|GIS for Health and the Environment: Proceedings (International Development Research Centre, 1995)|
Don de Savigny, Lori Jones Arsenault, and Pandu Wijeyaratne
IDRC has been supporting the development and application of Geographic Information Systems (GIS) in developing countries since 1986. During an internal review of progress in this field conducted in 1991, we were struck by the fact that despite rapid and productive adoption of this tool by sectors such as agriculture, natural resources, demography, urban and regional planning, and so on, the health sector had not yet begun to explore the potential utility of GIS for either health research or for health programing. A review of the literature at that time revealed only one publication that described a developing-country health application of GIS. Thus, although GIS itself is not new to most developing countries, its extension into the health sector for interdisciplinary health research and health development provides a new and exciting focus.
At the same time, both commercial and public domain GIS software are becoming increasingly simplified, affordable, and available on PC computer platforms. We felt that the moment had come to encourage some experiments in the use of GIS in a variety of developing country settings to generate some experiences from which decisions could be taken on the potential utility of GIS to either health research or health development. Since then, the Health Sciences Division of IDRC has helped develop and support 10 such studies. It was always intended that at a critical juncture in this effort we would convene an international workshop of the principal investigators to share their experiences, problems, needs, and visions for the future.
This moment came in September, 1994, when the first international workshop on the use of GIS in health in developing countries was convened by IDRC in Colombo, with superb facilities and organization provided by the University of Colombo, Sri Lanka. From these modest beginnings, this workshop attracted much attention, testifying to the rapid uptake of this tool now underway in the South. Papers were presented by all IDRC GIS health projects and a number of other projects currently underway. Forty-five participants from 19 countries attended, representing a truly interdisciplinary mixture of health, social, environmental, and computer scientists from ministries of health, ministries of environment, nongovernmental organizations, academia, and the private sector. In particular, the workshop focused on the use of GIS as it related to the environmental determinants of health, and the management or minimization of the environment's human impacts.
The objectives of the workshop were to explore GIS utility for health surveillance and monitoring; explore GIS utility for health forecasting and control; introduce new or emerging GIS support methodologies; and facilitate networking for health-GIS. The expected outcomes were: enhanced practical ability and understanding of the use, potential, and limitations of GIS for the health sector; enhanced personal and institutional linkages, both South-South and South-North; and dissemination of the current experiences with health-based GIS in the South through an appropriate publication. These objectives were predicated on the question of whether GIS has a role in the struggle for health development. We have learned to be wary of technology-driven exercises. GIS is usually introduced as a turn-key operation. To be successful, GIS applications in developing countries are being developed, modified, and controlled by people in the South who are in the best position to understand the contexts (social, economic and political) and the technical possibilities.
Therefore, the program was in essence dedicated to exploring the state of the art of the GIS-health nexus, and included general review papers, specific project application papers, extensive discussion sessions, software demonstrations, digitizing and data analysis workshops, question and answer resource sessions, and a needs assessment. The various sessions were facilitated by 20 dedicated computers with a full range of GIS software, and large screen projection facilities for interactive demonstrations.
A selection of the papers presented in Colombo have been edited and collated in these proceedings. They are organized from the general to the specific. By way of introduction, the proceedings include a general overview of GIS in the Foreword, followed by a detailed introduction to GIS (Steve Reader), a primer on GIS specific to health applications (Luc Loslier), and a perspective on the epidemiological analytical capabilities of GIS (Flavio Nobre). This is followed by a variety of case study papers focusing on tropical disease management in general, specific vector-borne diseases in particular, other environment related health problems, and finally, health system applications. The appendix contains an annotated "bibliography" of currently available software, hardware, and resources associated with GIS applications pertinent to developing countries.
In addition to these proceedings there were a number of other beneficial outcomes of the Colombo Workshop. Most important was the fact that considerable networking occurred and continues today. IDRC recognizes that at the beginning of any new research endeavour, there are often a number of researchers working in complete isolation. At the time of the Workshop there were only five publications on GIS health applications in developing countries, yet dozens of researchers were already skilled and active in the field. The workshop provided a powerful opportunity for collaborations, mutual support, and trouble shooting to begin in a way that will serve to accelerate progress significantly. Part of the momentum of Colombo was carried forward to add a health session at the Africa GIS Conference held in Abidjan in March 1995.
The Workshop highlighted several areas of need. Among them: GIS is weak in spatial analysis, particularly spatial-temporal patterns which would be important for incidence modelling; there is a need (and an opportunity) to improve multisectoral approaches via GIS; there is a need for better interfaces with GIS. With regard to the latter, IDRC has identified this as a focus. Beyond direct support to GIS research applications, the Centre has been moving to supporting development of products like Redatam+ and expert decision support systems that interface into or out from GIS, respectively.
This workshop was locally arranged and hosted by the Malaria Group of the Faculty of Medicine, University of Colombo, Sri Lanka, with professional assistance from Conventions Colombo. Grateful thanks are conveyed to them for the efficient and excellent arrangements of participant travel, conference agenda, and logistics. In addition, the various social activities arranged by the group made this 6-day workshop one of the most efficient scientific meetings ever carried out in a developing country during our tenure with IDRC. Special mention in this respect must be made of Dr Renu Goonewardena and Dr Rajitha Wickremasinghe, and of the overall guidance of Professor Kamini Mendis, together with their dedicated secretaries who worked tirelessly.
Diane Dupuis of the Health Sciences Division, IDRC, worked through the immense task of maintaining close contact with all conference participants - no easy task - and ensuring the receipt of computer files and manuscripts. The success of this workshop and of the early phases of the proceedings was in large measure assured by Diane's efficient dedication to these tasks, which is gratefully acknowledged. Special thanks should also be passed on to Betty Alce, who took on the, at times, frustrating task of typing and formatting the manuscripts for publication. Her competence and patience are much appreciated by all.
Don de Savigny and Lori Jones Arsenault are with the Health Sciences Division, IDRC, Ottawa, Canada; Pandu Wijeyaratne is with Tropical Disease Prevention, Environmental Health Project, USAID, Arlington, VA, USA (formerly with IDRC's Health Sciences Division).