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?

"Opinions about how the state should address the fate of these Chemobyl victims also serve as a kind of barometer of the country's changing moral fabric"

"Cherobyl was a key political event, generating many effects, some of which have yet to be known; its truths have been made only partly known through estimates derived from experimental science."

" She told me that Ukrainians were inflating their numbers of exposed persons, that their so-called invalids "didn't want cover." She saw the illnesses of this group as a "struggle for power and mater sources related to the disaster." 

"The story of Anton and Halia (age forty-two in 1997) shows the ways such com- plicity functioned in the most personal arenas. The new institutions, procedures, and actors that were at work at the state level, at the research clinic, and at the level of civic organizations were making their way into the couple's kvartyra (apartment). Anton's identity as a worker, his sense of masculinity, and his role as a father and breadwinner were being violently dislocated and altered in the process "

A main focus of this article was the emergency response to nuclear power plant disaster at the Fukushima Daiichi power plant, or in better words, the lack there of. Points and arguments made include the fact that this won't be the last the world sees of nuclear mishap and risk and also the severe need to not only depend on accident prevention, but focus must be shifted onto being prepared during emergencies. During the essay the author point blank states that, the essay is to raise awareness on the need for the creation of an  "international nuclear response team." The essay then focuses on what we can learn from the nuclear accident in Japan in order to establish better post emergency protocols and responses. 

Overall, Schmid outlines the fact that changes need to be made on a global level. She illustrates where there are shortcomings in current protocols and the desperate need to establish a team that is equipped and trained to response to nuclear mishaps, such as the one seen in Japan. She also accentuates the need for this response team to be established should be fast and that we can no longer drag our feet, citing dangers seen at Fukushima, Three Mile Island and Chernobyl.  

Columbia University was one of the first medical schools to open a program in Narrative Medicine. This program was built within their College of Physicians and Surgeons. Rita Charon is the executive director of the program and is on the forefront of spreading the need for narrative medicine in the medical field. Colleagues of hers also believe that medicine has become too professional and clinical, and doctors focus on treating medical problems based off symptoms, not the patient. The educational program at Columbia created the opportunity to earn a Masters of Science degree in Narrative Medicine in 2009, making to one of the first programs devoted to only narrative medicine. 

This article focuses on the fact that there not only biological aspects of disease and the spread of it, but also social factors that need more attention. The article cites that epidemic disease is linked with social conditions such as structural violence, education, income and more. The article addresses the fact that social conditions have an effect on disease prevention and many diseases quickly become diseases of the poor due to this. There are social conditions that effect patient's abilities to defend themselves against disease based off money, social condition, infrastructure, access to food etc. The concept of structural violence and its effects on disease spread within the poor community is discussed and analyzed. Overall, the main point to be driven home is the fact that disease spread can be decreased with the reconfiguration and addressing of social issues. 

Miriam Ticktin is a professor of anthropology and co-director of Zolberg Institute for Migration and Mobility. She has a PhD in social sciences from Stanford and has many recent publications, all focused around immigration and humanitarianism, mainly overseas, as well as social research in these areas.

http://www.newschool.edu/nssr/faculty/?id=4d54-6379-4e44-4d35

The American Red Cross is heavily based off team work and altruism. As stated earlier, those that respond are volunteers, they are not obligated to help but they want to. The Red Cross volunteers work together as a team for the goal of aiding and tending to those in need, to the best of their ability. Their volunteering shows they perceive disaster as an unpredictable thing, but something that other members of the community can help those devastated get through. 

It is said that EMTALA doesn't apply to ambulance services, technically this would be true. Yet, EMTALA does indeed effect our patients, and anything that effects our patients can effect us and should be a concern of ours as EMS providers. If EMTs are spending time in the hospital sorting out insurance issues and payment, that is more time they are out of service. Also, if the patient's treatment time is delayed, not only will the hospital be blamed, but so will EMS. If a patient is in cardiac arrest, EMTs will not be stopping and wasting time to find out insurance and payment issues from family members, that will be the last thought on their mind. They will be transporting and attempting to stabilize the patient. EMTs and EMS will not compromise the health of a patient due to insurance or payment issues, just like hospitals are now mandated to do.

The arguments are supported by citing many studies and past experiences of organizations such as WHO and CDC. Based off the examination of current protocols of biosecurity interventions, it has been deduced that the process is still in formation and not completely settled. There are not "stable" or "clearly defined" understandings or strategies of possible interventions cited by WHO and CDC. This proving the point that there are clear actions that need to be made in terms of protocol development today.The AIDS crisis in the 80s was also used a supporting point for the argument in terms of response to emerging infectious diseases. The main focus of this was the alarm that was caused by science reports, journalists and novelists during that time. The effects this response had can be used today in the possible reformation of threat response now. The policy changes that have been seen in terms of public health and threat safety  were adequately researched and discussed in this paper. Showing the need for a changing system that adapts with time and needs globally.