Featured Image: Gardens for Health International’s agricultural agents complete a mental mapping exercise in Ndera, Rwanda.

At Broad Street Maps, we believe that health is inherently a geographic issue. In the U.S. today, your zip code is a better predictor of your health profile than your genetic code. And in much of the developing world, where resources and infrastructure are limited, physical access to primary care can be the single most determining factor in the utilization of health services, and consequently, the health of a population. Therefore, the majority of the problems health workers face in these countries on a daily basis are inherently spatial. Resolving concerns about access to services and coverage, allocating limited resources effectively, and understanding the distribution of phenomena across a catchment area all depend on geographic knowledge.

The strength of local public health systems is inextricably linked to basic infrastructure. And being able to visualize that system as a whole — one made up of health centers and hospitals, water wells, bus stops, and marketplaces — is essential for delivering services to where they are needed the most.

Maps were used in public health since the 1800s

More than 150 years ago, Dr. John Snow, the father of modern epidemiology, and local community leader Reverend Henry Whitehead set out to investigate the cause of London’s raging cholera epidemic. The duo conducted interviews and gathered data points, going door-to-door to track the source of the epidemic. As their research progressed, Snow decided to map of the distribution of deaths in relation to Soho’s water sources. The map showed a trend — many of the deaths occurred around the Broad Street water pump or around businesses that used the pump’s water. Bolstered by his visualization, Snow insisted that the city remove the handle of the pump. After the pump was removed, mortality declined rapidly, forcing the medical community to consider, for the first time, the waterborne nature of the disease. Dr. Snow’s actions not only saved hundreds of lives, they also marked the first time that maps were used to directly influence public health policy.

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Snow, J. On the Mode of Communication of Cholera, 2nd Edition, 1855.

Opportunities and Challenges in public health mapping today

Today, maps and geographic analysis are being utilized in a myriad of ways across public health. They have, for example, been used to record distances that patients have to travel to get to the nearest tuberculosis directly observed treatment (DOT) distribution points, to quantify a relationship between the accessibility to roads and HIV cases, calculate population per bed ratios at local clinics, spatially analyze clinic usage, and evaluate and improve ambulance response times.

But despite their proven value, geographic tools remain extremely underutilized in the field of public health. Anyone who has ever interacted with a geographic information system (GIS) can probably guess why. The software is incredibly complex and time-intensive. It requires either a trained staff member or a significant investment in consultation. And most significantly in the developing world, it requires complete and accurate geographic data.

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Analysis of the distribution of health centers performed in QGIS

Luckily, the proliferation of GPS-enabled smartphones is beginning to simplify the process of collecting and building upon this fledgling geographic data infrastructure. Tools like Magpi and ODK Collect allow users to update health surveys with the simple addition of a ‘Location’ field, thereby putting in place the essential building blocks for geographic analysis without exorbitant time, training, or cost. At the same time, Quantum GIS (QGIS) is offering a free and open source alternative to the close-source giants. And new platforms like CartoDB are making game-changing strides towards making web maps and geographic analysis more accessible.

But possibly the biggest obstacle to adopting these tools is a lack of roadmap on how to truly integrate geographic analysis into existing workflows. Smaller-scale organizations with limited bandwidth don’t have time to invest in new systems that don’t directly make their lives easier. Far too much ICT4D ends up being a burden. What we need are tools that streamline the process of analysis to decision-making. What we need are maps for action.

A Place to Start

Fortunately, organizations do not necessarily need to dive into software licenses and new tech to begin making action-oriented, spatial decisions. Hand-drawn maps have proven to be incredibly valuable tools for incorporating local knowledge, enhancing community ownership, and understanding local perceptions of distance and space. As Dr. John Snow and Reverend Henry Whitehead demonstrated, visualizing pertinent health data in even the simplest ways can elicit valuable new insights that inform future decision-making. And maybe even more importantly, the duo also proved that the grassroots process involved in understanding your “where” can be essential to developing a sound, and possibly life-saving, theory of “why.”

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Broad Street Maps helping to conduct a household survey and collect GPS locations of patients in the Sacred Valley of Peru

Inspired by both the lessons from London and our time in the field, our team at Broad Street Maps is committed to leveraging the power of maps to visualize information, identify patterns, and, above all, actively use this vital perspective to make decisions.

If you are interested in learning more, have any questions, or are just head over heels about maps, please shoot us a line at contact@broadstreetmaps.org. Our team is always happy to provide guidance to organizations interested in mapping at all stages of the process.

If you are passionate about mapping development data, take a moment to check out the incredible work being done in the OpenStreetMap, the Humanitarian OpenStreetMap, and the Missing Maps communities.

And lastly, for a true immersion experience, be sure to check out TechChange’s course on Mapping for Social Good. Course starts this week!

About Isabel
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Isabel Shaw heads cartography and product development at Broad Street Maps. She has worked with Save the Children and National Geographic and lived in Rwanda and Argentina. She is a TechChange alumna and holds a BA in Geography with concentrations in Global Health and Spanish from Middlebury College. Shaw lives in Seattle, WA.

Bob Corbett’s final mapping project on flood-prone areas in Bangladesh. (Note: this map was prepared as a mapping exercise. Anyone viewing the map should understand that it would need to be reviewed and validated by a qualified expert before it should be relied upon.)

By Bob Corbett, TC141: Mapping for International Development alumnus

During my undergraduate work in Landscape Architecture, I learned a method of analyzing spatial data by overlaying various types of information on acetate sheets or tracing paper developed by Ian McHarg, a Scottish landscape architect. The technique is described here (Note: I am not related to the author). I have always been fascinated by this technique and the GIS capabilities available today make this type of analysis readily possible. This offline overlay technique was the basis of my final mapping project in TC141.

In mid-2011, I launched SMS in Action, an Ushahidi Crowdmap that lists text message based programs worldwide that contribute to the social good. To date, nearly 240 programs classified under 29 different categories have been profiled on SMS in Action and viewed by thousands of visitors from 119 countries. With my general interest in mapping piqued by my Crowdmap experience, I ventured into crisis mapping with the Standby Task Force and more recently, Crisismapper deployments using the Tomnod platform. I have since worked on a variety of crisis mapping efforts from locating refugee encampments in Somalia, to tracking forest and bush fires in Colorado and Australia and identifying storm damage after Typhoon Haiyan/Yolanda in the Philippines to name a few.

TC141: Mapping for International Development

Taking the online course, Mapping for International Development, allowed me to combine my interests in ICT4D, international development, data visualization, and a love of maps. I very much enjoyed the format of TC141 with the combination of live presentations, weekly readings and videos, exercises, discussion forums, and the step-by-step instructions and “how-to” materials. Although I tried to “attend” each live presentation the fact that everything was archived for viewing at my convenience was a real plus. This being my first online course, I was surprised at the level of personal interaction available between participants as well as with the facilitator. Chris Neu was a great facilitator: always enthusiastic, arranged interesting presenters and shared an immense amount of information with course participants. I had no specific goals for the course at the outset other than to broaden my knowledge of available mapping technologies. I quickly realized TC141 provided me a chance to gain a capability to work with GIS, a long-term interest of mine. As a result, I selected QGIS, the open source GIS platform as the primary platform upon which to develop my course project.

Mapping with QGIS and MapBox’s TileMill
In a preliminary course exercise we were introduced to MapBox/TileMill. In a follow-up exercise I used MapBox/TileMill to create a simple map of the top ten world coastal cities at risk from flooding due to climate change – including Dhaka, Bangladesh. Given that we have a family friend from Bangladesh, I felt a more detailed investigation of flooding patterns in Bangladesh, an increasingly frequent problem, might lend itself to my major project for the course.

Drawing upon existing sources of information available via the Internet, I located shapefiles for administrative districts, the extent previous flooding, road systems, airport and hospital locations, topographic information, population data and more. After importing this information into QGIS I was able to identify recently flooded and flood prone areas of the country. Seeing how flooding can compartmentalize the country and disrupt the movement of people and relief supplies between areas, I then performed a quick search of key medical facilities and major airports to better understand which would be affected and which might be available to support relief efforts. The QGIS-based flood map was then exported into MapBox/TileMill where it was further refined using the tools and capabilities within the MapBox platform.

Mapping Bangladesh’s Flood-Prone Zones
Given that our Bangladeshi friend is engaged in development activities in the Khulna administrative district, I wanted to see whether flooding in Khulna might impact their area. Based on Internet research, I chose flooding from a 6-meter storm surge as the basis to work from. I then located ground elevation data for Bangladesh and loaded the file into QGIS. By filtering the elevation data I was able to “see” the general extent of flooding that might be expected in Khulna District by a 6-meter storm surge. I was very pleased with the resulting maps and the new skills and capabilities that I had gained. Prior to taking TC141, I was not even aware of QGIS or MapBox/TileMill. I feel compelled to note that my “flood maps” were solely academic mapping exercises and should not be interpreted to be definitive maps of anticipated flooding in Bangladesh. However, it did show me the new capabilities I had developed as a result of TC141.

Mapping in My Future
TC141 offered much more information than I have touched upon here. One area of discussion in the course was OpenStreetMap and Humanitarian OpenStreetMap. With my past involvement with crisis mapping I have developed an interest in pre-disaster planning. Although post-disaster efforts often involve hasty mapping after an event I am interested in what types of information and infrastructure could and should be mapped in advance of disasters as part of a preparedness program. For example, if we believe that climate change is expected to result in an increased frequency and intensity of tropical storms, typhoons, hurricanes, cyclones, etc. shouldn’t first responders and aid agencies have reliable maps to work with prior to a disaster? The Philippines experience, on average, 20 tropical storms per year. Accurate up-to-date maps of facilities and infrastructure needed to recover from such emergencies post-disaster should be mapped in advance in OpenStreetMap as part of a preparedness program. I am interested in learning more about the types of facilities and infrastructure that need to be mapped in advance as part of a preparedness effort and see OpenStreetMap as a logical platform for presenting that information.

Interested in learning how to build your own digital maps using the tools that Bob learned? Enroll now in our 4-week digital mapping course, Mapping for International Development.

Remember when map making used to be simple? Neither do we, which is why we’re teaching a new course on Mapping for International Development. This increasingly complex intersection between open/closed data, online/offline tools, and practitioner communities all relevant to digital mapping could use a handy primer.

Last week, MapBox closed a $10 million Series A from Foundry Group as part of a move seen to rival Google Maps with an open-source mapping solution. While the results of this investment remain to be seen, there are echoes in this conversation from the intense debate last year around the World Bank’s initial decision to use Google Map Maker instead of OpenStreetMap, which raised concerns from organizations such as Global Integrity about why the bank would choose a closed data solution over an open one. Ultimately, the World Bank reversed its decision and went with OpenStreetMap, which provides simple, complete access to its database under an open license.

And it’s not just about the maps themselves, but what is being done with them. The Global Slavery Index by Walk Free chose to visualize slavery numbers by country. Team Rubicon partnered with Palantir to repurpose maps used to track IEDs to help rebuild homes needing repair after Hurricane Sandy. Democracy International and New Rights Group visualized voter data in Tunisia to present stakeholders with better information for the electoral process. And InterAction produced an NGO Aid Map to improve coordination of NGO activities.

Image from the Atlantic on Morningside Analytics visualization

Photo Credit: The Atlantic

But data visualization and mapping isn’t just restricted to geodata. Since information and individuals are only a click away online, work being done by Morningside Analytics to map the “cyber-social geography” of the internet — analyzing who is talking to whom and what they’re talking about — is just as valuable, if not more so.

So far, we’ve had a great response for the course on Mapping for International Development, which is nice to know we’re not alone in our enthusiasm. We’re excited to welcome participants so far from about a dozen countries including Australia, Cameroon, Canada, Ecuador, Jordan, Kosovo, Mexico, the Netherlands, the Philippines, USA, and UK. Participants in this course represent organizations such as the World Bank, UN Foundation, UNICEF Innovations Lab Kosovo, Gallup, InterAction, Telecentre Foundation, Canada Foundation for Innovation, Australian National University, IFES, School of Oriental and African Studies, Centre for Development Innovation, Generations for Peace Institute, ACT/JEVS Human Services, CIMM, Stability: International Journal of Conflict and Development, and many more.

There’s still time to join, so if you’re interested in registering for our four-week online class on Mapping for International Development, register here. We hope you’ll join us!