakes for each thing she does right. She will be annoyed because she can enlarge the font size and the display size of her smartphone, but this will disrupt her WhatsApp screen lay-out and she will feel lost again. Even so, with time, she will become more confident to try new things and make new mistakes and learn with them. In doing that, Pandora will discover that one more gift was left inside her smartphone. Pandora will finally experience the smartness of her smartphone. A smartness that is only achieved in practice, when the smartphone provides a solution for someone’s need or desire.

Fear, low self-steam and anxiety will still exist. But Pandora won’t have time to pay much attention to them. She is now checking Google Maps for the easiest way to go to a museum with her friends. She is deciding to take an Uber so she can improve her English with Duolingo during the trip. She is experiencing that fraction of smartness that makes her think that her smartphone was actually a gift from the gods to mankind. A gift she had the curiosity to open and the courage to keep it on.

Downsizing, Rightsizing, Upsizing — by Daniel Miller

By Xinyuan Wang, on 24 June 2019

A while back, Pauline Garvey and myself decided to write a chapter for our book about downsizing. This means that we rather assumed that downsizing would be an evident phenomenon for the age group we are studying, mainly people in their sixties and seventies. Certainly, in Ireland there is pressure on older people; hints from the media and the state that moving to a smaller home would help free up large family homes for families with children and perhaps release equity for their own children who are finding it hard to buy their own homes.

I found that most of my informants resent such pressure, feeling that they have worked hard for and deserve their homes. Their children may be living abroad and when visiting, my informants want to host them in their own homes.  Anyway, there are no hotels in Cuan. These people often want to move from the older estates they currently live in, where houses are typically expensive to maintain. But the evidence, confirmed from interviews with estate agents, is that they are not downsizing. Rather they aspire to move to new build houses, but with at least three bedrooms. When visiting such houses I found that they use this opportunity to express their desire to be modern and youthful. Far from squeezing possessions accumulated over decades into small retirement flats, they give these away and embrace modern furnishings and styles for their bright new houses.

Similarly, while they may be getting rid of their many accumulated possessions in the process. They may use this realign themselves with modern sensibility, viewing these actions as evidence that they have embraced the modern ‘green’ environmentalist perspective. So both in moving home and in divesting themselves of possessions, it seems that, far from preparing for ageing, they are seeking ways to become more youthful and more attached to contemporary mores.

Other evidence suggests that there is only limited transfers of equity down the generations to enable younger people to buy their own homes.  It seems more common for them to suggest that their children’s families can come back and stay in these reasonably spacious homes, while they are saving money to purchase their own. Most commonly, these children really want to be able to buy a home within Cuan itself, and this is expensive.

Actual downsizing is important in relation to frailty at whatever age this arrives. Alongside the need for specialist aids, downstairs bedrooms and toilets and, when required, a move to specialist sheltered accommodation or a nursing home. But, consistent with our earlier findings, this is about physical need. Otherwise, it seems to matter little whether people are in their eighties or fifties, they no longer consider themselves as old people who have to shrink their worlds, rather they remain concerned to find strategies for updating their world and remaining contemporary.

I thought this was quite an original, even radical finding; but perhaps we have not gone far enough. A 2016 report by the UK’s NHBC Foundation called Moving insights from the over-55s based on a survey of 1,500 households who have moved home, suggests that nearly a third have actually upsized, that the most popular homes are four bedrooms and that 46% have put more money into their new homes, rather than released equity. Unfortunately, the survey is not broken down by age. It is not then surprising that terms such as rightsizing are coming to displace downsizing. What that report doesn’t do, which we hope our project will do, is delve into the deeper context that may explain why this is happening.