Mapping Territory, Mapping Care: Reflections from the Design Museum and Primary Health Care - fabioluizvieira

In May 2026, during a visit to the Design Museum in London, I encountered the exhibition Tools for Transition, part of the Future Observatory programme exploring how design research contributes to sustainability and community development across the United Kingdom.

One section of the exhibition presented the Public Map Platform, a participatory mapping initiative developed in Wales through collaboration between researchers, local authorities, community organisations, and residents. Using digital tools, environmental sensors, community workshops, and interactive mapping software, the project collects insights into how people—particularly children and young people—relate to the places where they live.

As I explored the exhibition, I was struck by how familiar many of its concepts felt.

More than twenty-five years earlier, during my postgraduate training in Family Health at the Federal University of São Paulo (UNIFESP), I participated in a territorialisation project at the Vila Aparecida Family Health Unit in Pedreira, São Paulo, Brazil. The resulting monograph, Rethinking the Territorialisation Process of the Vila Aparecida Family Health Unit, examined how health teams could better understand and organise care according to the realities of the communities they served.

Mapa Inteligente — demographic and territorial mapping, Vila Aparecida Family Health Unit, Pedreira, São Paulo, Brazil, 2000 — Mapa Inteligente — multi-layer paper map used in the territorialisation process, Vila Aparecida Family Health Unit, Pedreira, São Paulo, Brazil, c. 2000

Final territorial boundary map, Vila Aparecida Family Health Unit, Pedreira, São Paulo, Brazil, 2000 — Final territorial boundary, USF Vila Aparecida, Pedreira, São Paulo, c. 2000

Open sewage and social vulnerability in informal settlement, Vila Aparecida territory, Pedreira, São Paulo, Brazil, 2000 — Social and environmental conditions identified during territorial mapping, Vila Aparecida, c. 2000

At that time, one of the key methodological tools was what we called a Mapa Inteligente (“Intelligent Map”).

Unlike today’s digital platforms, the process relied on large printed maps overlaid with transparent sheets. Each layer represented a different dimension of the territory: demographic distribution, areas of social vulnerability, community organisations, informal settlements, health resources, environmental conditions, and local barriers to healthcare access.

By superimposing these layers, health professionals could visualise patterns that were often invisible in routine clinical practice. The map became more than a geographic representation; it became a tool for understanding how social, economic, and environmental factors shaped health outcomes.

Looking at the Public Map Platform exhibition in London, I realised that despite the technological differences, the underlying questions remain remarkably similar:

Who lives here?
What matters to them?
What resources are available?
What barriers exist?
How do people experience this place?
How can services be designed around these realities?

The Welsh project uses digital interfaces and participatory software to capture community knowledge. The territorialisation process in Brazil relied on paper maps, field visits, household surveys, and community engagement. Both approaches recognise that meaningful interventions require an understanding of territory as a living social environment rather than simply a geographic location.

This perspective continued to influence my work in other contexts.

Years later, while participating in a capacity-building programme for primary healthcare services in Angola, territorial analysis again proved essential. Although the institutional and social realities differed significantly from those in Brazil, the same principles applied: understanding local populations, available resources, community structures, referral pathways, and barriers to access before implementing organisational changes.

Across these experiences, I observed that territorialisation is not merely a public health technique. It is a broader framework for understanding the relationship between people, services, and places.

Interestingly, this concept remains highly relevant in my current work through My Brazilian Doctor, a telemedicine service supporting expatriates, international visitors, and digital nomads throughout Brazil.

At first glance, this population appears detached from territory. Digital nomads move between cities and countries. Expatriates often maintain connections with multiple healthcare systems. International visitors may spend only a few weeks in Brazil.

Yet effective healthcare still depends on territorial knowledge.

Patients need to know where to obtain laboratory tests, how to access pharmacies, which hospitals provide appropriate services, how referrals work, and how to navigate the Brazilian healthcare system. Even in a digital consultation, healthcare remains embedded in physical places and local networks of care.

Part of my role is therefore helping patients navigate not only medical problems, but also the healthcare territory itself.

In this sense, telemedicine has not eliminated the importance of territory; it has transformed how territorial knowledge is accessed and applied.

What I found particularly compelling about the Design Museum exhibition was the recognition that disciplines as diverse as architecture, design research, sustainability studies, and primary healthcare are increasingly converging around similar methodologies. Whether called community mapping, participatory design, place-based research, or territorialisation, these approaches share a common objective: understanding how people interact with the environments they inhabit and using that knowledge to improve decision-making.

The technologies may have changed dramatically since the paper-based “Mapa Inteligente” developed in Brazil in the early 2000s. The questions, however, remain remarkably consistent.

Understanding territory remains one of the most powerful ways to understand people.

Related Resources

Territorialisation in Primary Care

fabioluizvieira.com.br/territorialisation-in-primary-care-research-practice-and-academic-dissemination/

Public Map Platform

https://publicmap.org/en

Future Observatory

Wikidata

Video

A short video recorded during the exhibition illustrates how the Public Map Platform uses digital mapping and participatory methods to capture community perspectives and support place-based decision-making in Wales.

Also available on Wikimedia Commons: Community Mapping in Ynys Môn – Public Map Platform exhibition at the Design Museum London

Wikimedia Commons

Photographs from this project are available on Wikimedia Commons:

References – Wikimedia Commons