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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?

The data used to support the argument includes numerous publications by other authors providing information on the correlation between mental health and disasters. Background information on different disorders is also provided as well as interviews and case studies from patients and doctor as well as experts on the topic. 

The Chernobyl nuclear power plant explosion in 1986 led to a ten day reactor fire that resulted in a large and unknown amount of radiation spilling into the surrounding areas in Ukraine. This caused the contamination of the environments and those around the reactor. Hundreds of thousands of people had to evacuate and to this day it remains to be an issue. Due to this controversy that still surrounds this disaster, the IAEA, FAO, UNDP, UNEP, OCHA, UNSCEAR and WHO created the Chernobyl Forum. They generate "authoritative consensual statements" on the environmental consequences due to the radiation exposure. Ultimately they and this event in Chernobyl are what called for this report. 

The objective of this study was to evaluate whether the amount of cases of thyroid cancer post Fukushima disaster reported were overestimated. The study focused on noting and analyzing if the high reported prevalence of thyroid cancer cases in the areas surrounding the disaster were over diagnosed. Factors such as O/E ratio, utilizing the life table method, as well as national estimates were used in order to determine whether the reported amount of thyroid cancer cases of those aged 20 years in the area were accurate or too exaggerated and ultimately over diagnosed.

This article mainly notes on the influences of culture on patients and their depiction of their medical history. The way a patient describes a narrative of their illness depends on their beliefs, set of morals, culture and customs in which they are used to and identify with. There is a correlation with the physicality of an illness and how it is perceived by their culture along with the way they depict it to professionals and pursue alleviating the issue. The importance of doctors recognizing this cultural influence and perhaps raising of stigmas is also reported since it can deeply impact the way a patient is taken care of and treated. 

This organization is aimed at healing those suffering when faced with emergency situations. The American Red Cross responds to areas of needs using volunteers and donors. Those affected by disaster receive care, shelter, aid, etc from American Red Cross. Ultimately, America Red Cross offers disaster relief and acts as an emergency response to destruction and disaster. 

I further researched the history of sexual violence and its role in times of war, since its use as a weapon was mentioned. I also researched the background of sexual violence and stigmas that are associated with them in the countries mentioned in the article, in order to better understand underlying meanings and cultural struggles aside from the obvious atrocities of the violent act. Also since Medecins Sans Frontieres kept being cited, I did further research on them since much of the study was based off their findings, this lead me to further study Doctors Without Borders, which is what it is commonly known as in the US.

I found aspects involving the governments response to the situation very unconvincing. I would like to have seen more in the documentary about the government's attempts to inform and the actions they took. This may have been due to a lack of efforts taken by the government. Yet seeing more about the government's involvement as well as the hospital's and doctor's would have made that side of the situation far more compelling. The way it was portrayed in the documentary made it very unconvincing and I was not compelled by it. 

The bibliography of this article is quite extensive and thorough. This shows that a lot of research and effort was put into this article. The sources cited are all from very reputable labs, organizations, and researchers. This reflects the validity and expertise in this article. 

The author is Scott Gabriel Knowles and he works in the department of History and Politics at Drexel University. He focuses on disaster risks in cities, modern areas and public policy. He got his BA and MA in history at the University of Texas. He also got his PhD at John Hopkins University. He has written a book,  "The Disaster Experts: Mastering Risk in Modern America" (UPenn Press, 2011) as well as edited  "Critical Studies in Risk and Disaster" (UPenn Press, launch 2014).  He also is a member of Fukushima Forum collaborative research community and is currently co-writing a volume on the Fukushima disasters.