This activity aimed to catalyze local interest in the UN Decade of Healthy Ageing and its enabler on hearing the diverse voices of older people and strengthening their meaningful engagement in the key action areas to foster healthy ageing. A major challenge in the Decade is to ensure that the human rights of older people are championed, including their rights to be heard and to participate in decisions that affect their lives. The Participatory Video (PV) process was selected as an innovative, creative and collaborative methodology for older people at the grassroots level to explore issues of healthy ageing in their own way, represent their perspectives as they wish and be in control of the process, including initiating dialogue with their wider community and local decision makers. This moves them into a process of meaningful engagement rather as passive informants in tokenistic, extractive and externally driven agendas. The Decade centres human rights and adopts the principle of leaving no one behind as enshrined in Agenda 2030 for Sustainable Development. Indigenous people are identified as one of the world’s most excluded and left behind population groups, often not counted, considered or even heard in many areas of policy making and planning across many sectors. This focus on human rights and participation is also aligned with the 2002 Madrid International Plan of Action on Ageing.

Older people in general, Older people with chronic health conditions or disability, Older people with vulnerabilities, Both older and younger people

Education, Health, Housing, Information and Communication, Labour, Long-term care, Social protection, Transportation, Urban development

Government, Civil Society Organization, Older People's Association, Academia, Health Care, Social Care

Older people were part of the process at multiple or all stages

The initiative was a collaboration between HelpAge Canada (an Affiliate Member of HelpAge International), InsightShare, the World Health Organization and Regional Office for the Americas / Pan American Health Organization. With the consent of national and local authorities, an InsightShare Facilitator based in Canada set up and ran the PV cycle, supported by HelpAge Canada. The Noojmowin Teg Health Centre hosted and provided transport and local liaison. The PV cycle consisted of five distinct steps: an intensive workshop (12 days) using participatory exercises to explore healthy ageing using the Decade’s Action Areas and learning to use equipment; a consensus-building for planning the film and storyboarding; filming of community voices and scene setting; participatory or collaborative editing; and a community screening for reflection and action. Collaboration was built through peer-to-peer training, topic exploration and a Group Agreement for practicalities and preferences. Games (e.g. “Video Statements”; “A great day in my life in ten years’ time”) and energizers (e.g. “Mirror Me”) helped the creative collaborative process, build skills and spark ideas. In small groups, the older people discussed questions about fostering healthy ageing, capturing responses on flipcharts and colour cards categorized into challenges/barriers and solutions/recommendations. Collectively they grouped results and identified interconnections to use as the basis for planning the filming stage. In different groups, they filmed stories and recommendations in the Healing Lodge and at other locations and illustrative scenes and translated voice-overs from the Ojibwe language. They collectively agreed who from the local community, decision-makers and media should be invited to the screening.

The older people gained new abilities to explore healthy ageing from a range of perspectives. Demystifying new technology and gaining digital skills was also seen by them as a positive, empowering and confidence-building experience. The Health Centre responded by waiving the venue hosting fees to enable the group to buy their own video equipment and receive further training in their new kit from InsightShare. Friends, neighbours and family members of the older people were involved in interviews, dramatized scenes, drone footage and the soundtrack and so also became participants in conversations about healthy ageing. The local screening included the wider community and decision-makers, attracting local media coverage. Post-screening discussion highlighted the need to shift thinking. For example, a Member of the Provincial Parliament said: “There are lots of good recommendations in the video. We need to look at what has been mentioned. There is a lack of communication of these needs to policy makers. The resources are not flowing.” A Wiikwemkoong Elders’ Council Member recommended that: “Administrators, decision makers, politicians need to pay attention to the views of older people. They need to all watch this film”. Mental health was also highlighted as key to healthy ageing. The older people powerfully included reference to the traumatic history of the Residential Schools which removed indigenous children from their families, inflicted abuse and deprived them of their languages. The project enabled them to emphasise the importance of valuing, preserving and transmitting their indigenous languages, crafts (e.g. beading) and cultural practices (e.g. singing and drumming) for health, wellbeing and intergenerational connection.

We faced many challenges of logistics, risk assessment, safety and cost doing community-based participatory activities on Manitoulin Island during the COVID-19 pandemic. A protocol for minimising transmission risk was developed with the local authorities, including testing, masks and sanitizers available. The group complied with safety rules, worked outside as much as possible and ensured inside spaces were well ventilated, and everyone involved was keen to make the most of the opportunity. The local screening was on Zoom due to an outbreak. This experience shows that a PV process is possible and can be managed safely even in challenging circumstances. In addition, for indigenous people, using their own languages is key to their identity and expression of their authentic voice. Regrettably, the budget for our activity did not sufficiently account for the time and resources needed to ensure that all the older people could use their indigenous languages, except for a few opening statements that were captioned in English. Future PV work for the Decade engaging indigenous people should address this, particularly in the context of the International Decade of Indigenous Languages 2022-2032. Finally, one of the Decade’s action areas is changing how we think, feel and act about age and ageing. This can expose intergenerational tensions. However, rather than complaining about young people as the cause of intergenerational tensions, the older people spoke instead about earning the respect of children and young people to build relationships. They recommended screening the video with young people, to inspire them to care for themselves and discuss mutual respect.

Many projects related to older people ask them to reminisce and think of their past. However, right from the start, the Manitoulin Island group chose an optimistic, forward-facing narrative. They demonstrated humour, curiosity, energy, wisdom and dedication to serve their community, in contrast to negative stereotypes of older people as passive, disengaged, dependent and vulnerable. They picked the storyboarding exercise “A great day in my life in ten years’ time” to work on individually. These gave insights on what they considered important to foster mental and physical health and social wellbeing which were used to shape the organization of their film. The PV process also allows ways to explore local meanings of healthy ageing. ‘Being at peace’ emerged as a strong theme, including with oneself (e.g. through overcoming addictions) and with others, including through finding forgiveness for the traumas and abuse inflicted on indigenous children and their families through the Residential Schools system. Finally, it is important to be responsive to how older people wish to represent themselves and to understand and use their preferred learning styles through choice of exercises that facilitate the incorporation of their culture. This older group of people wanted their indigenous worldview and practices to shape their activities and be woven through the film. They started each day with a Ceremony for reflection and gratitude, held the ceremonial talking-feather during interviews as would happen in a traditional council circle, and incorporated scenes of fire-keeping, smudging and items from Nature to represent the Earth and the non-human world.

Manitoulin Island is the largest fresh-water island in the world. Today it is home to seven First Nations, as well as non-native people, living in reserves and small towns. Some First Nations lived on the island before colonization whilst others were resettled here. In the Ojibwe language, Manitoulin Island means “Spirit Island”, reflecting animistic beliefs that everything in the natural world has a spirit and is interconnected. The older people involved in this activity highlighted the impacts of climate change, ecosystem degradation and biodiversity loss on healthy ageing for humans and other life forms on Earth. As indigenous peoples are custodians of 80% of the world’s biodiversity, we need to take every opportunity to ensure their voices and views are heard and acted on. In addition to building the skills of the group of older people, the PV process provides opportunities to build the capacity of key people in local organizations. It has also fed into local and global dialogue and advocacy on solutions and transformative change for healthy ageing, including at the 15th Global Conference on Ageing in Canada in November 2021 (see https://ifa.ngo/project/ifa2020/); at a side event of the 48th Session of the Human Rights Council held in September 2021; and a global premiere screening of all 3 films in the global project organized by WHO on 29 March 2022. Through his hands-on involvement in the whole PV process on Manitoulin Island, the head of HelpAge Canada has been inspired to take PV forward in future activities.