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Smartphones,’addictions’ and connections in Italy

ShireenWalton14 May 2019

Photo (CC BY) Shireen Walton

Last week during one of the women’s group activities at the Multicultural Centre I have been regularly attending in Milan I was asked if I could take a photo for one of the Italian women, Maria, in her early 70s, who volunteers at the Centre three days per week. Maria had just been found on Facebook by an old school friend and wanted to instantly send her a nice photo of herself ‘here and now’ on Facebook messenger to acknowledge and build the connection. Maria spent some minutes deciding where to pose, and how to fix her appearance, to the extent that it cut short in an abrupt manner the end of the meeting. Maria’s desire to connect across time/space there and then was so strong that the barries between the smartphone’s buzzing social universes and the physical social setting of the Centre had crossed over, with mixed responses by others present.

Centro Multiculturale, Milan. Photo (CC BY) Shireen Walton

Such examples of smartphone ‘intrusions’ into a social scene are not uncommon, and go hand in hand with a range of attitudes and judgements – that are often expressed and shared, ironically in smartphone-circulated memes, cartoons and photos. During my time in Italy a range of popular mantras reflect the alleged intrusion that digital connectivity feel poses to life: ‘we are all addicted!’ ‘just look at people on the metro – all face down, scrolling away, ignoring everyone and everything around them’, ‘at a party, no-one speaks to each other anymore, it’s crazy!’ and so on..

As an anthropologist, I find the worries and anxieties that some people have about smartphones – their over-reliance, seeming addiction or just about their general usage, part of the curiosity in exploring what the smartphone is, and how people describe it in relation to their everyday practices.  Peeling back the layers of these discourses, one sees the spectrum of practices that smartphones are implicated in in individuals’ lives, from connection with family, friends and community, to tools for navigating bureaucracy, citizenship, and health. All the while, the digital infrastructures that form and shape the basis for these interactions and practices (wifi, roaming data, connection speed…) form a part of people’s contextual and sited experience with their smartphone in daily life.

The notion of the ‘switched-on-self’, the boundaries between digital and non-digital lives has been a more general theme in my research and participant observation in my fieldwork with Italians and migrant groups in Milan. The correlation between being on/off in the person’s mind/body recalls and in some sense plays into wider global social trends like the flourishing of mindfulness and yoga that are posited by many people I speak with here as opportunities for peace – ‘places’ and practices to go to and do to ourselves and our bodies to ‘switch off’ from our busy, including constantly connected, digital lives.

Outdoor yoga in the park in the Milan fieldsite; moments for digital detoxing. Photo (CC BY) Shireen Walton

Throughout my research I have noticed how the issues of technology addiction and connection have been defined along age lines. At AUSER, a nation-wide NGO association for active ageing in Italy with a headquarters in my fieldsite, and Milan-based organisation Grey Panthers that is concerned with ageing and technology, what I have deduced is that while facilitating digital connectedness is a core policy concern aimed at older people (senior/anziani) [1], while policies and initiatives being designed to tackle digital addiction have been identified an issue prominent amongst the young (giovani) [2]. The ASSA project’s interest in middle-age has helped nuance these discourses about young and older populations by looking at how people live their lives with smartphones – including between ‘old’ and ‘young’ categories of age.

To take some examples. Alberto is 60, by policy standards he is neither old nor young. He still works full-time as a history school teacher at the local public school, and is an active volunteer in local community events. Reflecting upon his relationship with his smartphone Alberto describes how he does not consider himself particularly technologically savvy, nor up-to-date with regards to apps. However, from the moment he wakes up (first his alarm, followed by checking WhatsApp, Facebook and then email notifications from bed) he is attaccato (‘attached’) to his phone. He says he is mindful of his pupils’ usage, particularly in the classroom, but confesses to regularly checking his phone during school hours himself. He is in touch with his daughter in her 20s who is searching for work, as well as with the left-wing community organisations he co-runs with friends, monitoring Facebook pages dedicated to spreading awareness of local history and resistance to Fascism, particularly in light of the current policies of the present Interior Minister Matteo Salvini’s far-right anti-migrant stance. Alberto’s smartphone is a reflection of his social universe, and this visibly engagements and investments with this smartphone.

Photo (CC BY Shireen Walton)

Meanwhile Davide, 64, is retired, on a state pension. He volunteers running one of the community allotments in the neighbourhood several days a week. Davide uses his smartphone regularly. It is central to the way he runs the allotments, communicates with the community, and maintains his social life as a single, retired, socially-active man in his mid-60s. Davide also does not consider himself a tech-savvy person. Speaking about apps and app usage he, like many other people I find, explains: “I don’t have any apps really… I rarely use any…” We then discover together, by observation with the phone, that he does have a number of apps, and in fact uses a number of these frequently – many of the social media apps, an app for his gym, an app for the weather, apps that identify what certain plants are… He is not ‘addicted’, but he is reliant, reasonably heavily, on his phone.

Milan neighbourhood community allotment. Photo (CC BY) Shireen Walton

Smartphone practices for some like Alberto and Davide are involved in reflecting and shaping individual lives, social identities and wider offline practices. However, digital infrastructure and connecting to the Internet also plays a significant part in explaining smartphone reliance, and people’s conceptualisation of their phone. In some cases, loss of Internet connection (due to low reception or running out of credit) can be annoying, humiliating, and harmful.

Adla from Tanzana is in her mid 30s, and has a 1-year old daughter. She has been in Milan for a year and a half. Her daughter was born in the city, but has been told by authorities that her daughter is not yet old enough to attend nursery. Adla explains how she does not feel entitled to take part in certain social / support groups since her daughter is too young to go to school and she is uncomfortable attending the mothers groups in here area that are a big source of community life here but which are dominated by Arabic-speaking Egyptian women, which makes Adla feel like the ‘wrong kind of foreigner’ with the ‘wrong kind of languages’, being Tanzanian, speaking Swahili and some English, but limited Italian. Adla relies on her smartphone to navigate the geography of the city, including finding relevant administrative offices, using Google Translate to communicate in basic Italian, and maintain connection with her family – her sister in Sweden, her husband is working in another country in Africa, and the rest of her family are back in Tanzania. Adla does not have Wi-Fi in the one-bedroom apartment where she lives, so uses data roaming through her basic monthly social services allowance to access her familiar social universe. This connection to her smartphone as a physical thing holds intense meaning for her and her ability to navigate her way through each day. Even when the data has run out and it is not connected it is of comfort to Adla in the absence of physical, familiar, offline social life. Unlike Alberto or Davide, whose smartphones reflect their wider activity and presence in the neighbourhood, Adla’s smartphone life takes on heightened significance where her offline life is marred by insecurity and limited physical participation.

In a final example, an Egyptian family in the neighbourhood have been applying for a visa to visit their immediate family in the US who they have not seen for several years. The couple, in their mid-40s, work full-time in Milan as a baker and cleaner respectively, and their teenage children attend local public schools. Every year they apply for entry to the US via a lengthy application system. The family do not have WiFi at home and have limited data roaming on their phones. Upon receiving a letter in the post saying that they need to check the status of their visa application on the US state department website within a specific time period, the couple try to do this in the hours when they are not working, and due to their long working hours that leaves little time to stay for long periods of time in Internet cafes. The site keeps crashing and needs refreshing, and entering the application details in English, a language neither of them speak, is time-consuming. They repeat the process over and over again on their basic smartphones, at times in public free WiFi zones in the city, or at home with their limited data, to no avail. Upon learning about their experience with this process I become involved – the couple ask me to assist with internet access and English translation. Eventually, we discover that their application has been refused, to the couple’s stoic acceptance. It is but a small anecdote in this family’s larger experience of social stress, living on the margins of society in Milan as a close-knit ‘stranieri’ (foreign) family making do in their current set-up, where smartphones, Internet connections, are all part and parcel of broader lived realities; practices, experiences and desires.

In sum, the relationship between the smartphone, and what is often viewed as addiction or social rudeness – particularly amongst youth – are important themes to nuance further, along broader demographic lines. Understanding how and how much different people, of different ages and socio-cultural backgrounds, use and shape their lives around in a given context in relation to smartphones may well point to technological addiction, ill-health, and too much screen time, but it also highlights how central the phone is as a thing itself – for many, an object of attachment, including and beyond its switched on capacity for digital connection. A wide range of factors stemming from broader social contexts thus situate the smartphone holistically as an object of everyday life.

Notes and references:

[1] Auser’s mission statement is aimed at ‘promoting the active ageing of the elderly and enhancing their role in society’, which includes technological education and encouraged usage for wellbeing and for a positive impact on lifestyle. In the University of the Third Age for over 60s that Auser runs through a network of volunteers, ‘technological awareness’, as well as lectures on the dangers of data and privacy issues form a part of a broader curriculum on a wide variety of topics from horticulturalism to cooking to tourism and so on.

[2] De Pasquale, C., Sciacca, F., Hichy, Z. (2017). ‘Italian Validation of Smartphone Addiction Scale Short Version for Adolescent and Young Adults’ in Psychology 08(10): 1513-1518.

 

 

Thoughts inspired by exhibitions in Shanghai

XinyuanWang1 February 2019

As one of China’s major cultural centers, Shanghai boasts a wealth of cultural events. Many locals, especially the younger generation, often go to theatres, galleries and museums. During my stay in Shanghai, beside curating the exhibition for my research participants, I also go to exhibitions on a regular basis in order to keep pace with the ever-changing cultural landscape of the metropolis. Different exhibitions attract different groups of people in Shanghai, therefore going to exhibitions also allows me to observe my fellow exhibition goers in an organic way. Every single exhibition which I went to was very interesting as I could always enjoy watching people even if the exhibition per se may by any chance fail me.

For example, the 2018 Shanghai book fair attracted a quite wide range of audience. Through the lens of my research concern upon the use of smartphones, it was also curious to see that in the sea of books some were quite happy to sit on the steps checking their smartphones and a grandfather using two smartphones to take photos of his grandchildren.

2018 Shanghai book fair

Checking smartphones in the sea of books

Taking photos with two smartphones

On the West bund art expo, I met probably the most international dwellers in shanghai who also attribute to the unique temperament of Shanghai.

West bund art Expo

Whilst an amateur painting exhibition at a community library attracted many retired people from the neighborhood. I happen to spot a lady in her 60s showing the exhibition via the WeChat video call to her family with the help of her friend.

Recently, to my surprise, I happened to walk into a pop-up exhibition about the social changes in the past 40 years (1978-2018) of ‘Chinese economic reform and opening up’ (gai ke kai fang) in the middle of an underground station. With a variety of daily life materials as well as typical scenarios of social interactions, this exhibition vividly represents what has happened in ordinary people’s daily lives and what people are longing for. (Check the short video of this exhibition)

A pop-up exhibition about the social changes in China in the past 40 years

A pop-up exhibition in the middle of an underground station in Shanghai tells you about the social changes in the past 40 years of ‘Chinese economic reform and opening up’, where the techonology plays a significant role. Filmed by researcher Xinyuan Wang

Posted by Anthropology of Smartphones and Smart Ageing on Friday, 1 February 2019

In the first section, an old-school bike represents the most advanced household transportation in the first decade of the reform era. Two semi-transparent figures, being father and son, imply a scenery associated with the old bike – the father is giving a lesson of how to ride a bike, the boy is wobbling about on the bike, asking: “Daddy, can you buy me a bike once I can ride it? Oh no please don’t let me go, I will lose the balance anytime!”

Beside the parent-child interaction, there were household items including an old sewing machine, a radio, a fridge and a TV set. The caption of this section read “My understanding of happiness started from the moment of our whole family watching TV together”. For long, the TV set has had great significance in Chinese households and the place where the TV set is located is where the family spends quality time together.

As shown in the neighboring showcase, more technology entered into people’s daily life, among them the landline telephone was the most important one. To have a household landline installed was regarded as a great honor in the late 1980s as only the public institutes had such privilege before. The caption of this section reads “For years the landline telephone had been my pride, and since then I always used the landline number as my password for my bank cards.”

Many of my research participants share the similar memories displayed at the exhibition that one has to queue at public telephone booths or visit friends who were privileged to have household landlines to make a phone call. In front of the showcase, a little boy asked his grandpa what is the landline telephone, the grandpa answered, “it is called landline telephone (zuo ji), kind of mobile phone before you were born!” Here the future is used to define the past.

Little Boy: what’s that? Grandfather: It is called landline, kind of mobile phone before you were born

The next highlighted landmark of daily technology is OICQ in 1990s along with PC. OICQ soon changed its name to QQ, and even nowadays QQ is still one of the most widely used social media platforms in China. The conversation between a school boy and a girl in the showcase is – boy: “I have got 50 friends on OICQ, and one of them even come from HuHeHaoTe (a city in northern China” Girl:” Please help me to register a QQ account!”

For years, QQ has occupied the PC screen of millions of Chinese people. The use of QQ also gradually spread from Chinese cities to rural China. Six years ago, when I conducted my PhD field work in a small factory town in southeast China, QQ was still the most widely used social media among rural migrant workers.

In terms of the digital device, as one of my research participants put it “In the past decade, the screen has become smaller, while the function has become stronger”. After a series of mobile phone ‘evolutions’, by the beginning the fourth decade of the reform era, China has entered the age of the smartphone. With proliferation of the use of smartphones, more and more older people in China have adopted a new way of interpersonal communication with their family members.

As shown in the last section of the exhibition, in a well-equipped modern kitchen, a young person is cooking while having a video call with his parents, saying: “Mum, look, I can take care of myself. Those are what I just got from the food market. Daddy has high blood pressure, don’t let him drink too much! ” His mum said: “What worry us most is that you don’t eat properly when you live outside alone, having take-away for every meal.”

A passer-by in his 30s commented: “it is so true, my mum would nag so at least ten times a day!” and his friend remarked: “in my case, it’s my mum who will hold her smartphone while she was cooking, showing me all the nice food at home via video call.”

From the old-school bike to landline telephone, from the offline family time in front of the TV set to the online family time facilitated by the digital technology, a small pop-up exhibition captures those subtle but significant material and moments of the daily lives of ordinary Chinese in the past forty years.

On top of it, located in the middle of one of the busiest underground junctions in Shanghai, this exhibition manages to reach the widest audience as possible – I have never seen so many older people and young kids in other exhibitions. Furthermore, I was most impressed by the way this exhibition gets all kinds of people involved, and such willingness and skill to disseminate knowledge is also something our project can learn from.

The challenges of staying active – by Maya de Vries

ShireenWalton25 September 2018

Author: Maya de Vries

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

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

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

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

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

References:

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

The Internet of Health in Yaoundé – by Patrick Awondo

ShireenWalton12 September 2018

Author: Patrick Awondo

Over the last decade, Internet penetration rate in Cameroon has more than doubled, from around 10% in 2007 to 21-30% in 2017 (these figures leave aside small and medium-sized cities, and do not take into account connection-sharing practices that are part of people’s daily habits). The internet boom, made possible by the democratization of smartphones (which 80% of the population now have) has impacted significantly upon behavioural habits and the ways in which individuals and groups live at different stages of their lives. Among the areas chiefly affected by such changes, health is attracting attention in the digital landscape because it is the subject of unprecedented publicity, and is considered to offer many affordances to people.

In Yaoundé as in other African capitals, health remains a significant problem, but also, is undergoing  ongoing processes of change, and permanent questioning. In the smartphone age, health is an area of intense social activity. Three types of issues in the online health context deserve attention for the importance of the activities they generate:

  1. The variety of access to online health resources
  2. The diversity of information and forms of access offered by the Internet
  3. Challenges related to the density of supply, and what our colleague, Daniel Miller, perceives as inequality in interpretation, and the ability to appreciate in a fair and balanced way, the different “resources” of health online.

The variety of access to health resources

Generally speaking, people in Yaoundé use the Internet in contexts of/for health either to publicize health resources, that is to say, to present information that aims to simultaneously improve access to health through good practices. Or, to find the right information about very specific health problems. The latter is undertaken through a range of sites and links dedicated to specific health issues. Specific health issues can include pandemics such as malaria, tuberculosis or HIV / AIDS, which are priority public health problems usually treated by public health actors. However, people also turn to the Internet to search for diseases that have no visible presence in public health discourses, and which generally lack in public awareness – such as Typhoid fever, as well as certain female health issues such as ovarian cysts, dermatological problems, and infertility. These issues are addressed in forums, and blogs, but more and more, via dedicated Whatsapp groups that are often created by individuals with such concerns. There are also many health bloggers from Cameroon and the Cameroonian diasporas. Some are not always of Cameroonian descent or nationality, but blog membership appears most strong when individuals are Cameroonians or presented as originating from the country.

Overall, there are different ways of accessing the  internet of health in Yaoundé. Informants could be classified into 3 categories:

  1. those who watch YouTube for health
  2. those who Google-search health problems
  3. those who follow specialized health blogs

Health-searching practices on YouTube

Amongst my young informants, (19-31 years), the practice of searching for information on YouTube seems to be fairly common. Informants describe a typical double scenario, whereby they have a health concern, for various reasons that may be related to a lack of economic means, or the inability to join a health service. In this case, they will introduce on YouTube the name of one or more symptoms, which they hope a video will help inform them about. A 31-year-old security officer at a mobile phone operator explained how she regularly used YouTube on her smartphone to get video responses mainly about intimate grooming techniques, and a set of problems related to gynaecology. Interested in plant medicine, she regularly follows a “youtubeuse” specialized in herbal care for women. Many under-educated people like this female informant with limited income, but also among people with higher levels of education follow the youtubeurs of Cameroon almost daily. Other informants in the same social category stress that seeing a specialised doctor can be difficult in Yaoundé because of the high rates that these specialists practice. About 10,000 XAF consultation is already 10% of the salary of a security guard as our informant.

These high prices are not those charged in public hospitals, where a specialist costs half the price in private. Another factor determining the choice of Youtubeurs health advice is to be found in the strong competition that plant medicine imposes on modern Western medicine in Yaoundé. This appeal of alternative, natural therapies can be found amongst all social strata.

Those who “Google read” health on the Internet

During interviews and observations in one Yaoundean clinic, it appeared that searches on Google densified as a large part of the population access the Internet via the smartphone (specifically, the android phone, which is most popular here). Healthcare professionals in this capital’s leading private clinics point to the fact that a growing number of patients in consultation rooms are talking about diagnostic elements previously sought on the Internet, or afterwards in order to be able to make analogies by comparison.

The issue of individuals making their own comparisons with official health advice is intriguing. In another clinic, a 40-year-old teacher explained his reliance on seeking health information on Google through the dual need to better understand the disease from which his son had suffered from for 6 months at the time of the interview, but also, to compare the information received during diagnosis with that available on the Internet. If the case of this Father is not isolated, it reveals the complexity of different persons and needs that are engaged in via the search for health information on Google.

So while some informants point out curiosity and the primary need for knowledge of the disease or to understand the symptoms, this informant took to researching online for secondary purposes, to in some sense validate the official medical diagnosis. Another 44-year-old informant, a married, bookstore employee and Mother of two who lives in mvog-Ada, stressed the fact that the availability of the internet is a key factor in explaining its popularity and usage. Suffering from a Glaucoma, she went to an Ophthalmologist in a public hospital. The latter professional indicated that surgery was inevitable. Frightened and seeking reassurance, she turned to Google from her office to access information about her own illness. For this informant and for the first mentioned above, the search for information becomes a way to access a second opinion on the diagnosis of the doctor, especially in the case of serious diseases.

Health blogs and their followers

At the beginning of August, I was walking in the streets of Mvog-ada, the low-income neighborhood, when I was accosted by a group of people ;  two young men, a man, and a young woman, all wearing a green T-shirt on which read the name of a company that distributes herbal medicines. The group explained to me how they had created an online site with an active blog through which to communicate and sell their products. Like this distribution company, many groups have online blogs that are subscribed to by many Cameroonians. As a rule, these Blogs are put online from Cameroon and in particular the two big cities that are Yaoundé and Douala. But some of the blogs are often domiciled in Europe, particularly in France.

Such blogs cover broad health issues ranging from exclusively female problems (such as intimate care practices, ovarian problems, and so forth) to major pandemics (Malaria, Typhoid Fever, Cholera). There is also a very large number of sites dedicated to plant medicine. These plant medicine sites, still called herbalists, are very successful in the online contexts.

In sum, health on the Internet seems to play a major role in Cameroon, affecting the way people access health information on the one hand, and the way in which this – and also non-Internet accessed medical information such as doctors’ diagnoses – is evaluated. These last observations highlight two types of concerns: on the one hand, the difference between specialized and non-specialized information (also professional and non-professional); on the other hand, the issue of inequalities, linked to the ability of informants to analyze ‘good’ and ‘bad’ news offers. This brings us back to the classic issue of the reproduction of (health) inequalities related to economic context and education levels, and how these factors influence the use or non-use of information and the evaluation of their quality and/of efficacies.

 

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

LauraHaapio-Kirk26 August 2018

Author: Marilia Duque

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

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

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

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

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

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

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

Blame the phone..! UI design and elderly smartphone users.

Alfonso ManuelOtaegui12 August 2018

Photo (CC BY) J Stimp.

 

As I mentioned in my previous post, a first step in my ethnography of the experience of ageing and the use of smartphones involved volunteering at a cultural center in the working-class neighborhood where I am living in Santiago de Chile. For a couple of months, I have been a teacher’s assistant in two workshops on the usage of smartphones aimed at elderly people. In these workshops lasting for four weeks, enthusiastic grey-haired students learn the basics of smartphones settings (unblocking the phone, connecting to Wi-Fi, turning on and off the GPS, flight mode and the like), how to use the Camera app, Whatsapp and Google Maps.

In addition, for a couple of weeks, I have been giving a complementary workshop by myself, for those who have already finished the main workshop. This complementary workshop focuses on repetition and exercising: students have the opportunity to practice in more extended periods of time what they have learnt in the first workshop, and to go step-by-step over and over again. This complementary workshop has given me the opportunity to be in more frequent contact with the students, and to become more familiar with their struggles and their success in mastering this nowadays pervasive new device. Many of the difficulties I noticed have been also spotted by my colleague Marilia Pereira in her field site in Brazil.

One of the most common feelings expressed by the students at the beginning is frustration: the phone doesn’t do what the teacher has just shown, the screen goes off all of a sudden, or cryptic warnings pop up, among other things. In my short experience so far, the most common —yet invisible— difficulty lies in the touch interface. Many elderly students find it difficult to distinguish between a ‘tap’ and a ‘long press’, and they tend to do a ‘long press’ when a ‘tap’ is required. I believe it is related to the lack of self-confidence when using the smartphone: they press the button long enough to be sure they are pressing it (as with a door bell). The problem though, is that the long press is a different input and therefore produces a result other than the expected one. Another difficulty lies in hitting the exact right spot on the screen, as, again, a slight miss has a different outcome (e.g. on Android’s Whatsapp’s chats menu, hitting the contact picture will show you that picture, hitting just a little to the right will open the chat), contributing to the general feeling of frustration.

Another common experience is the feeling of being overwhelmed by the vast array of menus, gestures, and different ways to do the same things on the smartphone. Having shared many classes with these elderly students, I started to grasp the experience from their point of view. Considering the difficulties of the touch UI, the diversity of Android iterations, manufacturer’s software skins, etc., I can see how complex and overwhelming this experience might be. All the functions of the phone seem chaotic to me now: there is no clear logical hierarchy in the arrangement of apps and functions. Most of the students do not recognize the difference between the home screens and the app drawer (the majority have Android devices), especially when the wallpaper in the app drawer is the same as on the home screens (but, adding to the confusion, this does not happen with every phone). One old man did this to access the camera: instead of tapping the camera icon on the home screen, he would tap the app drawer icon, and then the camera icon inside the app drawer. Furthermore, as the teacher of the main workshop pointed out, they expect to learn the ‘one way’ to do something on the phone, while multiple ways are possible (and sometimes these are needed, when one of the ways does not work).

In these situations of frustration, they tend to blame themselves (“I don’t understand technology” or “my head is not good for this”) as they judge themselves unable of learning the intricacies of this device, which seem evident for their grandchildren (who don’t have the time nor the patience to teach them). Having experienced this frustration myself when trying to teach a simple procedure to a new student whose specific smartphone model I have never used, I wish they would allow themselves to blame the phone now and then (I certainly do). Sometimes the interface is not as intuitive as it should be, sometimes too many shortcuts stay in the way and sometimes there is no visual cue on where to tap (the flat design of previous years has made this worse). However, I must say that they blame the phone sometimes, but in the most radical way: ‘this phone does not work’ (therefore, it must be changed). This has happened when they had accidentally left the phone in flight mode or silent mode, and they were unable to either receive phone calls or hear them, respectively. It is as if they could see the problem only in themselves or in the hardware (the phone as a device), while the software (and UI design) remains a blind spot. The interface is there, yet it goes unnoticed.

All in all, this is just the beginning of a long path for these new old beginners. It will be interesting to see if, as the workshop progresses, these engaged learners build up more self-confidence and make their way through the garden of forking paths of mobile UI.

The digital divide in age-friendly Dublin

LauraHaapio-Kirk14 June 2018

Author: Pauline Garvey.

Age Action website[1]

 

Recognising that over the next 30 years the number of people in Ireland over the age of 55 will double and the number over 80 will quadruple, there are lots of initiatives dedicated to positive and active ageing in the capital city. In 2013 the Irish Department of Health published the National Positive Ageing Strategy which set out a ‘vision for an age-friendly society through the achievement of four national goals (participation, health, security and research)’[2]. Dublin City Council claims the city was the first capital in the world to adopt a city-wide approach to becoming age-friendly[3]. In order to do this the Dublin City Age Friendly Programme 2014-2019 tackles nine key areas that may negatively impact on older individuals[4]. Under a series of headings it commits to providing alternatives to sheltered housing (Home and Community); supporting older people’s engagement with social and community life in which they live (Social Economic and Political Life); helping people volunteer or work in their locality (Learn, Develop and Work); providing facilities to engage in sports and activities (Healthy and Active Living). It also aspires to make the public sphere more manageable for older people such as providing adequate seating and level footpaths (Outdoor Space and Buildings); ensuring that public transport is adequate for journeys that older people are taking and the pedestrian crossings are timed at the correct speed (Transport, Safety) and finally ensuring access to information, both online and off-line for older individuals (Information).

Over the course of my research I will look at some of these initiatives more closely, but for now I’m interested in exploring how people access information. It is here that the digital divide can be most striking: when smart and competent people find themselves grappling with digital technologies such as simple commands on smartphones and computers. For an ever-growing number of activities such as booking a flight or reserving a table at a restaurant one is required to do it online. One organisation that is working to combat digital exclusion is Age Action and I was interested to note that one route to signing up for computing courses is by filling out an online form![5]. What at first glance looks like a contradiction is in fact something quite different. The Age Action website is directed to friends and relatives because feeling excluded from digital media impacts whole families and networks of friends rather than solitary individuals. One’s place in a social network is continually reiterated through simple messaging such as checking in with kin or organising meet-ups, allowing people to demonstrate care as well as receive it. Of course the question remains, what about the people who need help getting started but have no one who will intervene of their behalf? For these, the digital divide remains an insurmountable barrier.

 

 

  1. https://www.ageaction.ie/how-we-can-help/getting-started-computer-training/sign-up
  2. http://www.dublincity.ie/agefriendlycity
  3. http://www.dublincity.ie/sites/default/files/content/HousingAndCommunity/Community/Age%20Friendly%20Charter-English%20A2.pdf
  4. http://www.dublincity.ie/sites/default/files/content/HousingAndCommunity/Community/Age%20Friendly%20Charter-English%20A2.pdf
  5. https://www.ageaction.ie/how-we-can-help/getting-started-computer-training/sign-up

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.

Being Together Alone in East Jerusalem – by Maya de Vries

ShireenWalton23 May 2018

Author: Maya de Vries

As the days go by, I am starting to become more familiar with my field site of Dar al Hawa in East Jerusalem. Recently, I joined the Elderly’s Club in the village community center.

The club was opened in 1985, before the foundation of the community center. A group of 50-60 year olds meet here twice a week – on Sundays and Thursdays at 10am, for 2-3 hours of various activities – including lectures concerning culture, health, welfare, nutrition and religion. One of the most popular activities they have is a regular sports lesson for adults, usually while sitting on a chair.

Photo (CC BY) Maya de Vries

Photo (CC BY) Maya de Vries

Most of the elderly people who come to the club were born and raised in Dar al Hawa. It is their hometown, in which they feel most comfortable and safe. In many cases, the houses people live in are the same in which they grew up, or moved into when they got married. This is especially the case for women, many of whom live close to their children’s families. So why should they join this club, rather than remaining within the comfort and safety of their own home and families?

The act of leaving the security of an elder’s home is not simple, since it usually takes quite a lot of physical effort. Those who live nearby can easily walk, but others who live in more distant streets use a special transport system organized by the community center. Their presence is also depended on the weather; if it is too cold it is most likely that less people will show up. Some will call their friends to see if they are coming or not, but most of them will provide updates on their actions through the WhatsApp group of “the elderly club”, administrated by the club instructor.

One reason this club is succeeding in retaining its members is that it has tried not to impose rules on its participants. This is important in respecting the seniority of older people. As such, each person can come and go as she/he wishes; they just need to be friendly to each other and quiet during a lecture or class. Being quiet does not always come easily however, as they seem to enjoy their conversations.

The majority of the people who attend the club are women. In the exercise class, the women sit on sofas close to the wall, while the men sit at the front table. Over time, individual women will develop particular roles. One woman serves water, making sure no one will be thirsty. There is also the ‘joker’, who keeps everyone laughing during an activity, another walks in and out of the room as she takes various phones calls.

Mobile phones frequently go off during lectures, meetings and films, even during a religion lesson given by the local Imam. When asked who carries a mobile phone, everyone raised their hand. All but two were Smartphones. The most popular apps are WhatsApp Messenger and Imo – these two apps make it easier and cheaper for people here to speak with relatives and friends in Jordan, Kuwait and America. At first glance, it seems that despite their age, they handle their device quite well.

Photo (CC BY) Maya de Vries

On closer inspection, however, the problems become more apparent. It is often hard for individuals to hear the ringtones, or to make the swiping action needed to unlock and open their phones. Many of these people may not be aware of the presence of apps already on their phone, which could potentially help them with health issues such as exercising, Most of the people I speak with here do not know they can download an app for the local health clinics that can assist them in setting doctor appointments, renew subscriptions, and so on.

Notably, every person I talked with about his or her smartphones told me that they are getting help and instructions from their grandchildren – they teach them how write, how to upload a post, how to call and even how to post on Facebook. In this manner, smartphones, from isolating people, may help to bring family members closer together, and to bridge a kind of digital divide that exists between the generations. At the same time, the interruptions created by phone calls cuts through the flow of the group’s activity, undermining its unity; – it literally pulls out the elderly from the room.

In short, both the club and the smartphone work here at the intersection of individualism and sociality. The club is a social forum that helps counter isolation, but works by respecting the individual. The phone is strongly associated with the individual, who may not be aware of many of its possibilities, but it has become a major link to the wider collective. These two aspects appear to work in tandem. Hence, a person who lacks the support of their family or community is also unlikely to learn to use their phone.

Photo (CC BY) Maya de Vries