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40 million deaths a year go unrecorded: Lancet

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Washington: Two in three deaths or 40 million people go unreported and one in three births – another 40 million people – go unregistered globally, a group of leading epidemiologists revealed.

The solution lies in tapping the growing smartphone technology for accurate data collection that could crack the problem as mobile phones are now common virtually everywhere, they suggested.

In a series of papers that appeared in the prestigious journal The Lancet, professor Alan Lopez from University of Melbourne argued that accurately recording birth registration and cause of death is vitally important to leaders around the world.

“To put this in perspective, 140 countries or 80 percent of the world’s population — do not have reliable cause of death statistics,” said Lopez, one of the series lead authors.

He led a global campaign to improve how countries capture civil registration and vital statistics (CRVS).

The four-paper Lancet series promote the case to change CRVS systems to collect more reliable and timely data.

“Policy should be informed by accurate and timely data. Poor quality data equals poor decisions which, in turn, leads to lost opportunities to improve population health,” Lopez added.

In remote areas where there are no doctors, CRVS improvements could include family members of deceased responding to a limited number of questions about symptoms experienced by the deceased which can be analysed to record a most-likely cause of death.

“In many cases, an algorithm can record cause of death more accurately than a physician,” he noted.

The first paper highlighted inconsistent record-keeping worldwide and argued for marked improvements in order to gather better statistics to help policy makers make better decisions.

The second paper makes the case that good CRVS data is not only required for informing health policies but that it is also actually good for health.

In the third paper, the authors monitor the development of existing CRVS systems and its limited growth.

The concluding paper presents a research and development agenda for CRVS and challenges global health and development agencies to ensure that every birth and death is registered.

Technology advances such as mobile phones can transmit information about recent cases of births and deaths, the authors concluded.

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Lockdowns in China Force Urban Communities to Defy Censorship and Vent Frustration Online

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Anyip Mobile Proxies

Shanghai’s rich middle class is leading a wave of online dissent over the strict and prolonged lockdowns imposed in various parts of the country. Chinese internet censorship is struggling as patience is wearing thin in many urban centers, coming up with creative forms of online protests.

Social Media Posts Revealing Lockdown Tension in Shanghai

Drawn-out lockdowns are nothing new in China as authorities insist with the nation’s zero-Covid policy since the start of the pandemic. Currently over This time around, however, metropolitan areas like Shanghai are increasingly difficult to keep quiet, given that its more than 25 million residents have seen weeks of total isolation along with food shortages and many other service interruptions.

Dozens of towns and reportedly over 300 million Chinese citizens have been affected by lockdowns of different severity. As expected, urban netizens have been most outspoken over their difficulties by finding creative ways to get around state censorship and bans placed on topics, news comments and spontaneous campaigns.

Shanghai residents have been using mobile proxies and hijacking seemingly unrelated hashtags to talk about healthcare issues, delivery failures and the overall severity of their situation. The “positive energy” that the Chinese government wants to transmit during the recent prolonged series of lockdowns does not come naturally to those counting food supplies and online censors are working hard to filter words, trending topics and undesired social media sharing.

WeChat groups and message threads are under constant monitoring. Posts questioning the zero-Covid approach have been quickly deleted, including by leading Chinese health experts like Dr. Zhong Nanshan. Video footage is soon censored and protests and investigations are quickly made to disappear.

Where this has not worked, officials have exposed banners with warnings and outright threats like “watch your own mouth or face punishment”, while drones have been patrolling the city skies. Yet, if anything, this has led to further tensions and unspoken confrontation with Shanghai’s educated and affluent middle class.

Creative Online Solutions Harnessing Civic Energy

Announcements by Chinese social media that they would be publishing the IP addresses of users who “spread rumors” have not helped either. Tech industry research has shown that much of Asia’s tech-savvy population has a habit of using mobile proxies and other privacy tools, quickly finding workarounds to browse the internet freely and talk to the world about the hottest topics.

The sheer volume of forbidden posts is already a challenge for the very censorship system, experts explain. Unable to track all trending hashtags, state workers overlook topics that speak about the US, Ukraine or other popular news. Linking human rights elsewhere to their situation, Chinese online dissidents establish their informal channels and “hijack” the conversation to share personal or publicly relevant information about the Covid suppression in their town.

Sarcastic and satirical posts still dominate. Others hope to evade the censors by replacing words from famous poems or the national anthem. One thing is certain – social media, when harnessed with the right creativity, has proven its ability to mount pressure on the government in even some of the most strictly controlled tech environments like China.

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