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Weibo’s Digital Graveyard: Remembering the Dead on Chinese Social Media

‘The Dead’ honors the deceased and tries to break existing taboos on death in China.

Brydon Brancart

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With China’s rapid digitalization and flourishing online media environment, there’s one crucial societal topic that, although taboo, also now finds its place on Chinese social media: this Weibo account collects the stories of the dead and writes their online eulogies. In doing so, they are trying to break longstanding taboos around death in China.

“My grandmother passed away due to illness in 2016. She was 78 years old. My grandmother was a kind soul. She married my grandfather after his divorce. They had never even seen each other before [her] mother and father prepared the marriage, and yet she lovingly cared for him her entire life.” This eulogy was posted on Weibo on February 12th of this year.

Within hours after it was posted, over 100 people had replied with the most popular emoji for these type of posts: the candle.

Since 2011, thousands of these kinds of posts have appeared on Weibo, one of China’s biggest microblogs, thanks to “The Dead” (@逝者如斯夫dead), an account run by a small team dedicated to memorializing the deceased. Through their online memorials, they have encouraged conversation of a taboo topic.

 

HUNTING FOR THE DEAD ON WEIBO

“We wanted to provide a place for people to remember those who had passed away”

 

Starting small, ‘The Dead,’ which borrows its Chinese name from the Confucian phrase “All passes like a river” (逝者如斯夫 Shì zhě rú sī fū), has amassed over half a million followers. “We wanted to provide a place for people to remember those who had passed away,” a team member recently explained to What’s on Weibo.

Weibo users typically contact the account requesting eulogies about their deceased loved one, but such direct requests were rare just a few years ago. Instead, the account started by hunting for the dead among Weibo’s pages. They searched for signs of a user’s passing, like comments about mourning, and then monitoring the account for inactivity.

‘The Dead’ told What’s on Weibo that “while at present most of our information comes from Weibo users,” its team will still “go through the deceased’s page…looking through comments in the discussion section and asking about the user’s current condition” to confirm a death and glean facts for a memorial posting.

Few of its half a million followers personally know the people in the obituaries. But their reaction to its eulogies reveals a deep and often emotional connection to the topic of death.

“Every now and then I go to their page and scroll through the memorials,” one follower writes: “Those people, who were so full of life, passed away just like that. It’s so moving that sometimes I scroll until my eyes fill with tears.”

Another follower comments: “Whenever I’m feeling low I go and scroll through [the page], it always calms me down. I’ve been very inspired by it, thank you.” For many Chinese, such an open discussion of death would have been unthinkable in the past.

 

DEATH AS TABOO

“This taboo has an independent power in shaping human action”

 

Every culture confronts death differently and few do it well. Traditional Chinese culture shunned discussions of death, notes Cheris Shun-Ching Chan, professor of sociology at Hong Kong University.

Chan believes that Confucian silence on questions of death and folk Buddhist references to “a dark world (yinjian) and a cruel hell (diyue)” account for the topic’s avoidance. She also points to fears that a premature death could mark the end of one’s lineage (Chan 2012,37).

Chan’s survey research found that avoidance of any discussion about death was so widespread that it had become taboo. “The taboo manifests as an observable avoidance of the topic,” Chan writes, “particularly unexpected, accidental, or premature death, among not only the elderly but also the generation in their late 20s and 30s” (Chan 2012,36).

While religious belief waned during the tumult of the 20th century, the taboo persisted. “Today, this taboo has an independent power in shaping human action,” Chan argues: “In other words, one does not need to hold beliefs about hell, the dark world, ghosts, evils, and precipitating death in order to observe the taboo” (2012,38-40).

Stifling discussion about death has consequences, big and small. Individuals unwilling to acknowledge death are reluctant to write wills or register as organ donors. Respecting the death taboo, doctors avoid delivering a terminal diagnosis to patients, informing family members instead.

One news story from 1993 exemplifies this taboo on death; when residents near China’s first hospice care center protested the presence of death in their neighborhood, matters turned violent. They started shattering the center’s windows, driving doctors and their patients from the center in the middle of the night. As the health needs of China’s population evolves with its economic growth, the death taboo threatens much more.

In a rapidly aging China, people live longer and deaths cost more than ever before. The World Health Organization reports that eight of the top ten causes of death in China are now due to non-communicable diseases.

As deaths caused by accidents and communicable diseases have dropped, death by stroke, heart disease, Alzheimer’s, and cancer have jumped double digits and with that jump, a commensurate increase in the costly treatments of these diseases.

A 2013 study of the cost of non-communicable disease on the Chinese economy predicted that between 2012-2030, China will spend 27.6 trillion dollars remedying non-communicable disease. The death taboo threatens to leave China unprepared to care for a population living longer thanks to better medical care but dying at higher rates of chronic illness.

Health care in China is free, to a point. According to the Economist, China’s national health-insurance system caps reimbursements for treatment of serious chronic illness like heart disease and end of life care. The death taboo poses a risk to families in a country where it is still considered unfilial by many to pursue a course of treatment other than one meant to cure the patient.

Hospice care, which should be cheaper, is rarely considered and seldom available. While hospice care is now part of the standard course of treatment for end of life care in EU and North America, the death taboo undermines demand for the service. This, in turn, removes pressure on medical insurers to provide hospice coverage. Insurance coverage for hospice care is so limited that families are forced to pay out of pocket for most hospice care.

 

ADDRESSING DEATH

“Everyone ought to admit death’s existence and face up to its realities”

 

Addressing these challenges starts with acknowledging death as a part of life. “People have slowly become more willing to discuss death,” the Weibo ‘The Dead’ team observes: “You can see this in Weibo users openly posting about the passing of loved ones.”

Beyond Weibo, the account’s rejection of the death taboo has also found powerful allies elsewhere. In Beijing, Chen Yi and Luo Ruiqing, children of prominent CCP members, launched the Beijing Living Will Promotion Association, advocating for individuals and families to openly discuss and plan for end of life care.

Yi and Ruiqing explain to Caixin that watching the slow and painful death of their parents with few options for palliative care moved them to take action.

Their website provides information to help individuals decide about the kind of end of life care they want and how to ensure their wishes are followed through the use of a living will, a standard feature of Western health care but new to China.

In Shanghai, Wang Ying, a psychologist who now specializes in end-of-life, is taking a different approach to addressing the same problem. Ying founded Hand in Hand, an organization that encourages individuals to openly discuss their deaths as a form of preparation.

Like Yi and Ruiqing, Ying’s determination to challenge the death taboo stemmed from her conviction that repressing a discussion about end of life care and death causes his elder relatives needless suffering at the end of their lives.

Noting the rising interest in their Weibo account, ‘The Dead’ has recently started a Wechat mini app where users can send manage their own memorials and share them with others. The team believes that Weibo and Wechat allow them to reach out to a large audience all over the country.

They admit, however, that problems of economic disparity have limited their reach, and guess that most of their subjects and contributors are urban dwellers. Still, they are hopeful that their work can help change many people’s perspectives.

“Everyone ought to admit death’s existence and face up to its realities,” they say: “Working hard to live with an understanding of death is a lesson every Chinese person must learn.”

By Brydon Brancart

References (other sources in-text through hyperlinks)

Chan, Cheris Shun-Ching. 2012. Marketing Death: Culture and the Making of a Life Insurance Market in China. Oxford: Oxford University Press.

Spotted a mistake or want to add something? Please let us know in comments below or email us.

©2019 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

Brydon Brancart is a writer and Chinese translator. Originally from California, he has lived in both Beijing and Shanghai. He is interested in understanding the role modern media trends play in shaping worldviews, personal identity, and social behavior.

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China Digital

WeChat’s New Emoji Are Here (Including a Watermelon-Eating and Doge One)

WeChat’s new emoji are based on popular memes.

Manya Koetse

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On January 14, Tencent’s Wechat introduced new emoji to its existing emoji set. The new emoji include, among others, a watermelon-eating emoji and a smiling Shiba Inu.

On Weibo, the new emoji have become a topic of discussion under the hashtags “WeChat’s New Emoji” (#微信上线新表情#), “WeChat’s Watermelon Eating Emoji” (#微信上线吃瓜表情#), and “WeChat’s Dog Emoji” (#微信上线狗头表情#).

Different from the Unicode emoji (see Emojipedia), WeChat and Weibo have their own sets of emoji, although there is overlap.

The reason why especially the watermelon-eating and dog emoji are being discussed on social media, is because these emoji are based on popular internet memes.

“Eating watermelon” (吃瓜 chī guā) is an online expression that comes from “watermelon-eating masses” (吃瓜群众 chī guā qúnzhòng), which describes a common mentality of Internet users who have no idea what is actually going on but are still commenting or following online stories for their enjoyment – perhaps comparable to the “popcorn memes” that are ubiquitous on Western social media platforms.

The smiling dog has been around since 2013 and is known as the doge meme, based on a photo of a Shiba inu. The meme was originally spread on social media platforms such as Reddit, but then also became hugely popular in China, where it became a symbol of sarcasm (also read this Abacus article on this topic).

Other new emoji are the “wow” emoji, and others to express “ok,” “add oil,” “emm,” “oh!”

There’s also a “shehui shehui” (社会社会, lit. “society society”) emoji, which also comes from online culture and is a way among friends to (self-mockingly) talk about being ‘gangsters,’ ‘brothers.’ or ‘scoundrels.’

As the new emoji are still in their testing phase, not all WeChat users can use the new emoji yet, so you might have to wait a bit before being able to try them out.

By Manya Koetse, with thanks to @caaatchina
Follow @whatsonweibo

Spotted a mistake or want to add something? Please let us know in comments below or email us. First-time commenters, please be patient – we will have to manually approve your comment before it appears.

©2020 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

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‘Good Doctor’, Digital Hospitals: How Mobile Apps Are Alleviating China’s Healthcare Problems

With the rapid digitalization of China’s healthcare, Chinese patients now have more ways than one to receive medical assistance.

Manya Koetse

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China’s healthcare industry is facing some serious challenges. As Chinese society is rapidly digitalizing, mobile apps now provide innovative solutions to alleviate pressing problems in the country’s health services sector.

 
This is the “WE…WEI…WHAT?” column by Manya Koetse, originally published in German by Goethe Institut China on Goethe.de: “Good-Doctor Apps und Digitale Krankenhäuser.” 
 

Social Credit System, artificial intelligence, surveillance cameras; these are some of the hottest topics making headlines in mainstream Western media when discussing China-related developments recently.

With the rapid digitalization of Chinese society, these topics certainly have come to play a more important role in social media discussions within the People’s Republic of China (PRC). But if there is one issue that seems to concern Chinese social media users the most, it is not facial recognition nor their ‘Sesame score’: it is the topic of healthcare.

In December of 2017, a photo showing a crying mother kneeling down beside a toddler on the sidewalk in front of a Shanghai hospital went viral overnight. The moment was captured on camera by a reporter who was visiting Shanghai’s Children’s Hospital.

The photo of Guo Yinzhen and her son that went viral in China (image via NetEase, source: https://3g.163.com).

The mother, Guo Yinzhen, is a single parent who had traveled from a remote village to seek medical help for her 3-old-son, who was suffering from congenital hydrocephalus or ‘water on the brain.’ Already having traveled to the city multiple times and spending all her money on medical bills, Guo could not afford the additional 100.000 yuan (€ 12.600) for medical procedures needed to save her son’s life.

Guo’s story struck a chord with Chinese netizens, who continue to share the heartbreaking photo on social media to this day. It has become emblematic of China’s healthcare problems.

 

Crowded Hospitals and ‘Healthcare Disturbance’

 

The key to an adequate healthcare system, no matter where in the world, is that there is a right balancing in the “iron triangle” of efficiency/cost containment, high quality care, and patient access.[1] China, however, struggles with all three sides of this triangle.

Guo’s case is an extreme example, but many people in China dealing with less serious health issues and needing basic medical services also struggle to afford and access the healthcare they need.

Over 95% of people in China have health insurance, but people from different regions do not enjoy the same benefits and their out-of-pocket expenses can vary greatly. Uncovered medical costs can sometimes be catastrophic and simply unaffordable for patients and their families.

As more money flows are going to healthcare facilities in China’s cities, there is also the issue of varying levels of providers’ medical education and the overall healthcare quality, with the substantial majority of modern hospitals still existing in urban areas.

Easy access to the right kind of healthcare can be especially problematic for China’s rural population, as people often need to travel long distances and have to go through the lengthy process of registering and waiting for their doctor’s appointment, which sometimes requires them to stay in the city overnight.

For all of these reasons, China’s bigger public hospitals can get super crowded, sometimes resembling shopping malls on an end-of-season sales day. On social media, both patients and medical workers often complain about the stress brought about by the huge crowds and the shortage of doctors in hospitals across the country.

Perhaps it is no wonder that China even has a word to describe outbursts of violence between patients and doctors: ‘Yī nào’ (医闹, literally: “healthcare disturbance”).

Weibo user ‘Sunscreen’ complains about the crowds at Huashan Hospital.

One major problem within China’s healthcare conundrum is the lack of local family or primary-care doctors, which often makes bigger hospitals the first stop to any kind of medical treatment for Chinese patients.

The reasons for this issue are manifold. There is a general lack of trust in private and smaller local healthcare clinics, for example, and patients often choose to go directly to a bigger hospital to avoid making extra costs.

This makes it extra difficult for many community health care centers – that are already struggling – to make enough money and to retain qualified staff. In a society that is rapidly aging, the challenges facing China’s healthcare industry are only becoming more pressing.

 

A Doctor Today, Just an App Away

 

As China’s online environment is thriving, new innovative online apps are popping up on a daily basis. Some of these apps, that have found their ways into China’s most popular app rankings, are offering solutions to some of the country’s most pressing healthcare problems.

One of these apps is Ping’an Good Doctor (平安好医生), which was developed by health insurance provider Ping’an in 2015 and calls itself China’s “one-stop healthcare ecosystem.”

“Ping’an Good Doctor” promotional image by Ping’an.

Employing some 1000 medical staff in its in-house team, contracting over 5,200 external doctors, and collaborating with 3000 hospitals and thousands of pharmacy outlets across the country, the app is somewhat of an “online hospital.”

Through the app, users can look through an online database of medical professionals, order medicine at nearby pharmacies, get 24/7 online medical consultancy, search for information about both Western and Chinese Traditional Medicine, etc., but they can also use Ping’an Good Doctor as a fitness app to track their own health.

Screenshot of Ping’an app screen, by author.

When looking for a specific doctor for a one-on-one consult, the app first lets users select an area of expertise (e.g. dermatology or gynecology), and then offers a list of different specialists in various price categories.

Doctors from well-known hospitals, for example, or those with excellent ratings, have a one-time consultation fee of 100 yuan (€ 12,60). Other doctors can be consulted starting from 30 yuan (€3,70). All costs can be paid efficiently via online payment apps.

Doctors to pick from within the app’s various price categories.

Ping’an Good Doctor uses an AI-driven system to ask patients various questions about their symptoms and to automatically create a user’s medical record to save time. Based on the AI-generated record and the conversation with the patients – files such as photos can also be uploaded to the app -, the doctors can prescribe medicine or refer the patient to a hospital for an offline appointment if needed.

Ping’an recently announced that its number of registered users exceeded 300 million users, with 62 million monthly active users. Because the app keeps building on its AI-driven system, Ping’an Good Doctor can be expected to only become a ‘smarter’ smart health app the more popular it gets.

Although Ping’an is now leading within China’s medical app category, there are many other apps providing similar services, such as Chunyu Yisheng (春雨医生), Haodafu Online (好大夫在线), or DingXiang Doctor (丁香医生).

The emergence of these apps is just one of the many ways in which China’s digital developments, online media, and tech giants are impacting the healthcare industry, profoundly changing how patients receive healthcare information and access medical services now and in the future.

List of recommended medical apps in the Tencent app store.

In a way, China’s medical consultation apps fill the void in offline primary care. Patients who would otherwise turn to hospital care as their first stop can now  access medical consultations any time, any day, at a relatively low cost. Those who suffer from relatively harmless conditions could be diagnosed by a medical specialist via the app and get the medicine they need within a matter of minutes. With the growing popularity of these kinds of apps, many patients no longer need to visit a hospital at all.

Are smart health apps such as Ping’an Good Doctor the solution to China’s healthcare problems? No, they’re not. Struggling mums like Guo Yinzhen will not find the help they need there. But they do contribute to a more efficient healthcare environment where crowd flows in hospitals can be reduced, and patients do not need to spend a lot of time and money to stand in hour-long queues to get five minutes of their doctor’s time.

Although smart health apps could not help Guo Yinzhen and her son, social media apps could. As soon as their story went viral in late 2017, Shanghai Children’s Welfare Foundation Xiaoxingxin offered to cover medical treatments for the little boy, with a notable pediatric neurosurgeon operating the child. According to the latest updates, the boy’s situation was “looking good.”

Hopefully, the same holds true for the challenging sides of China’s healthcare industry.

By Manya Koetse
Follow @whatsonweibo

[1] Burns & Liu, 2017: 3-4.

References/Linked Sources

Burns, Lawton Robert, and Gordon G. Liu. 2017. “Introduction.” In China’s Healthcare Industry: A System Perspective, Lawton Robert Burns and Gordon G. Liu (eds), pp-1-116. Cambridge: Cambridge University Press.

Economist, 2017. “China needs many more primary-care doctors.” The Economist, May 11 https://www.economist.com/china/2017/05/11/china-needs-many-more-primary-care-doctors [20.10.19].

Zhou, Viola. 2018. “Does China Have Universal Healthcare? A Long (And Better) Answer.” Inkstone, Oct 10 https://www.inkstonenews.com/health/china-translated-does-china-have-universal-health-care/article/2167579

This text was first published by Goethe-Institut China under a CC-BY-NC-ND-4.0-DE license (Creative Commons) as part of a monthly column in collaboration with What’s On Weibo.

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