What can a teacher do with a cellphone ? Using participatory visual research to speak back in addressing HIV & AIDS

The ubiquity of cellphones in South Africa, a country ravaged by HIV and AIDS, makes cellphones an easily accessible tool to use in participatory approaches to addressing HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immunodeficiency Syndrome) issues, particularly in school contexts. In this article we explore a participatory visual approach undertaken with a group of rural teachers, to uncover and address HIV and AIDS related issues. Drawing on our experience in using participatory video, we used cellphones to produce cellphilms about youth and risk in the context of HIV and AIDS. Noting that the teachers brought highly didactic and moralistic tones into the cellphilms, we devised a “speaking back” approach to encourage reflection and an adjustment to their approaches when addressing HIV and AIDS issues with learners. We draw on the example of condom use in one cellphilm to demonstrate how a “speaking back” pedagogy can encourage reflection and participatory analysis, and contribute to deepening an understanding of how teachers might work with youth and risk in the context of HIV and AIDS.


Introduction
More than a decade ago Hubert Charles (1999, n.p.) stressed the importance of the educational response to HIV and AIDS in sub-Saharan Africa: HIV/AIDS presents the greatest learning challenge to education systems.In the past, the consequences of failure to learn involved simply a delay in progress from one academic level to another or confinement (sometimes temporary) to a lower socio-economic order.With HIV/AIDS the consequences of pedagogic failure [may be] terminal … (Charles, 1999: n.p.) Recent statistics on HIV rates amongst youth show that infection rates have dropped by 25% in 16 of the hardest hit countries, including South Africa (United Nations Programme on HIV/AIDS [UNAIDS], 2010).However, a number of rural districts in the provinces of KwaZuluNatal, Eastern Cape, and Limpopo continue to report high rates of infection especially amongst girls and young women.Salim Abdool Karim and Quarraisha Abdool Karim (2010), in their study of the Vulindlela district of KwaZulu-Natal note that while one in ten girls aged 15 years is HIV positive, by the time they turn 24, the rate is higher than 50% and by the time they turn 30 the rate is over 60%.This is in a context of health initiatives that have ensured easier access to voluntary counseling and testing and relatively easy access to antiretrovirals, suggesting that addressing HIV and AIDS is about more than 'just access'.
At the same time, a recent study funded under the European Programme for Reconstruction and Development, organised by Higher Education of South Africa (HESA), HIV and AIDS in Teacher Education (Higher Education AIDS Programme of South Africa [HEAIDS], 2010), highlights the significance of teachers' knowledge of local contexts.The study refers to stigma, AIDS denialism, gender and sexuality, and cultural practices -all issues which are relatively understudied in teacher education and school-based literature on prevention and sex education in sub-Saharan Africa (Boler & Archer, 2008).The findings of the study relate to many different concerns, i.e. awareness of context, collegial sensitivity, caregiver role, reflexivity, leadership and biomedical HIV and AIDS knowledge, discrimination, and professional practice (HEAIDS, 2010).One of the main conclusions is that without a deeper understanding of specific cultural issues raised by teachers, particularly involving rural young people and communities (as well as teachers' own lives), education interventions as they stand are doomed to fail (see also Khau, 2009).The study does not suggest that educational initiatives are the definitive answer but does highlight that in rural settings at least, the school remains one of the main points of entry for working directly with young people, particularly contested sites related to gender and youth sexuality (including virginity testing and medical male circumcision).As an example from that study, we found that many teachers in the deep rural areas of KwaZulu-Natal, Eastern Cape, and Limpopo identified local belief in witchcraft as possibly the greatest barrier to addressing HIV and AIDS and HIV-related stigma.A group of women teachers in another study revealed their own beliefs about the links between witchcraft and violence (De Lange, Mitchell & Bhana, 2012).
Clearly there are a number of culturally complex issues, well known to many rural teachers as we discovered in the HIV and AIDS in Teacher Education study, and continuously explored in sociology, gender studies, and anthropology (see for example Le Clerc-Madlala, 2001;2003;Marcus, 2008;Scorgie, 2006;Scorgie & Parle, 2001;Meissner & Buso, 2007;Vincent, 2008).However, these issues are not well represented in educational discourses such as teacher education, life skills training, and the management of HIV and AIDS in schools.Significantly the discourses of youth sexuality in sub-Saharan Africa and elsewhere increasingly point to the need for a more nuanced understanding of the politics of safe sex (Allen, 2005b;2005a;Campbell & MacPhail, 2002;James, 2002), life skills materials (Buthelezi, Mitchell, Moletsane, De Lange, Taylor & Stuart, 2007), masculinities (Morrell & Makaye, 2006;Sathiparsad & Taylor, 2006), gender based violence (Bhana, Mitchell & De Lange, 2009), pleasure in youth sexuality (Kippax, Aggleton & Crew, 2003;Allen, 2009;Fine & McClelland, 2006;Ingham, 2005), youth engagement (Robbins, 2010), and, of particular relevance to this study, the rural context itself (MacEntee, 2011;Balfour, Mitchell & Moletsane, 2008) and a place-based consciousness (Corbett, 2006;2007).Moletsane (2011:205-206), in her consideration of the contentious issue of culture and nostalgia in relation to youth and sexuality in contemporary South African education, states: …communities need to be helped to develop new or alternative understandings of what a productive African masculinity or femininity is and can be … Without these new understandings, traditional and current interventions (such as virginity testing and traditional male circumcision) that are presented as 'culturally appropriate strategies' for managing the HIV and AIDS pandemic will continue to put young people at risk of infection.She cites the work of Lewis (2003:2) who calls for "innovativeness in contesting discourses, practices, and identities that police our rights, freedoms and desires" (Moletsane, 2011:206), and ends with a call for imaginative possibilities for social action.This is a challenge in the area of teachers' professional engagement in South Africa (and elsewhere in sub-Saharan Africa) since teachers, and the field of education itself, is often sidelined as is evident in the development of 'teacher proof materials', the absence of dedicated courses in the area of sexuality and life skills in teacher education and well designed courses on how to integrate HIV and AIDS across the curriculum (Van Laren, 2007;2008).This article addresses one aspect of this challenge by exploring the ways in which rural teachers' voices might become integrated into an analytic framework, posing the umbrella question, "What can a teacher do with a cellphone?"Specifically, we ask how mobile technologies can contribute to participatory research with teachers to identify and act on critical issues related to youth sexuality?

Participatory visual research, mobile technology and social change
Arguably, there are few innovations in technology that have had a more profound effect on the everyday lives of people in sub-Saharan Africa than the cellphone.Available data suggest that mobile use was 76% in 2010 (Hutton, 2011) and that cellular subscription penetration was 100.48 % (International Telecommunication Union [ITU], 2010).As various academic and non-government organization (NGO) publications have highlighted (United Nations Children's Fund [UNICEF], 2012), widespread access to mobile phone technology has changed everything from how AIDS patients are reminded to take their ARVs at regular intervals (Lester & Kariri, 2009), to serving as a critical tool in Egypt and elsewhere for citizens, and especially women, to report cases of sexual violence (Kilonzo, 2013;Rosenthal, 2013).In educational contexts, increasing attention is being paid to how cellphones in otherwise resource-strapped schools might be linked to teaching and learning (Motlik, 2008;Valk, Rashid & Elder, 2010), although as we point out (Mitchell, De Lange & Moletsane, 2012), the use of cellphones in schools is often still framed in what might described as moral panic, particularly in the context of cyber bullying.The case, for example, of a group of boys in Soweto who used their cellphones to film the rape of a mentally disabled girl and post it on the internet (Monnakgotla, 2012) remains a cautionary note on the abuses of technology in and around schools.
Notwithstanding the potential for abuses of technology, we focus on the ways in which rural teachers' widespread access to technology can make it possible for them to engage in participatory research in ways that ultimately do not rely on access to expensive video equipment, digital cameras, and other tools associated with participatory visual research.As we have argued in relation to participatory video (Mitchell & De Lange, 2011;Mitchell, 2011), it can be particularly valuable in bringing local voices to research, and in developing tools and texts that can have an 'afterlife' (De Lange & Mitchell, 2012).Participatory video, as we have found, has immeasurable benefits for teachers, young people, parents, and community health care workers, particularly with regard to giving a face to the critical issues of HIV and AIDS.The downside is that the technology is not indigenous to the community, and so once a project is over the equipment often disappears with the researchers, or if donated to the participants gets carefully stored away by a gatekeeper.Finding a way to transfer the knowledge we have gained in our extensive work with participatory video to cellphones as a medium for creating video texts, or cellphilms, promises to overturn some of the drawbacks of participatory video.
Cellphilms are movies "made with a cellphone, made for a cellphone, made by a cellphone for streaming …" (see Dockney & Tomaselli, 2009:126).Cellphilm technology reflects a shift of the moving image from its traditional consumption venues (the cinema and television) to other screens such as a Personal Computer (PC), cellphone, or car television (TV) (Simons, 2009).While the technology for cellphilms is relatively new, it is an increasingly popular medium in South Africa because of widespread access to mobile phones (Dockney & Tomaselli, 2009).Dockney, who has pioneered cellphilm technology at the University of Kwazulu-Natal in the Centre for Culture, Communications and Media studies, considers the cellphilm a particularly critical technology for South Africa because it skips some of the conventional (and less accessible) platforms that are necessary in traditional types of film distribution (see also Baker, Schleser & Molga, 2009).Critically, however as we have found with participatory video, the process does not end with the production of a video (or cellphilm); it really only begins.Indeed, the strength of visual technology is that it 'puts out there' the issues in ways that are open to debate, discussion, and contestation.Visual production lays bare some of the dominant representations of youth sexuality and the ways in which children and youth are positioned as innocent and in need of protection, an approach that often deprives young people of access to information about sexuality and HIV and AIDS, and more importantly prevents them from asking the questions they need to ask (see Bhana, 2008).The strength, and the challenge, of participatory visual work is that it creates what Kumashiro (2002) refers to as a 'troubling pedagogy' in that it sets the context for interrogating the images produced in participatory video and photovoice projects.In "speaking back" the most appro-priate people to interrogate images are those who produce them, and visual technologies such as cellphones (and cellphilms) are the ideal mediums for doing so.It opens up the possibility for participants to reflect on their work and to possibly change how they view and approach a particular issue, which positions the work in a critical paradigm (Mouton, 2001).
The study: Me and my cell phone 1 We have written elsewhere about our cellphone work with two groups of rural teachers, a group from KwaZulu-Natal and one from a farm school in the Eastern Cape (Mitchell et al., 2012;Mitchell & Moletsane, 2013).We had previously worked with the teachers from these two schools on related participatory work linked to addressing HIV and AIDS and had established a relationship of trust with them.We received ethical clearance from the university and proceeded to work with the 19 teachers (one male and 18 female) who chose to participate in the cellphone project; therefore convenience and purposive sampling (Strydom, 2005).Their teaching levels varied with some teaching in the foundation phase, and some teaching at intermediate and senior phases.Their experiences also varied with some having taught for only one or two years, while others were very experienced teachers.They were not necessarily life orientation teachers, but were aware of and concerned about HIV and AIDS in their schools and the communities from which the learners are drawn, and keen to do something about it.Many were parents themselves, a fact that introduced another layer of reality to the work.
Writing about our cellphone work as 'digital retreats' (Mitchell, 2012), we noted some of the technological and ethical issues (Mitchell et al., 2012), and some of the ways that individual teachers have adapted the use of cellphones to represent their lives and their own teaching (Mitchell, De Lange, Moletsane & Stuart, 2013), as described here.

"Digital Retreat" approach
The teachers in each of the two provinces were introduced to the concept of making cellphilms in separate groups.As we determined in our preliminary workshops, all the teachers owned cellphones which they used to make and receive calls, send and receive text messages, take photographs, access Facebook, and so on.However, only a few had ever used cellphones to make a video except to perhaps film a wedding or community event.We introduced them to the idea of producing films by asking them to make a 'one shot shoot' cellphilm which was short and simple, requiring that the record button be pressed once to start filming and once to end filming.Once they had made the 'one shot shoot' cellphilms which were viewed and discussed, they went on to make more complex cellphilms.Here we introduced our participatory video methods (Mitchell & De Lange, 2011) which required them to brainstorm the issues, select the most important issue, develop a storyboard for the issue, and then shoot the cellphilm.The actual prompt dealt with "critical issues around risk and youth in the context of HIV/AIDS".The issues identified by the teachers were clear from the titles of the productions (e.g."Small knowledge skills", "Drug Abuse", "Power in our Hands", "Breaking News!Lack of Resources", "I made it", "Story of My Life", "Teenage Pregnancy", "There is life after every storm -I made it" and "Women Power."What was interesting is that once the teachers felt competent in their technical skills, they were able to consider the context and become more critical about the purpose of raising the identified issues.As one participant, Evelyn, pointed out: I think we all did a very good job, I think managing to highlight most issues that affect learners in the schools.But I think that we should have also done more in trying to come up with ways or strategies to solve the issues that challenge the learners in the schools and we just copying what everybody does; very good at picking up issues that challenge society and not being able to come up with strategies or solutions to help in solving those problems.When the two groups of teachers came together, it was Evelyn's comment that framed the digital retreat with the idea of going beyond simply identifying critical issues to generating strategies and solutions.The prompt for the group workshop involving both schools was: "Make cellphilms about strategies for addressing HIV and AIDS in school."The five resulting cellphilms tackled a variety of issues.In "Acceptance makes you stronger, Episode 1 & 2" a learner discloses her HIV positive status to a teacher who not only comforts her but helps her to gain access to a support group.In "Be Enlightened" a teacher discovers that the young learners in her class are playing with a condom which they found on the playground.She explains to her class that condoms can prevent the spread of HIV but that condoms are meant for adults and not children.In "HIV-AIDS Free Generation by 2020", a teacher addresses the HIV pandemic in her class by encouraging learners to report sexual abuse and practise abstinence.In "Speak Out" a teacher advocates for speaking out about HIV and AIDS so that it can be eradicated.In "Stay Fresh Live Longer" the teachers belong to an organisation which promotes abstinence before marriage, medical male circumcision, and virginity testing, as ways to prevent infection. A strength of visual participatory work is that the productions (in this case the cellphilms) are immediately available to both participants and researchers for analysis.While the participants offered comments on the productions and their messages (what Fiske (1989) terms the producer text as a unit of analysis), we as a research team were able to carry out an additional layer of analysis on the primary texts (the productions) via what the producers said about the cellphilms (see Fiske, 1989).

A pedagogy of speaking back
The cellphilms produced demonstrate the teachers' zeal in wanting to take action to prevent their learners from becoming infected.However, many of the strategies suggested were somewhat problematic in that they tended to reinforce approaches to sex education which have failed (see for example HEAIDS, 2010).For example, most teachers took a strong moralistic stand against sex before marriage and advocated that condoms are for adults only.In other cellphilms the position that medical male circumcision can prevent infection was presented in such a way that it could actually lead to casual sex.A cellphilm dealing with learners who are infected offered views that could exacerbate levels of stigma.In the "Be Enlightened" cellphilm the teacher points to the importance of using condoms in preventing HIV infection, but makes it clear that condoms should only be used by adults and not children, clearly putting the learners at risk by offering a dangerously limited point of view: Teacher: Oh, your sister told you it's a condom?Thenji: Yes, Ma'm.Teacher: What is it for?A condom?Who is supposed to use this condom?Thenji: Ma'm, when my father uses this condom he normally take [sic]  Teacher: How do we get AIDS then?Sheila: My friend said to me…when I sleep with a boyfriend, I will get AIDS.Teacher: Do you have boyfriends?(Thenji giggles) Teacher: Do you have boyfriends?Sheila: It's Thenji, Ma'm, it's Thenji, Ma'm.Teacher: I know, Thenji.She's got a boyfriend.Yes, when you have unprotected sex with your boyfriend, you might have a condom, but you are still too young for that.Drawing on the work of Kumashiro (2002) in his book Troubling education: 'Queer' activism and anti-oppressive pedagogy, we saw their cellphilms did not "trouble" some of the critical issues pertaining to youth.It was at this point that we as a research team realised the importance of addressing some of these problems directly.We followed up with a 'speaking back' workshop in which we, with the teachers, explored ways in which they could critically engage with their own work and 'speak back' to dominant images.As part of initiating a pedagogy of speaking back, we first introduced the idea of what it means to speak back as an approach to critique.To do this we offered a short power point presentation that included photos produced by young people from rural KwaZulu-Natal which documented their concerns about HIV-related stigma.While the photos had been produced some years earlier (see Moletsane, Mitchell, De Lange, Stuart, Buthelezi & Taylor, 2009), they provided a vivid and compelling entry point for considering what it would mean to produce new visual texts (in this case cellphilms) that would speak back to, these images of stigma.The teachers quickly adopted the idea, and before the end of this part of the workshop could be heard saying "We need to speak back to these pictures".Next we again screened the five cellphilms that had been produced in the previous workshop so that all the participants had a chance to review the content.To follow up, we posed several questions which we considered useful for teachers in reviewing their own cellphilms, for example: "What do you think was the main message of the cellphilm?""Who do you think the audience for the cellphilm is?", and "How could you speak back to the ideas in this cellphilm?"While audience, of course, is a key aspect of communication, it was interesting that when the teachers first reviewed their films, they thought that the films should be viewed "by everyone".It was only in the ensuing discussion that they spoke about the need to think more about audience and also about the messages and purpose, and especially "keeping learners alive".
After this the teachers, in small groups, planned new cellphilms that spoke back to the earlier ones.Interestingly, having developed a new sense of audience and message, they all decided to make a film for parents, and were all focused on messages they thought would be appropriate for opening up spaces for dialogue between parents and children.Thus, in "Breaking the silence" a mother discusses condom use with her son after seeing a girl spending the night in his bedroom.In another cellphilm also called "Breaking the silence" a mother catches her daughter viewing a picture of a naked person on her cellphone and discusses sex and safe sex with her in detail, to the consternation of her husband who refuses to have such topics spoken about in the house.In "Teen Vibe" a mother, realising her two daughters had slipped out to a party and then hitched a ride home with a man they did not know, has a discussion with them and warns them about the dangers of accepting rides with strange men.In "Speak Out" a mother who discovers her two daughters watching a sex video on the cellphone speaks candidly about sex and condom use.As we see in the excerpt below, the treatment of condom use in "Speak Out" is very different from the treatment of condom use in "Be Enlightened": Nosipho: I was hearing my friends talking about condoms.What are they for?Mother: Condoms are there … they are there at the clinic, they are everywhere.They are there to protect you when you are doing sex.When you want to prepare for sex, you have to use a condom … when you are ready for sex.But even when you are using a condom, you are not hundred percent safe from HIV and AIDS.Mother: Sometimes the condom breaks.Sheila: Are there any boys' condoms?Are there any girls' condoms, Mum? Mother: There are female condoms.We call it female condoms.They are there for you.You can use them, but only when you are ready for sex.
We do not want to overstate the success of the speaking back approach.Not all of the new speaking back cellphilms were equally successful in countering moralistic messages, but overall they were focused in terms of audience and, as the above transcript demonstrates, clearly less moralistic and didactic than the others.The fact that they were produced for parents and not for leaners may account for the difference.Moreover, the modeling of open-ended discussions with young people suggests, we would argue, a shift in the perspectives of these teachers.Whether it was appropriate or not to seize on the idea of reaching parents as opposed to targeting other adults in the community whose traditional task it is to offer sex education, may of course be problematic.However, it is worth noting that the teachers who are themselves parents commented that they were thinking differently about how to discuss sex and HIV and AIDS issues with their children.

Conclusions
The potential for community-based visual productions to either reproduce or challenge the dominant discourse of youth sexuality is an area that requires further study.However, the speaking back approach we describe here goes some way to challenging dominant discourses.We cannot say that this is a perfect process or that all participants will alter their views simply by following what we map out in here.The examples we provided are perhaps the most obvious because both the original cellphilm "Be Enlightened" and the resulting speaking back cellphilm called "Speak Out" both deal with condom use.Nor can we say that this is quick fix approach.By the time we had arrived at the speaking back session, we had conducted two two-day workshops with the teachers in each province and one two-day workshop with both groups together.As part of this work we had spent considerable time on the technical aspects of filmmaking.The sessions were organized as highly participatory and playful so that teachers were freer, we believe, to experiment and test out ideas.We highlight these points because we see that participatory visual methods can be central to shifting perspectives of teachers on how best to work with young people in an age of AIDS but that this work needs to be framed as a pedagogical project in and of itself.What we most want to emphasize in the work that we describe here is that teachers' easy access to cellphones and indeed their competence in working with this technology as part of their everyday experience broadens the possibilities for participatory approaches to addressing youth sexuality, HIV&AIDS, and risk.
it to the room and close the room with my mom.Teacher: With your mom.It means that condoms, it's for adults.Thenji, condoms are for adults.Do you know that?They use condoms to protect themselves from HIV and AIDS.Do you know what is HIV?I know you know about HIV.Sheila: They say HIV and AIDS, it's when you are sick, Ma'm.Teacher: Yes.Thenji: And when you have HIV you die, Ma'm.Teacher: Yes.You know that, that when you are having AIDS, you know you are going to die.When you are having AIDS you become sick, but how can you protect ourselves from this HIV and AIDS?You don't know?Sheila: No, Ma'm.