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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?

Several references are written by authors of this article, showing their expertise in the subject and the extension of previous thought. Their work with the PIH is the continuation with references used from studies mentioned in the paper. 

This film is meant to show the struggles of an ER waiting room from all sides. It shows the frustrations of patients waiting to be seen for hours, financial workers, social workers, and doctors struggling to see everyone in a timely manner. It also shows organizers tryign to sort everyone and move the patients around in ways that benefit all parties. Essentially, this documentary is highlighting the issues that exist in the ER because of lack of staff, beds, and overall means to take care of the large influx of patients. 

Those that cannot pay for healthcare services (or are suspected to not be able to) are the most vulnerable population as they can literally die because of their social standing getting in the way of care and treatment. 

1. "“In the globalized world of the 21st century,” it argued, simply stopping disease at national borders is not adequate. Nor is it sufficient to respond to diseases after they have become established in a population. Rather, it is necessary to prepare for unknown outbreaks in advance"
2. “World health is indivisible, [and] we cannot satisfy our most parochial needs without attending to the health conditions of all the globe.”
3. "This tension relates to a difference in aims but also in forms of intervention: emergency response is acute, short-term, focused on alleviating what is conceived as a temporally circumscribed event; whereas “social” interventions—such as those associated with development policy—focus on transforming political-economic structures over the long term. Thus, in global health initiatives we find a contrast between possible modalities of intervention that parallels the one already described in U.S.–based biosecurity efforts: between acute emergency measures on the one hand and long-term approaches to health and welfare on the other."
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."

The authors discuss that there is little information regarding this topic because there is a lack of research. This is pointed out by the fact that they could only find 38 articles that related to this topic. They also point out that there is an urgency for an analysis regarding the impact of this violence on the facilities, organizations, and on the populations that benefitted from the humanitarian presence. 

The author of this article is Scott G. Knowles, the Department Head for the History Deparment Center for Science, Technology and Society. He has a PhD from Johns Hopkins. He focuses on risk and disaster, with particular interests in modern cities, technology, and public policy. He's released several books on the topic. He has a hefty resume with various publications and activity on research boards, showing his vast knowledge on these topics. 

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 think the main takeaway for first responders would be to treat these refugees as if they were anyone else. They should be treated fairly and favorably and should not be discriminated against when it comes to emergency care. 

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.”