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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?

Dr. Kramer contends that the current atmosphere of hard, factual-based medicine could benefit from the inclusion of anecdotal evidence. Especially in the fields of psychiatry and psychology, where parameters are still heavily undefined, anecdotes can aid physicians in providing appropriate treatment for a patient. While medicine demands an element of precision only acquired through lengthy, controlled studies, some cases benefit from expedited decisions based on past experience.

This study was published in 1998 in the American Journal of Community Psychology. It is a bimonthly, peer-reviewed academic journal focusing on research devoted to community psychology. Community psychology attempts to place an individual's context within communities/community structure and in society. This includes quality of life for certain individuals, populations, and communities. The impact factor is only about 2, indicating that the journal is infrequently cited and does not have the prowess of larger journal publications. 

The report encompasses reports on the proceedings of the UN Scientific Comittee during its 60th session, May 2013. The UN report presents an unbiased plethora of data surmising Fukushima radiation exposure to both human an biological life. It primarily focuses on 2 reports detailing aspects of radiation exposure during the 2011 nuclear accident. The first report gives estimated levels of radiation experienced by individuals and non-human biota. Human individuals estimates are based on age and ongoing proximity to the accident. Evacuated adult citizens had an estimated exposure <10 mSv, while workers experienced doses >10mSv, with the highest exposure  an estimated 100 mSv. It places these values within the context of lifelong anticipated exposure and international expected exposures. This first report also briefly discusses effects beyond radiation, including the adverse outcomes thousands faced by evacuating. The second report concentrates on radiation exposure of children during the accident. While it concludes longer epidemological studies are needed to accurately assess the prevailing biolgogical effects, several important facts are highlighted. At a given radiation dose, children are more at risk of tumor induction than adults. In addition to this increased radiosensitivity (partially due to physical factors such as size), children also demonstrate increased prevalence of several cancers. These include leaukemia, brain, and thyroid cancers, all of which show radiosensitivity. The report also suggests narrowing the scope of inquiry, as radiation-induced cancers can be influenced by factors such as age and gender.

The agency itself is an illustration of emergency response; before BSVAC ambulance response time averaged around thirty minutes-- a far cry from the standard eight minutes aimed for by ambulatory agencies around the Capital region. The original goal of BSVAC was to cut down these times, thereby increasing patient outcomes and creating a sense of safety in a community rippling with gang and drug violence. In addition to this initial goal, BSVAC also reaches out to the surrounding community, teaching CPR, first-aid, and BLS to Bed-Stuy residents. This aids in emergency response, as CPR and first-aid measures can be delivered quickly to a patient even before the ambulance arrives. 

The latter part of the piece addresses current plans to combat the cholera epidemic sparked during relief efforts post-quake. However, due to many of the factors discussed earlier in the article, donors are hesitant to put money towards efforts. Moreover, the UN's plan worked on a 10-year timeline given the appropriate funding; stalling finances have pushed that timeline out to almost 40 years. Currently a lawsuit is being put forth by the Haitian government to obtain the promised money and support from the UN.

1) Definition of humanitarian crisis: This article denotes a multitude of situations, all of which seem to have a drastic effect on human health and well-being. That being said, some crisis or armed conflicts are not deemed a humanitarian crisis. According to several sources, the definition is incredibly subjective, and must be event(s) which harm the health, safety, or well-being of a community or large group of people.

2) Humanitarian worker protections: At this time, there does not seem to be a true movement to legally prosecute those who harm humanitarian or aid workers. However, within the Geneva Convention and later Protocols, there are legal protections for non-combatants during armed conflicts; this is in addition to a UN Security Council Resolution (1502) which gives greater protection to aid workers, classifying attacks on them as a war crime.

3) Non-combatants: This is where definitions of humanitarian aid workers and their protections under both the Geneva Convention and UN Resolution fall apart. The current climate and disregard for international sanctions has left many aid workers at the mercy of those who do not recognize the UN or global entities. As such, they are faced with the choice to remain non-combatants (those who do not carry or use a weapon during a conflict) and most likely be harmed; or to carry defensive arms and proclaim themselves a combatant, and thus be a target. Hence, the difficulty in being a health care worker in an age of general militarization. This is also a topic heavily discussed in the book Trauma by Dr. James Cole. As a member of the special operations, Dr. Cole was always well within danger; he discusses the choice to carry or not carry a weapon, and how discharging the weapon (even in self-defense) changes the nature of the health care provider and their position in an armed conflict. 

The policy does not make any specific mentions of how to deal with vulnerable populations. However, if one were to consider the nature of New York, it can be argued that the city's entire population is vulnerable to outbreak. As a hub of trade, finance, travel, and business, New York is at a considerably higher risk than a city without this high metropolitan activity. The policy does include measures on how to treat individuals who show signs and symptoms in public locations, but does not mandate testing or health checks for individuals involved in transport, travel, or who have limited access to health care (the homeless).

1) EPA: what are the exact duties and responsibilities of the EPA after a disaster? While we mostly consider it to focus on pollutants and environmental conservation, both this article and FEMA training seem to indicate it holds a much larger role in emergency situations.

2) Christie Whitman: a former governor of New Jersey and Administrator of the EPA from 2001-2003, Whitman served during the 9/11 attacks. Despite pointed personal criticism about her time in the EPA (including legal action), Whitman historical demonstrated a pattern of moderatism, often putting her at odds with the administration she served. It would be interesting to see where in the 9/11 lapse emerged-- whether it be from judgement, misinformation, or disinterest.

3) 9/11 Health Effects: The release of millions of asbestos and concrete particles into the air certainly increases the odds of chronic respiratory issues for NYC populations. I would be interested in whether any other chronic issues or epidemics have been noted as a result of pollution from the Towers' collapse