Open access image from Pixabay

Author: Daniel Miller

I want to make a slightly surprising suggestion. That my current ambition in anthropology is to become more like TikTok (or its original Chinese form Douyin). Because TikTok captures something that is central to the ethos of anthropology as a discipline. Currently the ASSA project is developing an approach called Smart-From-Below. The premise of this stance is that smartphones are cresting a wave that consists of a historical shift of creativity back to ordinary people. Enabled by its extraordinary capacities anybody can come up with a significant and helpful use of their smartphones in, for example, helping develop heath care or organising information. The idea of smart-from-below is that the anthropologist learns from observing these and then re-packages them in order to make these creative ideas available to everyone else. The 150-page manual we have published by Marilia Duque on our website about how you can use WhatsApp for health is an example of this approach. You can download the manual here.

Eugene Wei has recently written three fascinating blogs about the algorithm behind TikTok of which the most relevant is available here. The two previous blogs demonstrate how the company ByteDance developed an extraordinarily successful algorithm that watches you as you watch TikTok. It quickly learns from this your preferences and feeds you more and more of what you evidently like to watch. I am particularly interested because I also have a PhD student Ken Zheng who has just competed nearly a year working as an intern in ByteDance for her PhD studies. The third blog is not about the algorithm but about how easy it is for anyone to make TikTok videos. In the tradition developed as sampling culture in music, much of this riffs off and comments on prior videos circulating on TikTok. There was a profound book The Signifying Monkey by Henry Lewis Gates Jnr that argued for the origins of this kind of cultural practice in jazz and before that in particular African cultural systems.

What this means is that ByteDance doesn’t really need to know anything about its users or their content. All that matters is that it developed the best current system for allowing peer to peer cultural sharing and trajectories of creative development. In other words, allowing people to observe and learn from each other, rather than trying to impose or develop content itself. At this point the analogy between TikTok and Smart-From-Below should be clear. Anthropology has never been that concerned with telling people what to do, or creating their `content’. Rather it stems from our appreciation of what people themselves creatively develop as cultural forms and practices, and then letting other people learn from that. It is not the only thing we do, but one of our primary contributions is in facilitating peer-to-peer cultural learning. I would like to do this more effectively in the future. In other words, at least for this purpose, I would like to become more like TikTok.

Updated 21/03/2022

On re-reading my own post I decided it required a short caveat just to prevent any misunderstanding. I am only suggesting we might become more like TikTok in relation to peer-to-peer communication. I fully recognise that there are all sorts of other aspects of TikTok, whether its potential for superficiality or misinformation that of course, I have not the slightest desire to emulate. 

Open access image by Mohamed Hassan

Author: Charlotte Hawkins

As part of the ASSA project, we are currently working to publish a volume called: ‘An Anthropological Approach to mHealth: Health & Care in the Smartphone Age’. This volume consolidates insights from the team’s various anthropological initiatives in mobile health or ‘m-health’ – health-related uses of the phone – in diverse settings around the world. Drawing from an ethnographic perspective, we seek to contribute an anthropological understanding of mHealth, a growing industry often otherwise dictated by top-down priorities such as bespoke app creation. Instead, building from our own ethnographic insights about older people’s everyday uses of phones, and other studies stressing the evident importance of ‘informal mHealth’ (Hampshire et al., 2021), we illustrate a ‘smart-from-below’ approach which prioritises the everyday appropriation of phones and existing communicative apps for health purposes. We analyse the failures of conventional mHealth initiatives and the emergence of our alternative perspective, and how that led to several initiatives in which team members were themselves involved.

In this book, we offer a grounded ethnographic picture of mHealth in our various research contexts, with a view to broader global trends in population ageing, health and economic crises, the Covid-19 pandemic, declining public investment, increasing phone access, and global migration. This shows the potential of prioritising the everyday appropriation of mobile technologies in line with both social change and longer-standing care norms.. This is intended topromote an anthropological approach to support the relevance and effectiveness of mHealth going forward. We have already created a free online course (available here) for those interested in the topic but hope that the book will benefit other medical anthropologists and ethnographers interested in digital health, as well as digital health practitioners interested in social research around the design, implementation and evaluation of their work.

We have organised the book into three parts, reflecting what anthropology can offer for contextualizing, analysing and informing mHealth. Part one consists of three chapters concerned with contextualizing mHealth;

• Xinyuan Wang on mHealth practice in mainland China;
• Shireen Walton on visual digital communications about health during covid in Italy, and
• Laura Haapio-Kirk on social self-tracking in Japan.

This is followed by contributions analysing mHealth:

• Daniel Miller on googling for health in Ireland, and the ways it exacerbates existing disparities;
• Patrick Awondo on the failures of various mHealth initiatives in Yaoundé, Cameroon; and
• Pauline Garvey outlining the uses of phones to seek information and support around the menopause in Dublin, Ireland.

The volume concludes with three chapters informing specific mHealth initiatives:

• Alfonso Otaegui’s recommendations for scaling the ‘nurse navigator’ model in public oncological clinics in Chile;
• Marília Duque’s protocol for meal-logging and WhatsApp communications in Brazil; and
• Charlotte Hawkin’s and John Mark Bwanika’s work on a digital mental health programme in Uganda.

Taken together, the volume seeks to provide a grounded ethnographic discussion on the challenges and opportunities of anthropology for mHealth, and of seeking health and care in the smartphone age. We aim for publication in 2022 with UCL Press, follow ASSA on Twitter, Instagram and Facebook to keep updated.

References

Hampshire et al. (2021). Informal mhealth at scale in Africa: Opportunities and challenges. World Development, 139:105257, 1-23