Mapping the Gaps: How the Crowd Can Build Better Public Health Systems

In the United States, we take access to geographic data and tools like Google Maps for granted. Anything we want to know about a place we can now get on our phones — whether it’s detailed driving directions or the number of coffee shops within a half mile radius. And if you’re a student, researcher, or generally interested citizen, there is also publicly available census data down to just a few city blocks.

But in many places around the world, this is not the case. In much of the developing world, not only are there gaps in road networks or unreliable population data, there are entire towns and cities missing from the map. And what concerns us most about this is not what their absence means for the integrity of the map (though it is worth pause), but what the implications are for the people who live in those un-mapped places.

We know that the strength of local public health systems is inextricably linked to basic infrastructure. And that 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. Without this information, it is incredibly difficult for humanitarian response teams to respond effectively to crises, or local health organizations to understand what a true picture of access looks like for the communities they serve. And as the nature of development itself changes, accurate mapping of infrastructure becomes a huge advantage for countries or regions seeking investment of all types.

Luckily, we aren’t the only people who believe this. The advent of free and open source data collection and mapping tools is creating a powerful paradigm shift with widespread effects on health systems, local governments, community movements, and disaster response, to name a few.

The most significant of these new tools is OpenStreetMap (OSM). OSM is a collaborative movement that aims to create a free, crowdsourced map of the world that not only harnesses the power of local knowledge, but also allows individuals and organizations to download the data for their own use. The value of OSM has been proven time and time again in the wake of natural disasters. After the 2010 earthquake in Haiti, the 2013 typhoon in the Philippines, and the 2014 outbreak of Ebola in West Africa, volunteers from around the globe rallied to help build out local road networks and identify destroyed buildings, allowing emergency responders and local health workers to access the data they need to inform their decisions and focus their efforts.  

Monrovia, Liberia before and after volunteers mobilized to map the capital in response to the Ebola outbreak. According to the Missing Maps Project, about 3,000 volunteers have made almost 13 million edits to map roads, buildings, river and more since the start of the outbreak. Image courtesy of OpenStreetMap, 2014.

Monrovia, Liberia before and after volunteers mobilized to map the capital in response to the Ebola outbreak. According to the Missing Maps Project, about 3,000 volunteers have made almost 13 million edits to map roads, buildings, river and more since the start of the outbreak. Image courtesy of OpenStreetMap, 2014.

As the movement gains momentum, the Humanitarian OpenStreetMap Team (HOT) at OSM, along with The Red Cross and Médecins Sans Frontiers (MSF), are championing efforts to build a better data infrastructure well before disaster strikes. Through a combination of on-the-ground data collection agents, partner NGOs, and remote volunteers, the Missing Maps initiative strives to improve the quality of geographic data in developing countries for a wide range of planning and development initiatives, including the delivery of basic health services.

Another incredible tool that brings the crowd to the map is Ushahidi. Ushahidi originally formed in 2008 out of an effort to map the incidents of violence after the election fallout in Kenya. Frustrated that journalists weren’t able to report the full story, the map was almost entirely crowdsourced from text messages and tweets. In 2010, Ushahidi teamed up with OSM in Haiti, crowdsourcing vital, real-time information for humanitarian response teams about everything from obstructed roads to the locations of survivors. Over six years later, Ushahidi has emerged as a tech leader in East Africa, seeking to transform the way information flows. The global non-profit now provides multiple data management systems and real-time mapping and communications tools that allow both the public and professionals to visualize essential data and make critical decisions in times of crisis.

Crowdsourcing data to populate the map has proved valuable not only in disaster response but also in community-mobilization efforts and local politics. Held up as the case study of the power of grassroots mapping to influence change, Map Kibera began as a response to the lack of public and open data — both geographic and otherwise — about one of the world’s best-known slums. Relying heavily on both of the tools above, as well as a combination of hand drawn maps, walking papers, and public participatory GIS sessions, they built what is now a robust community information project with continued digital mapping. In addition to generating a complete map of Kibera — available to the public through OSM — the project also created a community news website powered by Ushahidi and a video journalism project. Access to these maps allows the population to actively engage in the debate about how to improve their own home and health. Map Kibera has also been used as a piece of hard evidence to rally support from local and national governments to recognize the legitimacy of the Kibera community and the people who live there. In doing so, Map Kibera has helped local communities justify their claims and demand vital services.

As geographers, we believe that health is inherently geographic. And, therefore, that viewing data on a map provides a new perspective, because it links seemingly independent events together, thereby identifying patterns otherwise unseen. Having more robust, dynamic datasets for both healthcare workers and local communities results in lifesaving actions, as demonstrated in Haiti, Liberia, and countless other places around the world. And, as the open source movement continues to democratize cartography through crowdsourcing and access to free and simple applications, maps themselves have begun to serve as essential tools for not only visualizing, but also contributing to the fledgling data infrastructure in the developing world.