The work of nurses and municipal guards: identity, gender and power O trabalho de enfermeiras e guardas municipais: identidade, gênero e poder El trabajo de enfermeras y guardias municipales: identidad, género y poder

Eduardo Pinto
Departamento de Educação (Department of Education)
Universidade Federal de São Carlos (UFSCAR). Rua Honduras
296São CarlosSPBrasil

; Márcia
Regina Cangiani
Fabbro Ii
Roberto Heloani III

Departamento de Enfermagem (Department of Nursing)
II
Universidade Federal de São Carlos (UFSCAR)
Rua 122202Rio ClaroSPBrasil

III Faculdade de Educação (Education College)
Universidade Estadual de Campinas (UNICAMP). Pça. Amadeu Amaral
8401327-010São PauloSPBrasil

The work of nurses and municipal guards: identity, gender and power O trabalho de enfermeiras e guardas municipais: identidade, gênero e poder El trabajo de enfermeras y guardias municipales: identidad, género y poder
6785E31C734194166B18F7029A6FDBD6Working womenIdentityGenderNursesMunicipal guards Palabras clave: Trabajo de mujeresIdentidadGéneroEnfermeraGuardias municipales
This paper aimed to analyze points in common in the work of women in two professional categories: nurses and municipal guards.This analysis was done by rereading the authors' previous studies.The methodology was based on comparing the characteristics of the day-to-day routines, such as anxiety, tension, risk to life and fear.Concepts like identity, power, gender and defensive ideology were dealt with.It was seen that work forms a constitutive element of identity, influenced by gender and power relations.These are historically constituted and have relational characteristics.It was argued that professional activities involving situations of anxiety, tension and risk promote the construction of defensive ideologies of denial of fear.This stimulates lifesaving ideals, heroic attitudes and ambivalent feelings.It was concluded that work situations in both of these professions, along with the management and organizational characteristics of the work give rise to psychological distress, stress and identity conflicts.

INTRODUCTION

The work is one of the cornerstones of the social being and a constitutive element of identity (Lessa, 2002).Work and identity, as Jacques (1995) argues, configure an indispensable articulation.The identity, formed and metamorphosed in socialization processes and in working life (Ciampa, 1991(Ciampa, , 1990;;Berger and Luckmann, 1978), is determined and determines the historically constituted configurations of gender relations in our society (Scott, 1995).Such relations, inevitably intertwined to power devices (Foucault, 1994(Foucault, , 1992)), require explicitness and critical analysis of women's work peculiarities as well as their consequences in terms of several aspects, among which stand out: identity conflicts, psychological distress (Dejours, 2004b(Dejours, , 1992) ) and weariness (Seligmann-Silva, 1994;Laurell and Noriega, 1989).This paper aims at analyzing common aspects of women's work in two different professional categories: nurses and municipal guards.First, we discuss the identity, power and gender concepts.Next, we present some considerations on the methodology of this article as well as on the researches carried out by the authors that provided the basis for the present discussion (Silva, 2005;Fabbro, 1996).Rereading those researches data enabled us to present new reflections that gave support to the analysis of women's work common aspects in the reported professional categories.We point towards the existence of psychological distress, stress and identity conflicts in women's work and towards its social and historical character permeated by masculinity and femininity normative definitions and by their underlying power relations (Kergoat, 2002;Scott, 1995).

The plot of concepts: identity, power and gender

In order to understand the municipal guard's and the nurse's identities and to better understand who these professionals are, it is necessary to both discuss the identity concept and to understand what is personal and social identity to then reflect upon the professional identity.The identity concept is complex and it has different conceptions in Anthropology, Sociology, Philosophy and Psychology.For the present paper, it will be used the identity concept in its professional dimension conceived as one of the individual's identity aspects (Dubar, 2005;Jacques, 1995).Therefore, we searched the literature for a sound theoretical basis in some authors, such as Berger and Luckmann (1978), Ciampa (1991Ciampa ( , 1990)), Dubar (2005) and Habermas (1983), who conceive the professional and personal identity as the result of an ongoing socialization process, that is, the identity is structured by means of intersubjectivities.They consider that the psychic structure of each person co-determines the identity construction as well.However, they also highlight the social environment as a strong source of influence in such construction.The other is a crucial component in shaping identity.In the socialization process, the individual identifies himself with the other in the same way he internalizes the underworld of social institutions (Berger and Luckmann, 1978).The identity can be modified along someone's life history according to his interrelation with the social environment.In this sense, it is neither set nor static, but rather an ongoing movement, a metamorphosis (Ciampa, 1991(Ciampa, , 1990)).The professional identity is shaped and forged by the social identity or even by the identification with the class and group it belongs to.As the municipal guards and nurses perform their jobs, they shape their identities through "acting" and "being" professional.Nevertheless, both of them are the legacy of the objective reality, inextricably articulated to the subjective reality by means of historical and social processes of internalization, externalization and objectification which, by their dialectical nature, cannot be thought of as occurring in a temporal sequence (Berger and Luckmann, 1978).Hence, the secondary socialization process where the professional-technical formation occurs possesses identification referentials confered by the population.We add to Berger's and Luckmann's (1978) discussions on the dialectic or on the indissociability between objective and subjective reality the concepts of subjectively suitable identity and socially attributed identity, which are concepts that, when retaken by Ciampa (1990), allow us to differentiate the Habermesian concept of the social role from the character concept (Ciampa, 1990).In Habermas 's view (1983), the social role is related to the socially established, to the systemic world.We highlight here only his reference to the role identity, that is to say, that one sticking to social predeterminism, to norms and rules that support reproduction and hinder personal autonomy.Ciampa (1990), using the character concept, relates it to the experiences singularity and concreteness in the individual biography, highlighting that such uniqueness is not divorced from collective and social dimension, but rather establishes with it an inseparable relation of mutual and reciprocal influence.In such a dialectical interplay between the individual and the social, it may emerge what we could adjectivate as stereotypical or inauthentic identities.Goffman (1990Goffman ( , 1988) ) approaches the stigma and spoiled identity concepts based on the analysis of total institutions (mental hospitals, monasteries and prisons) as well as of their power relations.The spoiled identity is related to human objectification and to certain stereotypes and attributes stigmatization.Such stigmatization confers normality to those who have power positions in institutions.Hence, such considerations on the identity concept lead us to discuss the power concept and its relational aspect.In Foucault's view (1994Foucault's view ( , 1992)), power is related to the movement concept as well.The power circulates, it is present not only in the institutional dimension (the State, schools, hospitals, the police), but also in discourses, in social relations, in everyday life.His great contribution, which moves forward in relation to Marxism, is with regard to micro-power and to the overcoming of the dominant-dominated dichotomy.Moreover, Foucault relates power and knowledge for highlighting the scientific discourse as a power device.Gender studies perspective also contributes to the discussion on power, inasmuch as it proposes a male and female understanding taking as a reference the construction of social and cultural roles performed by men and women as well as it denounces gender inequality arisen from sexual differences, but without falling into reductionism of the dominant-dominated dichotomy, especially in the studies of historical and relational perspective (Kergoat, 2002;Scott, 1995).Finally, we consider that the professional identity issue leads us not only to the aforementioned concepts, but also to Work Psychodynamics presuppositions (Dejours, 2004a(Dejours, , 2004b(Dejours, , 1992)).Under this perspective, work includes pleasure and suffering dimensions and it can be characterized as pathogenic, related to identity conflicts that disrupt the psychosomatic or even sublimatory balance, structuring the professional and personal identity (Dejours, 2004b).According to this perspective, the workers develop defensive strategies due to management modes and work organization.These strategies can configure a stereotyped and/or pathogenic adaptation to work adversities or a shield to psychological distress processes and/or to diseases.

Methodological aspects

The analysis of the nurses' and municipal guards' work presented in this paper is the result of a rereading of Fabbro's Master's Thesis (1996) and Silva's Doctoral Dissertation (2005) respectively, from the aforementioned authors as well as from co-authored papers with Heloani (Silva and Heloani, 2006;Fabbro and Heloani, 2004).Fabbro's case study research (1996) was carried out at a large teaching hospital.25 interviews with several professionals (director and supervisor of obstetrics, nurses, nursing assistants, clinical director and resident physicians) were conducted aiming at investigating the nurse's identity formation process in the hospital context based on work relations with the nursing1 and medical staffs.Interview data were vertically and horizontally categorized and analyzed according to presuppositions of the content analysis (Bardin, 1977) and of the qualitative research (Minayo, 1996).Silva's research (2005) addressed the municipal guard's work from the relations between organizational management and stress.238 questionnaires on health, work and family life were applied in 26 teams subjected to semi-structured group interviews; 42 semi-open individual interviews were conducted with municipal guards identified as stressed.The identification of stress and of its stages (alarm, resistance and exhaustion) was made through the Stress Symptom Inventory (Lipp and Guevara, 1994).The categorization and the vertical and horizontal analysis of the interviews also followed the presuppositions of content analysis (Bardin, 1977) and of qualitative research (Minayo, 1996).The results showed a total of 31.93% stressed municipal guards.In teams in which the female contingent was approximately 100% (management staffs and Operations Command staffs or telephony staffs), there were respectively 71.42% and 77.77% of individuals who reported feeling stressed out, which represented a very different percentage of the support staffs2 (18,75%), entirely composed of male workers (Silva, 2005).Both professional activities, usually performed in alternating shifts, are subject to generate occupational diseases, weariness (fatigue, stress, tension) and/or psychological distress.Furthermore, daily work is characterized by confronting anxiogenic and distressing situations, which involve life and death issues, insomuch that they turn out arduous and unhealthful activities that entangle crucial conflicts and tensions of human life and tend to impact negatively on the health of these women workers.Another aspect worth highlighting is that such situations, creating ambivalent feelings, involve repression/control and protection/care activities.Aiming at subsidizing the common aspects approach of the nurses' and municipal guards' work, we present next some brief reflections on some of the analysis originally done in the previously mentioned researches.

The hospital and the power-knowledge: working relations of the nurse with the nursing and medical staffs

In their everyday working lives, the nurses are embedded in the submissiveness web and in the hospital culture (Moreira, 1999).They tend to assume what we conceptualize as the role-identity (Habermas, 1983), since in their medical power-knowledge relationship (Foucault, 1992) they tend to reproduce stereotypes of the female gender and attitudes of either submission or of utmost dedication to the superwoman image -a heroic character that takes responsibility for all problems.Nevertheless, they are paradoxically labeled as subhuman, exactly for being submissive towards the medical staff and the institution itself (Fabbro, 1996).Therefore, there are vestiges in the institutional and socio-cultural imaginary that the nurse is merely a doctor's assistant and, exactly as stated by Gastaldo and Meyer (1989), the domestic space as a female space and the nursing as a home extension are enhanced.The nurse's relationship with the nursing staff unveil some other facets of power relations.An explicit hospital hierarchy in the hospital regulations decide upon each staff member's duties and responsibilities, from which power relations are established.Notwithstanding, there is the presence of other hierarchical forms among the nursing staff, legitimated by the tacit knowledge (seniority and practical experience at work), which elaborate activities different from those prescribed.When the nurses are the target of power devices and of discourses that inflict upon them both the political docility towards their hierarchical superiors and the economic utility for the benefit of the hospital organization (Foucault, 1994), they reproduce the socially attributed role-identity.On the other hand, in the game of forces operating in correlation and of circularity of power (Foucault, 1992), they face confrontation of that role-identity, having a political attitude which shows us that the political competence is equally or even more important than the technical competence for their work.It is noticeable a diversity of stances in the relationship between nurse and nursing staff.Sometimes it is evident the nurse's authoritarian attitudes towards her subordinates, and those attitudes imitate the male stereotype of command present in the nurse's relations with the medical power-knowledge.At other times, it is evident the tacit power-knowledge of those who have more seniority and practical experience at work, configuring a power relation that does not correspond to formal hierarchy of work management and technical division (e.g.cases of conspiracy between more experienced attendants and doctors to the detriment of the of the chief nurse's formal power).In such cases, however, it also corroborates the medical power-knowledge, the gender relations as elements which legitimize that as well as working practice dedication and submission.Santos and Barreira (2008) analyze the professionalization of women and nurses during the military dictatorship in Brazil, from 1930 to 1940, and they emphasize the historic dimension of gender issues at work.The authors indicate a symbolic and material striking division of the social world, which is explicitly reflected in the nurses' work social division and in the evocation of feminine attributes to their professional activities.The authors consider that the persistence of the sex roles division is revealed by means of the discreet, silent, kind and altruistic care practiced in the nurse's daily work.Male dominance is demonstrated through the divisions between female and male spaces in order to create a state of symbolic dependence of women who tend to be conditioned by male expectations and, consequently, to be subordinated and subjected by them.Such aspects, which we argue as being current, albeit not so explicitly, are also tackled in classical studies on gender, health and nursing (Lopes, Meyer and Waldow, 1996).

Stress and identity in the work of municipal guards

The women workers of the management and telephony staffs were responsible for providing assistance or support in which it tended towards reproducing the gender stereotype and the preestablished and standardized role-identity.Such kind of work was depreciated by organizational culture, as opposed to the predominantly performed by men "street work", which was permeated by power, strength and bravery signs, creating a masculine and fetishized image of the police identity (Silva and Heloani, 2006;Silva, 2005).The women workers' stress is therefore related to the current gender and power relations in the existing socio-institutional reality as well as to the dialectic among family, work and social lives (Silva, 2005).Police work generally causes life balance disturbance and, consequently, family life disturbance.Female police officers, besides being subjected to pathogenic aspects of professional activity, are in charge of both domestic work and support to family problems, what intensifies the psychosocial adversities with which they have to cope with in their daily routines (Silva, 2005;Farmer, 1990).Dejours (1992) analyzes defensive ideologies of collective workers from various areas that are structured as a way of preventing psychological distress or diseases.The fear denial defensive ideology is tackled in the cases of workers of petrochemical industry, civil construction industry and fighter pilots.The work is characterized as pathogenic in the first two categories.The stereotyped nature defensive ideology does not satisfactorily exert its protective function.Fear denial is structured upon gender stereotypes, adjectivally used by Dejours (1999) as virile defense, besides being work situations whose technical mastery or control under risk situations (chemical industry explosions and civil construction accidents) are very restrict (Dejours, 1992).In the petrochemical industry, playing with dangerous situations, as throwing oil on the floor so that a workmate slips, function as a symbolic attempt to face risks which are not controllable by the engineers' expertise.Sometimes such defense temporarily avoid illness, but it does not avoid psychological distress that remains latent or hidden regarding manifest acting and that is insidiously and chronically associated with management exploitation and work organization.It takes advantage of the workers' fear denial defensive strategies as well as of the self-reinforcing need of "manhood," strength and courage as tools to impress the "spontaneous" search upon hard and intense work, maximizing productivity by exploiting suffering, generating psychosomatic disease or psychosomatic disorders (Dejours, 1992).In relation to the case of the civil construction industry, denial implies refusal to use safety equipments since they are seen as a fragility symbol.Many workers who do not accept the defensive ideology give up work, when they are not nearly expelled from the workplace by the collective pressure (Dejours, 1992).On the other hand, in the case of the fighter pilot work, characterized as sublimatory, it involves a high degree of worker's technical knowledge and high demand and evaluation levels, being the fear denial a psychological attitude crucial for facing the high-risk task for which the fighter pilot is already technically prepared by means of a long professional development process.In this case, the adaptive defense, necessary and useful to perform the worker's task, maintains the psychic balance and the positive self-image (Dejours, 1992).The fear denial defensive strategies are used by nurses and by municipal guards as well; however, they do not immunize them against psychological distress and/or disease and may be related to identity conflicts and to gender and power relations, built inside the contradictory and dialectical nature of the historical process and of its social and work relations.As for nursing, the nature of professional activity evokes a strong sense of responsibility (Menzies, 1970).Regarding hospital work, there are high-risk and patients' death situations.The high degree of responsibility entailed in the position, permeated by gender issues and idealized images of the profession, resulted in a pathogenic work configuration (Fabbro, 1996).Concerning hospital work, there is a considerable risk of nurses being overwhelmed by fear and anxiety due to life and death situations they have to cope with but are beyond their control (Menzies, 1970).They undergo considerable personal, health and somatopsychic energy weariness costs.The responsibility and the lives saving ideal, rather than acting towards sublimation (Dejours, 2004a(Dejours, , 2004b) ) are converted into a routine marked by external (institution, nursing and medical staff and patients) and internal pressures and demands, being both permeated by power-knowledge relations, role identities and gender relations (Fabbro, 1996).Work demanding and internal pressures are not merely subjective or belonging to a psychic dimension isolated from the whole social and organizational systems.We understand that there is an inevitable dialectic between objective and subjective in the daily social and work routines, which means a reciprocal and mutual influence relation between a certain profile required for professional practice -a socially constructed and shaped profile both by formation as by such practice -and its internalization.In this sense, the personal and professional, individual and collective profiles, outstandingly embodied by the ideal/idealization of saving lives/caring for lives is the result of the aforesaid dialectic, of the game of influences between socially attributed identity and subjectively appropriate identity (Berger and Luckmann, 1978).With regard to nurse's work, due to objective and subjective issues articulated in a contradictory and dialectical form, anxiety and fear cannot be revealed.Fear raised in the professional activity does not find a way of expression and of group and psychic elaboration.In this manner, fear denial collective defensive strategies are produced which, though effective at first, are transitory and unsustainable in the long run.Psychic conflict not eliminated by fear denial persists in latent form and tends to erupt through aggressiveness in work relations.Fabbro (1996) indicates that some emergency situations give rise to excessive anxiety and high stress level in all professionals.It is sometimes the case of a certain inertia of some workers (e.g., the nursing assistant or even the nurse) facing constant and busy demands of the medical staff in that situation.Such inertia tends to be seen as technical incompetence and/or personal unadaptability to the profession, mobilizing verbal aggression and interprofessional conflicts, therefore intensifying the tense situation.In other words, individual and collective fears, incited by real situations coupled to the imaginary dimension generate anxiety.Defensive and anxiogenic strategies are produced that feed back tensions and fears which fall on individuals, groups and organizational climate.It can be concluded that the counterproductive, ephemeral and defensive strategy does not hold and acquires a pathogenic nature.Psychic conflict is converted into interpersonal conflicts that become explicit in work relations.Fear and anxiety which are individually and collectively denied in extreme situations come up again in work relations by means of the projection defense mechanism, giving rise to aggressiveness among peers.It is about psychological dynamics tackled by psychoanalysis, in which what is ego driven and projected on the other ends up as a threatening object to the ego itself, producing persecutory anxiety and consequent hostility (Freud, 1987).Such dynamic takes place in the organizational and work contexts in which the aforementioned gender and power issues are crucial to mobilize the defense process, i.e., this is not the result of a particular psychodynamic or subjectivity, but rather of a contradictory and dialectical unit, the subject-object unit.Thus, nurses tend to complain that their assistants are incompetent and/or irresponsible.The nursing management complains that the nursing staff does not take responsibility for the group coordination, blaming them for unfulfilled routines.Nurses react and complain about the management imposing them a strict if not repressive discipline, treating them as if they had no sense of responsibility.From that comes the mutual and excessive work demand.The demands lose meaning or symbolic strength (Fabbro, 1996).They stop being indicative of a possible outcome and start representing surveillance and punishment standards (Foucault, 1994) in which the usual demand becomes meaningless, aimless, simply demanding by demanding.In this manner, the inherent pressure of extreme situations (patients' death risk) is associated with a context of interpersonal pressures and demands and engenders competitiveness in the search of the medical power-knowledge approval symbolically and hegemonically masculine.As a result, nurses and assistants get weary and vulnerable to stress and to psychosomatic disorder.Hence, similarly to the civil construction workers' case analyzed by Dejours (1992), the defensive ideology, in the nurses' case, induces an attitude of everyone's participation.The one who does not contribute or who does not share the content of this occupational defensive ideology is sooner or later excluded, either by dismissal or by a system that "labels" the employee.Such aspect generates new emphasis on collectivization of responsibilities so as to form vicious cycles characterized by stereotyped defensive strategies, rigid forms of management and of work organization, and psychological distress and disease processes (Fabbro and Heloani, 2004;Dejours, 1992).It is also worth mentioning that the responsibilities collectivization issue, supported by the service collaboration discourse and understood as an institution power device, induces women workers to be subjected to work overtime and to work pace intensification.Such situation worsens due to a specific work condition: the high service demand with a reduced number of employees.According to Meyer (1995), such induced collaboration can be translated into a full-time availability to assume work activities, even if reluctantly, and forged by the medical institutional power.Fear denial and defensive ideology are also present in the municipal guards' work, having specific ways and peculiarities if the workers are men or women.Cavassani (1998) ponders that the psychic fragility has no place in the police organization, being interpreted as a sign of "madness".From our point of view, given the sociocultural conditions of the female and male construction, the female police officers are the main targets of such stigmatizing interpretations.Sampaio and Carneiro (1997, p. 313) also identified, in a clinical study of a female military police, that each and every fragility was denied or undesired by the organizational ideology, which valued "the strong being" as well as "self-control, cleverness and defensive readiness."Cruz (1989) addresses the fragile heroic identity of the military police.The work activity that enables the hero imaginary creation is related to street work, predominantly carried out by workers.It can be noticed a human fragility denial in the heroic identity valuing.In other words, the workers tend to develop a defensive professional ideology (Dejours, 1992), of stereotyped nature, which tends to place the female police officer, or even the femininity, in a position of inferiority so as to reproduce the aforesaid and historically constituted normative definitions about the female and the male (Scott, 1995).The metaphors "hunter" and "hunted", present in the municipal guards' discourse in reference to "street work" and to the offender-police clash, show us that the active position ("hunter"), which in the sociocultural imaginary presented itself as mainly male, was highly valued, whereas the passive position ("hunted"), seen as essentially feminine, was feared and rejected, besides being configured as incompatible to the desired professional identity.In such position, the work was experienced as a stress or weariness factor (Silva, 2005).The active and passive positions in the face of fear and/or anxiety in work activity result in opposite configurations, namely: pathogenic work and sublimatory work.In the predominantly male support staffs, anxiety was actively "managed" by workers, so that the work tended to be sublimatory.On the other hand, in the predominantly female telephony staff work, anxiety could not be actively "managed" because the women workers only required their "street work partners" to take care of the police reports and they did not get to know what actually happened, therefore configuring a pathogenic work (Silva, 2005).That work was less valued, routinized and more controlled by management, involving unpredictability and sense of powerlessness which generated significant anxiety.As for the support staffs, unpredictability was experienced with positive valuing of a not routinized activity, besides being consistent with a libidinally invested professional identity, valued by the organizational culture and by the workers themselves.Thus, in the female group, the unpredictability and risk situations were configured as harmful to health, whereas in the male group they were either positively experienced or as a source of professional pride.The women workers' activities did not generate the sense of "authenticity" of police work and dissociate themselves from the strength and courage symbols, valued by power devices (Foucault, 1992) present in gender relations discourses, either at the micro level or at a wider level of organizational ideology and culture (Silva, 2005).The patrol staffs of women workers were usually disdainfully and disrespectfully treated by part of the population, of the male guards, of the ones responsible for management, and of the infringer (Silva, 2005).Notwithstanding, we found out another side of this issue in the case of one of the interviewed women who was considered "operational" and valued by her male partners because of her skills related to bravery and strength symbols.For being a woman and seen as less capable and fragile, her action was usually unexpected, and not rarely more effective, due to what was called "surprise factor" (Silva, 2005, p. 276), which favored success in the approach to police reports.This situation illustrates the relational nature of gender social construction (Scott, 1995) as well as Foucault's concept of circularity of power (Foucault, 1992), both previously mentioned.

The work of municipal guards and nurses: psychological distress and defensive ideologies

In that case, being a woman had neither subjective consequence nor negative self-image, or even did not hinder her to perform her work competently.This example demonstrates that power and gender issues are not entirely insurmountable.On the other hand, it is important to highlight that the success of her actions was many times favored due to the offenders seeing her under a sexist perspective, so they usually did not expect such agility and technical domain coming from a woman.As previously exposed, we can state that the defensive ideology in the guards' work is sometimes adaptive, in order to enable actively facing fear/risk, task performance and the establishment of professional identity consistent with the workers' aspirations.Other times, it is stereotyped and/or pathogenic, when fear/risk is merely denied, hampering professional action and reproducing the myth-identity (Ciampa, 1990) based on the fragile and illusory heroic identity of the police (Cruz, 1989).Thus, we can state that the power and gender issues in police institution give rise to a sexual division of labor once the women workers, who tend not to agree with the defensive ideology, are led to assistencial work closer to a stereotyped condition of women work, therefore institutionally and socially depreciated (Maia, 1993).The research also made evident that the role of care, of dedication and of emotional support in the family was primarily performed by women workers.Consequently, it was found that the female condition in police work, given the institutional and sociocultural realities as well as the predetermined family and social roles (caretaker of home, of family health problems, of school and personal problems of her children and so on), was a significantly favorable factor to weariness or to stress, so that the adversities experienced at work and in the family tended to place women in a more vulnerable condition to stress (Silva, 2005).

Final Remarks

The analysis of the nurses' and municipal guards' work reveals common aspects and some peculiarities or distinctions.Hospital and police works present themselves as opportune activities to psychological distress, stress and identity conflicts, being the women workers privileged targets given the relations among identity, power and gender in socioinstitutional reality.The professional activities involve risk situations and foster the formation of fear denial defensive ideologies.They mobilize the ideal of saving lives, heroic attitudes and ambivalent feelings as well.In both cases, protection and care are present in their work, together with repression and control.The heroic characters identified in Fabbro's (1996) and Silva's (2005) analysis revealed fear denial defensive strategies and specific forms to cope with anxiety.Findings show that women workers have the need to show themselves strong and present low effective attempts to oppose to psychological distress, to social norms and to gender and power relations (Scott, 1995;Foucault, 1992).The institution tends to use an internalized heroic image either for greater work intensification and exploitation (hospital) or for enabling stronger efficacy in performing street work (male police officers), what, however, does not always happen, given that such image does not endure in some real situations, even for not being backed by a condition of technical formation of excellence, as in the case of the fighter pilots analyzed by Dejours (1992).In the case of the majority of the female police officers, although there is a conscious or unconscious investment in the heroic image, they usually do not actually or actively face risk/fear situations, so that such image does not spare them from suffering at work; on the contrary, it tends to intensify it, producing a state of stress.Anxiety, which is intrinsic to the disease/patient care activity and intensified by the nursing work organization itself, dissipates collectively, being socialized by the team.Nevertheless, that socialization is presented as pathogenic.The team is induced to intensive work, to fatigue and to interpersonal conflicts.In the case of the nurse who assumes the character responsible for everything, the work intensifies, implying not only fatigue but also conflicts, since she has difficulties to delegate tasks and, as she radically internalizes such character, she presents difficulty in valuing the peer's work that presents itself as incomplete, if not ineffective, from a subjective point of view.In relation to the police work, findings show that anxiety occurs in different levels and conditions according to the staff position, being more intense and pathogenic for those who deal with it passively (telephony) than for those who deal with it more actively (street work).Due to their sexual division of labor, women usually occupied staff positions in which predominated passive ways of dealing with anxiety.In the specific case of the "operational" female police officer, who performed street work, the heroic image, as opposed to what happened to the majority of the women workers (telephony), was an element that tended to help the task performance, though, exactly as in the case of the male workers, the assumption of such image was not a guarantee of success in the police record.Fabbro's (1996) analysis allowed to indicate that the nurse's identity conflict is related to a difficulty of assuring her unique action, her knowledge, her work space in professional practice, being gender and power relations an important factor for the social construction of the picture of the apolitical and submissive nurse.Nevertheless, Fabbro (1996) asserts that although the nurse is still dependent on the role-identity, she is dissatisfied with what she experiences.Such dissatisfaction can be understood as the beginning of consciousness.Fabbro (1996) argues that seeking to understand that consciousness is, above all, revealing the multiple levels of submission/oppression to which the conscience is subjected to.The refusal of labels and stereotypes, such as "doctor's maid", "be a Jack of all trades" and "responsible for everything", leads the nurse to realize that it is not enough to have technical competence and that the political competence is as important or even more important to perform her job.That competence is manifested in small, discreet and transitory resistance forms.Silva's analysis (2005) revealed that the identity conflicts and the work and family relations conflicts are more intensively experienced by women workers and, consequently, they tend to be more vulnerable to stress when compared to male workers.The institutional place of work activity is labeled by the stigma of inferiority and by worthlessness.Based on the previously mentioned researches and on the pivot points among them concerning the topics identity, power and gender, it is possible to state that work organization and management and the organizational and sociocultural adversities, pervaded both by conservative gender relations and by power devices, are configured as essential determinants to suffering, illness and identity conflicts of the women workers.We conclude that socioinstitutional reality weariness (Silva and Heloani, 2006;Seligmann-Silva, 1994;Laurell and Noriega, 1989), the blocking of the relationship between men and work organization (Dejours, 1992), the dehumanization of the labor relations and the illness and/or psychological distress processes are issues to be faced courageously, aiming at the objectives of a healthier, more free, more creative and more autonomous work.Such challenge, if seen in relation to the work world, to the private life and to the relationships built in it, cannot prescind from the workers' defensive strategies analysis as well as from the critical analysis on the gender relations and on their understanding as historic, relational and socially constructed (Kergoat, 2002;Scott, 1995).We hope the reflections presented on this paper can contribute to broaden the theoretical dimension on the relations between work and health in order to provide more directness and objectivity to practical actions to improve the women workers' health in particular, and the male workers in general.

COLLABORATORS

Eduardo Pinto e Silva and Márcia Regina Cangiani Fabbro were responsible for writing the first draft of this paper, reviewed before being sent based on Roberto Heloani's comments and suggestions.The second version of this paper was written by Eduardo Pinto e Silva and Márcia Regina Cangiani Fabbro after the referees' suggestions and Roberto Heloani's new comments.
 The nursing staff consisted of: director, supervisor, nurse, nurse technician, nurse assistant and nurse attendant (position currently extinct), who were hierarchically subordinated.
Support staffs were denominated as the ones that, being better technically prepared and consisting of four guards, gave support to the vehicles patrolling the streets in instances of higher complexity or risk.

. L Bardin, Análise De Conteúdo, Lisboa, 197770

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References Gene regulation, evolvability and the limits of genomics
2009. 2009

EditorMiranda Robertson
Mol Cell Biol 1986

Miranda Robertson
3847-3853

References Gene regulation, evolvability and the limits of genomics

Journal of Biology
82009. 200910.1186/jbiol2091. Chan ET, Quon GT, Chua G, Babam T, Trochesset M, Zirngibl R, Aubin J, Ratcliffe M, Wilde W, Brudno M, Morris QD, Hughes TR: Conservation of gene expression in vertebrate tissues. Editorial
Of the fundamental issues in biology that remain unresolved, one of the most prominent is that of the evolution of gene expression. Unlike proteins, in which conservation of function is largely reflected in conservation of primary sequence, conservation of function in the regulatory regions of genes seems to be maintained in the face of quite widely divergent primary sequence. Since the diversification of species depends much more on divergent gene expression than on divergent gene sequence (we famously share 95% of our genomic sequence with chimpanzees), the relationship of promoter structure to promoter function and the evolution of gene expression are a focus of considerable topical interest.Earlier this year, we published a paper from Chan et al.[1]examining the relationship between conservation of gene expression and conservation of regulatory sequence in twenty tissues from three vertebrate species. They reported almost no conservation of associated noncoding sequence for genes with highly conserved expression patterns -a result that is consistent with accumulating evidence from other studies, discussed in the associated commentary from John Malone and Brian Oliver [2].In this issue, Tirosh et al.[3]review recent studies in yeast aimed at identifying those properties of promoters that might account for the evolutionary divergence and the evolvability of gene expression, and focusing not on the primary sequence of regulatory regions but on their more general architectural properties and the relative contribution of regulatory DNA and the proteins that are required for its regulation.The number of binding sites for regulatory proteins is larger in promoters of genes with divergent expression patterns, which does not seem hard to understand; and there are more bound nucleosomes, which is not so easy to understand (Tirosh et al. suggest more scope for regulation); and expression levels are noisier in genes in which they have diverged. But two of the conclusions reached by Tirosh et al. are particularly striking. The first is that divergence of expression patterns between different yeasts is associated with promoters that contain TATA boxes, a property generally associated with inducible rather than constitutive gene expression (an important association first noted by Struhl and colleagues[4]). The second is that it is mutations in proteins and not in regulatory DNA that chiefly accounts for expression divergence -although it is important to note here that we do not know the identity of the proteins: the experiments simply ask whether in a yeast hybrid the pattern of gene expression travels with the DNA containing the gene, or with the DNA of the other parent -that is, in the classical terminology, whether the effect is in cis or in trans.The predominance of trans effects is consistent with the intuitively reasonable idea, gaining general currency and rehearsed by Tirosh et al., that the divergence and indeed the evolvability of gene expression is associated with the responsiveness of promoters to varying input -for example, from signals from the environment. This of course also fits neatly with the association of divergent expression patterns with inducible genes.The mechanisms associating promoter architecture with expression evolvability remain unknown. But it seems clear that the information available from genomic DNA alone, no matter how ingeniously analyzed, is unlikely to provide the answer. : The genomic 'inner fish' and a regulatory enigma in the vertebrates. J Biol 2009, 8:32. 3. Tirosh I, Barkai N, Verstrepen KJ: Promoter architecture and the evolvability of gene expression. J Biol 2009, 8:95. 4. Struhl K: Constitutive and inducible Saccharomyces cerevisiae promoters: evidence for two molecular mechanisms.

Of the fundamental issues in biology that remain unresolved, one of the most prominent is that of the evolution of gene expression. Unlike proteins, in which conservation of function is largely reflected in conservation of primary sequence, conservation of function in the regulatory regions of genes seems to be maintained in the face of quite widely divergent primary sequence. Since the diversification of species depends much more on divergent gene expression than on divergent gene sequence (we famously share 95% of our genomic sequence with chimpanzees), the relationship of promoter structure to promoter function and the evolution of gene expression are a focus of considerable topical interest.

Earlier this year, we published a paper from Chan et al. [1] examining the relationship between conservation of gene expression and conservation of regulatory sequence in twenty tissues from three vertebrate species. They reported almost no conservation of associated noncoding sequence for genes with highly conserved expression patterns -a result that is consistent with accumulating evidence from other studies, discussed in the associated commentary from John Malone and Brian Oliver [2].

In this issue, Tirosh et al. [3] review recent studies in yeast aimed at identifying those properties of promoters that might account for the evolutionary divergence and the evolvability of gene expression, and focusing not on the primary sequence of regulatory regions but on their more general architectural properties and the relative contribution of regulatory DNA and the proteins that are required for its regulation.

The number of binding sites for regulatory proteins is larger in promoters of genes with divergent expression patterns, which does not seem hard to understand; and there are more bound nucleosomes, which is not so easy to understand (Tirosh et al. suggest more scope for regulation); and expression levels are noisier in genes in which they have diverged. But two of the conclusions reached by Tirosh et al. are particularly striking. The first is that divergence of expression patterns between different yeasts is associated with promoters that contain TATA boxes, a property generally associated with inducible rather than constitutive gene expression (an important association first noted by Struhl and colleagues [4]). The second is that it is mutations in proteins and not in regulatory DNA that chiefly accounts for expression divergence -although it is important to note here that we do not know the identity of the proteins: the experiments simply ask whether in a yeast hybrid the pattern of gene expression travels with the DNA containing the gene, or with the DNA of the other parent -that is, in the classical terminology, whether the effect is in cis or in trans.

The predominance of trans effects is consistent with the intuitively reasonable idea, gaining general currency and rehearsed by Tirosh et al., that the divergence and indeed the evolvability of gene expression is associated with the responsiveness of promoters to varying input -for example, from signals from the environment. This of course also fits neatly with the association of divergent expression patterns with inducible genes.

The mechanisms associating promoter architecture with expression evolvability remain unknown. But it seems clear that the information available from genomic DNA alone, no matter how ingeniously analyzed, is unlikely to provide the answer.

Conservation of gene expression in vertebrate tissues. E T Chan, G T Quon, G Chua, T Babam, M Trochesset, R Zirngibl, J Aubin, M Ratcliffe, W Wilde, M Brudno, Q D Morris, T R Hughes, J Biol. 833Chan ET, Quon GT, Chua G, Babam T, Trochesset M, Zirngibl R, Aubin J, Ratcliffe M, Wilde W, Brudno M, Morris QD, Hughes TR: Conservation of gene expression in vertebrate tissues. J Biol 2009, 8:33.

The genomic 'inner fish' and a regulatory enigma in the vertebrates. J Malone, B Oliver, J Biol. 832Malone J, Oliver B: The genomic 'inner fish' and a regulatory enigma in the vertebrates. J Biol 2009, 8:32.

Promoter architecture and the evolvability of gene expression. I Tirosh, N Barkai, K J Verstrepen, J Biol. 895Tirosh I, Barkai N, Verstrepen KJ: Promoter architecture and the evolvability of gene expression. J Biol 2009, 8:95.

Constitutive and inducible Saccharomyces cerevisiae promoters: evidence for two molecular mechanisms. K Struhl, Mol Cell Biol. 6Struhl K: Constitutive and inducible Saccharomyces cerevi- siae promoters: evidence for two molecular mechanisms. Mol Cell Biol 1986, 6:3847-3853.


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

Claudia Mitchell email@example.com
School of Education
University of KwaZulu-Natal
South Africa

Naydene de Lange Faculty of Education
Nelson Mandela Metropolitan University
South Africa

What can a teacher do with a cellphone? Using participatory visual research to speak back in addressing HIV&AIDS
C549E1551D8664E18D177EB1076667E9cellphilmcellphoneHIV&AIDSlife orientationparticipatory researchsex educationteacheryouth
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.

AcknowledgementsWe acknowledge the involvement of the 19 teachers who participated in the "Digital Voices" project as well as the participation of our two colleagues, Relebohile Moletsane and Jean Stuart and the able assistance of Vimbiso Makamure.Finally, we acknowledge the financial assistance of the Social Sciences and Humanities Research Council of Canada.Note1 We note Crystal Powell's (2012) book title of the same name: Me and my cell phone and other essays on technology in everyday life.Bamenda, Cameroon: Langaa Research and Publishing CIG.
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