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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?

The entirety of this document illustrates how vulnerable refugees are. They define refugee to be someone who has been persecuted for reasons of "race, religion, nationality, membership of a particular social group or political opinion." They discuss the fear that refugees feel and that they should be treated favorably, sympathetically, and like other citizens of the contracting state. 

The "core competencies" as the academy calls them, or the 5 academic pillars that are necessary for DRLA are: human & social factors, economics of disaster, encironment and infrastructure, disaster oprations, and measurement and evaluation. 

In this program, either a Master of Science or a certificate can be obtained. A Master's degree would require 36 credits that can be done in 2 years or in 3 semesters. 18 of these credits must come from core courses that highlight each of the academic pillars as well as 2 research-based courses. The other 18 come from electives, 6 of which must be DRLS. In order to obtain a certificate, 12 credit hours of coursework over 2 semesters is needed. These 12 should be composed of 4 core academic pillar courses.

The aim of this program is "to equip students with a skill-set in emergency preparedness, nonprofit leadership, disaster management, grass-root development, monitoring and evaluation and disaster risk and recovery".  Through this aim and other goals, the requirements for the program create graduates with the professional responsibility, ethical behavior, and integrity expected of leaders in this field. 

Chief Bruce Shisheesh - chief of the Aboriginal people mentioned. Announced that the community was in a state of emergency.

House of Commons 

Dr. Caroline Tait - Psychiatry professor in the COllege of Medicine at the University of Saskatchewan. She helped start the First Peoples-First Person Indigenous Hub, a research initiative meant to examine mental health issues among Aboriginal People. She received her PhD from Departments of Anthropology and Social Studies of Medicine at McGill University. 

Nunavut Premier Peter Taptuna - declared suicide a crisis in the territory in order to avoid the temporary concern that a public health emergency would grant.

Manitoba Assembly Chiefs Grand Chief Derek Nepinak - pointed out the importance of preservation of culture on the mental wellness of these people.

Inuit people - have the highest suicide rate in the world

Bob Merasty - Federation of Saskatchewan Indian Nation Vice Chief. 

Georgina Jolibois - member of parliament for the region. Stood in the House of Commons and voiced concerns about mental health issues in the area and lack of resources or attention.

National Aboriginal Health Organization - non-profit organization meant to help the community. 

The triages are shown in a flow-chart type of visualization. The rest are on a selection basis. For example, for management algorithms, we are first given the option of: Incident Orientation, Contamination: Diagnose/Manage, Exposure: Diagnose/Manage Acute Radiation Syndrome, and Exposure & Contamination. Clicking one leads you to further flow charts describing the actions that should be taken place. Within those exists more information in order to help healthcare providers make correct, educated decisions on treatment. 

1. I looked for more information regarding the disaster.
2. Cancer projections as a result of this disaster
3. Current healthcare in these areas as a result of this disaster.

They calculated the observed/expected (O/E) ratio of thyroid cancer prevalence for residents in Fukushima Prefecture that were below the age of 20. Observed prevalence was calculated by the number of thyroid cancer cases detected by the end of April 2015. The number of detected cases was corrected for screening rate by multiplying the inverse of the age-specific screening rate. The expected prevalence was obtained from another report, which was calulated using a life-table method using national estimates from 2001-10. Age-specific prevalence of thyroid cancer was estimated using the cumulative risk from 2010. The annual percent change of increasing cases of thyroid cancer was taken into account as well. 

The author's name is Miriam Ticktin. She is an Associate Professor of Anthropology and Co-Director of Zolberg Institute for Migration and Mobility. Her PhD from Anthropology is from Stanford. Miriam works at the intersections of the anthropology of medicine and science, law, and transnational and postcolonial feminist theory. She has published many papers and a few books, some of which discuss borders as new forms of political inclusion and exclusion.

Emergency response is discussed more in terms of prevention. While the PIH model was used as a response to the high prevalence of disease in the area, it can be used to show how emergency response may require reaction using a model or system that can be long-term. Prevention is explored using the concept of structural violence and how inherrent structures within our society are causing spread of disease. The paper offers the idea that identifying issues within a society could help response to further emergencies. 

According to Google Scholar, this report has been cited over 130 times. It has been used in various other articles regarding gender identity and discrimination. Many articles are also discussing counseling and support that this community requires. Some news reports have used this as a citing of statistical data.