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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?

Lakoff has a PhD in social anthropology and is an associate professor of sociology at the Univeristy of Southern California. Collier in an associate professor of international affairs at the New School in New York. Both authors have extensive backgrounds in studying people, but not disease, so their stance in this paper is not looking at the biological or emergency response aspects, but more how people plan and react to such.

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 health of the inmates is in serious jeopardy and there was in instance in which an ambulance was unable to get to the island, which resulted in a death. There are also a lot of suicide attempts so that should be a warning to someone.

Medicaid covers the elderly and low-income families, those that are likely to not be able to afford health care, since children and the elderly often\ require more medical attention. It would seem to me that mental disabilities don't discrimintate based on age or strength, like physical issues may, however old age and decreasing physical abilities can harm mental health. These populations, with lower income, do not have as much access to mental health help, and that can further their economic situation, so this policy ensures that they will be taken care of sufficiently. At the same time, it ignores the needs of the middle-aged patients, as they must be covered by the state or in other ways.

The program is targeted for the entire world. They want to advance science while encouraging peace and furthering the training and knowledge of those who will save lives in the face of disaster. This is able to apply to the whole world, based on the possible size of disasters associated with the magnitude of these types of power. Thus, the goal is for everyone to be involved, and most of the world is involved at this point.

Emergency response is not directly discussed in this article, however seizures are a common reason to call  for EMS. Seizures, or "fainting" as they called it, can be dangerous, especially if the patient is alone or if it is at night. If there are a lot of people with epillepsy that is not controlled, then there could be an overload on the EMS system.

"But more significantly, in addition to revealing the reproduction of inequality, the fissures rendered visible by the entry of gender-based violence into humanitarian missions force an engagement with new forms of the political. Humanitarianism’s mission has expanded so that it now occupies a dominant place in the global political arena – whether humanitarians asked for this or not"

"It seems that humanitarianism, as universalism,both erases and depends on difference; on the one hand, it manages difference, declawing it so that it doesn’t tear apart the humanitarian kit, made to fit and rehabilitate everyone into a basic bare-bones humanity. That is, it assumes that difference ultimately leads back to sameness: to some nondescript, generic human survival. Yet on the other hand, humanitarianism is necessarily built on difference – the difference between two populations – those who have the power to protect, and those who need protection66 – those who suffer, and those who recognise and address suffering"

"It seems that MSF workers assumed that sexual violence would bring a particular sort of shame, greater than that accompanying other forms of violence or brutality; and therefore that it should be kept quiet, confidential, in the private realm. This particular approach stems from the historically and culturally situated belief that a woman’s chastity is her most precious possession and that sexual violence is more significant than other forms of violence – of course,the question is whether it is equally significant for female and male, straight and queer."

""USAID has spent about $1.5 billion since the earthquake,' Johnston told Goats & Soda. 'Less than a penny of every dollar goes directly to a Haitian organization.'"

This quote shows the extreme difference in total money donated compared to the money that is being used to help Haiti directly. I was mentioned that their government is hard to trust, so outside companies tend to hold the money, but that means that they can decide how they want to spend it.

"The U.N. and its agents are "absolutely immune from suit in this Court," Oetken ruled."

This quote shows the irony of the situation, by using the word "immune" it brings light to the fact that the UN's actions had major impacts on Haiti, from with the people of Haiti are very much not "immune", as cholera affects so much of the population.

I was very compelled by the entire film. It was very interesting and revealing of all aspects of the ER. Most people only get to see one perspective ever, let alone at one time, so this helps give perspective and show everyone that everyone else is working hard and trying to help.