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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?

This article is discussed and referenced in STS based courses and emergency response seminars and planning committees. The paper is also cited in a book Edited by Richard Hindmarsh and Rebecca Priestley entitles "The Fukushima Effect."

Those that complete the course requirements and achieve all their points will graduate with an MS in Narrative Medicine. 

Paul Farmer cites this paper in some of his other studies and articles written after this. The article has also been cited in a book entitled "Social Medicine in the 21st Century" by Samuel Barrack. This article has also been cited in: 

https://dash.harvard.edu/bitstream/handle/1/10612556/3585352.pdf;sequen…

http://opensample.info/blindness-survey-methods-response-from-sudan-stu…;

Humanitarian aid is not directly a form of emergency response in a sense of EMS, but it does give help and attention to those in areas of need, and often times, forms of aid are medically related. Though emergency response isn't directly addressed in this paper, humanitarian aid is a form of a response to an emergency situation. This paper focuses more on the analysis of humanitarian efforts to those that at one time may have needed emergency response in the moment due to violent act. Yet the paper focuses on the social aspects of humanitarianism and its tie to gender based violence, not EMS or emergency response.

There were numerous people invested in this situation and effected by the repercussions of it. The main focus is on the citizens of Liberia. The film shows their account of what happened, in terms of the severe amount of deaths and deplorable conditions in which they lived in. There was a complete lack of health care and public health or awareness, as well as resources such as food and supplies. Citizens were at first not taking the situation as seriously as it should have been, not heeding the warnings from doctors, convinced the government was exaggerating. Yet, once the turmoil and panic of officials was displayed, citizens soon began to worry. There were issues and decisions made involving protecting themselves from the disease as well as their families. Those infected also faced many issues. There was a complete lack of resources for those separated from the population due to infection. There were scarce amounts of food, water, supplies and medical attention. Fear, death and disease spread fast throughout the population. Decisions about not only quarantine and families had to be made, but also decision of whether leaving the country was a good choice, as seen by the main family in the documentary. Other stakeholders include health care officials as well as government employees. There were many decisions made by them in terms of allocating resources, as well as informing citizens about the situation. 

There are numerous methods utilized to support the claims in this paper. Research workshops were analyzed and discussed and the conclusions and discussions of experts were examine and presented. There was also an ample amount of expert interviews that were discussed and analyzed. The authors' expert opinions as well as analysis of current data can be seen throughout the paper, but also an analysis of the lack of health specific data. 

After looking up the bibliography, many of the citations found were government agencies or studies performed on bioterrorism, biological weapons and disease security, all from reputable sources and agencies. This shows that a lot of work and investigation went into this paper and it is valid and accurate research. 

The data is mainly visualized in report form. There is also a section of the site where data and statistics that have been confirmed are written out separated by disease/disorder type. So in the "what we know" tab PTSD, depression, tobacco use, asthma, lung function, respiratory issues, heart disease and adolescent health are separated into different sections with confirmed disease rates, correlations and numbers listed beneath each section. The same group that runs this registry in terms of research, called the 'WTC Medical Working Group' also provides links to other current studies on the matter, some of which they have partaken in. 

"The crumbling infrastructure at Rikers leads to more than flooding. The majority of weapons found on the island (about 79 percent in 2014) are fashioned out of building materials at hand, and not smuggled in."

"In my cell, it feels like it’s 104 degrees in my cell when it’s 94 degrees outside. I feel like I’m dying in the cell. I have a heart murmur and my heart will start pumping hard. I get dizzy and get migraine headaches from the heat.”

"The landfill underneath burps methane, a noxious gas, as the garbage decomposes naturally. Less than a mile away in Queens sit five power plants that spew volatile organic compounds and nitrogen oxide, a pollutant. The Poletti power plant, infamous for being the biggest polluter in New York, sat within a mile of Rikers and operated until 2010"