Analyze

This document promotes trauma-informed and healing-centered engagement frameworks, practices, and policies as a way to address childhood adversity and trauma in Louisiana. 

With the pupose of creating a "trauma-informed Louisiana", the plan identifies four essential priorities: Collaboration, Awareness, Prevention + Healing, and Workforce. Under each of these, the plan makes a series of recommendations. Some of these include fostering meaningful community engagement; coordinating cross-system collaboration; establishing a framework of shared accountability; and creating shared data infrastructure.

"RECOMMENDATION C2 Establish a Shared Accountability Framework Objective C2.1 | Develop a shared accountability framework to ensure that all relevant systems and entities are held accountable for achieving shared goals and outcomes. ... 

RECOMMENDATION C3 Develop Shared Data Infrastructure Objective C3.1 | Establish shared performance metrics and data tracking systems to monitor progress of the WHL State Plan objectives and improve clarity across entities, with a particular focus on public agencies. ... 

Objective C4.2 | Partner with community-based and local organizations to advance prevention, recognition, and treatment of childhood adversity and its impacts through a community-centered lens. (See PH3)" (23)

The document does not explicitly refer to this discourse, but notably emphasizes the importance of collective action to address childhood adversity and racism.

"Healing justice is a framework that recognizes the impact of trauma and violence on individuals and communities and names collective processes that can heal and transform these forces to free us from the toxic injury." (Denese Shervington, p. 15)

"Achieving healing justice, however, is simply not a matter of behavior change due to awareness of implicit bias. Todd McGowan has posited that racism is not simply a problem of knowing – if it were, it could be summarily corrected and eliminated – we would just need a little diversity training that teaches us that our biases were unfounded. Instead, he notes – “Racism is not the result of a bias in our knowing, but rather we have a bias in our knowing because of racism.”26"  (Denese Shervington, p. 15)

McGowan, Todd. (2021). The bedlam of the lynch mob: racism and enjoying through the other. In Lacan and Race: Racism, Identity and Psychoanalysis (Chapter 1), edited by Sheldon George and David Hook. Routledge. https://doi.org/10.4324/9780429326790. 

In contrast to the discourse on health as a matter of cultural deficit/social dysfunction, the healing-centered engagement framework highlighted in this document uses an asset-driven approach that centers "repair and resilience using a strengthsbased lens that utilizes the knowledge and skills of the individual and their community. The focus is on wellbeing and positive outcomes, rather than pathologizing damage.12 This requires empowering individuals and communities to reclaim their agency and identifying and nurturing individuals’ strengths, resources, and cultural assets as sources of resilience and healing.27" (16). 

Ginwright, S. (2023, January 31). The future of healing: Shifting from trauma-informed care to healingcentered engagement. Medium. Retrieved from https:// ginwright.medium.com/the-future-of-healing-shiftingfrom-trauma-informed-care-to-healing-centeredengagement-634f557ce69c.

Flourish Agenda. (2022, January 28). Our Process. Retrieved from flourishagenda.com/our-process/.

This document outlines a state plan to improve health in Louisiana by addressing childhood adversity through cross-system collaboration. Funding for this plan includes $1 million dollars annually for the first five years, led by a public-private partnership between the Louisiana Department of Health and the Whole Health Louisiana Statewide Lead. The plan began in January 2024 and is set to continue through to December 31, 2028. 

"The WHL State Plan is grounded in the science of early adversity and resilience, the experience of professionals, leaders, and community members throughout the state." (4)

The document refers to metrics from America's Health Rankings, the National Child Traumatic Stress Network, and Substance Abuse and Mental Health Services Administration (SAMHSA). 

Though the document refers to the science of early adversity and resilience, it goes into less descriptive detail into the evidence of toxic stress than California's Roadmap for Resilience. 

When asked about the origins of trauma in their communities, participants “overwhelmingly cited the persistence of extreme concentrated poverty and pollution in neglected areas” (58).

In a paper included in the WHL plan, Dr. Shervington refers to "crumbling built environments with inequitable exposure to environmental toxins" (15) as evidence of the unequal distribution of adversity, and suggests embracing indigenous knowledge to “help Louisianans consciously and explicitly reconnect and recognize the reality that, as humans, our existence is embedded and interconnected with each other and our physical world."

"Although disasters affect everyone, they often exacerbate long-standing disparities and inequities experienced by people from racial and ethnic minority groups, people with low incomes, and other communities with less power and access to resources. Decades of systemic and environmental injustices have resulted in these groups being disproportionately affected by disasters. A recent study of the impacts of urban flooding found its impacts are most harmful to Black communities,21 and Black neighborhoods are less likely to receive flood protection.22" (12)

"Systemic and structural inequities create disparities in both trauma exposure and impacts by contributing to a greater experience of secondary disaster-related traumatic experiences among Black, Hispanic, and Native American communities related to displacement as a result of the disaster, delays in restoration of infrastructure services, lack of access to health care, and loss of social networks in the weeks and months following the disaster." (12)

Howell, J., & Elliott, J. R. (2018). As Disaster Costs Rise, So Does Inequality. Socius, 4. https://doi. org/10.1177/2378023118816795

SAMHSA. (2022, October 24). Diversity, equity, and inclusion in disaster planning and response. Retrieved October 19, 2023, from https://www.samhsa.gov/dtac/ disaster-planners/diversity-equity-inclusion.

Research for this documented was organized and implemented by the Louisiana Department of Health’s (LDH) Bureau of Family Health and Trepwise, a strategy consulting firm. More than 700 experts and community members participated.

Eexpert individuals and organizations referred to in this document include: Dr. Shawn Ginwright, Substance Abuse and Mental Health Services Administration (SAMHSA), Coalition for Compassionate Schools (CCS), the Power Coalition for Equity and Justice, and Dr. Denese Shervington, MD, MPH, an expert in public health and psychiatry at the Institute of Women and Ethnic Studies. Dr. Shervington is focused on historical, intergenerational, interpersonal, and community trauma and healing practices.

The process of drawing the WHL State plan also included “Community Conversations,” an effort to engaged communities in drafting the plan (organized and facilitated by the Power Coalition of Equity and Justice from January 2023 to November 2023). During these conversations, participants expressed concerns about extractive research projects and lack of followup, as well as a desire for greater access to local and state government. When asked about the origins of trauma in their communities, participants “overwhelmingly cited the persistence of extreme concentrated poverty and pollution in neglected areas” (58).

Resilience is defined as "the learned ability of a child or adult to recover from and show effective adaptation following traumatic events or an accumulation of adverse circumstances.7 A consistent and nurturing relationship with at least one supportive parent, caregiver, or other adult is the single most common factor for children who develop resilience.8 Collective resilience results when individuals with a shared identity band together to support one another and draw on their solidarity to promote healing.9 Systemic resilience refers to policies and practices that promote healing.10" (9)

National Child Traumatic Stress Network. (2016). Resilience and child traumatic stress. Retrieved from https://www.nctsn.org/sites/default/files/resources/ resilience_and_child_traumatic_stress.pdf.

Center on the Developing Child at Harvard University. (2023). Resilience. Retrieved from https:// developingchild.harvard.edu/science/key-concepts/ resilience.

Drury, J., Carter, H., Cocking, C., Ntontis, E., Tekin Güven, S., & Amlôt, R. (2019). Facilitating collective psychosocial resilience in the public in emergencies: Twelve recommendations based on the social identity approach. Frontiers in Public Health, 7, 141. https://doi. org/10.3389/fpubh.2019.00141.

Ungar, M. (2018). Systemic resilience: Principles and processes for a science of change in contexts of adversity. Ecology and Society, 23(4). https://doi. org/10.5751/ES-10385-230434.

When the first lockdown orders were passed in India and stay-at-home orders in California, many in my family dispersed across nations felt containment for the first time. An old couple had arrived to the US in December last year and could not leave now. I had planned to spend summer in Delhi with my family but that is not going to happen. It is too risky to be mobile. At the same time, our lives under lockdown are dependent on people being productive, at home or beyond. When I think about theorizing place and COVID19, I must take containment seriously. The moment reveals the inadequacy of concepts as containers, making the discursive gaps apparent (Fortun 2012) but leaving us flailing about as we meet each other, fingers-crossed. 

The clearest inadequacy is methodological nationalism (Wimmer & Schiller 2002): even as lockdowns have visibly occured across national borders, the transmission of virus through arteries of transnational industrial capitalism (some of it late, some not) and the privilege of transnational mobility point that as long as these infrastructures remain in place, so will this virus and more such to come. We continue to order things online, and Amazon continues to maintain these infrastructures. Public spaces are gradually opening with questionable safety norms in place. India, like other countries, is rescuing its citizens and bringing them back home, even as it continues to let migrant workers starve. 

There is consensus that things will not be as before, even as transnational mobilities continue to function. With enough PPE, fingers-crossed, everyone will be fine. What does it mean to take containment seriously, at a time when we are opening up? As things will continue to be normalized to our collective surprise and fatigue, this moment should mobilize us to think about different ways of organizing and care. These do not have to be new ways of thinking and doing but those that have blossomed in our lands for some time. 

In my annotation, I offer brief summaries of articles that animate my thinking about theorizing from confinement and that offer ways of doing already present: 

• Epidemics in American Concentration Camps: From the “White Plague” to COVID-19: Japanese Americans have formed the group Tsuru for Solidarity, calling for decarceration from prisons, jails, and detention centers. As these violent confined places become hotspots of infection, residents and descendants of residents of World War II concentration camps located across the US (most famously in Manzanar, California) recall accounts of epidemic management. Not surprisingly, the burden to remain healthy and disease-free was on detainees, which meant aggregating community and family resources when detainees were already deprived of livelihoods. As staffing problems arose during tuberculosis epidemic in 1940s, the hospital management even considered family members to take hospital shifts. 

• By Desperate Measures Relieved?: Public Health, Prisons, and the Politics of Life: Jason Ludwing writes about how notions of accelerating vaccine development for COVID19 through human "challenge trials" reminds him of medical experiments on incarcerated people in the US. Challenge trials depend on a volunteering body to take on the infection, but for people in prisons, the line blurs between a consenting body that volunteers and a coerced body that is sacrificed. He points to the prison-university complex  in collaboration between University of Maryland and Maryland Corrections in typhoid experiments based at Prison Volunteer Research Unit (PVRU) which launched many publications and research careers. The researchers frame those as ethical experiments because the male inmates received better accomodation and pay. Even though incarcerated populations will not be experimented upon during COVID, prison factories have remained open for producing PPE. Ludwig reminds us that this is not because of the moment, but an inevitable consequence of a system that deprives people of their bodies. 

• COVID-19, Biopolitics and Abolitionist Care Beyond Security and Containment: Eva Boodman argues that we must see beyond individual protection against microbes (biodefense) especially when it comes to people confined by coercion. Building from Foucault's biopolitics (make live/let die), Boodman sees this as continuation, not departure from what many groups have known all along: that the state and university is not for them. They know that we will keep getting messages of management and security as care. Boodman has a vision for abolitionist care, arguing that abolitionists over the years have assidously foregrounded racialized and class-ed neglect that COVID exacerbates and called for its end rather than thinking with. Abolitionist vision would mean calling an end for prisons, jails and all forms of carceration and in line with neglect of public health, an end to all for-profit nursing homes and treatment centers. It means to center mutual aid groups that have been working on-ground for a long time, and those that are built anew. It would mean for both to learn from each other. But mutual aid groups will also be careful to not be co-opted (as Black Panther Party's free breakfast program was co-opted by USDA), or serve as justification for further state neglect. Abolitionist care acknowledges that it will have to work temporarily with security apparatuses even as it continues to resist from inside. The end goal is not to settle for a liberal future.

• Beyond Inside/Outside: Imagining Safety During Covid-19: Author mobilizes her experience of leaving domestic abuse to think about living and working in confined domestic spaces. Feminized labor blurs inside/outside boundaries, revealed starkly by COVID. It is fatigued and exhausted but carries on. She says: "My experience of abuse was organized around waiting. Waiting for something bad to happen and then waiting for the bad thing to be over”. She says that the years of abuse live in her body. She was afraid to call for mediation because the police and state have worked to either criminalize or pass judgement on people like her. The work of transformative justice and prison abolition made her ask the question: why must we endure? Even though staying can be strategic, a way of survival, community can be elusive too. She offers the notion of "pod-building": does away with romantic ideas of community predicated upon shared identities and political analysis and pushes us to rely on relationship-building and trust with people we already know: that are reliable, have good boundaries and skills, which do not necessarily mirror our politics. This reconfiguration of care comes as she recognizes the link between intimate partner violence, gender-based violence, and prison-industrial complex that disrupted her healing and now animate her activism. 

• Working During COVID-19: Occupational Hazards and Workers’ Right to a Safe Workplace: A brief history of labor organizing around occupational safety and hazards and the role of ILO. To be recognized as occupational hazard, a worker in the American context must demonstrate that disease was contracted in place of work. For mining industry, the struggle to include silicosis and lung-based infections went on for decades and was successful but still requires heavy bureaucratic lifting. For petrochemical industries, this is even difficult as communities live in contamination, blurring home and work places. Workers in informal economy are even more precarious and face either starvation or contagion. As the ILO called for COVID to be recognized as a workplace hazard, could workers demand better conditions and from whom and how? The authors offer two examples from "occupied" factories, or those controlled by workers' assemblies: Rimaflow from Milan (Italy) and Traful Newen in Neuquen (Argentina). These workplaces implemented safety protocols much earlier than ordered by the state, and allowed older people, people with co-morbidity, and those who have domestic emergencies to stay at home with pay. Rather than decreasing production, these workplaces have seen an increase and created more jobs in a more ethical way.  

More reading: Care not Cages! #COVID19DecarcerateSyllabus

I've found myself returning to thinking about/around/within interstitial spaces of care, particularly within hospital settings, interested in how viral activity unsettles the ideas we have around space and boundaries, both biological and infrastructural. In COVID-19 pathology and response, the inbetween, the interstitial, become sites challenge and possibility. With COVID-19, we see an acknowledgment of once forgotten spaces quite obviously, with hospital atria and hallways being reconfigured into patient care spaces, makeshift morgues established in refrigerated trucks, and hospitals spilling out into neighboring streets and parks. More than ever, we see how hospitals are simultaneously bounded and unbounded--the most stable and unstable sites for care. Along this line of thought, what might thinking through hospitals as heterotopia of crisis and deviation afford?

Foucault outlines six principles for heterotopic spaces

The heterotopia is capable of juxtaposing in a single real place several spaces, several sites that are in themselves incompatible

Heterotopias are most often linked to slices in time—which is to say that they open onto what might be termed, for the sake of symmetry, heterochronies. The heterotopia begins to function at full capacity when men arrive at a sort of absolute break with their traditional time. This situation shows us that the cemetery is indeed a highly heterotopic place since, for the individual, the cemetery begins with this strange heterochrony, the loss of life, and with this quasi-eternity in which her permanent lot is dissolution and disappearance.

Heterotopias always presuppose a system of opening and closing that both isolates them and makes them penetrable. In general, the heterotopic site is not freely accessible like a public place. Either the entry is compulsory, as in the case of entering a barracks or a prison, or else the individual has to submit to rites and purifications.