Search

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?

I researched the statistics and numbers of HIV and and information about demographics as well as prevalence in areas such as Rwanda and Haiti. I also researched the PIH and its efforts globally while browsing their website and read about their Priority Programs, as well as countries they assist. I also researched the authors and took a look at the main author's other articles that he cited this paper in. 

Looking at the references, it is very clear that an extensive amount of work and research went into writing this article. Many of the references are from reputable books on sexual violence and gender based violence and its role in society. Many research articles and studies on gender persecution are cited, as well as works written by other experts in the field on human rights, women rights and sexuality and violence of women are cited. The citations also cover a broad range of time showing depth and span of the information that was used to produce this article. 

I found the testimony of those effected in Liberia to be the most compelling. The personal statements and recountings of the situations that they underwent is what really reinforced the main purpose of the documentary. Seeing footage of people crying in the streets as well as the lack of food and resources, paired with the bodies and caskets is really the most persuasive aspect, in my opinion. It communicated the true devastation that occurred in Liberia during this outbreak. 

This article has been cited in one other paper entitled "Documenting Attacks on Health Workers and Facilities in Armed Conflicts" according to Google scholar.

This health registry relies heavily on collaborations and other organizations. There is actually an entire section of the website dedicated to listing all the organizations that collaborate and work together in order to provide this information for the registry. The registry is a collaborative effort between the US Department of Health and Human Services and NYC. 

There are 3 advisory groups that work with WTC health Registry, they are the Community Advisory Board, the Labor Advisory Board and the Scientific Advisory Board. The following organizations are also listed as organizations that this registry depends on for research, number and data:

Government

• National Institute for Occupational Safety and Health (NIOSH)
• Agency for Toxic Substances and Disease Registry (ATSDR)
• Centers for Disease Control and Prevention (CDC)

Scientific 

• Albert Einstein College of Medicine
• Boston University – School of Public Health
• City University of New York – Graduate School of Public Health and Health Policy
• City University of New York - Hunter College
• City University of New York - Queens College
• Columbia University - Mailman School of Public Health
• Columbia University – Medical Center
• Columbia University - New York Psychiatric Institute
• Cornell University
• Fire Department of New York City (FDNY) - Bureau of Health Services
• Fordham University
• HHC WTC Environmental Health Center at Bellevue Hospital Center
• Hospital for Special Surgery
• Johns Hopkins University - Bloomberg School of Public Health
• Mount Sinai Medical Center
• New School University
• New York City Police Department - Chief Surgeon's Office
• NYU Medical Center
• New York State Department of Health
• Rutgers University
• San Francisco State University
• State University of New York – Albany – School of Public Health
• State University of New York - Stonybrook
• State University of New York -Stonybrook University Medical Center
• University of California – San Francisco – School of Medicine
• University of Greenwich (United Kingdom)
• Weill Cornell Medicine

The main point of this article was to display the inner workings of Rikers and what it is like within the walls. Factors such as weather conditions, solitary and its effects on mental and physical health, mistreatment, pollution and other environmental aspects, internal dangers and abuse are some of the things discussed and revealed within this article. These overall main points are supported through facts and figures, as well as first hand testimony from those that have spent time at Rikers, recounting their stay there and the conditions in which they lived in. 

The article utilizes first hand testimony from those living in new Orleans that lived through the disaster and were evacuated, documenting their hardships faced. The article also cited different government agencies as well as different papers and organizations for statistics on post disaster government funding, emergency response and preparedness.

"Health care service delivery may be challenging in the post-disaster environment and often requires coordination and cooperation among levels of government, health services programs, schools, media, and community organizations  "

"The first challenge lies in identifying the correct sampling frame, which generally comprises all persons affected by the disaster. The sampling frame may be even more difficult to identify in natural disasters, when the geographic area of impact is larger and less defined."

"The second challenge lies in finding potential participants and completing interviews. Widespread displacement and communication breakdown may make it difficult to reach per- sons who have experienced the disaster, and if they can be reached, they may be consumed with recovery efforts and may not agree to participate in research .  "

"Psychological first aid (PFA) has become the preferred post-disaster intervention, with three goals: Secure survivors’ safety and basic necessities (e.g., food, medical supplies, shelter), which promotes adaptive coping and problem solving; reduce acute stress by addressing post-disaster stressors and providing strategies that may limit stress reactions; and help victims obtain additional resources that may help them cope and regain feelings of control.  "