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Ageing Actively in Focus

By Shireen Walton, on 8 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.

Riámonos juntos- por Marilia Duque

By Alfonso Otaegui, on 4 January 2019

Autora: Marilia Duque

Marilia (izq) con su amiga

Ya ha pasado un año de trabajo de campo y debo confesar que estoy aquí, riéndome sola al recordar todos los buenos momentos que pasé con mis informantes. Podría haber sostenido, al principio, que la mayoría de ellos estaban luchando contra los estigmas de la edad. Por un lado, eso quería decir que estaban haciendo lo mejor posible para ocultar sus limitaciones físicas con el fin de mantener su autonomía e independencia. Por el otro lado, eso también quería decir que estaba tratando de adaptarse al modelo del ‘envejecimiento exitoso’ (‘sucessful ageing’ en inglés), una imagen de adultos mayores respetuosos que gozan de buena salud, son productivos y tienen una intensa vida social. En verdad, están siempre alerta y luchando por su espacio, y esa resistencia puede dar lugar a una especie de auto-vigilancia, con cero tolerancia para con aquellos que intenten burlarse de los adultos mayores.

Ahora bien, basta esperar a que te acepten en el grupo, que se sientan cómodos con tu presencia y te sorprenderán. ¡Se ríen de la gente mayor todo el tiempo! Reconocen sus debilidades y se ríen de ellas. Es así que estaba en un evento con gente mayor la semana pasada, en el cual una señora mayor se llevaba todas las miradas, bailando con sus muy largos cabellos, cuando otra señora también mayor –y celosa– me suspiró al oído “le va a fallar el pañal para adultos mayores”. Después de un rato, cuando sirvieron el almuerzo y se formó una larga cola de gente mayor, uno de ellos dijo riendo “¿Cuál es la fila para ancianos? ¡Tengo prioridad!”. También hacen bromas sobre cuestiones como impotencia, pérdida de la memoria, sordera, insomnio y las dificultades que tienen con la tecnología. Se refieren con humor al tiempo que pasan en los hospitales, a todo lo que tienen que pagar con su seguro de salud, a cómo los jóvenes piensan que ellos son estúpidos, y a cuán cansados en verdad se sienten después de tener que haber fingido que no eran “tan viejos”.

Este año compartimos momentos increíbles en los que ellos no eran ‘adultos mayores’. Eran simplemente seres humanos enfrentándose a algunas dificultades en la vida y envejeciendo un poco cada día, tal como yo o cualquier otra persona.

Let’s laugh together – by Marilia Duque

By Xin Yuan Wang, on 26 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.

Neurochemical selves or social prescription? by Pauline Garvey

By Xin Yuan Wang, on 15 December 2018

Social Prescribing Brochure available at https://www.hse.ie/eng/health/hl/selfmanagement/donegal/programmes-services/social-prescribing/social-prescribing-brochure.pdf

In an academic article in the early 2000s sociologist Nikolas Rose asks ‘How did we become neurochemical selves? How did we come to think about our sadness as a condition called “depression” caused by a chemical imbalance in the brain and amenable to treatment by drugs that would “rebalance” these chemicals?’[i]. During the decade from 1990-2000 Rose charts high rates of prescribing psychiatric drugs in Europe, Japan and the United States. In Europe growth in the value of prescription drugs rose by over 125% while growth in sales of similar drugs in the United States rose by over 600%. He notes that a decline in prescriptions for hypnotics and anxiolytics was matched by a rise in prescriptions for anti-depressants of about 200% (2003: 46).

There is, however, another trend that is gathering momentum on the international stage and which couldn’t be more different than the trends that Rose documents.  Social prescription takes an altogether different approach to health and embeds it in social networks and cultural activities. It is defined by the NHS as ‘helping patients to improve their health, wellbeing and social welfare by connecting them to community services which might be run by the council or a local charity[ii]. In Ireland the Health Service Executive webpage speaks directly to the reader and defines it as a free service that ‘helps to link you with sources of support and social activities within your community. These include Physical activity, Reading groups/books for health, Self-help programmes such as the Stress Control Programme, Men’s Sheds, Community gardening, Arts and creativity’. Social Prescribing is for you if you feel that you need some support to mind your health and wellbeing, you feel isolated, stressed, anxious or depressed, you simply feel you need the service[iii]

In a comparable project called Local Asset Mapping Project (LAMP) run through St James’s Hospital in Dublin their webpage again addresses the reader directly and conjures the scenario: ‘Imagine visiting your doctor and as well as getting a prescription for a pill, you get an electronic  prescription designed especially for you, with a list of all the local businesses and services around you that might improve your health – that is the vision of LAMP’[iv]. The LAMP project points out that wellbeing is determined by ‘good health behaviours’ such as exercise, nutrition, minimal alcohol consumption and good social networks, but notes that traditional medical consultation does not address this adequately’.   As if to echo these arguments, just two weeks ago the Irish Longitudinal Study on Ageing at Trinity College Dublin (TILDA) presented their most recent findings regarding ‘Change in life circumstances’ for Ireland’s over 50s between 2009 and 2016. They found that quality of life peaks at 68, and therefore shouldn’t be thought of in a linear way (ie as a steady decline) but also that fundamental to quality of life is social connnectedness. Quality of life improves with age for the majority of their sample, but only if social engagement is strong. [v]

As an anthropologist the holistic approach to health and wellbeing makes perfect sense. My respondents do not organise their lives ‘in silos’ (see LAMP), and how one feels ripples into all aspects of life, in the same way that everyday experiences are integral to how people think about their wellbeing, happiness – and age. Some respondents occasionally talk in neurochemical terms -particularly when wondering how to get a good night’s sleep, but the majority of their time and energy is devoted to their busy lives.  One of my informants aged in her early 80s resisted joining Active Ageing groups because she did not consider herself elderly. Another woman said ‘I’m 78 but I feel 60, I feel younger, not older’. In the course of my research I have met some retired men and women who are lonely, isolated or bored but many others take to retirement with vigour and enthusiasm. What interests me is whether these activities such as knitting, writing or meeting friends for coffee are reflected upon as ‘good health behaviours’. What are the social trends that social prescription is tapping into, or indeed leading?  Meanwhile as I conduct me research the benefits of social embeddedness seem clear. As one man told me since retiring from work he has never been so busy.

[i] Rose, N. (2003) ‘Neurochemical Selves’ Society 41 (1): 46–59.

[ii] https://www.england.nhs.uk/contact-us/privacy-notice/how-we-use-your-information/public-and-partners/social-prescribing/

[iii] https://www.hse.ie/eng/health/hl/selfmanagement/donegal/programmes-services/social-prescribing/

[iv] http://www.ehealthireland.ie/Case%20Studies/Local-Asset-Mapping-Project-at-St-James-Hospital/

[v] https://tilda.tcd.ie/news-events/2018/1812-w4-key-findings/

Enfermeras de enlace y WhatsApp: un ejemplo de ‘inteligencia desde abajo’

By Alfonso Otaegui, on 11 December 2018

Foto de Alfonso Otaegui

Dentro del marco el proyecto Antropología de los Smartphones y del Envejecimiento Inteligente (ASSA), nos hemos comprometido a trabajar colaborativamente con una iniciativa local de salud móvil, o cualquier iniciativa que mejore el acceso a los servicios de salud y el bienestar de las poblaciones con las que hacemos trabajo de campo.

Al principio, aún antes de comenzar mi trabajo de campo, yo imaginaba que esta iniciativa consistiría en la creación e implementación de una aplicación específica de salud móvil, la que respondería a una necesidad observada en el campo. Este abordaje implicaba detectar un vacío en el campo –una necesidad aún no abordada pero advertida por el etnógrafo– y crear una aplicación que llenaría ese vacío. Era en verdad una idea de implementación desde arriba hacia abajo: sería yo quien le daría a la gente algo que necesitaba, pero cuya necesidad ellos mismos desconocían.

Luego de un par de meses, advertí que sería más sensato simplemente describir una aplicación ya en uso –y usada creativamente por la población– y llevar ese uso particular, esa idea local, a otro lugar donde tal idea pudiera ser útil. Este abordaje, que podría definirse como ‘desde abajo hacia arriba’, implica –al contrario del abordaje anterior–  el reconocimiento de la creatividad de las poblaciones locales en la adopción de tecnologías de comunicación, lo que Pype (2017) llama ‘inteligencia desde abajo’. Con el mismo objetivo de llevar buenas ideas de un lugar a otro, también hemos comenzado en el equipo a armar una lista de ‘buenas prácticas’ en atención médica a lo largo y ancho de todos nuestros sitios de campo.

Con este objetivo en mente, pasaré los últimos seis meses de mi trabajo de campo en Santiago llevando adelante una etnografía en un centro oncológico en un hospital público. Este hospital en particular es el único hospital público en Santiago que ha implementado el modelo de cuidado de ‘enfermeras de enlace’ o ‘nurse navigator’ (Devine 2017).

Las enfermeras de enlace trabajan como mediadoras entre los pacientes oncológicos y el sistema médico y burocrático de un hospital público en una zona de bajos recursos. Los tratamientos oncológicos implican dos complejidades para el paciente: la complejidad médica del tratamiento en sí, y la burocracia del sistema de salud pública. Los diversos tratamientos oncológicos pueden tener variados efectos sobre distintos sistemas del cuerpo, por lo que seguir el tratamiento implica manejar mucha información. La gestión del tratamiento implica una serie de procedimientos (diagnósticos de imagen, sesiones de quimioterapia, exámenes de sangre, etc.) que requieren recetas y turnos, que tienen que llevarse a cabo en un orden específico, y dentro de cierto tiempo (si no, las probabilidades de mejora decaen). Las enfermeras de enlace gestionan el tratamiento para el paciente, ya que tienen conocimientos para enfrentar ambos tipos de complejidades.

Según el oncólogo Bruno Nervi, presidente de la fundación Chile sin Cáncer, hay cerca de 100 oncólogos en Chile, cuando se necesitan 400 (55.000 personas son diagnosticadas con cáncer cada año) (‘La Fundación Chile sin cáncer (…)’ 2018). Dado el gran número de pacientes, los oncólogos no tienen el tiempo de explicar todos los detalles del tratamiento. Las enfermeras que trabajan en la sala de quimioterapia enfrentan el mismo problema, ya que tratan de atender tantos pacientes como sea posible. Las enfermeras de enlace, entonces, llenan este vacío al educar a los pacientes sobre los detalles de la enfermedad y su tratamiento y al mediar ente los pacientes y el complejo sistema burocrático de la salud pública de Chile. Ellas hacen todas las citas para exámenes, análisis de sangre y demás –lo que requiere mucho papeleo– y se mantienen en contacto con el paciente en caso de que éste tenga alguna duda o inquietud. Estas enfermeras dedicadas constituyen un factor humano en los servicios de salud que ninguna aplicación puede reemplazar. Las enfermeras de enlace, sin embargo, sí usan una aplicación, la aplicación de mensajería más usada por los pacientes: WhatsApp. Según las enfermeras de enlace, WhatsApp les da la capacidad de usar los varios modos de comunicación según las particularidades y necesidades de cada paciente: algunos prefieren una llamada por teléfono, otros se sienten tranquilos al ver una foto de la receta o turno de examen, algunos necesitan un mensaje de audio que puedan escuchar varias veces hasta entender (muchos pacientes son de bajos recursos con escaso nivel educativo). Además, las enfermeras de enlace están disponibles para los pacientes por cualquier duda o pregunta que puedan tener. Estas enfermeras están ahí para ellos, para responder sus inquietudes y confortarlos, ya que el tratamiento y esta relación de cuidado a distancia puede llegar a durar años.

Daniel Miller, investigador coordinador del proyecto ASSA, escribió en su último libro ‘The Comfort of People’ sobre el uso de nuevos medios de comunicación con pacientes terminales con cuidados paliativos. En ese libro Miller recomienda crear un protocolo de uso de nuevos medios entre paciente y personal de salud (2017: 218). El uso de WhatsApp por parte de las enfermeras de enlace de hecho sigue un protocolo que se fue desarrollando en los últimos años a partir de la experiencia. Yo intentaré describir este protocolo y este uso de WhatsApp y construir un modelo que pueda ser replicado. Realmente tengo la esperanza de poder llevar esta buena idea que se desarrolló localmente a otros hospitales públicos de Chile.

 

 Referencias

Devine, A. (2017, 3 de abril). The Nurse Navigator: A Patient’s Compass On The Healthcare Journey. Extraído de https://nurse.org/articles/nurse-navigator-career-path-salary-job-description/

La Fundación Chile sin cáncer y su contribución para cambiar la historia del cáncer en Chile. (2018, 15 de octubre). Extraído de https://www.uc.cl/es/la-universidad/noticias/31765-la-fundacion-chilesincancer-y-su-contribucion-para-cambiar-la-historia-del-cancer-en-chile

Miller, D. (2017). The Comfort of People. Cambridge: Polity Press.

Pype, K. (2017). Smartness from Below: Variations on Technology and Creativity in Contemporary Kinshasa. En C. C. Mavhunga (Ed.), What Do Science, Technology, and Innovation Mean from Africa? (pp. 97–115). Cambridge, Massachussetts: The MIT Press.

Nurse navigators and WhatsApp: an example of smartness from below

By Alfonso Otaegui, on 8 December 2018

Photo by Alfonso Otaegui

Within the scope of the project Anthropology of Smartphones and Smart Ageing (ASSA), we are committed to work collaboratively with a local mHealth initiative, or any initiative that will improve the access to healthcare or the wellbeing of the populations among whom we are carrying our fieldwork.

At the beginning, before even starting my fieldwork, I envisioned this initiative as the creation and implementation of a bespoke mHealth app, which would respond to a necessity observed in the field. This approach implied spotting a gap in the site –a need not yet addressed but noticed by the ethnographer– and creating an app which would fill that gap. It was certainly a top-down implementation approach: I would give the users something they needed but were not aware they needed.

After a couple of months, I realized it would be wiser to simply describe an app people already used in a creative way, and bring this local idea to another place, where this idea could be helpful. This approach, which could be described as ‘bottom-up’, implies acknowledging the creativity of local populations in the adoption of communication technologies, what Pype (2017) names ‘smartness from below’. With the same aim of bringing good ideas from one place to another, we have also started in our team to build up a list of ‘best practices’ in healthcare throughout all of our field sites.

With this aim in mind, I will spend the last six months of my fieldwork in Santiago doing ethnography at an oncological center in a public hospital. This particular hospital is the only public one in Santiago having implemented a ‘nurse navigator’ model of healthcare (Devine 2017).

The navigator nurses work as mediators between oncological patients and the medical and bureaucratical system of a public hospital in a low-income area. Cancer treatments mean two complexities for the patient: the medical complexity of the treatment and the bureaucracy of the public health system. Different cancer treatments can have several effects on different systems of the body, so managing the treatment implies handling a lot of information. The treatment is based on a series of procedures (image exams, chemotherapy sessions, blood tests, etc.) which require prescriptions and appointments, and have to be carried out in a specific order, and in certain amount of time (otherwise the probabilities of success decline). Navigator nurses actually manage the treatment for the patient, as they have the expertise to deal with both kind of complexities.

According to oncologist Bruno Nervi, president of the foundation Chile sin Cancer (‘Chile without cancer’), there are around 100 oncologists in Chile, when 400 are needed (55.000 people are diagnosed with cancer every year) (‘La Fundación Chile sin cáncer (…)’ 2018). Given the high number of patients, oncologists do not have the time to explain all the details of the treatment. The nurses working at the chemotherapy room face the same problem, as they try to fit in as many patients on a day as possible. The nurse navigators then, fill in this gap by educating the patient on the details of the disease and its treatment and mediate between the patient and the complex bureaucratical system of public healthcare in Chile. They make all the appointments for exams, blood tests and the like –which requires a lot of paperwork– and stay in touch with patient in case this has any doubt or question. These dedicated nurses constitute a human factor in healthcare that no app can replace. The nurse navigators, however, do use an app that is the most commonly used messaging app amongst patients: WhatsApp. According to the navigator nurses, WhatsApp gives them the chance to use various means of communication depending on the particularities and necessities of every patient: some prefer a phone call, some other need to see the info written in a text message, other will be reassured if they see a picture of the prescription or an exam order, some need an audio message they can listen to several times in order to understand the meaning (most of the patients are low-income people with low levels of education). Besides, nurse navigators are available for the patients for any doubt or question they might have. These nurses are there for them, to answer their questions and to comfort them, as the treatment and this relation of distant care can last for years.

Daniel Miller, principal investigator of the ASSA project, recommended in his last book ‘The Comfort of People’ on hospice patients and the use of new media, that it would important to create a patient/carer charter of new media use (2017: 218). The usage of WhatsApp by these nurse navigators actually follows a protocol which developed out of their experience in the last couple of years. I will attempt to describe this protocol and app usage and build up a model. I really hope it will be possible to bring this locally developed good idea to other public hospitals in Chile.

References

Devine, A. (2017, April 3). The Nurse Navigator: A Patient’s Compass On The Healthcare Journey. Retrieved from https://nurse.org/articles/nurse-navigator-career-path-salary-job-description/

La Fundación Chile sin cáncer y su contribución para cambiar la historia del cáncer en Chile. (2018, October 15). Retrieved from https://www.uc.cl/es/la-universidad/noticias/31765-la-fundacion-chilesincancer-y-su-contribucion-para-cambiar-la-historia-del-cancer-en-chile

Miller, D. (2017). The Comfort of People. Cambridge: Polity Press.

Pype, K. (2017). Smartness from Below: Variations on Technology and Creativity in Contemporary Kinshasa. In C. C. Mavhunga (Ed.), What Do Science, Technology, and Innovation Mean from Africa? (pp. 97–115). Cambridge, Massachussetts: The MIT Press.

We are all going to die before we get old

By Daniel Miller, on 2 December 2018

When The Who sang ‘I hope I die before I get old’, the underlying assumption was that unless they died first they would become elderly. For The Beatles we were already sitting by the fireside knitting a sweater or with grandchildren on the knee by the age of 64. As a result it is possible to give a precise date to the ‘death’ of the elderly, which is 28th May 2007, when a band called The Zimmers consisting of people who had to use zimmer frames, sang ‘I hope I die before I get Old’ on the BBC. They later also covered You Gotta Fight for your Right to Party.

When we started this project I was aiming to concentrate on what I called Mid-Life, roughly between 45-70. It didn’t take long to realise I had been hopelessly simplistic. Mid-Life would need to be between two other categories. But this doesn’t really work if people no longer regard themselves as getting old or elderly. What our fieldwork demonstrates is how variable this issue of age and elderly has become. To have a fixed age bracket makes no sense when people rarely live into that bracket in our Kampala site, routinely retire at 50 in Shanghai and are still planting rice at 95 in Japan. But the other major issue is that in each site one senses that becoming elderly is turning into a choice. Visiting our Palestinian site it was clear that many women in their sixties are comfortable taking on the clothing, mannerism and activities designated for that separate senior group that could be called elderly. In my own Irish fieldsite there remain some people where this is still the case. Most conspicuously at the rather misnamed Active Retirement Group that is dedicated to playing bingo and a few mild activities such as tea dances, but clearly rejected the suggestion that they might replace bingo on one occasion with computer classes.

As fieldwork has progressed, it has been increasingly clear that they represent a declining proportion of people, in that most I meet of the same age as those in this relatively (in)Active Retirement Group, feel no affinity with that shift into a category of elderly. Nor do they relate to the idea of mid-life. Instead they state firmly, if slightly apologetically, that they feel in almost every respect youthful. The Rolling Stones were prescient in that apparently, they will Not Fade Away.

The Rolling Stones at Marcus Amphitheater in Milwaukee, USA, performing at Summerfest festival on June 23, 2015 – Photo by Jim Pietryga (wikemedia commons)

The people I meet really do feel that youth was wasted on the young and they spend their time power walking, and bicycling if they are fit enough, or otherwise playing intensely competitive bridge and learning new skills such as painting or singing. They still listen to rock music and at least consider dating, if appropriate. When, as here, a 13 year old is desperate to see 72 year old Cher at Las Vegas the relationship between music and age is pretty unclear.

The other side to this change is that previously to be senior was to gain ‘wisdom’ and respect. This made sense in an agricultural society where older people were skilled as a result of longer experience. But the skills that matter more today consist of things like using smartphones. Many of these older people welcome this loss of wisdom because it is replaced by continued equality with youth, rather than being placed in another category. On a committee they are listened to simply to the extent that others find their argument convincing, the same as everyone else.

The category elderly is likely to remain but now seems to designate physical disability and the dependence upon others, within which the clearest example is dementia. People recognise that there will eventually be a physical deterioration leading to death, so the category is more about dying and incapacity, rather than entering a different cultural category. Until then they will not regard themselves as having become old, however white their hair or resplendent their liver spots. Different societies are moving in this direction at different speeds but my prediction is eventually we will all die before we get old.

 

Keeping up appearances: the importance of ageing smartly – by Charlotte Hawkins

By Xin Yuan Wang, on 24 November 2018

Author: Charlotte Hawkins

Gloria works for KCCA (Kampala City Council Authority) cleaning the roads, starting every morning at 6am. This often means she arrives late at the bi-weekly meeting of a support group for women in Godown where we first met. She hopes to set up her own business, investing in a machine for grinding g-nuts and sesame, but it would cost 2 million Ush ($535), capital she doesn’t yet have. Meanwhile, she said she makes ends meet by “joining hands together” with her sons, all in their 20s. She earns 180,000 Ush ($50) each month, putting 80,000 Ush ($22) on food and 20,000 Ush ($5.50) on beauty products, including make-up and hair oil. “Even without money I have to be smart. I don’t need to be shabby”. The rest goes on rent and her sons ‘top up’. I asked what they do when there’s a health emergency to pay for, and she said, “we rarely fall sick” thanks to her prayers: “when you light a candle for Mother Mary you cannot fall sick”.

Gloria’s hair and make-up collection. Photo by Charlotte Hawkins

Gloria’s candles for prayer. Photo by Charlotte Hawkins

Almost 10% of her monthly salary is invested in being ‘smart’, a word often used here to compliment the visible effort someone has put into their appearance, “you’re smart today!”. Gloria is not alone in stressing the importance of ‘keeping up appearances’, despite financial constraint; as one older man explained, dressing well and looking good are “a way of gaining public trust”. Or as at the weekly parties for a women’s savings group in Godown, the ways the beneficiary and her two ‘honourable members’ dress up is an important part of the celebratory proceedings. They often design and tailor their matching outfits, taking photos of each other and themselves on smartphones. Even the bar will be ‘dressed’ according to the beneficiaries’ preference, with different colour fabrics and lights draped on the ceiling and walls.

Women dancing and looking smart at a weekly party for their savings group. Photo by Charlotte Hawkins

Taking photos of a beneficiary, dressed up for her party. Photo by Charlotte Hawkins

It seems that another way to look smart, especially for older women, is to look young. According to my research assistant, who grew up in the area, many of our female interviewees lie when we ask their age, wanting to seem younger than they really are. Whilst being called ‘Jajja’ (grandmother) signifies respect, so do remarks on a deceptively youthful appearance. Ageing gains admiration, but particularly if you’re smart.

Retirement and its malcontent in Yaoundé – by Patrick Awondo

By Shireen Walton, on 15 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

Scan the QR code to connect with the deities

By Xin Yuan Wang, on 12 November 2018

Recently, Danny came to visit my field site in Shanghai. As he remarked on his on-the-spot tweet, one of the biggest ‘shocks’ he could feel immediately was that: “Curious that in this age of supposed global homogeneity, here in China you really don’t seem to be able to do anything without a QR code, while in Europe you can’t do anything with a QR code.” We ordered food, rented bikes, hailed taxis, booked a hotel…all by scanning QR code here – actually since I came to Shanghai in February 2018, I only used cash twice.

Having said so, I felt Danny was a bit exaggerating about the ubiquity of the QR code in Shanghai until more recently I visited Jing’an temple.

On the last day of the seven-day shui lu fa hui (the water and land rite) of Jing’an temple, I visited this famous temple with more than 780 years history in the very center of the most flourishing and buzzing downtown area of Shanghai. Besieged by a proliferation of high-rise shopping malls, Jing’an temple is the only place where people burn ‘money’ not in luxury consumption, but for the benefit of their ancestors.

Jing’an temple. photo by Xinyuan Wang

One woman who was busy burning ‘ghost money’ (ming bi) explained that the money made by tin foil paper is for the ghosts and deities so that the souls of the deceased persons will find some peace during purgatory, so called chao du, she added earnestly: “Today is the last chance of this year that ghosts would receive money!”  According to her, basically, in the after-world ghosts have to be bribed to treat the passing ancestors without too much torture and hardship.

The air was full of choking smell of the dense smoke of the burning ‘ghost money’ and burning incense. The smoke which indicates  immaterialization symbolizes the transformation from the tangible material world to the intangible spirit world.

On the other side of the raging flames one could sees a big standing electronic screen called ‘Prayer merit and credit list’ (qi fu gong de bang).  Standing in front of the big screen, people is were busy reaching the deities in a more ‘environment friendly’ way: holding their smartphones against the screen to scan the QR code on the top so that they could make a prayer online. The prayers they made would pop up in the form of vertical red scroll on the big screen immediately after submitting, and many take a photo of the screen for the record.

Scan the QR code and make a prayer online. photo by Xinyuan Wang

Last time I saw such a fancy way of interaction was during the exhibition ‘from selfie to self-expression’ of Saatchi Gallery in London which was supposed to be the pioneering art experiment in the digital age.

In that exhibition, visitors could post selfies on their personal twitter accounts with given hashtag and the selfies would be projected immediately against the wall of the exhibition hall. As I recall, a young lady who just saw her selfie popped up on the wall, exclaimed thrillingly “Oh my god… isn’t it amazing?!”

I guess she was not really asking god’s opinion about it, but I really wonder which way ghosts and deities in China prefer to be reached… smoke or QR code?

 

(check the short video here)

The QR code in JingAn Temple, Shanghai

In Shanghai, people scan QR code for almost everything, including to get connected with deities during religious ceremony. Video by our researcher Xinyuan Wang.

Posted by Anthropology of Smartphones and Smart Ageing on Sunday, 11 November 2018