Carrie Dolan’s research requires her to work with one foot in the world of big data and the other foot, well, just about anywhere in the world.
“I study where big pots of money go in developing countries and try to figure out how that funding translates into health outcomes — like a decrease in under-five mortality or access to health care,” she said. “Then I make recommendations to places like the Gates Foundation and World Bank for how they can get more bang for their buck by making a funding decision more efficient, effective or equitable.”
And so Dolan follows the funding. The groundtruthing aspect of her work takes her from Williamsburg-James City County schools to sub-Saharan Africa. She has logged enough time investigating health care issues in the world’s remote locations from Jamaica to Kenya to be named a Fellow of the Explorers Club.
It's an elite group. The Explorers Club was founded in 1904 to promote “the scientific exploration of land, sea, air, and space by supporting research and education in the physical, natural and biological sciences,” as the club’s website notes.
As a Fellow, Dolan enters the top tier of Explorers Club membership. Fellows, the application for membership reads, must demonstrate significant contributions to geographical exploration.
“It’s fun,” Dolan said. “Members include people like Buzz Aldrin, James Cameron, the Cousteaus, the Leakeys…and now me."
Dolan is an assistant professor in the Department of Kinesiology & Health Sciences at William & Mary. She began her scientific explorations as a Peace Corps volunteer in Jamaica, working with the Ministry of Health. The project was to evaluate the effectiveness of funding directed at HIV prevention, and she worked as part of a team that conducted a cross-sectional study that included three different types of interviews, visiting sites where people meet new partners.
They mapped out the data and hung it on the door in their Ministry of Health offices. The data were collected in a map that peer educators could use to target areas that had the highest need for HIV-prevention. She said the satisfaction of witnessing that translation of knowledge into action remains one of her biggest career wins and set a theme for her work.
“This is where I learned the power of maps,” Dolan said. “I could use the same map to convey complex information to academics, but more importantly, to the Minister of Health and the community peer educators who could then use that data to make programmatic decisions.”
She went on to conduct similar studies of STD/HIV-prevention effectiveness, in Virginia, and also in other countries, under the aegis of the monitoring and evaluation arm of USAID. Her work includes a hefty data science component and she is a member of the AidData Research Consortium and the Center for Geospatial Analysis Steering Committee at William & Mary.
Her research is affiliated with the William & Mary Data Science Program and the Global Research Institute. Dolan says she maintained that model of translating data to knowledge and knowledge to action throughout, including an evaluation of a malaria bed net program in the Democratic Republic of the Congo.
“I am a spatial epidemiologist, but my work lies at the intersection between public health, geography and economics,” Dolan explained. “I use data with and without a spatial component, but all work I do has some spatial base.”
Her on-site work is vital to understanding the effectiveness of individual public health initiatives and pointing out where things aren’t working. For instance, Dolan studied a health aid program in Malawi aimed at combating malaria in children recently. She found that the funding was being directed towards microscopes and other lab equipment for identifying bacteria through the gram stain procedure.
“But moms weren’t taking the kids to use the resources in the clinic. That is because they didn’t have trained staff in the clinics to implement the tests,” Dolan said. “Therefore, the work shows that yes, it is important to fund equipment. But we also need to develop a mechanism to fund training for the people to use the equipment if we want moms to bring their kids to get tested for malaria, and subsequently treated.”
Dolan also has documented success stories. She recalled her examination of a similar anti-malarial campaign in the Democratic Republic of Congo. The funding was directed toward distribution of anti-malarial bed netting. The campaign resulted in a 41 percent decline in mortality in the target group, children under five years old.
“This study measures a lever that governments and aid donors can directly affect—access to a bed net program—rather than one that they can only indirectly influence, like ensuring household and individual use of bed nets,” Dolan said. “The implication of this work was that governments and aid donors should continue to support efforts to make sure the poorest households in rural, high-malaria areas indeed have access to bed nets.”
Her work contributes value in three arenas that don’t always overlap: practitioners in the area of study, governmental and funding agencies and academia. Dolan uses the same locally sourced, spatially oriented data and distills it into papers submitted to peer-reviewed journals, reports to government/funding agencies and recommendations to the people who remain on the scene.
“I think of my work like one of those old anatomy textbooks with the clear pages where you layer on bones, tissues, muscles,” she explained. “I do that with data. I layer on malaria risk, with roads, hospitals, levels of poverty and money. Then I am able to answer old questions in new ways by harnessing the power of lining up that information and using econometric models to analyze it.”
Dolan pauses when asked for interesting anecdotes that she might exchange with other Fellows of the Explorers Club. “No charging rhinos,” she says. But her fieldwork has had its sporty moments.
In Jamaica, she collaborated with the neighborhood bosses known as “dons” to implement HIV-prevention program. She happened to be in Kingston during a particularly violent election year and one morning helped to scrub blood from the doors of the Ministry of Health.
“On happier notes, I became a divemaster and taught scuba diving on the weekend,” she recalled. “I hiked up an active volcano one morning before work, and I’ve seen the most amazing stars where there is no ambient light.”
Her adventures in the cuisine of the remote parts of the world had an apex (so far) in Ghana where she dined on local fare known as a grasscutter. It’s a large rat. But Dolan says that there is more common ground among the people she’s encountered than differences.
“What I typically learn when I travel is that the core values of most moms are the same whether or not they live in Williamsburg or are part of a traditional nomadic, pastoralist tribe in Kenya, like the Maasai. Moms want to take good care of their little kids and get them access to medical care when they need it,” she said. “My job is to help bridge that gap just a little by taking a next step in terms of translating data into information. By making it easier for someone to have malaria medicine near where they live or access to transportation to take them to a clinic.”