Visible voices, shared worlds: using digital video and photography in pursuit of a better life.
    
    Vincent O’Brien
    University of Cumbria Lancaster , England
    
    Kenesh Djusipov
    Kyrgyz State Medical Academy Bishkek, Kyrgyzstan kenesh@mac.com
    
    Flavio Wittlin
    Viramundo Rio de Janeiro , Brazil
    
    vincentobrien@mac.com
    
    flavio@viramundo.org.br
    
    ABSTRACT
    Visible Voice projects use participatory video and photography techniques to explore experiences and perceptions of everyday life, health and well being. The projects aim to engage participants in collaborative construction and public exhibition of videos and photographic galleries providing a ‘visible voice’ with which to articulate community concerns, views and interests. Beginning with an outline of the context of Visible Voice projects in Kyrgyzstan and Brazil we situate our research within a Freirean, constructivist approach to research and community development. We describe the Visible Voice process and examine the social interactions within and between the participant groups and their communities i n response to the project activities. We conclude by reviewing how, following the initial workshops, participants continue t o make use of visual materials, engaging a from of ‘visual activism’ in pursuit of a better life.
    
    2. SETTINGS AND CONTEXTS 2.1 Kyrgyzstan
    Kyrgyzstan is a remote and mountainous, former Soviet republic in Central Asia. By tradition a nomadic people, the Kyrgyz traveled with their horses, cattle and goats along the Silk Road trade routes between China and Eastern Europe until the early 1930’s. The collapse of the Soviet system in 1991 brought about a rapid economic and social transformation that had devastating consequences on the health of the Kyrgyz population ([18]). Average earnings in 2004, across all social groups, was $55 per month ([17]). Infectious and parasitic diseases re-emerged as a serious problem in the post Soviet period with an average of 50,000 new cases of parasitic disease year ([22]). Geographic isolation, economic, social and physical infrastructure collapse in post Soviet Kyrgyzstan have all contributed to worsening public health conditions ([16]). The health of people living in Kyrgyzstan’s remote mountain valleys is influenced, in part, by altitude and local environmental conditions ([11]). But social problems such as poverty and unemployment have also intensified health problems in the wake of economic collapse. ([18]) In April 2006 we undertook our first Visible Voice project i n Kyrgyzstan in response to a request from the Ak Terek Public Fund. Ak Terek is a Kyrgyz NGO working on bio-cultural sustainability projects with remote village communities in the Kochgor region of Kyrgyzstan. Visible Voice contributed t o the Ak Terek programme by providing participatory video workshops for people living in Kokjar and Tolok Villages. The projects were essentially ethnographic studies of everyday life with an additional aim of helping villagers identify and prioritise local health issues in preparation for small grant applications to the Ak Terek Public Fund.
    
    Categories and Subject Descriptors
    J.4 [Social and Behavioral Sciences]: Sociology H.5.2 [Information Interfaces and presentation (e.g. HCI)]: User Interfaces – theory and methods, Miscellaneous
    
    General Terms
    Human Factors, Participatory Video, Visual Activism.
    
    Keywords
    Participatory Video, Photography, Visual Ethnography
    
    1. INTRODUCTION
    The pursuit of a better life is a primary social goal and achieving that goal requires us to formulate, prioritise and communicate our needs and preferences to others. Our success in this enterprise is bound up with our ability to articulate and communicate our desires to influential audiences and decision makers. A combination of factors such as social status, wealth and education help to situate us, provide essential skills and give us access to key decision makers. For disadvantaged communities, a common barrier to a better life is often the relative lack of appropriate communication skills and limited access to supportive media representations within the community. In recent years, the development of digital media technologies have created new opportunities for participatory development of powerful visual messages that can be used t o articulate community concerns and support social change. The Visible Voice initiative (www.visiblevoice.info) emerged from our earlier collaborations in Kyrgyzstan ([18]) and i s been informed by a desire to undertake meaningful research capable of engaging people in collaborative action in pursuit of a better life. The first Visible Voice project took place i n April 2006 in the remote mountain villages of Kokjar and Tolok in the former Soviet republic of Kyrgyzstan. In June 2007, we extended Visible Voice to include our work with Viramundo, a Brazilian NGO working alongside people living in the Rocinha favela settlement in Rio de Janeiro.
    
    2.2 Brazil
    Brazil is one of the most economically divided countries i n the world with 10% of the population earning 50% of the national income, while about 34% of the population live below the poverty line. ([19]) With the highest number of TB cases in the Latin American region, an estimated 110,000 cases occurring each year, poor housing, inadequate education, poverty and other social factors are important determinants of population health. ([5]) Rio de Janeiro is the second largest city in Brazil and home t o 6 million people but more than 40% live in the city’s favela (urban slum) settlements ([23]). In 1969 there were 300 favelas in Rio, but migration from rural areas in search of work in the 80’s and 90’s, along with rising living costs in the city, means that there are now more than 600 favelas in Rio de Janeiro. Not only have favelas increased in number and size, they also have merged to form vast communities sprawling across adjacent hillsides. ([19]) In June 2007, we undertook our first Visible Voice project i n the Rocinha favela, in partnership with Viramundo, a Brazilian NGO working to support health development amongst Rio’s poorest communities (www.viramundo.org). Rocinha is the longest established and the largest of the favela settlements i n South America ([5]). Poverty, poor housing, inadequate sanitation, low levels of literacy and violence between police and local drug gangs dominate the lives of people living i n this community. Average earnings in Rocinha are around $245 per month compared to non favela residents in the same area of the city who earn on average $1330 per month ([19]).
    
    3. METHODS 3.1 Theoretical Foundations
    We take the view that social oppression thrives on the limited capacity for social analysis and initiative that exists within disadvantaged communities and we support the Freirean notion of raising critical consciousness as a key mechanism for social improvement ([7]). Paralleling Freire’s approach t o adult learning, Visible Voice places strong emphasis on engaging participants and researchers as co-creators of knowledge. In this way, we make explicit our desire to shift the power dynamics of knowledge creation away from researcher driven enquiry to a more egalitarian pursuit of knowledge through collaborative introspection. Most approaches to social research require participants to produce instant descriptions of their views, opinions and experiences, in language based responses to researchers’ questions. ([9]) In contrast our work places strong emphasis on maximising participant involvement in determining both the focus of research and collaborative analysis of emerging themes and issues. Visible Voice is, we believe, an exemplar of activity based, ethnographic action research situated within a wider tradition of visual sociology. The problem, as we see it, is that individual perceptions, cognitive processes, decisionmaking and individual motivations are complex. Language based responses to researcher questions do not always provide sufficient opportunities for participants to reflect before responding. Consequently responses tend to be narrowly stated and framed within the participants’ initial interpretation of researchers questions. The use of creative activities, such as photography and video, allows time and space for participants to construct metaphorical responses that can be modified, explained, justified, tested out and reframed by the authors depending on audience responses and their own developing understanding of the issues and messages. Through the use of creative activities the participant is, to a greater extent, the author of representations of his or her own life as it i s encapsulated and represented within the creative products. Visible Voice uses participatory video and photography in a similar way to Freire’s use of drawing and storytelling i n community education projects. ([4]) Workshop participants learn how to make films and take photographs in order t o illustrate and explain self identified issues. The use of creative activities allows participants to identify, reflect upon and articulate their views on lived experiences. The process of narrative construction encourages critical reflection on the relative value of influencing and contributing factors, and can also lead to identification of possible solutions. The videos and photographs created during the workshops provide a focus for ongoing discussion and debate within the group and, later on, within the wider community. In common with other forms of participatory visual research ([4]) Visible Voice seeks to • • • • Engage people in active listening and dialogue around community issues, Create a safe environment for introspection and critical reflection, Facilitate movement of people toward actions that can improve conditions in their own communities Inform the broader community and more powerful social actors to support social change.
    
    The Visible Voice process provides multiple opportunities for participants and researchers to engage in reflection and critical thinking. This includes deciding what to film or photograph, developing a narrative style, making editing decisions (determining what is important) sharing viewpoints, participating in collaborative dialogue, public exhibition of completed work and engagement with audiences at exhibitions and screenings.
    
    3.2 The Visible Voice Process
    Anthropologists and sociologists originally used photography and film as scientific tools to gather and record objective data. Visual records provided documentary evidence of social rituals and everyday life. Images were also used t o survey and document observable environments and practices such as dwellings and agricultural techniques. ([10]) Recently, visual sociology has moved away from a purely documentary approach and towards interpretive and creative use of visual images. Howard Becker, an early advocate for visual sociology, argues for critical analysis of the underlying meanings, motives and messages contained within and around visual images. For Becker documentary images are “social constructions, pure and simple. In this they resemble all the other ways of reporting what we know, or think we have found out, about the societies we live in.” ([1]) Within Visible Voice we focus on participatory visual communication as a process which allows people to speak for themselves ([2]). This process enables participants to address, consider and present their views on complex issues through a powerful, yet mundane, visual medium. Our analytical concerns focus largely on the authors of the message because, we believe, they are the people who shape content, perspective, and messages. We also observe the dialogue between participants during and after production and at the point of public exhibition. Our use of participatory video and photography challenges the norm within popular visual media, where experts or journalists report on an issue. In line with Becker ([1]) and others ([2]) we question the notion that communication is a product and consider the visual exhibits to be socially constructed representations, rather than objective records, of the views, opinions and experiences of the communities we work with. For us, the construction and dissemination of visual narratives is a process: a means t o understanding not an end in themselves. It is this process of constructing and communicating viewpoints rather than the specific message content that holds our interest.
    
    3.2.1 Recruitment and Selection of Participants
    
    Projects usually begin with an initial meeting with community members and an invitation to engage in participatory digital media workshops. Constantly shifting social conditions, uncertainty and changing personal priorities are a common experience for many participants in the communities that we work with in Kyrgyzstan and Brazil. The likelihood of successful engagement with communities in these kinds of settings is heavily dependent on researchers being able t o maintain an open, flexible, responsive creative approach t o their original research plan. The important thing to remember is that the research is about analysis of everyday life as i t arises in and around the process of narrative construction and not the completion or evaluation of workshop products. Completion of the workshop according to the original plan, attendance at workshop sessions and delivery of narrative products are a means to an end and not an end in themselves.
    
    3.2.2 Digital Media Workshops
    
    In each project, our aim is to assist participants to develop a ‘visible voice’ with which to clarify and express concerns, hopes, beliefs and lived experiences. During workshops participants, learn the basic skills and techniques that they will need help them create visual narratives. Groups work together to plan, and produce their own visual narratives illustrating important aspects of everyday life and health i n the local community. On completion, films and selected photographs are screened and exhibited to an audience from the wider community. Each workshop programme begins with a short introduction t o the research project, along with discussion and clarification of issues such as consent, copyright and personal safety before moving on to a technical skills session. The technical skills session (1- 2 hrs) uses examples of visual materials and narratives drawn for popular media sources to explore visual language, metaphor and messages. Participants also have opportunities to try out cameras and camcorders on simple point and shoot exercise. A whole group discussion of possible topics provides a starting point for the formation of smaller groups of four t o six people who work together on specific narratives. Each group determines narrative content and style. Technical guidance is given as required by members of the project team. Participants usually spend a short time story boarding and o n more detailed planning of content, narrative style, locations and outline scripts. The amount of time and attention spent o n storyboarding varies with considerably within each group. After some discussion, reminders about technical, ethical, legal and safety issues, groups are free to go out and capture images and video footage. Fig 1 Filming the Opening Shots for “Livestock Breeding” Kokjar
    
    for video editing and iPhoto for image editing and construction of slideshows or photo galleries. iMovie is a video editing application aimed at non professional users. The interface is straightforward and makes extensive use of drag and drop editing and icons which helps to keep text menus to a minimum. As such, it is ideal for use where language or literacy skills are an issue. Despite being directed at non professional users there are a wide range of special effects, titling and transition options included or available as third party plug-ins. iPhoto is a photo library application with limited, though very useful, image editing features such as crop, colour, brightness adjustments, sharpen, straighten and simple export options t o image file, web page, slideshow and QuickTime formats. Again, the interface is primarily visual and makes good use of drag and drop editing within a visually coherent structure.
    
    3.4 Dissemination and Collaborative Review
    Public viewing and review of exhibits is an important part of each project. Seeing their ideas and experiences framed on a video screen, or exhibited in a slideshow or photo gallery often changes the participants’ perspective on the issues raised in their work. Public exhibitions are often profound experiences for the producers and their audiences with a potential to make a significant impact on the lives of the individuals and the community. ([2]) Fig 2 Community Screening Tolok Village
    
    At various points throughout and at the end of each day, the project team (researchers and translators) meet with the groups to discuss the day’s events and progress with narrative construction. The project team also record and meet separately to discuss their observations of the process and to reflect o n themes and issues from the day. A summary of interpretations and viewpoints feeds into subsequent discussions with participants. ([20])
    
    Full quality DVD or VHS copies of all completed films, along with print outs of photo galleries or JPG files, are left with the participants. Copies of videos and selected photographs are also made available on the internet for wider distribution and discussion.
    
    4. THE PROJECTS 4.1 Kyrgyzstan
    The Kochgor valley is a dry mountainous region in central Kyrgyzstan. Tolok and Kokjar villages are about 6 hours drive from the capital Bishkek, assuming favourable weather and road conditions. Following a wave of emigration by Slavic and German populations in the immediate post Soviet period, the remaining population is now predominantly ethnic Kyrgyz. Social problems such as poverty and unemployment have intensified in the wake of the economic collapse in the early 1990’s. ([21]) The health of people living in these
    
    3.3 Hardware and Software
    During the projects, we use miniDV camcorders, digital still cameras and Apple laptops. Apple’s iLife software suite (www.apple.com/ilife/) is used extensively throughout the projects with most of the work undertaken using iMovie6 HD
    
    mountainous regions is also influenced by altitude, local agricultural practices and environmental conditions ([11]).
    
    4.1.1 Kokjar
    
    Kokjar lies at around 1700 meters above sea level in the Kochgor valley and is home to around 2,500 ethnic Kyrgyz originating from one tribal group. Coming from the same tribal group provides a degree of social coherence that i s noticeable in the community. Most families make their living raising horses, sheep, goats and a few cattle. In the summer months it is possible to grow a limited range of crops, although many villagers continue to live a semi nomadic life, migrating with their animals to the high mountain pastures during the warm summer months. There are no piped water or sanitation facilities to houses in the village and local people are currently dependent on rivers and open channel water supplies. Electricity supplies in the village are unreliable and there is no reliable landline or mobile phone coverage in the area. However, satellite TV is intermittently available, depending on local electricity supplies. With little employment other than shepherding, men in the village spend a good deal of time in winter watching TV, resetting satellite receivers and coping with staying warm between electricity supply interruptions. All the villagers had watched TV and had seen computers and cameras on TV but none had previous experience of using computers, camcorders or still cameras. The project began with a village meeting during which we introduced the projects to around 40 mostly male villagers. A village committee, consisting largely of older men from the community, administers the village. Women and younger men may engage in political debate but normally only after due deference to the village elders ([13]). At the village meeting the elders’ gave their approval for the project and after a few questions from younger members of the community about ‘what can be filmed and photographed’ ([13]) the elders they agreed permission that the films could cover all aspects of village life. On the afternoon of the following day, after numerous delays, we finally began the workshop at 2.00 pm. Four hours after our agreed start time! Throughout most of the workshop we had workshop a constantly changing group of 3 to 10 villagers entering and leaving the room. Even so, in less than an hour two groups had formed and were on the move equipped with cameras and camcorders ready to shoot footage for their films. Unreliable electricity supplies and lack of lighting in village streets meant that we had to work quickly to finish the films i n the short time available. The participants had very clear ideas about content and narrative structure before the workshop and decided to shoot footage in sequence. However, none of the participants had previous experience using a computer, so we decided, given the time constraints, that the physical task of editing films would be done by project staff under the direct instruction of the participants. This enabled the groups t o complete two films, from initial planning through filming and editing in less than five hours.
    
    groups and consequently there is little coherence evident i n village political life. Perhaps as a result of the lack of tribal traditions women appear to play a much more important role i n village affairs even though the nominal village elders are male. ([13]) The weaker social structure in Tolok was evident in the absence strong cultural traditions and family affiliations that contributed to overgrazing of pastures which had become dangerously destructive of the local environment. ([14]) Despite the social fragmentation evident in the village the participants completed two films during the workshop.
    
    4.2 Brazil
    Rocinha is Brazil’s oldest and largest favela settlement. Rising up the steep mountains that form the backdrop to Rio de Janeiro’s prosperous Ipanema and Leblon districts, Rocinha has been home to a growing population of migrants from deprived communities in the rural North East of the Brazil since the early 1960’s. According to local estimates, and i n contrast to official census data, Rocinha is home to between 150-200,000 people ([20]). Yet Rocinha is barely acknowledged on official maps and is poorly served by local health education and welfare services. An estimated $5m in drugs passes through the favela each month ([20]) and the interior streets of the favela are patrolled by young gang members armed with automatic weapons whilst armed police can be seen at their posts on the periphery of the favela. Drugs are not produced within the favelas and the profits from the drug trade do not remain within the community. As Vargas points out the favelas are “mere points of sale, nodes in a transnational web…the true drug barons are neither in the favelas nor of the favelas.” ([23]) The Visible Voice workshop took place in June 2007 i n collaboration with Viramundo, a local NGO working o n community health projects within the favela. Our original intention had been to offer two three day workshops over a ten day period involving two groups of 15-20 people from the favela. However, at lunch time on the first day of our workshop a shoot out between federal police and local drug gangs, resulting in the death of a policeman, raised serious questions about the advisability of proceeding with a video and photography project against the back drop of a potential street war between armed police and the gangs in the favela. After some discussion with the group we agreed to continue with the project but film only indoors until it became clearer how the conflict between police and the drug gangs would develop. As it turned out there was no further violence, but the potential for more violence proved to be enough to keep almost all male members of the group away from the project for the next few days. We revised and reorganised our plans on an almost daily basis at the request of the remaining participants and in response to the constant stream of participants who joined the project of the following days. By the end of the project around 25 people had captured 3 hours of video and contributed in some way to the production of three films and between them took in excess of 1,200 photographs over a 10 day period.
    
    4.1.2 Tolok
    
    Tolok village is situated in an isolated location, 2,300m above sea level, 25km away from Kokjar in the Kochgor valley. Originally established by Stalin as a place to locate dissidents from other parts of the Soviet Union ([14]) the village is now, in the Post Soviet era, entirely Kyrgyz. However this small community of 1500 people come from 17 different tribal
    
    5. DISCUSSION 5.1 Kyrgyzstan
    The Kyrgyz groups came to the workshops with a very clear idea of the stories they wanted to tell and spent little time o n
    
    planning during the workshop. Kyrgyz culture draws on a long oral tradition of storytelling with music and songs playing an important part in sustaining cultural identity ([13, 14]). The remote location, nomadic traditions and a relaxed approach t o daily life in the villages reinforced the importance of working with the community rather than to our original workshop timetable. Agreements were always made in advance about dates and times of workshops but these were rarely adhered to. Participants dropped in and out of the workshops on an ad hoc basis. Consequently, there was little opportunity to discuss the detail of planned narratives with the groups before filming commenced. In one case only 2 members of the filming group turned up at the workshop but reassured us that “there are more women in the group. They know what they are doing and will join us later”([13]) Video footage in Kyrgyzstan was mostly shot in sequence making editing simple and straightforward. This approach also made the storyline evident to non Kyrgyz members of the team supporting the film crews without the need for translation. After the first few scenes had been captured it was clear where the story was going and what the participants were trying t o achieve. ([13]) In both villages gathering the community for meetings, workshops and community screenings proved to be a challenge. Telephone lines rarely function and communication between the villages and the outside world is heavily dependent on word of mouth contact and people traveling through the valley. Although Ak Terek had a local activist i n each village who was paid a small fee to keep the community involved, and meeting times and dates were agreed in advance, arrangements were frequently forgotten by villagers. Locating key members of the community usually involved going from door to door asking if anyone knew where people were. Most often we were met with the response “he might be up in the pastures with the horses” ([13]) Kyrgyz participants speak Kyrgyz, a Turkic language common amongst ethnic Kyrgyz living in rural areas of Kyrgyzstan. Translators needed to be fluent in Kyrgyz and also have a good level of competency in Russian and English. The Kyrgyz language has few scientific or technical terms such as are likely to needed for working with digital technologies. Direct translation from Russian or English to Kyrgyz was complex. For the most part we found it more straightforward to use gestures and practical demonstrations to support use of the cameras and computer software.
    
    of the workshop the project team were caught in between a gun battle between police and local drug gang members, during which a federal policeman was killed. This provided us with a dramatic reminder of the day to day dangers of life in the favela. The tension in the favela after the gunfight prompted a discussion about the ‘normality’ of violence in the favela. Some of the group felt that this was “just a normal part o f living in the favela” so we should just carry on with the project. Others rejected the idea that the violence was ‘normal’ arguing that although it was ‘common but not normal to have to live in crossfire between police and the drug gangs”. The group as a whole were keen to convince us that we should keep the project running as they felt they had few opportunities t o express their views in the course of their everyday lives. ([20]) The threat of continued a potential invasion by armed police did affect attendance on subsequent days, especially amongst the young men in the group. After some discussion between the participants and project team about the risks of working with video and photography in the favela we agreed to carry o n with the project although with a smaller group of young women and a few older men who felt less exposed to the risk of retaliation from the police. Attendance became variable and fragmented over the next few days with numbers varying between 3 and 20 people attending the workshops on different days. However, the remaining participants were enthusiastic and worked late into the night on some days to complete their projects. Most participants had little, if any, previous experience of working with computers, cameras or video equipment. However the visual emphasis of the project and the intuitive nature of the software made learning new skills relatively straightforward for most people. A small number of participants had experience of working on community video projects although these were always been filmed and edited b y ‘expert’ users. Despite language, and occasionally, literacy issues, the participants adapted to the software environment quickly and were independently editing video and photographic materials within 10 minutes of importing media. ([20])
    
    5.2.1 Motivations and Messages: Kyrgyzstan
    
    5.2 Brazil
    Participatory research is based on the phenomenological paradigm, which accepts that knowledge is a consequence of social interaction The notion of a binary opposition between researcher and research subject of research is rejected leaving the research environment open for collective participation i n determining focus, sharing interpretations and reviewing competing analyses. The participatory research process is an ongoing negotiation between researchers and participants about the nature, meaning and significance of events, actions and interpretations. Recognition of this makes it possible for participatory researchers to work in challenging and constantly changing social environments. We had planned to offer two separate 3 day workshops i n Rocinha. Initially we recruited a mixed group of 24 people who joined the first workshop. At lunch time on the first day
    
    Different participant motivations and messages were evident in each project. In Kyrgyzstan, the participants’ primary motivation was to express their views on local conditions t o others in their community and to use the films in support of applications for funding from agencies such as Ak Terek. Although there were no computers in the villages and none had ever accessed the internet, Participants were conscious that their films would also be screened to a wider audience around the world via the internet. ([13]) The four films produced during the Kyrgyz project follow a straightforward reporting style. Different members of the group took on the role of reporter and interviewed local people about their lives in the village. At times questions were pointedly seeking confirmation of group views about health challenges in the village. The films illustrate different aspects of Kyrgyz culture, the harsh climate and living conditions, and the needs of women and young people living in the villages. They also raise concerns about poor nutrition, hot water, water supply and the difficulties of living in remote mountain areas. There is an explicit focus on the climate, poverty, womens working lives and their influence the health of the population and the difficulties of womens lives.
    
    Film 1 Kyrgyzstan “Livestock Breeding” Kokjar Village
    
    but at the village screening, he decided he wanted his contribution taken out of the film. He argued that as the film also showed a member of the group drinking water directly from the open channel this might make things difficult for him with his employer. Interestingly he also pointed out that the film would also be seen by audiences via the internet and felt this was not a good way to represent the village to the rest of the world. After a debate between the young film makers and the older man they agreed to remove the interview from the film. In Kyrgyz society, young men rarely make a public challenge against the views of older men. But the film makers were proud of their work and were keen to defend their representation of life in the village. This incident provides interesting example of how engagement in the creation of visual narratives can transform relationships in communities. Film 3 Kyrgyzstan “Health in a Mountain Village” Tolok Village
    
    Filming was shot in sequence using a standard report style. The film begins with opening shots of the reporter introducing the audience to the village against the backdrop of the Kochgor valley. The film moves on to focus on livestock breeding and following the production process through from sheep sheering through washing wool to making clothes. In the process the film illustrates the everyday experiences of women in the village. Some direct references are made to the relationship between women’s lives, social conditions and health challenges. “It would be better to rinse it out in warm water if we could. Then life would be much easier for women. It would be easier for women if we had the proper conditions. We wouldn’t get so tired” Film 2 Kyrgyzstan “Everyday Life in our Kyrgyz Village” Kokjar Village This film explores local environmental conditions and their relationship to health as well as discussing issues around womens’ lives in the village. Reporter “What do you think about your work what would make it easier?” Interviewee “I’d like to make it easier but I don’t know how to. If my work was easier I could look after my health better. Women’s work is very hard, especially on your hands and feet Women’s lives here are very, very hard and difficult.” The Kyrgyz people are optimistic and rarely voice the possibility of worsening conditions in the future in the belief that speaking about future potentials makes them more likely to occur. ([18]) The film ends with a typically optimistic Kyrgyz wish: “We wish our people good prospects and peace in the future. Let our village become a richer place to live and enjoy more fruitful projects in the future.” This film was made by a group of young men from the village and focuses on their proposal for investment in ‘sports facilities’ for young people in the village. The proposal i s linked to perceived problems with alcoholism, smoking and lack of physical fitness amongst young people. The film also shows the drinking water supplies in the village which proved controversial at the village screening. The original film included an interview with a villager who was working on a project to bring a closed water supply to the village. It was one of the few positive developments in the area
    
    Film 4 Kyrgyzstan “Mountainous Tolok” Tolok Village
    
    inappropriateness of medical training, health care rights and inadequate service provision. Film 1 Brazil “Visible Voices of Rocinha”
    
    In this film the group examine health and everyday life in the village and also show examples of bread making, clothes production and comment on poor transport and communication networks and the lack of sports facilities for young people in the village. The main focus of the film is o n the difficulties of life in an isolated mountain village where growing crops is limited by cold, dry climate and long winters. “Fruit, vegetables and cereals don't ripen here because of the climate. The only vegetables we can grow are carrots, potatoes, garlic and beets. “life is difficult here in the mountains and the deficiencies o f vegetables and fruit affects people's health. This results in a high rate of heart attacks, strokes, anaemia and brucellosis in the village”
    
    This is the main film from the project and makes use of interviews with local residents, medical students, academics and the president of the Brazilian National Institute for Health (Fiocruz) to raise issues about health services, access to health care, and medical training in relation to conditions in the favela. Film 2 Brazil “An Interview with Paulo Buss”
    
    5.2.2 Motivations and Messages: Brazil
    
    Participants in the Rocinha project in Brazil demonstrated a clear political motivation and a strong desire to raise issues of social and political concern. The groups changed frequently but there was always a continuous debate and reflection on the direction of the film. Issues such as whether to include ‘outsiders’, the quality of contributions from Rocinha residents during street interviews and the variable attendance at the workshops took up some time on almost every day of the project. For the most part the participants worked through these issues independently only occasionally coming back to the project team to clarify the extent to which they could make their own decisions. Trusting outsiders- the project team in this casewas a constant issue that was raised in discussions amongst the participants. The whole project revolved around issues of trust. For the participants the issue was the extent to which they were ‘allowed’ to determine content and style. For some of project team the project was a new way of working and entailed a risk that the participants would not engage with perceived health problems in the favela. Trust was required o n both ‘sides’. The group eventually completed three films. One short film about a local Capoeira group and two films based around interviews with the President of the National Institute of Health, the Head of the Faculty of Medicine at the University of Rio de Janeiro, medical students and Rocinha residents. These films contain explicitly political messages about the
    
    A film crew were given an opportunity to interview Professor Paulo Buss, President of the Oswaldo Cruz Foundation (National Institute for Health) The interview, it’s editing and inclusion in the project films, proved to be controversial. One influential member of the group argued forcefully against including the interview i n project films. At that time, the group were working on a single film to represent the whole project. Group debate centered around the balance between interviews with ‘outsiders’ and Rocinha residents. Although it wasn’t a view that was widely held within the group the argument was forcefully put by a dominant member of the group. As a result, only a very short segment of the interview was included in the film. Other participants wanted to include more footage from the interview and decided to go ahead and produce a separate film.
    
    The second film included the Presidents’ views on issues such as TB, the overemphasis on hospital based medical skills i n medical training and the need for political engagement b y favela communities. The experience of interviewing and filming in the grandiose surroundings of the Fio Cruz headquarters provided a potent example to the participants of how useful visual media can be in gaining access to powerful social structures. Discussions about the violence in the favela inspired some participants to seek out more positive ways to represent everyday life in Rocinha. This was evident in the decision to take a series of photographs contrasting the bleakness of open sewers and narrow alleyways with portraits of favela residents at work, market stalls and panoramic views over the rooftops of the favela. A discussion about the negative way that the favela is represented in the media during the workshop, led to the making of a short film featuring a local Capoeira group i n action on the rooftops above the favela streets. The film demonstrates the strong cultural connection that many Brazilians feel towards their African cultural origins. Film 3 Brazil “Acorda Capoeira”
    
    6. CONCLUSIONS
    Creative research strategies, such as participatory video and photography represent a new form of research which enables people to communicate in a meaningful way about their own lives, thought and experiences. ([9]) The Visible Voice projects make the researchers’ gaze explicit within the research process. The process also draws attention to the relationship between researcher and the researched, the observer and the observed. They focus our attention on who is in control of the technology, what is being filmed or photographed and how visual narratives are produced, ([12]) disseminated and received by different audiences. They represent an optimistic, trusting approach to research that is founded on a belief that the participants can generate interesting theories and observations themselves. ([9]) Visible Voice, provides a different way into a research question. The reflective process of creating visual narratives takes time and the act of making something that you can look at, think about and change, i s different to responding to interview or survey questions. Like other creative strategies the Visible Voice process “engages the brain in a different way, drawing a different kind o f response” ([9])
    
    6.1 Transformation
    Each of the Visible Voice projects has demonstrated it’s own unique characteristics and participants have presented distinctively different approaches to working with video and photography. The focus of attention was usually on ‘telling the story’ and the participants paid little attention t o developing computer skills. The Kyrgyz groups had the clearest sense of narrative, which seemed to have been in place even before the workshops commenced. The Brazilians engaged in ongoing debate about the politics of everyday life, the need to mobilize the community and differences of opinion about the inclusion of interviews with outsiders. In each case, there is evidence of the transformative affect of working with visual technologies. Although we have not been able to maintain contact with villagers in Kyrgyzstan, due largely to the difficulties of communication and transport, students at the medical school have now begun to take photographs and make films as part of their education working to alleviate the many public health challenges in Kyrgyzstan. Recently we have been contacted by Ak Terek and other Kyrgyz agencies with request to return to the villages and t o train local researchers and community workers in the use of participatory video. There is also evidence of personal development amongst the participants. The most prolific photographer in the Rocinha project told us “At the start I was not sure if I was capable o f taking photos” but after the workshops she said “I should be proud with the results. I cherished so much peoples’ comments on our work… everybody is happy” ([20]) Participants also report a change in their understanding and awareness of the issues addressed in the narratives. “I have acquired a better vision about health problems in Rocinha. It was very emotional for me seeing our finished work! Before the workshops, filming, photos and interviews I had only a vague notion about these issues. Afterwards, I could see with more accuracy how rats and garbage and our lack of concern for ourselves can represent a true danger for human health” ([20])
    
    5.2.3 Mobilizing the Community
    
    Throughout the project participants made clear their desire t o ‘mobilise the community’ ([20]) in pursuit of a better life i n Rocinha. Post workshop reviews demonstrate a self critical approach to the organisation of the workshops and reflect the desire of some members of the group engage large numbers of people from Rocinha in the project. Unfortunately, the violence in the favela on the first day affected attendance o n subsequent days. Yet, those who attended were able t o complete their films and also constructed and exhibited eight slideshows and a photo gallery at the community screening.
    
    5.2.4 Gender
    
    The enthusiasm of women for working in participatory video projects has been noted in elsewhere [[25]] and this was evident in the Brazilian and Kyrgyz projects where women outnumbered men at the workshops. In Kyrgyzstan three of the four reporters in the films were women and these films included a strong focus on women’s lives. In Brazil many women had to balance their attendance at the workshops with childcare responsibilities and the threat of conflict between the police and drug gangs on the street.
    
    Others spoke directly about the opportunity to tell their own story and to understand their lives in a different way to that presented in the ‘Big Media’. “the Project gave us a rare opportunity to make visible to the people of Rocinha issues quite different from violence. I mean the Big Media almost always interviews us only when there i s a shooting inside the favela. So, for me it was important t o talk to the people, to enter into their homes and lives, to know a little bit more about human nature, to understand that everybody has something to contribute, and pass all these things on to other people through the films we made.”([20])
    
    6.2 Moving on
    The Visible Voice projects started as small scale visual ethnographic studies but have since extended into an extensive international collaboration between researchers, project participants, students and health professionals with an interest in community development and visual activism. The development of the Visible Voices Social Network (www.visiblevoices.ning.com) and recent changes to the project and partner websites now enables participants t o upload new images and films to galleries providing a participatory online environment for further project activities. The Rocinha Films have been exhibited at numerous events
    
    over the last few months including public screenings t o audiences of 400 people at a planning event for the World Social forum conference taking place in Brazil in January 2008. We believe that the ongoing use of project materials and the continued involvement of participants in photography and video projects in Brazil and Kyrgyzstan represents an emerging ‘visual activism’ amongst the local communities. By visual activism we mean the self directed use of visual materials to raise public awareness and stimulate debate around social issues. This is particularly evident in Brazil but is also present in the engagement of students and NGO’s i n Kyrgyzstan in the use of participatory visual methods for community development.
    
    7. ACKNOWLEDGMENTS
    We would like to thank all of the people who participate in and support the Visible Voice projects including those who gave their time to help with transport, translation and day-to-day logistics. Local arrangements for these projects were organised by the Ak Terek Foundation (Kyrgyzstan) and Viramundo (Brazil). The projects were supported by financial grants from the Centre for Health Research and Practice Development and the Research and Development Fund (University of Cumbria).
    
    8. REFERENCES
    [1] Becker, H., S. 1995. Visual Sociology, Documentary Photography, and Journalism: It's (Almost) All a Matter of Context. Visual Sociology, 10 (2), 5-14. [2] Bery, R. & Stuart, S. 1996. Powerful Grassroots Women Communicators: Participatory Video in Bangaldesh. In Servaies, J and White, S (Eds.), Participatory Communication for Social Change. London: Sage. [3] Braden, S. 1999. Using Video for Research and Representation: basic human needs and critical pedagogy. Learning, Media and Technology, 24:2, 117 129. [4] Carlson, E. D., Engebretson, J., and Chamberlain, R. M. 2006. Photovoice as a Social Process of Critical Consciousness. Qualitative Health Research (6), 836852. [5] Cavalcante, S. Soares, E., Pacheco, A Chaisson, R, and Durovni, B. 2007 Community DOT for tuberculosis in a Brazilian favela: comparison with a clinic model International Journal of Tuberculosis and Lung Disease 11(5):544–549 [6] Centre for Addiction and Mental Health 2004 Photonovella Health Promotion Project Ontario, Canada available from www.camh.net/About_CAMH/Health_Promotion/Comm unity_Health_Promotion/photonovellas.html [7] Freire, P. 1996. Pedagogy of the Oppressed Harmondsworth, Penguin Books. (Originally published 1970) [8] Gauntlett, D. and Holzwarth, P. 2006. Creative and visual methods for exploring identities. Visual Studies, 21,1. [9] Gauntlett, D. 2007. Creative Explorations: New Approaches to Identities and Audiences. Routledge. [10] Harper, D. 2002. Talking about pictures: a case for photo elicitation. Visual Studies 17:13-26. [11] Kasymov O.T., Djusupov K.O., Mambetaliev B.S. 2003 Occupational Health in the Highlands of Kyrgyzstan Central Asian Medical Journal. Vol 9. 54-59. Russ. [12] Kindon, S 2003. Participatory video in geographic research: a feminist practice of looking? Area 35:142153. [13] Kyrgyzstan: Fieldwork Notes April 2006 Kokjar and Tolok Kyrgyzstan [14] Kyrgyzstan: Interview April 2006, Nazgul Esengulova, Director, Ak Terek Public Fund, Bishkek, Kyrgyzstan [15] MacLeod, P. 2004. Participatory Film making and Video - Building on the legacy of the Fogo Process. Symposium on Communication for Social and Environmental Change, University of Guelph, Canada. [16] McKee, M., Healy, J., and Falkingham, J. 2002. Health Care in Central Asia. Buckingham: Open University Press. [17] National Statistics Committee. 2005. Kyrgyzstan in Figures. Bishkek, Kyrgyzstan p305 [18] O'Brien, V, Djusupov, K and Kudaibergonova, T. 2005. Public health challenges in Kyrgyzstan: developing a new curriculum. Rural and Remote Health 5:461. [19] Perlman J E. 2003. The Chronic poor in Rio de Janeiro: What has changed in 30 years? Conference on Chronic Poverty, Manchester, UK April 7- 9th 2003. [20] Rocinha: Fieldwork Notes June 2007 Rio De Janeiro, Brazil [21] Sargaldakova, A., Healey, J., Kutzin, J., and Gedik, G. 2000. Health Care Systems in Transition: Kyrgyzstan. European Observatory on Health Care Systems: Copenhagen [22] Toigonbaeva V.S., Usubalieva J.M., and Belekov J.A. 2006, Helmintofauna of Kyrgyzstan. International
    
    conference of public health specialists, 26-27 April Bishkek, Kyrgyzstan [23] Vargas, J. C. 2003. The Inner City and the Favela: Transnational Black Politics. Race and Class, 44(4), 1940. [24] Wang, C. and Burris, M. 1997. Photovoice: Concept, Methodology and Use for Participatory Needs Assessment. Health Education and Behavior 24:369387. [25] White, S. A. 2003. Participatory Video: Images that Transform and Empower, London: Sage.

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