"The Uncounted" is the name of a project by the Colombian-American photographer and filmmaker Juan Arredondo.
That title refers to people who have no life cycle records. No birth certificate. No death certificate. Or in some cases, the document may exist but finding a copy is like trying to climb Mount Everest.
Arredondo traveled to six countries to explore the importance of these records and the impact of their absence. His photos are currently part of the sprawling open-air Photoville exhibition in Brooklyn, New York, open through May 30.
Every unrecorded birth means a life without a legal identity and all the rights, services and protections that come with it.
Every unrecorded death means that someone is invisible to the health system, their cause of death a missing piece of data that could prevent future losses.
And there are a lot of people who go uncounted. "Each year, nearly half of all deaths and 25% of all births go unrecorded worldwide," Arredondo notes.
The photo at the top of the story, from Bangladesh, shows mothers holding up newly issued birth certificates after a government registration drive. Having the certificate enables residents to enroll in a food assistance program.
There are other benefits to documentation. "Fundamental to public health is understanding what the data says about deaths and births," especially the causes of children's and other premature deaths, explains Jennifer Ellis, who leads the Bloomberg Philanthropies Data for Health Initiative. The challenge is that across the globe, an estimated half of all deaths and a quarter of all births are left unrecorded. Or even if they are recorded, the paperwork may be unfiled, undigitized and effectively inaccessible.
Because the majority of deaths in remote or low-income countries occur at home rather than in a hospital, clinical or medical descriptions of the reasons for the mortalities also remain unknown. Without that missing information, Ellis says, communities and governments may lack the means to identify previously unrecognized health threats or track the emergence of communicable disease epidemics. By contrast, with cumulative data in hand, health officials can tailor their policies to respond effectively.
That is what happened in Zambia when the Bloomberg Philanthropies program analyzed a childhood mortality study and found found that 75% percent of all children born with HIV but untreated for it would die by the age 5. That led to a change in government policy making sure at risk children would be tested and treated if need be. As a result, that number rose from a low of 3% to children tested and treated, the number rose to 85% percent.
Arredondo worked with the Bloomberg Philanthropies Data for Health (D4H) Initiative and the public health organizations Vital Strategies and CDC Foundation as he made photos that tell the stories of what it means to be uncounted –- and to at long last be counted.
Diane Cole writes for many publications, including The Wall Street Journal and The Washington Post. She is the author of the memoir After Great Pain: A New Life Emerges. Her website is DianeJoyceCole.com
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