Elizabeth Hoover is an anthropologist and associate professor of environmental science, policy and management at Berkley, who long claimed to be native (receiving grants and research access under this assumption) but has recently admitted otherwise. She has a PhD in anthropology from Brown University with a focus on Environmental and critical Medical Anthropology.
Katsi Cook, Mother’s Milk Project, collecting samples of breast milk: “Katsi has described this work as “barefoot epidemiology,” with Indigenous women developing their own research projects based on community concerns and then collecting their own data.” (90) - 61? – used a private lab to analyze samples because women did not trust the New York State Health Department
“Barefoot epidemiology” is a concept borrowed from China’s “barefoot doctors”—community-level health workers who brought basic care to China’s countryside in the mid-twentieth century. Hipgrave, “Communicable Disease Control.” According to a “workers’ manual” published by the International Labour Organization, barefoot research is often qualitative, and qualitative research is not the standard approach for conducting health studies, which tend to be based on laboratory experiments and clinical findings. See Keith et al., Barefoot Research” (294)
Civic Dislocation: “In many instances Mohawks experienced what Sheila Jasanoff calls “civic dislocation,” which she defines as a mismatch between what governmental institutions were supposed to do for the public, and what they did in reality. In the dislocated state, trust in government vanished and people looked to other institutions . . . for information and advice to restore their security. It was as if the gears of democracy had spun loose, causing citizens, at least temporarily, to disengage from the state” (118)
“Dennis Wiedman describes these negative sociocultural changes and structures of disempowerment as “chronicities of modernity,” which produce everyday behaviors that limit physical activities while promoting high caloric intake and psychosocial stress” (235)
Third space of sovereignty: “This tension that arises when community members challenge political bodies while simultaneously demanding that they address the issues of the community has been theorized by political scientist Kevin Bruyneel, who describes how for centuries Indigenous political actors have demanded rights and resources from the American settler state while also challenging the imposition of colonial rule on their lives. He calls this resistance a “third space of sovereignty” that resides neither inside nor outside the American political system, but exists on the very boundaries of that system.” (259)
“Akwesasne residents’ main criticism of the Mount Sinai study was that at its conclusion, the researchers packed up and left, and community members felt they had not received any useful information.” (76)
“As scholars of tribal health risk evaluation Stuart Harris and Barbara Harper explain, among most tribal people, individual and collective well-being comes from being part of a healthy community with access to heritage resources and ancestral lands, which allow community members to satisfy the personal responsibilities of participating in traditional activities and providing for their families.” (96)
“By placing “race/ethnicity” on a list of diabetes causes without qualifying why it is there, the CDC neglects the underlying root cause—that race/ethnicity is often associated also with class, education, levels of stress, and access to health care and fresh foods.” (231)
“Chaufan argues that to counter the focus on the medicalized aspects of diabetes, which has led to the individualization and depoliticization of the issue, a political ecology framework needs to be applied to the disease, one that is concerned with the social, economic, and political institutions of the human environments where diabetes is emerging.39 Such a framework would highlight how diabetes rates among Mohawk people are influenced more by changes in the natural environment and home environments than by genetic makeup.” (231 - 232)
“Understanding community conceptions of this intertwined “social and biological history” is important because, as Juliet McMullin notes, examining the intersections of health, identity, family, and the environment helps to “denaturalize biomedical definitions of health and moves us toward including knowledge that is based on a shared history of sovereignty, capitalist encounters, resistance, and integrated innovation.”61 The inclusion of this knowledge can lead to the crafting of interventions that community members see as addressing the root causes of their health conditions and promoting better health.” (249)
Hoover’s book is an analysis of the material and psychosocial effects of industrial pollution along the St. Lawrence River, which runs through the Mohawk community of Akwesasne. Hoover focuses on resistance to private and state efforts at land enclosures and economic rearrangements. Hoover shows how legacy of industrialization and pollution (GM and Alocoa, primarily) ruptured Mohawk relationships with the river, and incurred on tribal sovereignty by disturbing the ability to safely farm, garden, raise livestock, gather, and recreate in ways fostered important connections between and amongst people and the land (“ecocultural relationships”). Hoover describes how confusion about risk and exposure is culturally produced and develops the "Three Bodies" analytic framework to show how individual, social and political bodies are entangled in the process of social and biophysical suffering.
Hoover also highlights how in response to pollution, Mohawk projects of resistance emerged - a newspaper, documentary films, and community-based health impacts research. Hoover conducts a comparative history of two research projects tracking the effects on industrial-chemical contamination on Akwesasne people and wildlife: the Mount Sinai School of Medicine’s epidemiological study in the 1980s, which failed to engage Akwesasne people in the production of knowledge or share results meaningfully, and the SUNY-Albany School of Public Health Superfund Basic Research Program study (in the 1990s and 200s), which ultimately began incorporating key theoretical and methodological principles of CBPR.
The film looks at the struggles of the doctors in MSF while on missions in third-world countries. These issues stem from lack of supplies, quality of the facilities, and high patient influx. The doctors in the film are burning out quick, with way too many responsibilities to tkae care of. The setting is in Liberia and the Congo during a period of war. The film also examines the tensions developed between the doctors due to differences in style, knowledge, and culture. The clash of personalities and reasons for being in MSF also contribute to the tension.
The film largely plays on emotional appeals and drama. By documenting the interviews of the doctors, which often are about the other doctors, the viewers see just how hard it is to detach ones self from their work. There is a scene in which the doctors talk about how, despite all the issues they face in the medical setting, everything at the end of the day is about personal relationships. It even briefly touches on sex between the medical staff and how that contributes to the care given. Since the film is based on personal interviews, little to no scientific information is given about the disease and injuries seen; its all based on personal opinion.
The stakeholders in the film would be the doctors, the local health ministry, and the patients themselves. The doctors were the most focused on, and they were put into a lot of situations in which they were the sole decision makers. However, many times the decisions weren't life or death, but death or comfort. For instance, Davinder was in a situation where a child was inexplicably swelling all over his body. The doctors weren't well equipped for diagnosing his illness, and thus the child was doomed to worsen and die. A nurse informed him that the mother had taken the child and left, to which Davinder remarked that he couldn't blame them. He believed the comfort of the child in somewhere without his care was worth just as much as, if not more than, his care in the hospital. This was quite different than Kiara's opinion that they needed to stay in the hospital. She blamed it on a lack of confidence in medical ability, while he saw it as being human.
Following the time on the mission, the doctors all had to decide what was next. Dr. Brasher left MSF to practice medicine in Paris, while Dr. Gill went to Australia to become a pediatrician, with no plans of returning to MSF. Dr. Lapora was promoted to Emergency Coordinator, and established three more missions in other parts of the world. Dr. Krueger still works with MSF and has been on a number of other missions. All of the doctors continued medicine, but their experiences in Liberia dictated their plans on whether to continue this service.
Emergency responders as a unique group aren't discussed or portrated in the film. However, the doctors had to take on the role of emergency responders often, while not neccesarily being emergency doctors. The question in the film became whether or not the doctors were prepared for these roles, and if they had the energy to dedicate to them. Some doctors burn out, and others thrive, but regardless they are challenged to make sacrifices that emergency responders often must decide on.
The film would have the most impact on the general population, like something that would be played on a news channel before prime time. The level of emotional appeal and interpersonal drama is enough to keep anyone intersted for the length of the film. The film does however paint the experience in a negative light, which could discourage professionals from pursuin mission worlk. Thats why the general population would be most receptive to the struggles. Its easy for them to say "I would do something like that if...." without having the ability to do anything.