Now that I’ve mentioned it to her, Ms. Pacidal—an Amis Indigenous woman in her 80s—starts to fiddle with the watch on her left hand. It has a black, square, and boxy plastic face, on which shines a dimly lit screen that shows the date and time, location tracking services, and a daily step count. “It’s light,” she says. “In fact, almost forgettable!” It’s secured on Ms. Pacidal’s arm with a rubber strap, and she tells me that she has not taken it off for months.
“It goes with me into the shower, when I cook, when I clean. And the battery lasts for almost a week. So it’s almost invisible,” she says.
“So invisible,” a nearby care worker interrupts and laughs, “that it’s measuring her vital signs and she doesn’t even know!”
Ms. Pacidal laughed, and pulled her long flannel sleeve back down to conceal the watch—like it didn’t even exist.
Ms. Pacidal’s smart watch, which features a dimly lit screen showing the time and date, location tracking services, and a daily step count. Image by author.
In Taiwan, the Amis, or Pangcah, and other Indigenous communities that make up 2 percent of the country’s population have historically endured a glaring ten-year life expectancy gap in comparison to their Han counterparts. They have been subject to over 500 years of successive Dutch, Spanish, Chinese, and Japanese imperial forces, not to mention today’s settler democracy, which, like the United States, praises itself as a liberal multicultural haven that nonetheless takes for granted the deep material inequalities of Indigenous communities and migrant workers.
In 2016, President Tsai Ing-wen issued the country’s first official apology to its Indigenous peoples, launching a new wave of historical and transitional justice initiatives across numerous government sectors. But, interestingly, rather than addressing the enduring material effects of Indigenous dispossession in Taiwan—from land loss to economic inequalities—these new initiatives have overwhelmingly centered on practices of technological inclusion and “diversity work” (Ahmed 2012). In public health, these new ideas of community-based technological innovation are upgrading classic settler intentions to “do good” through Indigenous health with a digital twist (Kowal 2015, cf. Lea 2008 and Stevenson 2012).
Ms. Pacidal’s new smart watch is the result of such policies. For almost two years, I conducted ethnographic research in and around Cultural Health Stations (文化健康站 wenhua jiankang zhan)—local public health institutions in Indigenous communities dedicated to rectifying the life expectancy gap, which have exploded in number, from eighty to 481, in the decade following President Tsai’s apology. Cultural Health Stations provide medical services each weekday morning to the community as well as promote free Indigenous-centered exercises, cultural activities, and meals to local elders as a way of sustaining cultural and physical health. But at a select number of Cultural Health Stations, Indigenous elders, like Ms. Pacidal, have been given an array of medical technologies, like these smart watches—a consequence of government-sponsored partnerships between local hospitals, public health institutions, and health technology companies.
From my conversation with Ms. Pacidal, I was fascinated by the seeming invisibility of these watches—like they didn’t even exist. From the wired to the wireless (Mackenzie 2010) to the wearable, it seemed at once that these watches partook in a teleology of technological experience that mirrored the increasing invisibility of the innovations that surround us. But it was through probing Ms. Pacidal about this invisibility that some of the more alarming dimensions of these free health wearables began to surface.
“How are you so relaxed with the watch? Aren’t you always checking your health data?” I asked Ms. Pacidal. “Everyone I know with health wearables is obsessed with monitoring their daily statistics.”
“Maybe I would be,” Ms. Pacidal said to me, “but I usually can’t see that data.”
“The statistics are collected by the local hospital and archived in case public health bureaucrats ever need to access it,” her care worker at the Cultural Health Station explained to me. “And their families can see it in case there’s some sort of emergency. But it’s not like those fancy, hi-tech wearables that connect to apps on your phone or something like that. These are a little more simply practical—in case vital signs are off, we know; or, some of our elders have dementia and get lost, so we can ask the hospital for their location if need be.”
As an occasionally digital ethnographer, I was fascinated to learn that following the data, to modify George Marcus’ (1995) formulation, could reveal a landscape of institutional power and inequality that couldn’t be detected at the level of personal experience. While Ms. Pacidal herself seemed comfortable with the watch—almost too comfortable with its non-presence—it was only through following the movement of information upstream of that experience that different dynamics could be ascertained.
Indeed, the very design of these wearables—lightweight, low-tech, barely visible, designed for passive data extraction—echoes a broader aesthetic and political logic of settler governance: the more invisible the intervention, the more benign it appears. Yet this invisibility is precisely what renders it powerful. For Ms. Pacidal, the device fades into the background of everyday life, but for the institutions that gather, store, and analyze her data, the watch remains fully present—always on, always watching. This disjuncture between bodily experience and institutional legibility reveals how wearables can become tools of asymmetric surveillance, justified under the banner of care.
Newer anthropological research on health wearables has usually focused on how consumer technologies like fitness trackers ground eugenic principles of human health or transform the relationships between individual humans, bodies, and societies (Tamminen and Holmgren 2016, Ruckenstein and Schüll 2017, Lupton 2020, Vora 2024). When such research has instead focused on global Indigenous communities and government-sponsored, often “humanitarian wearables” (Sandvik 2020), it often highlights the generative potentials of wearables to advance Indigenous health through provisional digital intervention (Jones et al. 2017, Cooke 2021, Henson et al. 2024)—an updated manifestation of “the biotechnical embrace” (Good 2001).
But thinking through the materiality of data and its flows in the case of Ms. Pacidal can open us onto a different set of analytical considerations. While health wearables certainly have produced alarming transformations at the core of our psychological and bodily experiences, they also have the potential to re-entrench existing forms of colonial power in unexpected ways. That Ms. Pacidal has no access to, or ownership over, her health data returns us to long-lasting concerns over stewardship and sovereignty that cannot be ignored by even the most seemingly inclusive or benevolent of multicultural health efforts. Much about the management of this data—how it is organized, who provides regular maintenance for the servers, and whether or not leaks or theft have ever presented significant issues—is black boxed by state power.
We might thus helpfully introduce questions of Indigenous data sovereignty (Kukutai and Taylor 2016) to the study of health wearables in new ways, shifting the conversation from unilateral concerns around consumer behavior to questions like: How are experiences with health wearables made unequal, depending on one’s subject position and relationship to data access and ownership? And outside of the consumer world, how do wearables simultaneously present a way of improving health inequalities and an opportunity to re-entrench settler-colonial dynamics in the digital sphere?
Turning from consumer psychology to different questions about Indigenous stewardship and data sovereignty can indeed inspire thinking about communal digital possibilities for all. For instance, scholars have written about how Fitbit and other technologies of mobility can actually help to produce novel community solidarities in occupied and colonized territories where movement is restricted (Meneley 2019). Or, in public health, models like the First Nations Health Authority (FNHA) in British Columbia might provide compelling alternatives as they allow Indigenous communities to govern, interpret, and mobilize their own health data. While the language of an easy technological “solution” certainly cannot undo the history of Indigenous injustice in Taiwan, it is important to remember that new technologies always also bring with them novel ways of imagining material relationships—of ownership, use, and control. To stay with such possibilities would entail not just denouncing health wearables altogether or aspiring toward a technology-free past, but would allow us to locate different ways that the trajectory of wearables might be changed to emphasize new relations of governance and self-determination.
This post was curated by Contributing Editor Paige Edmiston.
References
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