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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?

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.

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.

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.”

I had difficulty finding direct discussion of that particular chapter, but according to Google Scholar there are 22 citations of the larger work, some of which cite this particular chapter.

1) “The current concern with new microbial threats has developed in at least four overlapping but distinct domains: emerging infectious disease; bioterrorism; the cutting-edge life sciences; and food safety”

2) “’Global health’ is a second field in which health threats have been problematized in new ways.”

3) “The regulation of what Ulrich Beck calls “modernization risks” comprises a third field in which biosecurity has been newly problematized.”

4) “Although there is a great sense of urgency to address contemporary biosecurity problems— and while impressive resources have been mobilized to do so — there is no consensus about how to conceptualize these threats, nor about what the most appropriate measures are to deal with them.”

More focus on the care, treatment, containment, and management of contagious diseases like Ebola would have increased its educational value, especially to first responders.

With over 80 citations, and a wide variety of sources (few of which are repeated), we know that this research article was infer that a good deal of time and care was spent on this article. There are lots of citations to steel investigation, structural and architectural references, government building standards, similar historical disasters, and news articles reporting on 9/11. Without even reading the article, one can suppose a good deal about the article and how it was produced.

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)

The extensive citation show the work that went into the research to put the article together. The article cites other research articles as well as government publications and interviews.