X Close

ASSA

Home

Anthropology of Smartphones and Smart Ageing

Menu

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

LauraHaapio-Kirk10 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.

 

Drawing as ethnographic method

LauraHaapio-Kirk4 February 2019

Drawings made during a group interview about the smartphone.

The anthropological method of participant observation can only go so far when trying to understand the role of an object such as the smartphone in a person’s interior emotional life. The relationship a person has with their phone is deeply connected to the relationships that person has through their phone, to others and to themselves. Yet asking people about their relationship with their phone often yields limited responses: “It’s convenient for staying in touch”, “I rely on it for everything”. People take for granted that the smartphone is a helpful tool, but they typically have not considered their relationship to it specifically, and how it affects their relationships, behaviour, and identity, therefore I needed to find a way to have deeper discussions about the smartphone if I was to understand it in terms of affect. In order to explore the topic directly I thought that engaging informants in drawing might be a way to make the subject more tangible. I asked a group of middle-aged friends to make a two-minute sketch of their relationship with their smartphone, to bring to our next lunch date.

One of the members of the group has been undergoing chemotherapy for the past six months. While I was hoping that the drawing task would elicit reflection on the affective nature of the smartphone, I did not make that an explicit part of the instructions: I only asked if they could represent their relationship with their phone in a drawing. So I was delighted when this woman produced the most striking drawing out of the group, which shows her at the centre holding her smartphone surrounded by the range of ways she is emotionally affected by the smartphone in her daily life. She explained to me:

Especially while I have been sick, the smartphone has become very important to me. It is my connection to the outside world. The days following chemotherapy my body feels drained and I cannot leave the house. During that time if I receive a Line message or sticker from my friend I feel uplifted. But I can also feel sad and disappointed if I hear from my daughter that she is having relationship problems. When I am at the hospital having chemotherapy I watch films on Netflix and they often make me feel emotional. I also sometimes read surprising news stories. My smartphone makes me feel all of these things!

During this time of illness and potential loneliness, the smartphone offers an escape from her present situation to the world beyond.

“During treatment my smartphone connects me to the outside world”

It was striking that half of the drawings were based on a design of the individual at the centre, with feelings or behaviours or information radiating out. When we discussed this as a group, the majority of women said that they feel that the smartphone is the centre of their life (chuushin), some had even written the word on their drawings. They agreed that it is an object that is not only physically close to them but emotionally central too since it connects them with many of the important people and things in their lives. For many of the middle-aged people in my research, beyond this friendship group, shifting from garakei to smartphones meant an increase in dependency on the device for daily activities, from communicating with friends, to arranging nurse visits for their elderly parents, to booking shifts at work, to online banking. One woman told me:

I switched from my old garakei to my smartphone last year when my husband died and I needed to start being more independent. It has completely changed my life – I do everything with it. I recently went to Tokyo to visit my daughter and I would not have been able to do the trip without my smartphone and the maps app.

This increasing dependency on the smartphone was treated with ambivalence by some members of the friendship group in this case study. One woman explained that the smartphone is the centre of her life but she wishes that it was not, because it then becomes a kind of burden.

This idea of the smartphone as a burden was repeated when discussing another similarity between two of the drawings: both depicting the user sitting while looking at their smartphone. For these two women, rather than reply to messages in the middle of doing other activities such as while on the train or walking, they almost always wait to reply to messages when they have enough time to sit and focus only on the smartphone. They explained that they are not capable of multitasking, yet the burden of knowing that there are messages waiting to be replied to gives them the sense that the smartphone is taking too central a position in their lives. They often will not open messages unless they have the time to sit and reply, because they do not want the sender to see that they have read their message and subsequently feel ignored if they do not reply immediately. While the smartphone can increase a sense of burden for some relationships, for others it can ease the burden of care:

My father has a smartphone and he sends me messages all the time, so many of them! Because it is so easy to send messages he tells me what he is eating and what he is doing. Giving him a smartphone is a way that I can care for him when I am not physically there. Although I feel he sends too many messages, it is easy to reply to him with a sticker to show that I care. So while there is more frequent contact, it is less troublesome contact than a phone call which would be disruptive.”

This statement reveals the affective capacity of the smartphone to enable a new kind of care from a distance, which is perhaps even warmer than if it were face-to-face due to its less burdensome nature.

This visual methodological experiment provided a basis for a three-hour discussion of the smartphone. I plan to repeat this experiment with other informants as I think that the activity worked well for focusing a discussion. The participants were all interested to see how their drawings differed from everyone else’s, and they were far more interested in the topic of the smartphone than on previous occasions since they had already spent some time contemplating it beforehand. After the session a number of the women messaged me to say that they had come away from the experience with a deeper understanding and appreciation of the role of the smartphone in their lives. The active nature of drawing enabled people to discuss their affective experiences in a deeper way, and connected people to their feelings about the smartphone more successfully than discussion alone.

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

LauraHaapio-Kirk22 October 2018

Harvested corn. Illustration by Laura Haapio-Kirk

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

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

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

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

The geographies of health and wellbeing – by Pauline Garvey

LauraHaapio-Kirk15 August 2018

Author: Pauline Garvey

Photo (CC BY) Anna Li

Fairly frequently the Irish media focuses on the ‘downsizing dilemma’ for retirees (O’Rourke 2017), but what receives less attention is the downsizing that comes with marital breakdown. As I conduct research the frequency with which I meet men and women who are separated or divorced is striking. This observation is backed up by recent census data that reveals that separation is currently a significant aspect of life for many Irish families. The Central Statistics Office figures show a significant increase in the percentages of people who separate in the forty-plus age groups (CSO, 2016). The rate of separation peaks at age 48.

This trend in mid-life is significant because, otherwise, marital breakdown is decreasing in the general population. In fact, there was a decrease of 11,115 separated or divorced persons aged under 50 between 2011 and 2016. By contrast there was a substantial increase of 29,224 persons over the age of 50 between 2011-2016. Not only is there an age factor but there is also a gendered dimension in how people report their marital status. Lunn et al. (2009) found that more women than men report themselves to be separated. The conclusion they drew was that men who are separated are more likely to identify themselves as ‘single’ rather than ‘separated’. Also a higher rate of re-marriage by men goes some way to explaining the disparity in figures between the rate of female separation and the rate of male separation, but it also raises questions about how Irish women self-identify following separation (see Hyland 2013).

What we learn from this is that marriage separation is particularly significant for people in their 40s and 50s, that a larger proportion of women do not re-marry and think of themselves as separated rather than single. This alteration in domestic circumstances may be experienced with a mix of emotions but the people I have spoken to are keenly aware of the importance of being accessible to others as they age. This has been discussed with me as either an issue regarding physical (‘what if I fall getting out of the bath?’) or emotional wellbeing (‘my daughter knows when I’m watching Love Island and she’ll text me “he’s a wally” …so I don’t feel alone’). One woman told me of a series of health problems she encountered around the time she was due to retire. As a result of what she calls a ‘bad reaction to life’, she suffered from acute depression and was admitted to a psychiatric hospital for 6 months. On her release and return home she described the effect of having automatic text messages sent to her from the hospital as part of her treatment. The text messages that she received were automatic daily messages: ‘they sent me texts every day or every second day saying ‘how are you doing?’, ‘hope everything is ok?’. So although the messages were not personalised, she describes them as  ‘sending some positivity, it was superb to think that someone knew you weren’t well and could send a text to say you weren’t alone’. The key issue for her is that regular text messages inquiring about her health represented ‘a life line, some contact from the outside world to say we care about you and hope you are getting on alright’. 

As my research continues it is clear that while no life experience can be viewed in isolation, the geographies of age, the places that one experiences midlife, can matter a great deal. My respondents are not just well or unwell, they experience age, health, illness or wellbeing in specific places, whether that is in the privacy of their homes, public spaces or doctors’ clinics. Similarly in contrast to being single, this research causes me to consider the ways in which ‘being separated’ is relational? Should we think of separation as a geographical term, suggesting a lingering connection to place as well as to person?

 

Central Statistics Office, Ireland (2016), available online at https://www.cso.ie/en/releasesandpublications/ep/p-cp4hf/cp4hf/ms/

Hyland, L. (2013) Doing’ separation in contemporary Ireland: the experiences of women who separate in midlife, D.Soc.Sc Thesis, University College Cork, available online at https://cora.ucc.ie/bitstream/handle/10468/1179/HylandL_DSocSc2013.pdf?sequence=2&isAllowed=y

Lunn, P., Fahey, T. and Hannan, C. (2009) Family Figures: Family Dynamics and Family Types in Ireland, 1986-2006, Dublin: ESRI and UCD.

O’Rourke, F. (16/09/2017) The downsizing dilemma? Getting rid of the family furniture, The Irish Times, available online at www.irishtimes.com/life-and-style/homes-and-property/the-downsizing-dilemma-getting-rid-of-the-family-furniture-1.3214649

The Challenge of Menopause – Daniel Miller

DanielMiller3 August 2018

Photo (CC BY) Daniel Miller

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

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

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

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

 

Experiences of ageing: as diverse as the experiences of using a smartphone

Alfonso ManuelOtaegui11 June 2018

Photo (CC BY) Garry Knight

Conducting an urban ethnography in Santiago, Chile,  has so far involved looking for opportunities in which to meet people who would agree to share their experiences on ageing and on the role of the smartphone in their everyday lives. As the coordinator of this project, Daniel Miller, once said, ‘Actually, as is often the case in ethnography, the best approach is through volunteering […], which has the clear upside that you are also contributing something’. I started, then, to volunteer as a teacher assistant at a cultural center for the elderly, helping out in two workshops on the usage of smartphones. This experience has been as rewarding as it is interesting. In four weekly meetings the students are taught the basics of smartphone usage: general settings (connecting to Wi-Fi networks, setting screen brightness, etc.), using the camera, WhatsApp and Google Maps. These very enthusiastic and engaged students do not represent the whole spectrum of relationships that the elderly have with the digital world. In a recent study in the UK by the Centre for Aging Better and the Good Things Foundation on the usage of internet by people aged between 55 and 93, the researchers aimed at including three key groups: resistant non-users (people who do not use the internet and do not intend to do so), lapsed users (former users of the internet who had stopped going online) and current users (experienced users and also beginners). If we used the same categories in my field site, we could say that the students of the workshop would be in the third group.

Even though I am working with a limited sample of people and am in the early stages of fieldwork, it is remarkable how ethnography has already allowed me to perceive the complexity of the practices surrounding the smartphone and to question several taken for granted assumptions on the life experiences of the elderly. One of the first things to notice here is the lack of homogeneity in the expectations of usage of smartphone: one lady wants to take HDR pictures to post later on Instagram, a man wants an app to scan QR codes he comes across in flyers, others want to use an app to measure glucose levels. In the same vein difficulties are also diverse: some might find it difficult to understand the difference between (paid) mobile data and (free) WiFi, or to understand the notion of ‘the cloud’, some others might have trouble with the touch interface. This diversity in the usage of the smartphone echoes the general diversity in the experience of ageing. As the psychologist specialized in pyschogerontology, Daniel Thumala, points out: ‘no hay una vejez, hay ‘vejeces’’ (2017). The contrast between the singular and the plural applied to ‘vejez’ (‘old age’) could be translated as ‘there is not one [standard] experience of ageing, there are [several] experiences of ageing”. Several factors play a role in every particular experience of ageing: family (as child and as parent), education, work, eating habits, exercise, toxic habits, etc. (Villalobos 2017). In the same way, several factors play a role in the adoption and usage of smartphones by the elderly: the usage of previous technologies (e.g. familiarity with a keyboard, or with playback icons), family support (e.g. tech assistance provided by grandchildren), education, fine motor skills and general expectations on the usage of the device (e.g. to gain independence, to stay in contact with family, to track bodily functions, etc.).

It will be interesting to go beyond the context of the workshop and to learn how the smartphone is integrated in the diverse experiences of everyday life of these engaged students. Media reports on the smartphone usually focus on the capacities it might bring to the user. If we take that perspective for a moment, even though it is by no means the only possible one, we could ask ourselves in what measure, if at all, the smartphone might be helpful for the elderly to gain higher autonomy. According to Thumala (2017) –and this goes against ageist preconceptions on the dependency of elderly people–, 76% of elderly people in Chile are autonomous. It would be interesting to see if the smartphone plays any role at all in this autonomy.

 

References

Miller, Daniel (@DannyAnth). “Actually, as is often the case in ethnography, the best approach is through volunteering (I am pretty good at making tea), which has the clear upside that you are also contributing something.” 19 April 2018, 12:18 a.m. Tweet.

Richardson, James. 2018. I Am Connected: new approaches to supporting people in later life online. Centre for Ageing Better and the Good Things Foundation. [free download at https://www.goodthingsfoundation.org/research-publications/i-am-connected-new-approaches-supporting-people-later-life-online]

Thumala, Daniela. 2017. Imágenes sociales del envejecimiento. Material del curso “Cómo envejecemos: una mirada transdisciplinaria”, impartido en UAbierta, Universidad de Chile

Villalobos C., Alicia. 2017. Conceptos básicos acerca del autocuidado. Material del curso “Cómo envejecemos: una mirada transdisciplinaria”, impartido en UAbierta, Universidad de Chile.

What is a smartphone?

DanielMiller1 June 2018

Author: Daniel Miller

Photo (CC BY) newkemall

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

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

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

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

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

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

From smartphones to target phones – By Marilia Duque

LauraHaapio-Kirk26 April 2018

Author: Marilia Duque

Photo (CC BY) Marilia Duque

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

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

Photo (CC BY) Pixabay

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

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

References:

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

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

Yaoundé’s obsession with sport and health – by Patrick Awondo

LauraHaapio-Kirk27 March 2018

Author: Patrick Awondo

Every day at 6 a.m. thousands of citizens invade the street of Yaoundé. As well as work, many are there for sporting activities such as running. They make evident the hundreds of formal and informal associations devoted to sports, and health.

This Saturday morning, as usual, retiree Samuel (58) is here with his wife (55) and his grandson (6). Samuel is the co-founder of a sport group called “club santé famille” (“family health club”). Starting in 2015 with 3 members, they now number more than 70. Each member pays a small participation fee for basic equipment (small carpets, tracksuit), and a coach who directs the two-hour session. These sessions are mainly held on weekends and include dance aerobic activities, running walking and also just relaxing. There are three main categories of such groups:

  • Sports groups based on ethnic and friendship networks
  • Sport and culture groups that include other self-help activities such as (informal banking, cultural activities)
  • Professional sport groups.

(CC – BY) Patrick Awondo

Sport and health in an unequal city

Yaoundé is a city of enclaves and inequality, which is reflected in these weekend sports. In my three main fieldsites, Mvog-Ada, Quartier Fouda and Mfandena, the distribution of sports infrastructures illustrate the gap between the citizens’ commitment to sport and the lack of public facilities to support those efforts. The Ministry of Youth and Sports, promote sport as a condition of a healthy life, as against smoking and drinking. Despite which there is a lack of public infrastructure to support sports initiatives. In Mvog-Ada there is basically no place for running or even walking on the narrow streets. Sports groups have to cross the city to find a stadium or free space for running such as the University of Yaoundé 1 campus,  and the Omnisport stadium which is being prepared for the 2019 African football nations cup.

Gender

One striking feature in Yaoundé is womens’ commitment to sports. While a decade ago an informant noted that women rarely participated in sport, today they dominate. As one of my informants (a 45-year-old teacher), underlined, you would rarely find women involved in those groups. Nowadays, the groups are dominated by women. In the “famille santé club” among the 70 registered members, 55 are women.

 

Looking to the Future – by Marilia Duque

LauraHaapio-Kirk3 March 2018

Author: Marilia Duque

By the year 2050, the Brazilian population over 60 years old is expected to grow from 24 million to 66 million[1]. Fortunately, my first impression of the District of Vila Mariana, in São Paulo city, where I have been conducting ethnography since January, is that there are already innumerable initiatives for the elderly, both public and private.

In addition to public health units, there is the AME-IDOSO for example, a centre dedicated exclusively to the care of people over 60, taking referrals from other health units in the city of São Paulo. It provides examinations, medical appointments and treatments, as well as activities such as dance classes. Just a few blocks away, you can find the Elderly Coexistence Centre (NCI), also subsidised by São Paulo City Hall. If you are 60+ and live in the Vila Mariana District you can join a large number of activities such as knitting and crocheting, fitness, circular dancing, senior dance, manual work, pilates, painting on canvas, chanting, memory games and rhythm dancing. I went there the week before the carnival. When I arrived, it was snack time. While one group were doing a dance class in the lounge integrated into a beautiful garden, another group were chatting and eating, all dressed up in traditional carnival ornaments. The worker told me that the menu takes into account the food restrictions and needs of the participants.

(CC BY) Marilia Duque

During this first month, I have already mapped five squares in the neighbourhood, all of them with gymnastics equipment, in another São Paulo City Hall initiative for people over 60 called “Longevity Playground: Happiness is Ageless”.

(CC BY) Marilia Duque

But if you keep walking you will also see many gyms offering activities for the elderly with special prices, not to mention Aqui Fitness, which has a program of physical activities developed by a geriatrician. And just a few minutes away, you can also exercise your mind and improve yourself; the Nossa Senhora da Saúde Parish offers an adult literacy course (20.4% of the population of Brazil over 60 is illiterate[2]), language classes and a Whatsapp course, especially for people over 60.

(CC BY) Marilia Duque

One of my ethnographic challenges is to investigate how the ageing population in the neighbourhood perceives these initiatives. Do they really work? Do they work for everyone? Could appearances be deceptive? This is an important point because Vila Mariana District is far from being a utopia. You can choose to see just the modern buildings that are rising everywhere among the two storey houses. But you will have some difficulty ignoring the Mario Cardin Community, a favela where more than 500 families live in precarious conditions, or the homeless people living on the streets.

(CC BY) Marilia Duque

But for the moment let us take this apparent wealth of amenities at face value. Actually, this raises a rather different question. Do Brazilian people have to get old before they experience something approaching the support and solidarity of an egalitarian state?

 

 

[1] http://www2.camara.leg.br/a-camara/estruturaadm/altosestudos/pdf/brasil-2050-os-desafios-de-uma-nacao-que-envelhece/view

[2] https://agenciadenoticias.ibge.gov.br/agencia-noticias/2013-agencia-de-noticias/releases/18992-pnad-continua-2016-51-da-populacao-com-25-anos-ou-mais-do-brasil-possuiam-apenas-o-ensino-fundamental-completo.html