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Luísa Reis-Castro: mosquitoes, race, and class

LuisaReisCastro
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As a researcher, I’m interested in the political, ecological, and cultural debates around mosquito-borne diseases and the solutions proposed to mitigate them.

When we received the task, my first impulse was to investigate about the contemporary effects of anthropogenic climate change in mosquito-borne diseases in New Orleans. But I was afraid to make the same mistake that I did in my PhD research. I wrote my PhD proposal while based in the US, more specifically in New England, during the Zika epidemic, and proposed to understand how scientists were studying ecological climate change and mosquitoes in Brazil. However, once I arrived in the country the political climate was a much more pressing issue, with the dismantling of health and scientific institutions.

Thus, after our meeting yesterday, and Jason Ludwig’s reminder that the theme of our Field Campus is the plantation, I decided to focus on how it related to mosquitoes in New Orleans.

The Aedes aegypti mosquito and the yellow fever virus it can transmit are imbricated in the violent histories of settler-colonialism and slavery that define the plantation economy. The mosquito and the virus arrived in the Americas in the same ships that brought enslaved peoples from Africa. The city of New Orleans had its first yellow fever epidemic in 1796, with frequent epidemics happening between 1817 and 1905. What caused New Orleans to be the “City of the Dead,” as Kristin Gupta has indicated, was yellow fever. However, as historian Urmi Engineer Willoughby points out, the slave trade cannot explain alone the spread and persistance of the disease in the region: "Alterations to the landscape, combined with demographic changes resulting from the rise of sugar production, slavery, and urban growth all contributed to the region’s development as a yellow fever zone." For example, sugar cultivation created ideal conditions for mosquito proliferation because of the extensive landscape alteration and ecological instabilities, including heavy deforestation and the construction of drainage ditches and canals.

Historian Kathryn Olivarius examines how for whites "acclimatization" to the disease played a role in hierarchies with “acclimated” (immune) people at the top and a great mass of “unacclimated” (non-immune) people and how for black enslaved people "who were embodied capital, immunity enhanced the value and safety of that capital for their white owners, strengthening the set of racialized assumptions about the black body bolstering racial slavery."

As I continue to think through these topics, I wonder how both the historical materialities of the plantation and the contemporary anthropogenic changes might be influencing mosquito-borne diseases in New Orleans nowadays? And more, how the regions’ histories of race and class might still be shaping the effects of these diseases and how debates about them are framed?

St. Louis Anthropocene: displacement & replacement

JJP
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A brief essay about St. Louis' notorious eminent domain history--

--along with 2 recent St. Louis Post-Dispatch articles about "urban renewal" projects that are scheduled to reoccupy the Mill Flats area, which hosted the most notorious episode of displacement of African-American communities: the Chouteau Greenway project (will it serve or displace low-income St. Louisans?); and SLU's Mill Creek Flats high-rise project, which certainly will, and whose name seems to me an especially tone-deaf if gutsy move...

https://humanities.wustl.edu/features/Margaret-Garb-St-Louis-Eminent-Domain

https://www.stltoday.com/business/local/steelcote-developer-plans-more-apartments-brewery-space-in-million-midtown/article_811eaf96-76e1-5c20-a870-1e79abd3f06e.html

https://www.stltoday.com/business/local/chouteau-greenway-project-aims-to-knit-st-louis-neighborhoods-together/article_55fea4e6-6829-5c80-9168-313305b4e3bb.html

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seanw146
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I looked more into the U.S. policy on uninsured patients, ER hospital policy, and how they are treated. If you go the ER without insurance, you are expected to pay the full bill; however you are guaranteed under the federal Emergency Medical Treatment and Labor Act to receive treatment regardless of your ability to pay it. There are assistance programs available to help those whom cannot afford to pay their medical bills. Some of these are private charities, there are government programs that help with those at or below the poverty line, and the hospitals themselves will often negotiate a much lower price than originally billed for to meet a patient’s financial need. Despite this, there are still many cases where all of the above are not sufficient enough to keep patients out of bankruptcy. (http://health.howstuffworks.com/medicine/go-to-er-without-insurance.htm)

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seanw146
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Dr. Emily Goldmann graduated from the University of Michigan with her PhD in Epidemiology and Columbia University with a Bachelor’s in economics and Chinese. Dr. Goldmann is currently a clinical assistant Professor of Global Public Health at New York University. “I am currently on the faculty of NYU's College of Global Public Health, in the Division of Social Epidemiology. My current research focuses on the intersection between physical and mental health in older adults, specifically trajectories of depressive symptoms following stroke. I also have a strong interest in the characterization, prevention, and treatment of mental illness in low-resource settings globally. I currently teach a master's level course in global mental health and an introductory course in epidemiology to undergraduate students.” (LinkedIn profile)

 

Dr. Sandro Galea graduated from University of Toronto with his MD, Harvard with a MPH, and Columbia with a DPH. Dr. Galea works as a physician and epidemiologist at Boston University School of Public Health. “In his scholarship, Dr Galea is centrally interested in the social production of health of urban populations, with a focus on the causes of brain disorders, particularly common mood-anxiety disorders and substance abuse. He has long had a particular interest in the consequences of mass trauma and conflict worldwide, including as a result of the September 11 attacks, Hurricane Katrina, conflicts in sub-Saharan Africa, and the American wars in Iraq and Afghanistan. ” (Boston University Biography)

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seanw146
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The author uses a wide variety of news and journal sources to make their point. Everything from the New York Times to East Asian Science. It also cites many volumes on disaster preparedness. For example, “The Chernobyl Accident: a Case Study in International Law Regulation State Responsibility for Transboundary”. The sources tell me that the article was developed around the news at the time and works that dealt with handling of disasters from the past. For me, this furthers the case that the author is making: that the way we have been doing things in the past is not working.

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seanw146
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I looked into how EMS operates in situations that are beyond protocols, standing orders, and medical control. I also looked into how story cases are used by other medical professionals. Further I looked into how “evidence” based approaches are formulated for studies and research.

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seanw146
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1) “…what would happen if race and insurance status no longer determined who had access to the standard of care?

…in addition to removing some of the obvious economic barriers at the point of care, the clinicians and researchers considered paying for transportation costs and other incentives as well as addressing comorbid conditions ranging from drug addiction to mental illness. They also implemented improvements in community-based care, conceived to make AIDS care more convenient and socially acceptable for patients. The goal was to make sure that nothing within the medical system or the surrounding community prevented poor and otherwise marginalized patients from receiving the standard of care.

The results registered just a few years later were dramatic: racial, gender, injection-drug use, and socioeconomic disparities in outcomes largely disappeared within the study population [35].”

2)            “This model [PIH’s model], with conventional clinic-based (distal) services complemented by home-based (more proximal) care, is deemed by some to be the world's most effective way of removing structural barriers to quality care for AIDS and other chronic diseases.”

3)            “While some interventions are straightforward, we also have to recognize that there is an enormous flaw in the dominant model of medical care: as long as medical services are sold as commodities, they will remain available only to those who can purchase them.”