29 Social Media for Health in Nunavik (Commentary)
Marie-Claude Lyonnais and Christopher Fletcher
The instant global connection afforded by the internet is now so much a part of daily life that it is becoming hard to imagine when it wasn’t. Social media have reshaped the ways we all interact, our relations with kin, the very notion of friendship, the ways we entertain, and the ways we position ourselves as socio-political actors, shifting, in the process, the constraints of time and geography on belonging. In Northern Canada the development of the internet has been slowed by the technological limits associated with a huge area without road or landline connections. In Nunavik, the Inuit land claims region of Northern Québec, where we have been looking at the use of social media as a means to circulate health information, social media have been widely integrated into the lives and homes of people beginning 2010. Facebook in particular is very popular. The low bandwidth required to operate the platform means that it works reasonably well even in an environment where the bandwidth available for a whole community is less than that of a single house in a southern urban center.
Health-related content of Facebook pages is broad and touches many of the most important social determinants of health among them quality relationships, financial and material resources, social inclusion, healthy local food, work, emotional support, educational opportunities, access to community activities and health services. Every community has multiple public pages that encourage discussion and provide information on topics ranging from hunting to items for sale to community events. Regional and national pages are also popular and in some cases draw disparate communities into new configurations around ideas, history, events, food, and politics. Facebook groups have a growing role as a site where people may express their emotional states and, in some cases, extreme distress. In many instances acts of reaching out for help to friends and community members is effective in marshalling support and solace. These positive stories are balanced against instances of cyberbullying and hurtful gossiping that can bring the recipients to terrible anguish.
While young people are the primary users of social media, the enthusiasm for Facebook reaches all age groups, including unilingual Inuktitut-speaking Elders, who are integrating this mode of communication into their routines. We see many analogies to the community radio stations and the UHF radios favored by hunters on the land. Facebook is so important that, when faced with an economic choice, more and more homes are choosing to cancel traditional telephone service and retain only an internet connection for access to the internet. In this situation Facebook is an important way to be connected to the community and the principal means to be contacted. Facebook has become a privileged way to maintain links with and follow the lives of loved ones. The photo and video capacities of the platform are particularly sought out and transcend language and dialectical differences. While local radio remains a core means of communication, some services and organizations are now turning to Facebook to be in contact with the population. As such, social media plays multiple roles: it is, for instance, a local newspaper; a site for classified ads, places of exchange, and requesting a service or traditional food; and a platform for asking questions and calling on elected officials. Facebook is an exceptional cultural vector and a social mirror that Inuit communities have appropriated in their own way, molding its use to their own reality.
Facebook has undeniable strengths to support professionals and various health care workers in their work. Community social and health workers were quick to recognize the potential of social media for education and as a means of monitoring community health issues. There is a clear consensus among them about the need to have a presence on the social media, yet they are largely prohibited to do so by policy set outside of the region. The Nunavik health system is under the control of the Québec system, which prohibits the use of Facebook for professional purposes. Some interveners, by force of circumstances, work around this rule by using social media informally outside their working hours.
Despite the undeniable importance of Facebook in Northern communities, we have noted a growing divide between institutional and everyday personal use of the technology. As in the case of the health system, it is quite common for local and regional organizations to block social media on their worksites and to prohibit people from interacting in an official capacity online. While there are justifiable concerns about confidentiality and productivity in the workplace, it seems that opportunities to better engage with and listen to local communities are being missed.
The ‘Feeding My Family’ page is a prime example of the effective use of Facebook for community health. Here, concern about the effects of high food prices on family health evolved from a page with a few members posting photographs of prices at local stores to one with thousands of members in North and South. The virtual community produced actual protests at stores and offices in several communities, and ultimately had repercussions on national northern food and health policy. Similarly, it is now generally accepted that the 2011 Nunavik Regional Government referendum was defeated in part because the proponents did not gauge and contribute to the local social media discussion about the impacts the agreement would have. Some organizations have been granted an exemption to set up pilot projects most of which are limited to using Facebook as a “promotional” showcase of their activities. In doing so they choose to reproduce the model of a poster, and miss the opportunity and challenge of engaging in dialogue through this medium.
Given the potential benefits to community health efforts, we believe it is time to explore ways to allow health care, social service and community workers to have use of social media as part of their efforts to engage with community. Social media already provide a new and powerful voice for northerners, rallying people and communities around common issues, and providing opportunities for Nunavummiut to voice their concerns.
The time is ripe to work within the evolving community mediascape to build knowledge, tools, and skills that promote health and reduce inequalities within communities and between the North and South. There is a strong regional commitment to transform the Westernized health model by prioritizing Inuit values and knowledge. For this to occur, it is necessary to have full community participation, especially among young people. To be successful, this must be done with respect for Inuit culture, and social and communicative norms. Social media are already playing a role in these important objectives.
