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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.

“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)

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)

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. 

The film is primarily the narratives of many first responders, so they play a large roll in the meassage being protrayed. They are seen as heros but also paid the price of their decisions through health issues.

The film is geared towards the general public, all medical terms are explained fairly well. No medical or first response background is necessary, and it is fairly educational for viewers.

The real threats of air quality were covered up due to politics and other reasons, wanting to get america back to work. Instead, the reports were edited and people were sent back into the dirty air to clean up the scene or back to office jobs in the area, with contaminated air surrounding everything. Decontanimation efforts did not start until very late in the process. Bush did not wear a mask and the workers were told they didn't need to, so they didn't. As a result, there were severe health problems afterwards.

The first hand interviews from first responders are compiled in a way that goes through the stories of what heppened, how health information was released and changed. The first repsonder stories are intermixed with testimonies from the EPA workers, showing differences in the science that was found and the press releases disclosing the health concerns. Many tear up upon realizing how their health will hurt their families. The doctors in the area caught onto the trends in poor health and started a monitoring program to make sure everyone got the medical screening and help they needed. The lives of all of the first responders and their families were changed drastically from their public service.

First responders share their experiences, how they responded, how they realized there weren't going to be many survivors. Many of them suffered from health issues afterwards. The air was very toxic and led to cancers. It makes you wonder how other safety information is given to first responders. They weren't even doing a rescue mission at the point that asbestos was being hidden in reports, so their lives should not have been risked like that for simply cleaning up rubble. Was it worth it for them to shovel the debris and pull out parts of bodies at that point, while putting their well being and lives at risk? If they had waited a few months for the dust to settle and be cleaned up, would that have saved many of the first responders? Offices in the area and houses nearby weren't inspected until even later. Schools opened as a sign of American strength led to asthma, bronchitis, etc. Are those lives worth the public image?

The school parent was interesting - explaining that the public image of resiliance was paid for by the lungs of the children being sent back into the uncleaned schools.

The person in charge of sending out the EPA press releases (and heavily editing them) had previously fought against the EPA for large companies.

The doctors eventually noticed the issues and tried to get more of the first responders evaluated and treated.

The first responders that risked their lives saving others now can't get fair treatment or benefits to help recover. They want to work but can't.

They needed to testify that they were on the scene in front of a judge to get benefits.