Counting folks:
I have an interest in malaria.  It seems to me it should be possible to eradicate it altogether so any number of deaths from it is too many.  But how many are there?  An article (Gretchen VogHow Do You Count the Dead? SCIENCE vol. 336 no. 6087 June 15, 2012 page 1372) explains why such a number is hard to get at.  An article referred to as having been published in The Lancet said that 1.24 people died of malaria in 2010, mostly adults.  But the UN says the number is half that and mostly children.  At least that’s what I gather, but obviously nobody knows. 

The bottom line is that the counts are thin.  In that same year the same Lancet article says that 7.6 million younger than 5 died.  How many of them had been seen by a medical professional and their tragedy recorded in some data bank somewhere?  3%

 I am stunned.  How could they even know that is the right number?  Well of course they work very hard at it, do surveys, interview people, work with whatever numbers do exist and so forth.  I’m sure their efforts are tireless and ingenious.  But with only 3% or anything close to 3% of the events being documented at all, being off by only about 50% strikes me as being pretty good.  Now if that 3% was a random sample, that many might seem useful.  But in the matter of deadly disease of children, sampling error has to be overwhelming. 

To me the only sure thing is that, yes, malaria is still around and it shouldn’t be.  I have sometimes tried to shock people by saying, “A half million children die of malaria every year,” and proceed to talk about optimal outbreeding and mosquito spraying.  But I see now that this was wrong.  I took the UN information on the age distribution and the Lancet article folks’ information on the raw numbers.  Silly old me.  I mean it might be true.  But that’s because we really don’t know.

I think it is fair to say that the overwhelming majority of deaths of young children occur in places where people are very poor.  After all, that’s where children are to be found in adequate numbers anyway.  Poverty kills.  Children are vulnerable.  I do not expect to be shouted down on the idea.

So what about births?  If I am at the direst level of poverty, so that survival is always an issue, and I have a sick child who may die I may make some serious effort to get the child to a professional even though it draws from the little money I have and draws from my time and energy, for which there are plenty of other uses.  But suppose I have a child being born.  I already have had a number of children.  It always went just fine.  There is no reason to expect a problem.  How much of an effort am I going to make in order to get that child enrolled in some data bank somewhere?  Let’s just guess that it is going to be a lot less of an effort than if there was already a child and that child was ill.

So in the poorest areas, the fecund areas, how many of the babies actually get counted?  Maybe later somebody comes through the village and counts noses.  But going from that somewhat shaky number to a birth rate when you don’t know about 97% of the deaths …

So I squawk, stamp around and ruffle my feathers, snort, study, write opaque prose, more or less do everything in my power to demonstrate that I am serious.  I am serious that there is a demographic issue.  It has to do with numbers.  Who is having how many babies?  I don’t know.  I don’t think anybody knows. 

But I still think it’s important.

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