Chapter Five was about understanding access to healthcare through ownership of devices and mobile-cellular network (eHealth). Among the participants, 38 (22 male and 16 female) had smartphones and 24 (15 male and 9 female) had regular mobile phones. The smartphones had Android operating systems. Two male participants had both smartphones and regular mobile phones. About 15 participants admitted that they had more than one SIM card. However, discussion on multiple SIM cards was not comfortable for the participants. The probable reason for this discomfort was the ongoing campaign by the Government of Bangladesh asking for the registration of all SIM cards with legal documents and identifications. Nine participants (five male and four female) had laptops in their households. The laptops mostly belonged to their older siblings or other older family members. For most of the, laptop was accessible by the corresponding participants occasionally. One of the female participants said: ‘… amar
bhai gotobochor ekta laptop kinse. Shathe internet modem. She oita diye chobi dekhe, gan shune. Abar majhe kaj kore. Ami majhe boshte pari, kintu she na thakle boshi na. Bhai na thakle laptop dhorle she khub raag kore. To be beshi ghataghati o kori na, Jodi nosto hoye jay?’ (‘My brother brought a laptop last year. He uses it to watch movies,
listen to music and sometimes for work. I am only allowed to use the laptop if he is around. But I do not use it much. What if I mess it up?’)
During discussions about access to computers, I considered both personal and household ownership. So, I asked everyone: ‘so, you have no preference about using a computer?’ Almost everyone mentioned the computer labs at their college. ICT is part of the secondary and higher-secondary school curriculum nowadays. Thus, any educational institute ideally has a computer lab with desktops no matter how old it may be. Most of my participants were students of Mirzapur Degree College. The computer lab at the college has about 30 computers. And the students have occasional access to these computers, especially during classes. So, I asked again, do you use those computers? Almost everyone agreed that they do not because the lab remains locked except for during class time, the computers are too slow, and
the lab is not for personal need. One of the male student participants mentioned: ‘… college computer gula
ekdom slow. Khulte pray 10 minuter upor time ney. Ar pray shomoy-e internet kaj korena. Internet o khub slow. Kaj kora shombhob. Ar tachara oi lab ta to talabondho thake. Official proyojon ba class na thakle khula hoy na.’ (‘The computers
at our college lab are too slow to work on. They take about 10 minutes to boot up. Besides the internet is very slow and doesn’t work most of the time. It is impossible to work on these computers. Besides it is locked most of the times unless there is some official work or class’).
During the interview, we discussed whether the participants were happy with their devices. The assumption was that being unhappy with their phones could may be a barrier to accessing eHealth. When asked, 32 respondents (19 male and 13 female) were found to be happy with their mobile phones and the rest were unhappy. Both the happy and the unhappy group had either smartphones and/or regular phones. It was not that only the regular phone owners were unhappy because they wanted smartphones. Happiness was a compromise made based on affordability. In some cases, unhappiness came from the will to switch to a smartphone or to a better smartphone. No one who mentioned their devices’ ability to navigate health information or services could mention any health portals. In some cases, reasons for happiness referred to their phones’ technological ability to take photos, offer games, show movies or Facebooking. One of the male participants mentioned: ‘… ei je dhoren amar hater phonta te ami shontushto na.
Eita diya chobi tula jay na, game khela jay na, majha majhe button o kaj kore na. Bibhinno bishoye jante gele bhalo phone dorkar hoy ar tar jonno lage taka. Taka hole ami obosshoi bhalo ekta Samsung phone kinbo’ (‘… for example, my
phone cannot take picture and I cannot play games. Sometimes, its buttons do not work. If you want to know about different things, you need a good phone. And that requires money. If I could afford it, I would have bought a Samsung phone’).
It was evident from the discussion that the affordability of technology was not limited only to the cost of switching to a new phone or having a fancy smartphone. It was also related to internet use, sending SMS messages and talk time for voice calls. Especially in the case of internet use, considering the cost, most college students were interested in spending their time and money on social networking rather than looking for any information or services, let alone health. As one of the male participants mentioned:
‘… internet-er dam emnitei beshi. Joto tuku pai, sheita diya amar kajer jinish dekhi. Jemon dhoren facebook kori. Oi khane onek kichu shikha jay dekha jay.’ (‘Internet is expensive. Whatever allowance I get, I prefer to spend
it for my work. For example, on Facebook. One can learn and watch many things on Facebook’). In addition, some mentioned the cost related to using call centres. Although nobody could mention any health portals, all of them were aware of the existence of various health call centres especially the network- run ones. One of the female student participants said: ‘… shob ta tei taka lage. Amra shikkharthi, taka pabo
koi? Ar call center sheta teo taka lage. Ami to jibone shastho sheba nei nai phone diye. Tateo nishchoi onek taka lagbe. Kokhono ora lukay taka ney.’ (‘Everything needs money. We are students, where would we get money from?
And call centres, that needs money too! I have never used health services with my phone. I am sure that’s very expensive, too! Sometimes they have hidden costs.’)