Analyze

I situate my research at the crossroads of history, philosophy, sociology and anthropology of science. In the past, I have focused on epigenetics, environmental research, empirical bioethics and environmental justice, within and outside the academia, as you can read here, or here. Now I am focusing on antibiotic resistance, and I use it as a lens to interpret the contradictions of the last century derived by industrial production, environmental degradation and biomedical cultures.

What interests me is the (at that time) new epistemic discourse that since the Forties has been produced to explain morphological changes of organisms produce when they experience new environmental conditions or perturbations. Through an important experiment at the base of the so-called concept of genetic assimilation, Conrad H. Waddington showed that a thermic shock can produce changes in wings’ veins of fruit flies, changes that can eventually be inherited across generations, without the environmental trigger that caused them.

This focus on production and (genetic) storage of biological differences elicited by the environment is nowadays coupled with the knowledge produced through microbiome research that explains the phenotypic patterns that recur across generations.

In a thought-provoking twist, with microbiome research, the focus shifts from production and inheritance of biological differences to production and inheritance of biological similarities. Microbiome research shows that some phenotypic patterns are allowed by ecological communities of microorganisms composing all animals. Bacteria allow the development and functioning of our bodies within an epistemic framework that is now key to understand biology. The network of vessels composing mammals’ stomach is formed through cellular differentiation and expression of genes coordinated by bacteria. The same is true for our immune system that is coordinated by gut bacteria. Food, which is an important aspect of our lives also impacts on this microecology and mediates between our biological functions and functioning of means of production whose parts dedicated to food production have immense importance for our biology and our internal and external ecologies. Antibiotic resistance is one of the crossroads where culture, biology, history and the Anthropocene meet. Indeed, Antibiotic resistance shows that means of production of our societies have an even more widespread, deep and allegedly unexpected impact on the biology of animals and plants. The microorganism can indeed adapt to resist the selective toxicity of antibiotics. Moreover, bacteria can transfer their genetic code horizontally, by touch, so that we can acquire antibiotic resistance by eating food that functions as a vector, by hosting lice on our heads and many other contacts. Bacteria that are resistant to antibiotics that have been used as growth factors in animal husbandry and to prevent diseases in livestock and aquaculture, spread in natural ecosystems and can be found in wild species. Rivers and estuarine waters are places hosting antibiotic resistance.

Searching on PubMed (the search engine for biomedical literature) titles of articles containing the terms ‘antimicrobial’ and ‘Louisiana’ I retrieved just one twelve-years-old article. No results with terms such as 'Mississippi' or 'New Orleans'. The authors collected and analysed Oysters from both waters of Louisiana Gulf and in restaurants and food retailers in Baton Rouge. In most of the samples gathered, scientists recognised the presence of bacteria (Vibrio parahaemolyticus and Vibrio vulnificus) resistant to specific antimicrobials. Food production is indeed the first factor in terms of the quantity of antibiotics used. This use and related antibiotic resistance impact all the living beings present in a specific area, and can easily travel around the globe through many channels. As Littman & Viens have highlighted, a sustainable future is a future without antibiotics as “there may be no truly sustainable way of using antibiotics in the long-run, as microorganisms have shown to be almost infinitely adaptable since the first introduction of antibiotics” (Littman & Viens 2015). But in the meanwhile, we need to use them and antibiotic resistance is a phenomenon that can be better studied through environmental research, by analysing wild species and emissions nearby livestock, for instance.

The study that I retrieved focuses on Oysters. But what about antibiotic resistance conveyed through food that is consumed by the most?

What about exposures of communities that are living in highly polluted areas?

And what is the additive value on antibiotic resistance for individuals who experience the presence of industrial pollutants and that live in areas where cancer epidemics are registered?

In this respect, there is a strategy to cope with the issue of antibiotic resistance promoted by the Center for Disease Control and Prevention. The document doesn’t mention any action to monitor and regulate the production and usage of antibiotics in livestock. Nevertheless, the CDC wants to scrutinise, through genome sequencing, “Listeria, Salmonella, Campylobacter, and E. coli and uploads sequence data into PulseNet for nationwide monitoring of outbreaks and trends.” Moreover, the document reports that “In Fiscal Year 2019, Louisiana will begin simultaneously monitoring these isolates for resistance genes. When outbreaks are detected, local CDC-supported epidemiologists investigate the cases to stop spread.”

The questions that I would like to ask (to local ppl, activists, researchers, practitioners..) are:

What could be the epidemiologic characteristics (socioeconomic status, gender, residence..) of the populations more vulnerable to antibiotic resistance?

What is the additive role of antibiotic resistance for people living in highly polluted areas?

What is the impact of antibiotic resistance for people and patients living in areas where cancer incidence is high?

And on the long run I am interested in imagining possible strategies to not only living with the problem but also to tackle the problem itself, which means to develop strategies to answer the questions:

Why antibiotic resistance, which is known since a century, it’s a problem on the rise?

What is the role and interest of capitalism, in terms of profit-making of corporations, knowledge production and environmental degradation, in not being able to resolve antibiotic resistance?

What can be strategies of local communities to tackle the problem and to promote environmental justice in terms of alliances with ecologists, doctors, epidemiologists and other activists?

By the public, it is regarded as a prestigious academic program that enables and creates an environment in which students can become leaders in their respective DRL careers. DRLA is also mentioned in the news alongside headlines including the USAID office of Foreign Disaster Assistance as well as Rwanda assistance and in high regards with the FEMA Chief of staff. It is clear that this program is intermingled with many governmental agencies and is regarded highly by them, as well as the public for its humanitarian efforts and abilities to produce excellent leaders in the DRL fields. It is very clear that this program is highly regarded academically, professionally and socially by the public as well. 

This is seen as a good start to a major problem that needs far more assistance and advancement. People cite that meeting eligibility requirements are very hard and there are people that make more money than allowed to qualify, but still cannot afford mental health treatment. This policy is appreciated in a certain capacity, yet it is very apparent that people want more and think more help is needed. Of course, you will always have an opposing side when it comes to politics and there are people who think this is the perfect amount of assistance and nothing else is needed. 

Emergency response is addressed in more of a public health aspect rather than EMS. The conditions post Chernobyl in terms of government involvement, political and social climates were emphasized. Along with this, the resettlement and life adjustments of those effected, as well as health and radiation implications are extensively discussed. 

The article is supported through the use of numerous examples and educated points made by the author. First, the author supports her arguments by going through the events that transpired that day at the Fukushima Daiichi plant. She uses the details of the events in Japan to support her argument that a global emergency nuclear response team is necessary. Schmid also cites other areas in the world where this was an issue and protocols were not clear. Ultimately which caused the incidences at Three Mile Island and Chernobyl, all of which would have benefited from a response team equipped and specially trained to deal with this type of situation. The author cites that incidences at Three Mile Island and Chernobyl were the result of systems that were too complex, tightly coupled  and technical, ultimately not allowing broad policy changes when needed. The author also cites that this occurred in one of the world's most advanced areas in the world, both technologically and economically. She states that having scientists and the elite left to make decisions about responses to disasters alone further proves her point and supports her arguments. She also notes that current organizations have little international authority and often suffer when attempting to include or talk to the public in terms of these situation which doesn't allow for full integration with the public. She notes the importance of this integration, but also that world leaders are attempting to do so and see how beneficial this is. She compared the way previous situations similar to that in Japan was handled and she mapped out new regulations that arose based off each of those incidences in order to see what can further be implemented as a blanket response globally for all nations in a situation like this.

This program is funded by tuition paid for my students (or maybe some form of scholarship, on a case by case basis.) Columbia University is a private institution, and those enrolled in this program pay a tuition for cost of the education and resources. 

The authors support their argument many ways, one being how that the rates of HIV/AIDS are so positively linked and correlated with social arrangements that it is often referred to as social disease. HIV commonly effects those that are poor and disease rates are fueled by gender inequality, racism and poverty. The article discusses how structural violence has influenced HIV progression. The article cites that structural violence influences diagnosis rates, staging and treatment. The also article references a study done in Baltimore which reports racism and poverty forms of structural violence and the effects on excess mortality among African Americans without insurance- ultimately showing  they were more likely to to be susceptible. The authors also used other historical data and research to support heir claims. Efforts through Partners in Health were made to prevent the spread and transmission of diseases in Haiti. The efforts made in Haiti and Rwanda were cited, both the positives and negatives. The article also discusses ways to incorporate more interventions to help eliminate any social influences of disease. 

The argument is supported through an analysis of current subjects of humanitarian aid and how it effects them differently and now the principle of neutrality is not apparent and discrimination is seen based off type of suffering. The argument is also supported through numerous essays from Medecins Sans Frontieres, which provide background information as well as statistical data. Also the expert analysis of the author is used to support the article based on her interpretation and experiences of gender based violence being a humanitarian problem. There is also an ample amount of facts and statistics to support the argument. 

A main concern is the fact that no disaster will ever be the same. A hurricane in one area will be very different in another area, despite the same source of destruction. This is because each areas has a different population, different needs  and different services available in each area. The most challenging part is the ability to foresee what might be good resources or equipment or forms of medical care and best to supply at each different disaster since each one is unique. 

This article focuses on the effect of violence on the heath service delivery in complex security environments on individuals, discrimination, property and more. The challenges associated with researching this are also discussed in this paper. The paper notes that there is a deficit in the ability to be able to analyze the correlation of violence and the health service delivery due to data collection. There is an overall lack of research that is health specific, publicly available and isn't gender based. This gap in research, overall limits analysis of the correlation.