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?

Vincanne Adams is a PhD at UCSF School of Medicine, she's the former Director and Vice-Chair of Medical Anthropology and History and Social Medicine. Her areas of research and publications include: Global Health, Asian Medical Systems, Social Theory, Critical Medical Anthropology, Sexuality and Gender, Safe Motherhood and Disaster Recovery, Tibet, Nepal, China and the US. Van Hattum works at the Louisiana Public Health Institute and Diana English is a professor at Stanford hospital. They all deal with populations that are effected my disaster and are disadvantaged economically and socially. 

http://profiles.ucsf.edu/vincanne.adams

In terms of first responders, not much of this policy will effect them due to the fact that issues such as insurance and medicaid are not really an issue handled by EMS. The only thing I can think of is how this might effect a patient possibly worrying about insurance and wanting to refuse EMS services due to money issues. This might also play a role in where patients are taken as well, but more likely not since no matter what their insurance, etc is, they'll be transported to the hospital of their choice or depending on their condition, cardiac arrest-->closest hospital.

This article has been cited in 85 different papers according to Google scholar. Most of the works it has been cited in are about societies in distress and biological  citizenship. 

The author uses data from the chain of events and steps taken in response to the disaster in Fukushima along with recollection of the event. She analyzes and collects data about how previous situations similar to the one in Japan and involving nuclear fallout were handled and compared those reactions of Chernobyl and Three Mile Island to the reactions that followed Japan's disaster. She also analyzes responses that leaders had in those nations as well as the public and the new policies that arose from those different situations. She pooled data about the reactions of the public, leaders, law and policies and responses. She then uses that data to develop a plan for possible emergency responses as well as support her argument.

This prgram is only offered in-camous adn takes roughtl 2-6 terms  to cp,plete. earnign the degree requires 38 points. Menaing fuill time studnes can copelte the program in one academic year and a summer. The degree requirements include  five Core Courses in Narrative Medicine (22 points) and the Research Methodology course (4 points), which is required for all students who have not taken a graduate-level course in research methodology. The other 12 to 16 points may include any combination of additional Topics in Narrative Medicine courses, elective courses chosen from other departments, Independent Study and/or Capstone (two to four points).

This article utilized a study from the 90s that was performed in Baltimore. Statistics and studies performed in Haiti and Rwanda on the populations were also cited as arguments in the article. Publications and information provided by the PIH were also referenced and utilized to support the argument in the paper.

"I argue that the shift to gender-based violence as the exemplary humanitarian problem could not have happened without the prior move to medicalise gender-based violence, and render it a medical condition like all others."

"Approaching gender-based violence as a medical or health issue alters how violence is both approached and understood; that is, rather than understanding gender violence in the context of gendered relations of power, or as part of larger histories and expressions of inequality which are inseparable from histories of class or race or colonialism, this type of medicalisation transforms gender-based violence into an emergency illness, requiring immediate intervention"

"Rape in armed conflicts played a central role in the recognition of the category of gender-based violence, putting it onto the human rights radar screen, first in the former Yugoslavia and later in Rwanda; human rights approaches forced the international humanitarian law system to understand rape as a particular form of violence"

"The role of humanitarian organisations was growing exponentially during this time: humanitarian intervention became increasingly important on the international scene after the 1994 Rwandan genocide, and humanitarian organisations took their place as autonomous interlocutors, as recognised by the Nobel Peace Prize awarded to MSF in 1999"

The main point and argument of this film is to demonstrate the importance of public health education and protocols for both the public and those in charge or part of the government. The documentary focuses on the West African Ebola outbreak. Specifically, the struggles of Liberia are demonstrated and portrayed. The outbreak proved to be something that the government wasn't able to fully contain and protect citizens from. The fact that this outbreak occurred right after the end of a 14 year long civil war also proved to be an obstacle. The documentary shows the uneducated, misinformed lack of effort to contain, stop or cure the spread of disease or to even inform those that were infected. There was a complete lack of awareness on diseases in general, Ebola specifically and of protocols to enact when faced with this issue demonstrated by the government.