As this blog wraps up, I wanted to focus the attention on what the future will look like for social marketing and how we as public health students can play a role.  I have explored some of the ways in which social marketing has impacted national and global public health, both positively and negatively.  Though a relatively new field, social marketing has come a long way in the past twenty years and has established itself as a relevant and recognized practice.

Many in the social marketing community are now calling for collective engagement for the creation of a global organization dedicated to social marketing.  Recently, a petition was released online that calls for the creation of such an organization.  It also sets out core principles that the social marketing community believes in and outlines a process for creating a social marketing organization.  You can find the petition here: http://fusomar.epetitions.net/.  The authors of the petition hope to have the principles and goals accomplished by June 2010, when the 20th anniversary of the Social Marketing in Public Health conference meets.  Some of the things this organization would do include:

o    Discuss and propose the goals, scope, structure, business model and operations of the association;
o    Draft a charter, mechanism to elect officers and other elements of the organization (by-laws);
o    Offer a guide for the emerging organization through all stages of development;
o    Establish workgroups for achieving other objectives (for example, education resources, staffing, practice standards, credentialing, communications, and advocacy);
o    Establish steps, stages, and timelines for further organizational development; and
o    Provide timely and regular communications with the larger social marketing community through electronic channels and social marketing publications during this process and be prepared to present their completed work at the Congress for open discussion and voting among all attendees.

Other trends in both commercial and social marketing will push the field in certain directions.  For example, business has apparently found it more profitable to retain existing customers than continually win new ones.  Social marketing adopts this idea and recognize the potential for people who are already interested in health improvement offerings (like smoking cessation services) to become more committed to health improvement.  This is only one approach and one opinion, and others point to social marketing’s role in intervention and radically changing behavior as more important.

Some of the issues that social marketing can benefit in the future include obesity, water security, malaria, environmentalism.  Social marketing has a proven track record in changing both dietary and exercise behavior, and many are hopeful that strategic health marketing can combat the obesity epidemic.  To reach its full potential however, social marketing must have a long-term approach.  Oftentimes political short-termism limits the ability for government to enact permanent changes in public health.  The government and public health organizations should match the kind of long-term, high impact branding that corporations utilize to sell a product.  Public health does not change overnight, and social marketing needs to plan accordingly in order to impact social behavior.

Since our speakers in the past couple of weeks have discussed what there is to be done in public health beyond the medical profession, I thought it’d be relevant to mention a few more ideas here.  Within social marketing alone, there are so many diverse opportunities available for one to impact public health.  Looking through the website for the 2010 Social Marketing in Public Health conference, the speakers and presenters involved come from a wide range of backgrounds.  You can see more here: http://www.cme.hsc.usf.edu .  There are public health education experts, communications professors, community health research professors, marketing directors.  It seems like a marketing background is not necessary to get involved in social marketing.  Not all social marketing campaigns take place at the level of things like the Red campaign or the Designated Driver campaign.  Local efforts to promote recycling or exercise are also opportunities for social marketing to have a role.  Regardless of what profession you pursue, there is a chance for your skills to benefit social marketing in public health, and it’s nice to see the different paths that people have taken.

http://fusomar.epetitions.net/.

http://www.cme.hsc.usf.edu

Lefebvre, Craig. “The Future of Social Marketing: A Call for Collective Engagement for the Creation of a Global Organization.” Weblog post. On Social Marketing and Social Change. 19 May 2009. 27 May 2009 <http://socialmarketing.blogs.com/r_craiig_lefebvres_social/>.

Stead, M., Hastings, G., and L. McDermott. “The meaning, effectiveness and future of social marketing.” Obesity Reviews 8.1(2007): 189-193.

In my last blog post I talked about the growing call for electronic health records to replace the cumbersome paper records that are use in systems now. Some of the reasons for this included community and public health benefits in the form of disease prevention, and also personal advantages such as more safeguards to prevent the overlooking of a possibly dangerous condition or complication. Thanks to feedback from the blog comments and further research, I have decided to take this idea further and explore some of the possible human rights issues associated with the transition, and some areas which might need a little more attention before the system goes global.

The largest concern that I have personally, which is also brought up by others familiar with the field is that of privacy. Medical records have long been the source of privacy concerns, and the potentially sensitive information could be used in ways that the individual might not be comfortable with. On a small scale, it could simply lead to the transfer of records being so convenient that they might be shared a little too widely. On a large scale, they could be used for very widespread issues.

The advantages are many - electronic records might be extremely beneficial to data on societies or statistics concerning certain diseases and conditions. Its potentially anonymous and widespread coverage could create a data pool which consists of an entire population, not just those few who decided to fill out a survey.

However, could this large amount of data lead to somewhat shady practices such as selling the information for marketing purposes? We already worry about telemarketers getting our phone numbers, how much worse would it be if medical information was used to target a specific audience potentially against their will or comfort level of having that information known by others. Along with this, widespread health data could eventually lead to some sort of discrimination based on healthcare records. (Forgive me if my sci-fi brain can’t help but making the connection to the movie GATTACA right here.) If health information could be obtained (however legally) by potential employers, universities, etc. it could strongly effect who gets offered the spot and who doesn’t. 

Another serious issue with privacy that is heavily considered with the topic of electronic records is the growing ability of computer hackers to access supposedly private information. Even with the most secure of electronic protections, it would always be a fear that the information could be breached. At the very least, someone could be trying to sell the widespread information to make a profit, but at the worst this could be used to target individuals.

In the end, these electronic records can do wonders for the convenience and effectiveness of the health system (not to mention the environment…) but the cost might be our right to privacy. With the administration pushing the electronic records, perhaps it is already out of our hands. 

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Sources:

http://www.nytimes.com/2009/02/01/opinion/01sun2.html

http://bits.blogs.nytimes.com/2009/04/05/health-care-industry-moves-slowly-onto-the-internet/

So far, my blog topics have mostly looked at ways in which public health marketing has helped to raise awareness on crucial health issues.  Social marketing has benefited public health in many ways, and many communities are better off now than they were before.  As with any “product,” however, we must remember the pitfalls that come along with marketing.  Recognizing what the source is and what the motivations are in marketing a public health measure are just as important as when deciding what kind of car to buy.  I was doing research for another class and came across an interesting article about the marketing of female sexual dysfunction.  There is a huge debate surrounding the very idea of female sexual dysfunction, and the pharmaceutical companies promoting the “disease” are undoubtedly a controversial player.

Before Proctor and Gamble’s testosterone patch went before regulatory approval, it sponsored a massive global marketing campaign to raise awareness of female sexual dysfunction.  They funded continuing medical education activities, produced a reporter’s guide to testosterone, created a website, hired an advertising firm to promote awareness of the “disease” and the drug to cure it.  A professor at NYU School of Medicine argues, “The product the company is selling at this stage is really the disease…then [the drug intervention] won’t be seen as the company pushing its product, it will be seen as health education.”

Female sexual dysfunction as a disorder is also controversial.  The diagnoses often do not encompass the full complexities of female sexual response, and it’s hard to account for relational and cultural factors.  Proponents of new medications for the disorder claim that the condition affects 43% of American women, but others say the estimates are unreliable.

While female sexual dysfunction could be a serious health problem for many women, the role of the pharmaceutical companies in promoting awareness on it seems very dubious.  As a consumer, I would be wary of the product if I knew the source of the information.  However, given the success of marketing campaigns in the past, how much power do consumers really hold?  Most are likely unaware that the advertisements, the educational campaigns, and the scientific experts on sexual dysfunction are backed by pharmaceutical companies.  Without disclosure of this information, it would be difficult for consumers to make an informed decision.

On a similar note, a couple months ago, Harvard Medical School was featured in a New York Times article for potential ethical violations regarding pharmaceutical industry influence in the classroom.  Many of the faculty members are affiliated with private industries, and the information coming from such industries oftentimes infiltrates the classroom under the guise of education.  Many of the students have taken issue with the practice and are pressuring the university to expose and curtail industry influence in the academic setting. According to the article, “The Harvard students have already secured a requirement that all professors and lecturers disclose their industry ties in class — a blanket policy that has been adopted by no other leading medical school.”

Difficult as it may be to implement, such oversight and accountability may be necessary in other marketing methods that are influenced by private industry.

References:

Wilson, Duff. “Harvard Medical School in Ethics Quandary.”   http://www.nytimes.com/2009/03/03/business/03medschool.html.  March 2, 2009.

Moynihan, Ray.  “The marketing of a disease: female sexual dysfunction.” BMJ 330 (2005): 192-194.

Last week, I introduced the challenges presented by the use of copyrights on the Internet. The major issue raised by implementing copyrights on works published online is that it prevents the spread of health-related knowledge to regions that do not have the direct means to undertake the intensive research projects themselves. People in these regions rely on the knowledge of the West in many cases to serve as a foundation of their background in healthcare, health assessment, treatment, and prevention.

In last week’s post, I provided the backdrop for why those who control what is made publicly available online should rethink their system of privacy and limited access in certain situations. In that vein, this week I want to introduce a joint project of the Center for Democracy and Technology and Internews. This project goes by the acronym, GIPI, which stands for Global Internet Policy Initiative. The aim of GIPI is “to promote transparency and predictability in business regulation; competition, privatization, open networks and universal service in terms of telecomm policy; and market-driven solutions, user-control and human rights protection in terms of government control.” It combines the efforts of various non-profits and non-governmental organizations to encourage developing and transitional countries to adopt the legal and political framework for an “open and democratic Internet.” To speed up these efforts, GIPI provides its member countries with draft laws in local languages that could be swiftly implemented by their national governments.

But like any other attempt at good will, GIPI’s practices face certain limitations. Currently, there are GIPI-related initiatives in effect in Afghanistan, Algeria, Armenia, Azerbaijan, Belarus, Bulgaria, Georgia, India, Indonesia, Kazakhstan, Kyrgyz Republic, Russia, Serbia and Montenegro, Tajikistan, Ukraine, Uzbekistan, and Vietnam. With the exception of Algeria in North Africa, none of the representative countries are in Africa. And isn’t it Africa that is experiencing the highest incidence of infectious diseases like HIV/AIDS and malaria? Well, yes. So aren’t the African countries the ones who that would benefit most from an open Internet that granted them access to more health-related knowledge and equipped their community health workers with a greater level of know-how in dealing with certain illnesses? Theoretically, yes. (I say “theoretically” because we have not yet even breached the question of the disparities in levels of access to a computer connected to the Internet among developing and developed countries.) So while it may be great that GIPI is working to promote transparency and openness in a number of other countries, the fact that Africa is essentially excluded may not imply any hopes for positive change anytime soon, at least not on the WorldWideWeb-information-dissemination front.

There are other concerns linked to this issue as well. One could argue that GIPI’s goals resemble a campaign to impose democracy and certain democratic principles on countries that are not necessarily inclined to accept or are simply not yet amenable to such practices. One point of focus is the market-driven nature of the Internet and making its control decentralized. This tenet may not be the most readily acceptable to certain policymakers. But these things considered, I still feel that the underlying aims of GIPI are noble and when considered in light of the copyright issue raised in my last post, are a step forward.

http://www.internetpolicy.net/

Throughout the course of the quarter, I have looked at mobile technology through various lenses. We have seen how it affects HIV/AIDS patients, patients in the United States dealing with a variety of diseases, and the health of sex workers in many different parts of the world. This week, I’d like to take you to Australia to explore an initiative spearheaded by Murdoch Institute’s Centre for Adolescent Health and funded by the Telstra Foundation. This program targets adolescents with mental health disorders, mostly those dealing with depression. It is unique in that it is the first of its kind and it is a pilot project. The results of the pilot project are promising and doctors hope to introduce the program on a national basis. An overview of the program follows:

The Target
The target population for this project consisted of adolescents and young adults between the ages of 14 and 24 in Australia. According to an article discussing the program, up to 30% of people in this age group will battle some sort of depression during their adolescent years. Unfortunately, many of these people do not seek care for many years, and some never seek care at all. The population that took part in the pilot project indicated that they faced depression issues and had sought treatment.

The Project
At this point in time, it is rather obvious that a vast majority of the population between the ages of 14 and 24 has cellular phones. Cell phones are the primary means of communication for this demographic. Consequently, the Murdoch Institute took it upon itself to utilize these mobile phones to retrieve health information and better the healthcare offered to this group.

In order to do this, the institute created a mobile program that provided each participant with a set of questions. The questions asked about how the patient was feeling that day, stresses he or she was facing, exercise and activity, coping strategies, eating patterns, and other factors contributing to his or her lifestyle. The data was then sent to a website which recorded the progress and tracked the changes in the patient’s answers. The patients’ doctors were then able to see this data, which helped them create treatment plans for their patients.

The Results
The doctors who took part in the program reported a better understanding of the condition that each patient was facing as well as a better ability to tailor a treatment program to each patient specifically. The pilot program proved to be rather successful in both increasing awareness of symptoms for the patients and the doctors. In asking the patients to track their data daily, it probably made them more cognizant of their feelings, setbacks, and variance between days. For the doctors, being able to see data across a span of days allowed them to know how the patients were doing on days that they did not see them. This provides an all-encompassing means of data collection.

Implications of the project:
This project demonstrates the fact that mobile technology can cross boundaries in the health world. Its use as a health device is not solely limited to “physical health”; instead it can be incredibly useful in the treatment of mental health issues as well. The program targeted a population that was both in need and had easy access to cell phones. Spending a few extra minutes on mobile phones logging this data probably proved to be easy and quick for these adolescents and young adults. It probably became habit very quickly.

One part of this initiative that I found promising was the fact that the patients were still seeing their doctors in person. The mobile phones were solely to add to the data that the doctors had in order to make the treatment plan more effective. Considering the fact that depression is different for every patient who suffers it, doctors could tailor treatment plans to the patients more effectively. The patients did not see the doctors any less than before, and they did not lose the relationship between doctor and patient. Instead, this relationship was probably strengthened as there was more information being shared between the two parties.

This program is special because it tackles mental health, which is so often ignored in the world of healthcare. It integrates a new form of technology with a field that battles intense stigma. In this sense, the mobile aspect helps patients battle stigma as their data logging can be kept relatively private. I hope that the Telstra Foundation and the Murdoch Institute implement this program on a wider scale in the near future.

Sources:
http://www.cellular-news.com/story/36648.php

http://www.telstrafoundation.com.au/dir148/tfweb.nsf/home/homepage?opendocument

In much of the developing world, there is a ‘brain drain’ phenomenon, where physicians will leave poorer nations in search of more lucrative positions. Many developed nations, even if they are able to train physicians, are unable to retain Doctors. Thus, much of the developing world faces a shortage of physicians. This makes mid-level health workers extremely important, especially in rural regions of the world, where patients are long distances away from health clinics and hospitals. In these regions, mid level health practitioners bear the burden of providing care for communities. Often, this hefty burden has led to low retention rates, poor follow-up treatment, and low drug adherence. The many problems faced by health workers who are unable to reach patients that are far away, monitor treatment, and administer diagnostics at the point of care, are exacerbated by the lack of support that they are receiving from outside sources.

Community health radio is a way to empower health workers, who are currently, an important component of the future of health care in developing nations. These health workers can gain training, support, and the ability to communicate with each other via the radio. Community health radios have been used in places such as Senegal to train health practitioners in basic emergency medical care. In Senegal, radio distance learning has helped to increase the knowledge base of health workers, so that they can serve their communities more effectively. The stated objective of the Johns Hopkins Center for Communications, which has created the Senegalese distance learning radio program, is to improve the knowledge of relay workers in maternal health, child survival, adolescent health, STI/HIV/AIDS, interpersonal communication and counseling, and action planning. The distance learning radio program seeks to empower and motivate relay workers in their communities. And also to encourage communities to seek services by providing them the same health information provided to relay workers through radio.

Supplementary assessments and radio programs that inform the people about critical health issues support the concept of distance radio learning. Combined, these elements sharpen both the health workers and their communities’ understanding of how to address health issues. In Zambia, this method was implemented to combat HIV/AIDS in particular. While a physician’s training costs tens of thousands of dollars, training a basic health worker costs only forty US dollars. The results were extremely positive, and many health workers were dispatched in the public health campaign that was aimed at reducing the mother-child transmission of HIV/AIDS. Although there have been examples of the positive results of radio distance learning, research about the efficacy of these programs has held that they should be combined with centralized health service centers. While, radio distance learning may not be the final solution, it certainly is a crucial component of empowering health workers to improve health care in the developing world. Combined with the development of centralized health clinics, radios provide an opportunity to improve health care through the intersection of both centralized approaches to health care (health clinics) and a decentralized approach to training health practitioners. This intersection is symbolic of a new era of health care, which brings together seemingly opposing ideas, creating multi-faceted solutions to complex problems.

Resources

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102283277.html

http://www.jhuccp.org/africa/senegal/radio.shtml#4

In a world where appointments can be automatically copied from your gmail to your gcal, via your iphone from almost any location in the world, it is hard to believe that paper forms and systems still exist. And yet, the health care industry is one that has resisted the move to a technology. When it comes to record keeping, most places still take histories on paper, and store them in the back room, to be accessed whenever you come back. As you might know yourself, this can lead to issues of communication, particularly when it comes time to switch doctors, or go to get a second opinion.

However, recently (and possibly in light of growing epidemic concerns,) the health care industry has begun to make the transition to online medical records. This can make it much easier to access these records yourself, transfer them when necessary, and most importantly to assist in monitoring concerns for public health. With everything digitized, the future holds computer programs which can scan all records looking for particularly dangerous combinations. This can find things doctors may have missed, or even be able to alert the health care professionals of people who may be more prone to contracting or spreading a communicable disease. 

This advancement towards maintaining public health includes collaborations such as the one between the CDC and GE Healthcare which is looking at providing ways to alert a doctor or office if a patient is at risk for a certain type of influenza or food-borne illness. Another project, being driven by the Mayo Clinic and I.B.M. is called “Open Health Natural Language Processing Consortium” and it looks at understanding language as it is used in medical settings, via electronic medical records. 

Projects such as these can benefit the United States greatly, both in convenience to the everyday person and also in disease control. The industry is set in this direction, and hopefully continuing to move faster toward the end goal with help from the current administration. The Obama Administration plans to spend $19 billion to hurry the shift to electronic record keeping, with an emphasis on being able to share them across networks. This dedication towards advancement in medical record keeping technology can benefit those directly involved and also begin a process of spreading information as only the internet can facilitate.

Hopefully with these new advances in technology, both personal and community health can be improved in the United States, and eventually move to become a global standard. With the fusion of health care and technology, public health issues can be address and hopefully public health disasters can be avoided. 

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Resources:

http://bits.blogs.nytimes.com/2009/04/05/health-care-industry-moves-slowly-onto-the-internet/

http://www.himssconference.org/

https://cabig-kc.nci.nih.gov/Vocab/KC/index.php/OHNLP

In light of Wednesday’s lecture and the emphasis on the importance of interdisciplinary work in improving the quality of life, my aim this week is to look at how information and communication technology can be used to promote communication across fields.  While searching for what’s been done with ICT to improve health care, I found out about Health InterNetwork.  As mentioned previously, there is a lot of potential for ICT to improve health by increasing access to health services and reducing the divide in access to care and information.  Information and the technologies that deliver it must be necessary for this tool to be effectively used - as we saw in Egypt, the pairing of a health campaign with a popular commodity made the campaign much more successful.  The United Nations Millenium Action Plan states that restrictions to exploiting the potential of ICT include: financial, technological, and infrastructure challenges; also, the “real needs of the users - which vary greatly due to educational, social, and culture differences - are often overlooked.”  This seems to be a common challenge of many public health interventions.  As we learned in Monday’s lecture, it is essential to look at the needs of the community and implement their needs and priorities into account.

This week, I will focus on what has been done to increase communication across different disciplines and organizations to improve health.  In September 2000, the United Nation launched a public-private initiative, the Health InterNetwork, to bridge the “digital divide” in health - this was led by the WHO and brought together international agencies, the private sector, foundations, non-governmental organizations and country partners, all under the purpose of ensuring “equitable access to health information” and to “improve public health by facilitating the flow of health information.”  This was one of the major initiatives of the UN Millenium Action Plan, and was designed to support existing public health programs and priorities through content (relevant, high quality, affordable), connectivity (improving internet access), capacity (training to use health information effectively).  It is encouraging to see that the core elements and purpose of the project deal with the issues brought up in class, and attempt to allow for equal access and cultural sensitivity.

One major project of this action plan has been the Health InterNetwork Access to Research Internet Initiative (HINARI).  This project has taken off recently, and it allows for many thousands of doctors, policy-makers, and researchers in over 70 developing countries (about 108 total countries, areas, and territories) to have access to one of the world’s largest collection of biomedical literature (about 6,200 journal titles).  As the WHO Director-General Brundtland stated, this is “perhaps the biggest step ever taken towards reducing the information gap between rich and poor countries.”   Hopefully, this information gap will be reduced so that the quality of life can be improved.  Some questions and challenges that this project are similar to the ones that face other initiatives.  How can resources be distributed so that developing countries can get access to this wealth of information that’s being shared?  How do we, as mentioned this week in class, move from a field of academic understanding to implementation to improve the quality of life?  What can be done to ensure that these initiatives are supporting the priorities and needs of the community?  While it seems that the purpose of the initiative is hopeful because it aims to “support existing public health programs and priorities,” it is imperative that this goal is actively incorporated into the interventions and initiative action plans.  By looking at what’s been done at a global scale to incorporate views from multiple professions, we can better understand what more needs to be done.  This initiative aims to integrate many professions of health, but perhaps more value can be added by including other fields into the discussion, as was mentioned on Wednesday.  Next week, I will talk briefly about a project that is currently taking place between Palestine and Israel with an online health forum that incorporates the views and needs of differing communities.  From this topic, it is apparent that ICT has incredible potential if harnessed correctly to significantly improve quality of life; nevertheless, there are important considerations that have to be accounted for, as even a global initiative faces challenges that can act as obstacles to reducing the gap in knowledge.

Scholtz, Michael.  “The Role of Information and Communication Technology in Health.”  WHO, February 2003.  http://www.itu.int/wsis/docs/pc2/roundtables/rt7/scholtz.pdf

United Nations Millenium Action Plan.  “Health InterNetwork.”  http://www.un.org/millennium/sg/report/Health-Aug2001.htm

Risk, Ahmad.  “Health InterNetwork Access to Research Initiative.”  30 June 2008.  http://www.hi-europe.info/files/2002/9991.htm

WHO.  HINARI Access To Research Initiative.  http://www.who.int/hinari/en/

Much as it may be hard to admit, celebrities have an incredible amount of power and sway in people’s lives.  They’re glamorous, rich, famous, and pretty to look at—it’s only logical that they are quickly swept up in marketing gimmicks.  When it comes to social marketing, the story doesn’t seem any different.  Just to put things in perspective, when George Clooney went on Oprah Winfrey’s show in April 2006 after his visit to Africa, contributions to UNICEF rose 20%.  After Lucy Liu visited earthquake victims in Pakistan in 2006, donations to earthquake relief funds increased by 240%.  Almost every celebrity and star seems to have his or her cause, and the humanitarian effort does seem to go a long way.  Of course, celebrities gain a lot in the process as well.  They do good and, in doing so, get their names out.

There is also something called entertainment education, which incorporates an educational message into popular entertainment content (TV shows, movies) to raise awareness or increase knowledge about something.  This strategy has raised a number of health issues in entertainment programming, including substance abuse, teenage pregnancy, HIV/AIDS, cancer, and other diseases.  Entertainment education is different from a public service announcement, but both have been effective tools in community health and social issues.  Apparently, after an episode of Happy Days where Fonzie goes to the library to meet girls and ends up with a library card, the nationwide demand for library cards spiked 500%.  These kind of plot lines are sometimes a result of the producers and scriptwriters or others who are directly associated with the production.  Other times, special interest groups or health organizations reach out to the entertainment community with the help of Hollywood-based advocacy organizations.  The Harvard Alcohol Project’s National Designated Driver Campaign has been considered one of the most successful efforts to promote health through Hollywood.  They were able to work with the Hollywood community and got more than 160 prime time shows, including The Cosby Show and Cheers, to include subplots, scenes, dialogue, and sometimes entire episodes addressing the campaign theme.

While celebrities help some causes, others criticize their role in social marketing.  Celebrities come with costs, both money and time-wise.  There are dangers in associating with celebrities- their reputation, good or bad, is associated with the cause.  It may be hard to match your cause with someone who will appeal to your audience.  Probably the most serious dilemma that comes with celebrity endorsement is the implication it has for “doing good” in general.  Some call it the “Hollywoodization of doing good” in which a big name is needed to get attention for a cause.  The emphasis on star power makes it really hard for worthwhile organizations who do great work to get public attention.  The nonprofit I work for- the Asian Liver Center at Stanford University- often feels like it’s competing with “sexier” causes who have sexy celebs backing them up.  As an example, a few years back, the United Nations Development Program and the Beijing-based Epin Media company created a program to increase awareness about HIV/AIDS and fight discrimination against HIV carriers and AIDS patients.  The public service announcement included Yao Ming and Magic Johnson, “calling on the public not to fear or discriminate against those with HIV/AIDS.” It was aired in Beijing’s buses, taxis, and local TV channels.  A search for similar TV ads related to hepatitis B did not return any results, and according to the Asian Liver Center at Stanford University, there are currently no hepatitis B public service announcements running in China.  Recently, NBC has expressed interest in airing a public service announcement in the United States about hepatitis B with celebrities spreading the message.  Despite the pitfalls of celebrity endorsement and the frustration it causes, it’s hard to deny the power of your favorite soap opera actress telling you to care about something.  If given the opportunity, who could resist the chance to use Hollywood as leverage for your cause?

Works Cited
Boustany, Nora. “Hollywood Stars Find an Audience For Social Causes.” Washington Post 10 June 2007.

“Cause celebre: Celebrities and their causes.” CNN 21 June 2006. 14 May 2009 <CNN.com>.
“Entertainment Education and Health in the United States.” Kaiser Family Foundation Issue Brief Spring (2004).

Keene, Alden. “Using Celebrities to Enhance Your Cause-Related Marketing.” Weblog post. Cause Marketing. 2 Feb. 2007. 14 May 2009 <http://causerelatedmarketing.blogspot.com/2007/02/using-celebrities-to-enhance-your-cause.html>.

“Yao Ming, Magic Johnson TV ad launched to fight discrimination against HIV/AIDS patients.” People’s Daily Online.  Source: Xinhua.  Updated 5 Mar. 2006.

In recent posts, I have spent a considerable amount of time looking at mobile technology and HIV/AIDS patients. This week, I would like to switch gears and examine the role of mobile technology in the sex worker population. Often times, we have this stereotypical image of sex workers lining the streets of red-light districts in developing nations. Yet, we must realize that with new technology, the dynamics of sex work have changed. For example, in Hong Kong, some sex workers have started their own businesses that they advertise on the internet. Clients call the workers on their mobile phones and they arrange to meet somewhere to complete the transaction. This new process has both pros and cons. First of all, it leads to independence from the pimp as the woman begins to run a business on her own. In a sense, this shift can be seen as empowering—although the woman is still using her body as her means of income, she decides (for the most part) who touches her and which clients she sees more than once. But, this process can also be seen as further objectifying the woman, making her more into a product being “sold”.

In places where prostitution is illegal, sex workers often use their mobiles phones as a means of communicating with one another. If a policeman or undercover cop is detected, one sex worker may send out a mass text message to all of her co-workers in order to save them from arrest. Interestingly, many times when sex workers are arrested by the police, their mobile phones are taken away. Police are aware that sex workers often use their mobile phones as a data collection device, and often they delete this information from the phones. If, by chance, the sex workers are able to keep their phones in jail, they often have an “SOS” text that they can send out to organizations that will come and make sure that their rights are not violated. This demonstrates the fact that the use of mobile technology is widespread in the sex worker community: it has many purposes and has come to be an important part of daily life.

In terms of global public health, NGOs around the world have come to value mobile technology as a form of data collection. It is rather rare for sex workers in most areas to have access to the internet; consequently, it is easier for them to log their data via mobile phone, as most of them have one. NGOs that work in the area of sex work focus on making sure sex workers are safe and that their rights are protected. One such organization, Tactical Tech, works with many different NGOs around the world to use technology as a means of advocacy. An example comes from one NGO that Tactical Tech works with: the Thai non-profit called Empower. I urge you to look at their website: http://www.empowerfoundation.org. Empower works with Thai sex workers to make sure they are guaranteed basic human rights as it teaches these women that they are a vital part of society, no matter the stigma that they live with. The opening page of the website reads:

“We are sex workers. We are workers who use our brains and our skills to earn
an income. We are proud to support ourselves and our extended families. We look
after each other at work; we fight for safe and fair standards in our industry and
equal rights within society. We are a major part of the Thai economy, bringing in
lots of tourist dollars. We are active citizens on every issue…politics, economics,
environment, laws, rights etc. We try and find the space in society to stand up and
be heard. Some see us as problem makers but actually we are part of the solution.
We are sex workers; we are Empower…”

As is apparent from this paragraph, the NGO seeks to ensure that these women see themselves as hard-working earners and individuals. They attempt to dispel the commoditization of women.

Tactical Technology works with both sex workers and HIV/AIDS patients in ensuring the maintenance of human rights. They work with organizations like Empower to help them incorporate information and communication technology into their mission and programming. The organization has created a series of workshops and online “tool kits” that assist in maximizing the impact of the advocacy work that different organizations do. Although Tactical Technology is rather far removed from the sex workers, it, and other groups like it, help in spreading mobile technology to the places and people who need it most. In the case of sex workers, one of the biggest problems that they face is stigma and exclusion from society. Organizations like these are working endlessly to battle these beliefs that are ingrained in so many cultures and promote the rights of this marginalized population.

Through the story of the sex workers, we can see the mark that mobile technology has made in the global public health world. It is used not only in populations that are classified as “physically ill” but also in areas where communication and data collection are necessary in order to keep a population safe. As technology grows, it will be interesting to see how it is incorporated into the lives of sex workers.

Sourcs:

http://www.tacticaltech.org/node/454

http://www.empowerfoundation.org/

http://www.tacticaltech.org/mobileadvocacy