Mobile Phone Use in Disaster, Conflict and Displacement: Difference between revisions

No edit summary
No edit summary
 
(40 intermediate revisions by 5 users not shown)
Line 1: Line 1:
<div class="editorbox"> '''Original Editor '''- [[User:Robin Tacchetti|Robin Tacchetti]] based on the course by [https://members.physio-pedia.com/course_tutor/sue-piché/ Sue Piché]<br>
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
== Introduction ==
== Introduction ==
Coupled with the increasing usage of mobile devices worldwide, about 95% of the global population is now covered by mobile signals (GSMA, 2020a), while smartphone ownership rose to over 600 m and 820 m in sub-Saharan Africa and India, respectively, in 2020 (GSMA, 2020a, GSMA, 2020b). This increased availability of mobile phone saturation cuts across societal segments, opening up new ways of gathering big data, accessing environmentally relevant information, and fostering positive societal interventions, all of which are important in Disaster Risk Reduction (DRR)
Mobile device usage has steadily increased with around 95% of the global population having mobile coverage. For marginalised individuals, mobile technologies help ensure more equitable resilience in disaster situations. Marginalised groups include people with disabilities, who are four times more likely to perish in disaster settings, and women, who have been identified as more vulnerable in disaster settings.<ref name=":1" /> In low-income countries, women are 10% less likely to own a mobile phone. This exclusion from the digital world negatively impacts a woman's opportunity to be rescued in dangerous situations.<ref name=":0" />
 
== Humanitarian Crisis ==
In emergency humanitarian situations, mobile phones can be used to inform and educate the public about the emergency and to disseminate information.<ref name=":1">Paul JD, Bee E, Budimir M. [https://www.sciencedirect.com/science/article/pii/S2212096321000255 Mobile phone technologies for disaster risk reduction]. Climate Risk Management. 2021 Jan 1;32:100296.</ref> Communities living in harsh conditions can use their mobile phone apps or platforms to:
 
* access up-to date information
* stay in touch with each other
* report on life-threatening conditions that require emergency help
* connect with humanitarian facilities<ref name=":0">Akhmatova DM, Akhmatova MS. [https://jhumanitarianaction.springeropen.com/articles/10.1186/s41018-020-00076-2 Promoting digital humanitarian action in protecting human rights: hope or hype]. Journal of International Humanitarian Action. 2020 Dec;5(1):1-7.</ref>
 
 
Mobile phones have become essential tools for displaced persons to "navigate their migration journeys [...] and the complexities of life during resettlement".<ref name=":3">Alencar A. [https://compass.onlinelibrary.wiley.com/doi/full/10.1111/soc4.12802 Mobile communication and refugees: An analytical review of academic literature]. Sociology Compass. 2020 Aug;14(8):e12802.</ref>
 
== Displaced Persons ==
For displaced persons fleeing their country, modern communication can provide some level of emotional support.<ref name=":2" /> Having mobile phones also allows displaced persons to avoid carrying maps, cash, documents, torches and dictionaries.<ref name=":6" /> Mobile phones not only enable displaced persons to keep in touch with their family at home, they also provide logistical information during dangerous and stressful journeys.<ref name=":2">Eide E. Mobile flight: [https://journal-njmr.org/articles/10.33134/njmr.250 Refugees and the importance of cell phones]. Nordic Journal of Migration Research. 2020 May 28;10(2).</ref> Specific logistical guidance is often needed regarding borders to cross, distance to cover, food, transportation and accommodation.<ref name=":3" /> In addition to logistics and communication, mobile phone use can help provide refugees with information, surveillance, entertainment and diversions along their journey.<ref name=":4">Alencar A, Kondova K, Ribbens W. [https://journals.sagepub.com/doi/pdf/10.1177/0163443718813486 The smartphone as a lifeline: An exploration of refugees’ use of mobile communication technologies during their flight.] Media, Culture & Society. 2019 Sep;41(6):828-44.</ref> Refugees prioritise mobile ownership and connectivity as crucial for their safety.<ref name=":3" />
 
The video below by Ars Technica demonstrates the importance of mobile phones for refugees:
{{#ev:youtube|SgK-JcaddBM}}
 
== Communication ==
Mobile access allows refugees to keep their friends and families updated about their journey. Texting or calling their loved ones provides emotional support through their journey. Some refugees postpone communication until they reach their final destination. In this case, mobile phones might be used to document memories of their experiences to share at a later date.<ref name=":3" />
 
== Social Inclusion ==
For displaced persons experiencing resettlement, the use of mobile technologies has been associated with social inclusion and opportunities to gain access to information that supports daily life.<ref name=":3" /> Being able to connect with loved ones at home while establishing new relationships in host communities helps create a sense of belonging. A mobile phone acts as a virtual space to develop transcultural connections, bridging the cultural gap between the local culture and the displaced person.<ref name=":5" />
 
== Social Network ==
Social media communication can connect migrants to fellow refugees in host countries, providing them with logistical information about routes, transportation arrangements and accommodation. In addition, these networks provide general information to help displaced persons navigate the following settlement issues:
 
* appropriate behaviour
* style of dress
* rights
* citizenship
* support services
* employment
* community housing
* language learning programmes<ref name=":5">Dasuki S, Effah J. [https://www.tandfonline.com/doi/full/10.1080/02681102.2021.1976714 Mobile phone use for social inclusion: the case of internally displaced people in Nigeria]. Information Technology for Development. 2022 Jul 3;28(3):532-57.</ref><ref name=":3" />
 
== Health ==
Mobile technologies can be used in a variety of ways to facilitate health inclusion. Displaced persons use online platforms to access health information, health support groups and to communicate with health care providers.<ref name=":5" /> Subsequently, providers can monitor a displaced person's health conditions virtually with the use of various apps.<ref name=":3" /><blockquote>" ... in healthcare, communication failures can directly or indirectly cause preventable harm. High-risk moments in communication may be during transitions of care, for instance, between care areas when patients are going from one area to another or shift changes; or relaying of orders, such as medication or treatments. Risks include any interaction which provides critical information about conditions and/or plan of care and they can be miscommunicated. That can lead to any delays in treatment or inappropriate therapies."
 
- Sue Piché, registered nurse</blockquote>
 
== Politics ==
Mobile phone use can enable refugees to exercise their right to engage in political discussion. Social media allows them to voice their opinion, advocate for refugee rights, influence policy and politics and engage in both offline and online activism.<ref name=":5" />
 
== Issues ==
Displaced persons may claim mobile phones are a lifeline, but there are inherent risks with their use during the journey to resettlement.<ref name=":6">Mancini T, Sibilla F, Argiropoulos D, Rossi M, Everri M. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886855/ The opportunities and risks of mobile phones for refugees’ experience:] A scoping review. PloS one. 2019 Dec 2;14(12):e0225684.</ref> In exile, displaced persons may face issues of connectivity and surveillance.<ref name=":4" />
 
=== Connectivity ===
Access to the internet via Wi-Fi, SIM-cards and battery charging resources are unpredictable and fragile.<ref name=":4" /> The ability to recharge a phone during the migration journey becomes a question of life or death. Many refugees report that they continually share, change and swap batteries with each other so as to not be disconnected.<ref name=":6" /> Once in a resettlement community, displaced persons may experience difficulty using their mobile phones due to:
 
* limited financial resources, which impacts access to a reliable / stable mobile network
* the difficulty of getting a sim-card due to uncertain legal / immigration status
* local communication infrastructure in host country / community<ref name=":5" />
 
== Surveillance ==
Digital surveillance of displaced persons can be accomplished through smartphone use. Displaced persons can be tracked by the countries they have left or the countries they are going to and/or by human traffickers.<ref name=":6" /> To counteract this surveillance, refugees report using pseudonyms and avatars to try and protect their identities and intended routes and destinations from the government of their home country or other groups.<ref name=":4" /><ref name=":3" />
 
== Clinical Considerations When Selecting a Suitable Mobile App ==
Security and privacy of client data and records are paramount in healthcare. This does not change when consulting via telehealth or when using a mobile app. Safety and security with video platforms is therefore extremely important and a necessity.
 
Countries and states have their own legislation, regulations and privacy acts related to health services. These can regulate how a client's personal information is handled and kept secure.  The rehabilitation professional may be held liable if sensitive information is not well-protected as the result of using a less secure or poor quality platform.<ref name=":7">Karen Finnin. What video platforms are suitable for telehealth. Published on 8 April 2020. Available from https://www.karenfinnin.com/what-video-platforms-are-suitable-for-telehealth/ (last accessed 13 November 2023)</ref>
 
A suitable mobile app must be:
 
* encrypted
* not interceptable
* not-hackable


Mobile technologies have rich potential in ensuring more equitable resilience by mobilising marginalised actors who might otherwise have been bypassed by more traditional knowledge generation practices. These include people with disabilities, who are four times more likely to die when a disaster strikes; or women, who are more vulnerable in disaster situations
=== Platform Security ===
The practitioner has to demonstrate that the selected platform is secure and private and if that changes in the future, a different platform needs to be considered. End to end encryption is necessary for video calls<ref name=":7" />. A comprehensive risk assessment should be done on the platform. Follow your country or state guidelines regarding General Data Protection Regulation (GDPR)  and Health Insurance Portability and Accountability Act (HIPAA).<ref>WebPT. The Rehab Therapist’s Guide to Practicing Telehealth.</ref>


Much attention has been paid to the tangible and highly visible role of mobile phones in emergency response: increasingly seen as a means to chronicle events being witnessed and/or experienced personally, they are also commonly used to disseminate information and educate and inform the public and emergency services (Gething and Tatem, 2011). By harnessing the viral capacity of such technologies, emergency response teams are able to alert and locate those in danger more swiftly than via traditional broadcast media or telecommunications methods<ref name=":1">Paul JD, Bee E, Budimir M. [https://www.sciencedirect.com/science/article/pii/S2212096321000255 Mobile phone technologies for disaster risk reduction]. Climate Risk Management. 2021 Jan 1;32:100296.</ref>
==== GDPR ====


* implemented by the European Union (EU)
* highest levels of data security standards in the world
* although not healthcare specific - it incorporates the storage and transmission of patient health data
* Under GDPR:
** healthcare provider known as the "data controller"
* data controllers have specific legal obligations such as "the right to be forgotten" - this allows the data controller to delete patient info upon request<ref>GDPR.EU. Complete guide to GDPR compliance. Available from [https://gdpr.eu/ https://gdpr.eu/] (last accessed 13 November 2023)</ref>


==== HIPAA ====


Some studies predict that smartphone subscriptions will almost double from 3.4 billion to 6.3 billion by 2021, meaning that most adults on earth will have access to some form of connected mobile device (Thomas 2016). New research, led by the International Committee of the Red Cross (ICRC), also suggests messaging apps could play a crucial role in humanitarian work in the future (Stoll 2017). From this, communities affected by harsh living conditions, war, and natural disasters can rely on these platforms to keep in touch with each other, have access to up-to-date information and connect with humanitarian facilities and volunteers to report on a difficult or life-threatening condition that requires emergency humanitarian assistance.<ref name=":0">Akhmatova DM, Akhmatova MS. [https://jhumanitarianaction.springeropen.com/articles/10.1186/s41018-020-00076-2 Promoting digital humanitarian action in protecting human rights: hope or hype]. Journal of International Humanitarian Action. 2020 Dec;5(1):1-7.</ref>
* US law
* purpose of the act - ensure that the healthcare providers keep protected health information safe
* Under the act:
** health care providers are "HIPAA covered entity"
** providers of assistance and support to health care providers are "business associates"
* Requires health care providers (covered entity) that stores and conveys confidential health data through technology platforms, to sign a business agreement with the technology platform (business associate)
* HIPAA compliant platforms ensure that security requirements fall within HIPAA guidelines<ref>US Department of health and human services. Summary of the HIPAA Security Rule. Available from [https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html] (last accessed 13 November 2023)</ref>


== Refugees ==
=== Common Publicly used Platforms ===
An important aspect of migration is border control. “The national borders of rich countries are increasingly becoming militarized” (Eriksen 2007: 95), and the refugees are subject to “a curious mix of humanitarianism and military action emanating from Europe in the Mediterranean” (Eriksen 2016: 76). These developments represent challenges to people in flight, and in the past 10–15 years, they have increasingly used modern electronic devices such as smartphones to meet these challenges.<ref name=":2">Eide E. Mobile flight: [https://journal-njmr.org/articles/10.33134/njmr.250 Refugees and the importance of cell phones]. Nordic Journal of Migration Research. 2020 May 28;10(2).</ref>


Modern communication may be of some emotional comfort for people in distress: it is good to ascertain that your folks at home worry less if you keep them informed of your current situation. Moreover, the cell phone represents a logistic device to facilitate a stressful and dangerous journey. Thus, it plays a crucial role in today’s ecology of communication (Altheide 2013); it provides organisation (of travel, togetherness), accessibility of information (when connection and charging devices are available) and contributes to structuring of sorts, of the whole flight.
==== Zoom ====


Cell phones, and particularly the smartphone versions, may be viewed as part of an “interplay among social activities, social change, and social organization and activities” or the “structure, organization, and accessibility of information technology, various forums, media, and channels of information  Cell phones, as a means of communication in situations of flight, have proven to guide refugees’ everyday and non-routine extraordinary activities (e.g. finding the way, escaping danger and securing financial supplies); in short, they prove to be an indispensable travel companion. f course, most refugees in Europe use their cell phones in different ways for “staying in touch with friends and family, but they are even more essential for refugees en route” (Gillespie et al. 2016: 11). This is a two-way process: those who are in flight are constantly worrying about those who are left behind, especially those who live with war; and those who have not left worry about their relatives’ perilous border crossings.<ref name=":2" />
* less streamlined interface
* download required for first-time use
* designed for meetings and webinars
* media-reports of security breaches of the platform - not ideal for health services where secure and private health information is conveyed
* calls may not be encrypted by default - the "Require Encryption for 3rd party Endpoints" setting needs to be switched on
* [https:/zoom.us/healthcare Zoom for Healthcare] - higher subscription fee. Integrates with some physiotherapy software and gives higher-level security with HIPAA compliance.


== Hurdles ==
==== Facetime ====
Usage of messaging apps, social networks, media platforms, and mobile money by people that are affected by humanitarian crises, critical situations, disasters, and accidents is being actively introduced (Lunt 2017; Kaspersen and Lindsey-Curtet 2016; Bouffet 2017). However, while the digital technologies provide new opportunities for communication in complex situations, the humanitarian and volunteer organizations do not have appropriate standards or internationally agreed and approved ethical norms for their deployment that in combination with people’s living conditions, specific culture of developing countries, social and material inequalities, and women’s rights problems can cause serious obstacles in facilitating humanitarian support.<ref name=":0" />


== Different Apps ==
* available anytime
s the digital state-of-the-art solutions, the mentioned platforms together with messaging apps contribute to response coordination and communication between affected communities, volunteers, and aid workers to provide the integrated digital environment for transparent and timely humanitarian assistance.  For instance, 4W (Who, What, Where, and When) maps were developed to provide information for the planning of humanitarian assistance, covering the critical questions, such as who is doing what, where, and when. Tracking of humanitarian responders, automated updating of their location and responsibilities were piloted for Nepal, Vanuatu, and the Philippines (Comes and de Walle 2016). Further, KoBoToolbox, developed by the Harvard Humanitarian Initiative, is a free suite of tools for humanitarian data collection to be used in challenging environments (KoBoToolbox 2009). TraceRx platform is positioned as a well-known humanitarian supply chain solution. In large-scale emergencies, such as the earthquake in Nepal in April 2015 and the hurricane in Haiti in October 2016, Humanitarian ID was used to perform the humanitarian contact lists management (United Nations Office for the Coordination of Humanitarian Affairs 2015; Stewart 2015).<ref name=":0" />
* data from chat and video call on Facetime can be stored in your personal iCloud - this may lead to non-compliant and legislative issues on the storage of private and confidential health records<ref name=":7" />
* have had security flaws in the past


messaging apps actualize problems related to data protection, privacy, and security since the information environment is often contested, and misinformation, propaganda, and rumors travel swiftly (Roby 2017), particularly, in the case of armed conflicts and disasters. For humanitarians, the risks of mobile app usage are associated with submitting or providing the permission to access the personal information, such as name, location, contacts, email address, and photos. The negative side is that this allows the provider of messaging app to collect a significant information on the user, including his daily routine, personal preferences, and list of trustees.<ref name=":0" />
==== Skype ====


* reports of poor quality of calls
* privacy and security issues and vulnerabilities


==== Whatsapp ====


spectrum of different technologies that could usefully be exploited for DRR (Fig. 1). In areas of poor Internet provision and/or depressed smartphone ownership, voice calls and SMS messaging are used to target broad swathes of the population; for instance, Monsoon flood alerts for certain rivers in Nepal and India, sent by each respective country’s governmental water bureaucracy (Pandeya et al., 2020). For Internet-connected smartphones, social media platforms such as Twitter and Facebook, as well as messaging services like WhatsApp, while commonly associated with emergency response, also offer an important channel for official hazard warning communications, and may also augment social capital (Kaigo, 2012, Agahari et al., 2018). Similarly, Geographic Information System (GIS)-based technologies represent another (spatial) means of risk communication. Google Maps, for instance, has been used to develop a user-led disaster management system in Bangladesh (Sonwane, 2014). OpenStreetMap (OSM), an open-source and collaborative GIS platform, has also been used to develop similar systems (Rahman et al., 2012), or to allow affected communities to generate local landslide hazard, risk, and vulnerability maps dynamically (Parajuli et al., 2020). However, the most commonly utilised mobile technology in DRR are apps: they provide a user-friendly means of feeding raw data into hazard early-warning systems (EWS), the output from which can then be disseminated in visually appealing form back to users (Paul et al., 2018). They are generally highly context (i.e. country, natural hazard)-specific: two examples are MAppERS (Mobile Applications for Emergency Response and Support), which aims to reduce flood risk in Denmark by allowing users to share geospatial data such as geotagged images of flood extent with basin authorities (Frigerio et al., 2018); and MyShake, a global seismic platform that exploits users’ smartphones to detect earthquakes and record the magnitude of ground<ref name=":1" />
* application is connected to individual mobile phone numbers
* issues for data security and compliance
* reports of security issues and hacking<ref name=":7" />


== Drones ==
==== Microsoft Teams ====
The advanced unmanned aerial vehicle (UAV), also known as a drone, is an item whose flight is controlled either autonomously by artificial intelligence, computers, or a pilot on the ground. The promising directions of drone application in humanitarian crises are the following: mapping, delivering essential items to hard-to-access locations, monitoring environmental changes, supporting damage assessments, etc. (Fondation Suisse de Déminage 2016). Humanitarian organizations have started to use UAVs, including in Haiti and the Philippines to provide real-time information and situation monitoring, public information, search and rescue, etc. (United Nations Office for the Coordination of Humanitarian Affairs 2014). In this way, different types of drones ensure accurate and up-to-date data on demand, helping representatives of humanitarian missions to make more informed decisions. However, some issues, such as data protection, should be addressed during application of drones.<ref name=":0" />


== Gender Gap ==
* more secure than Skype
1.7 billion women now own a mobile phone in low- and middle-income countries (LMICs), and over a billion use the mobile internet. However, a significant gender gap in mobile phone ownership and usage exposes women to the risk of being left behind in an increasingly digitized world. In this context, females in LMICs are 10% less likely to own a mobile phone than a man. The variations within specific regions and countries are significant (Downer 2019). Furthermore, women in South Asia are 26% less likely to own a mobile than men and 70% less likely to use mobile internet (Rowntree 2018). In India, 67% of men own personal mobile phones, but only 33% percent of women do (Vota 2019). The reasons for this situation are as old as time and associated with such obvious barriers such as the availability of new technologies, cultural, religious and social background, and attitude to women’s rights.
* set-up can be tricky
* user-friendliness can be an issue


The exclusion of women refugees and internally displaced women from the digital world and societies would negatively affect the possibilities to be rescued from dangerous situations and to express the rights to life, liberty, and security of a person, as it is stated in the Universal Declaration of Human Rights (1948).
== Summary ==
Mobile phone use provides opportunities for displaced persons to develop educational, social, linguistic, digital skills. Most importantly, smartphones promote social inclusion via a virtual double bond with an individual's own culture and their new society.<ref name=":6" />  When providing care for displaced person, there are many available mobile phone apps to help facilitate communication and continuity of care. It remains the responsibility of the healthcare provider to ensure the privacy and security of sensitive health information for clients.


The existence of such trends requires the immediate identification of cause-and-effect relationships and concerted action to remove obstacles to women’s equal access to mobile services in the context of countries, where the gender gap is greatest. Mobile operators, software developers, humanitarian facilities, and non-governmental organizations (NGOs) can work together to promote policies and initiatives aimed to reduce the cost of phones or enhance work on mitigation of the impact of cultural traditions and social norms on their use, such as awareness sessions, informative talks, and seminars.
This video by BBC Media Action summarises the benefits and risks of cell phone use during a displaced person's migration:
{{#ev:youtube|m1BLsySgsHM}}


The role of women humanitarians should be emphasized as they are also vulnerable to the dangers and perform the precious work in the conditions of armed conflicts, nature disasters, hunger, and humanitarian catastrophe, risking their health and lives. Subject of women humanitarians’ vulnerability has been brought to light in discussions of #AidToo movement, inspired by #MeToo and opposed to the sexual harassment, exploitation, and abuse. Widespread reports of sexual misconduct in humanitarian contexts threaten women humanitarians’ own safety and security (O’Donnell 2019) and confirm the violations of inviolable human rights.
== Resources ==


In the current context, there is a need to actively address the issues of gender equality in humanitarian action and protection of women from sexual harassment and abuse in order to ensure respect for women rights and dignity, since, according to Article 2 of Universal Declaration of Human Rights (1948), “everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, color, sex, language, religion, political or other opinion, national or social origin, property, birth or other status”. Furthermore, the specific limitations should not affect the access of women humanitarians to the digital solutions developed to enhance the effectiveness of their work under the changing environment.
* [[Global Challenges Relating to the Refugee Experience]]
* [[Cultural Competence and Access to Healthcare for Displaced Persons]]
* [[Health Concerns for Displaced Persons]]
* [https://www.servalproject.org Serval Project]
* [https://acalltoendpoverty.weebly.com/tera.html Trilogy Emergency Response Application (TERA)]


One of the most important links that connects those who need humanitarian assistance with those who are interested in responding is digital media and communications, integrating mobile mass communication with the Internet. According to Lobb and Mock (2007), during humanitarian response efforts, the mass media serves as the primary informational intermediary, informing donors, and policy-makers as well as the non-affected public.<ref name=":0" />
== References ==
<references />
[[Category:Rehabilitation]]
[[Category:Rehabilitation in Disaster and Conflict Situations Content Development Project]]
[[Category:ReLAB-HS Course Page]]
[[Category:Course Pages]]
[[Category:Global Health]]

Latest revision as of 12:24, 22 November 2023

Original Editor - Robin Tacchetti based on the course by Sue Piché
Top Contributors - Robin Tacchetti, Jess Bell, Stacy Schiurring, Kim Jackson and Vidya Acharya

Introduction[edit | edit source]

Mobile device usage has steadily increased with around 95% of the global population having mobile coverage. For marginalised individuals, mobile technologies help ensure more equitable resilience in disaster situations. Marginalised groups include people with disabilities, who are four times more likely to perish in disaster settings, and women, who have been identified as more vulnerable in disaster settings.[1] In low-income countries, women are 10% less likely to own a mobile phone. This exclusion from the digital world negatively impacts a woman's opportunity to be rescued in dangerous situations.[2]

Humanitarian Crisis[edit | edit source]

In emergency humanitarian situations, mobile phones can be used to inform and educate the public about the emergency and to disseminate information.[1] Communities living in harsh conditions can use their mobile phone apps or platforms to:

  • access up-to date information
  • stay in touch with each other
  • report on life-threatening conditions that require emergency help
  • connect with humanitarian facilities[2]


Mobile phones have become essential tools for displaced persons to "navigate their migration journeys [...] and the complexities of life during resettlement".[3]

Displaced Persons[edit | edit source]

For displaced persons fleeing their country, modern communication can provide some level of emotional support.[4] Having mobile phones also allows displaced persons to avoid carrying maps, cash, documents, torches and dictionaries.[5] Mobile phones not only enable displaced persons to keep in touch with their family at home, they also provide logistical information during dangerous and stressful journeys.[4] Specific logistical guidance is often needed regarding borders to cross, distance to cover, food, transportation and accommodation.[3] In addition to logistics and communication, mobile phone use can help provide refugees with information, surveillance, entertainment and diversions along their journey.[6] Refugees prioritise mobile ownership and connectivity as crucial for their safety.[3]

The video below by Ars Technica demonstrates the importance of mobile phones for refugees:

Communication[edit | edit source]

Mobile access allows refugees to keep their friends and families updated about their journey. Texting or calling their loved ones provides emotional support through their journey. Some refugees postpone communication until they reach their final destination. In this case, mobile phones might be used to document memories of their experiences to share at a later date.[3]

Social Inclusion[edit | edit source]

For displaced persons experiencing resettlement, the use of mobile technologies has been associated with social inclusion and opportunities to gain access to information that supports daily life.[3] Being able to connect with loved ones at home while establishing new relationships in host communities helps create a sense of belonging. A mobile phone acts as a virtual space to develop transcultural connections, bridging the cultural gap between the local culture and the displaced person.[7]

Social Network[edit | edit source]

Social media communication can connect migrants to fellow refugees in host countries, providing them with logistical information about routes, transportation arrangements and accommodation. In addition, these networks provide general information to help displaced persons navigate the following settlement issues:

  • appropriate behaviour
  • style of dress
  • rights
  • citizenship
  • support services
  • employment
  • community housing
  • language learning programmes[7][3]

Health[edit | edit source]

Mobile technologies can be used in a variety of ways to facilitate health inclusion. Displaced persons use online platforms to access health information, health support groups and to communicate with health care providers.[7] Subsequently, providers can monitor a displaced person's health conditions virtually with the use of various apps.[3]

" ... in healthcare, communication failures can directly or indirectly cause preventable harm. High-risk moments in communication may be during transitions of care, for instance, between care areas when patients are going from one area to another or shift changes; or relaying of orders, such as medication or treatments. Risks include any interaction which provides critical information about conditions and/or plan of care and they can be miscommunicated. That can lead to any delays in treatment or inappropriate therapies." - Sue Piché, registered nurse

Politics[edit | edit source]

Mobile phone use can enable refugees to exercise their right to engage in political discussion. Social media allows them to voice their opinion, advocate for refugee rights, influence policy and politics and engage in both offline and online activism.[7]

Issues[edit | edit source]

Displaced persons may claim mobile phones are a lifeline, but there are inherent risks with their use during the journey to resettlement.[5] In exile, displaced persons may face issues of connectivity and surveillance.[6]

Connectivity[edit | edit source]

Access to the internet via Wi-Fi, SIM-cards and battery charging resources are unpredictable and fragile.[6] The ability to recharge a phone during the migration journey becomes a question of life or death. Many refugees report that they continually share, change and swap batteries with each other so as to not be disconnected.[5] Once in a resettlement community, displaced persons may experience difficulty using their mobile phones due to:

  • limited financial resources, which impacts access to a reliable / stable mobile network
  • the difficulty of getting a sim-card due to uncertain legal / immigration status
  • local communication infrastructure in host country / community[7]

Surveillance[edit | edit source]

Digital surveillance of displaced persons can be accomplished through smartphone use. Displaced persons can be tracked by the countries they have left or the countries they are going to and/or by human traffickers.[5] To counteract this surveillance, refugees report using pseudonyms and avatars to try and protect their identities and intended routes and destinations from the government of their home country or other groups.[6][3]

Clinical Considerations When Selecting a Suitable Mobile App[edit | edit source]

Security and privacy of client data and records are paramount in healthcare. This does not change when consulting via telehealth or when using a mobile app. Safety and security with video platforms is therefore extremely important and a necessity.

Countries and states have their own legislation, regulations and privacy acts related to health services. These can regulate how a client's personal information is handled and kept secure. The rehabilitation professional may be held liable if sensitive information is not well-protected as the result of using a less secure or poor quality platform.[8]

A suitable mobile app must be:

  • encrypted
  • not interceptable
  • not-hackable

Platform Security[edit | edit source]

The practitioner has to demonstrate that the selected platform is secure and private and if that changes in the future, a different platform needs to be considered. End to end encryption is necessary for video calls[8]. A comprehensive risk assessment should be done on the platform. Follow your country or state guidelines regarding General Data Protection Regulation (GDPR) and Health Insurance Portability and Accountability Act (HIPAA).[9]

GDPR[edit | edit source]

  • implemented by the European Union (EU)
  • highest levels of data security standards in the world
  • although not healthcare specific - it incorporates the storage and transmission of patient health data
  • Under GDPR:
    • healthcare provider known as the "data controller"
  • data controllers have specific legal obligations such as "the right to be forgotten" - this allows the data controller to delete patient info upon request[10]

HIPAA[edit | edit source]

  • US law
  • purpose of the act - ensure that the healthcare providers keep protected health information safe
  • Under the act:
    • health care providers are "HIPAA covered entity"
    • providers of assistance and support to health care providers are "business associates"
  • Requires health care providers (covered entity) that stores and conveys confidential health data through technology platforms, to sign a business agreement with the technology platform (business associate)
  • HIPAA compliant platforms ensure that security requirements fall within HIPAA guidelines[11]

Common Publicly used Platforms[edit | edit source]

Zoom[edit | edit source]

  • less streamlined interface
  • download required for first-time use
  • designed for meetings and webinars
  • media-reports of security breaches of the platform - not ideal for health services where secure and private health information is conveyed
  • calls may not be encrypted by default - the "Require Encryption for 3rd party Endpoints" setting needs to be switched on
  • [https:/zoom.us/healthcare Zoom for Healthcare] - higher subscription fee. Integrates with some physiotherapy software and gives higher-level security with HIPAA compliance.

Facetime[edit | edit source]

  • available anytime
  • data from chat and video call on Facetime can be stored in your personal iCloud - this may lead to non-compliant and legislative issues on the storage of private and confidential health records[8]
  • have had security flaws in the past

Skype[edit | edit source]

  • reports of poor quality of calls
  • privacy and security issues and vulnerabilities

Whatsapp[edit | edit source]

  • application is connected to individual mobile phone numbers
  • issues for data security and compliance
  • reports of security issues and hacking[8]

Microsoft Teams[edit | edit source]

  • more secure than Skype
  • set-up can be tricky
  • user-friendliness can be an issue

Summary[edit | edit source]

Mobile phone use provides opportunities for displaced persons to develop educational, social, linguistic, digital skills. Most importantly, smartphones promote social inclusion via a virtual double bond with an individual's own culture and their new society.[5] When providing care for displaced person, there are many available mobile phone apps to help facilitate communication and continuity of care. It remains the responsibility of the healthcare provider to ensure the privacy and security of sensitive health information for clients.

This video by BBC Media Action summarises the benefits and risks of cell phone use during a displaced person's migration:

Resources[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 Paul JD, Bee E, Budimir M. Mobile phone technologies for disaster risk reduction. Climate Risk Management. 2021 Jan 1;32:100296.
  2. ↑ 2.0 2.1 Akhmatova DM, Akhmatova MS. Promoting digital humanitarian action in protecting human rights: hope or hype. Journal of International Humanitarian Action. 2020 Dec;5(1):1-7.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Alencar A. Mobile communication and refugees: An analytical review of academic literature. Sociology Compass. 2020 Aug;14(8):e12802.
  4. ↑ 4.0 4.1 Eide E. Mobile flight: Refugees and the importance of cell phones. Nordic Journal of Migration Research. 2020 May 28;10(2).
  5. ↑ 5.0 5.1 5.2 5.3 5.4 Mancini T, Sibilla F, Argiropoulos D, Rossi M, Everri M. The opportunities and risks of mobile phones for refugees’ experience: A scoping review. PloS one. 2019 Dec 2;14(12):e0225684.
  6. ↑ 6.0 6.1 6.2 6.3 Alencar A, Kondova K, Ribbens W. The smartphone as a lifeline: An exploration of refugees’ use of mobile communication technologies during their flight. Media, Culture & Society. 2019 Sep;41(6):828-44.
  7. ↑ 7.0 7.1 7.2 7.3 7.4 Dasuki S, Effah J. Mobile phone use for social inclusion: the case of internally displaced people in Nigeria. Information Technology for Development. 2022 Jul 3;28(3):532-57.
  8. ↑ 8.0 8.1 8.2 8.3 Karen Finnin. What video platforms are suitable for telehealth. Published on 8 April 2020. Available from https://www.karenfinnin.com/what-video-platforms-are-suitable-for-telehealth/ (last accessed 13 November 2023)
  9. ↑ WebPT. The Rehab Therapist’s Guide to Practicing Telehealth.
  10. ↑ GDPR.EU. Complete guide to GDPR compliance. Available from https://gdpr.eu/ (last accessed 13 November 2023)
  11. ↑ US Department of health and human services. Summary of the HIPAA Security Rule. Available from https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html (last accessed 13 November 2023)
Retrieved from "https://www.physio-pedia.com/index.php?title=Mobile_Phone_Use_in_Disaster,_Conflict_and_Displacement&oldid=345491"