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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?

Miriam Ticktin, PhD, is a current associate professor of Anthropology and a co-director of Zolberg Institute of Migration and Mobility. She received degrees from both Stanford University, Oxford University, and Ecoles de Hautes Etudes en Sciences Sociales. Her work typically focuses on the intersection of medicine, science, law, anthropology, and postcolonial feminist theory. She has multiple publications on the above subjects, including journal articles, books, special journal issues, and chapters. 

The report comes within a much larger book edited by Richard Hindmarsh focused on the Fukushima nuclear disaster. The book as whole explores social, environmental, and political issues in the aftermath of the incident. It appears to be available at multiple collegiate libraries including Boston College, Williams College, Harvard University, MIT, and Cornell University.

BSVAC was founded during the height of the crack-cocaine epidemic, when gang and drug violence were rampant throughout the city. While violence has decreased in Bed-Struy, felony assaults as of 2013 stood at around 5.9/1000, well over double the NY city-wide rate of 2.4/1000. This is an area rife with poverty, with median income of about $19,000 and a population heavily dominated by non-white individuals (latino, african-american, multi-race, ect.). Hence, the organization has been heavily molded by this urban, highly volatile environment. The vast majority of BSVAC personnel are of color and outreach is primarily aimed at keeping non-white youth away from street or drug life. The heavy emphasis on gun and drug violence in the area shapes the call volume and type, with shooting and stabbing wounds being a regular occurrence. The agency, for the most part, is a trauma-based service. Thus, their responses to calls would be different than an ambulance without this lengthy history and experience. Moreover, BSVAC has played a role in volunteering and responding to large-scale disasters, such as 9/11, Hurricane Katrina, and Haiti. As members are highly experienced in high volumes of large traumatic injuries, they are well-equipped to handle larger emergencies (similar to the ER physicians in County Hospital of LA or the trauma surgeons in Cook County outside Chicago).

The report quite clearly details the need to change our approaches to healthcare and epidemic emergencies. Currently, we seem to address these events in a singular method, and are unwilling to alter this approach. This is partially due to the narrow scope of patient care; for the most part, administering care to patients follows a standard guideline that does not seek to reach beyond that singular case. It is beyond the scope of a practitioner to attempt to mitigate socioeconomic discrepancies within their clinics alone. However, as Farmer and his colleagues argue, broadening this standard is necessary to combat illness. Biosocial factors, not just medicinal factors, need to be tackled in order to fully combat disease.

The article seems to be primarily composed of thoughts from the author supported by evidence from historical, well-known occurrences. Moreover, both authors seem to have personal research in the fields identified here, making many of their arguments based on field experiences. There are cited reports and publications, but there does not appear to be an associated "Works Cited" page provided. 

This article particularly focuses on analysis in the aftermath of emergencies. Specifically, in the investigative processes of structural disasters. It highlights the awkward melding of various agencies in the face of public demand for answers. More than anything, it presents this instability in the investigative processes surrounding many emergencies; understanding the logistics of a building's collapse or how a fire rapidly spread only furthers comprehension of the disaster as a whole. Moreover, findings from this analysis could provide strategies for avoiding future emergencies of a similar nature. The article opens investigations for scrutiny, asking why such an integral part of the post-disaster process often gets swept aside.

The chapter appears to be a compilation of accounts of immigrant medical treatments and overviews of the historical context behind several key situations. There is no bibliography, making it difficult to discern where these accounts came from. I can only assume most of this historical context came from Fissan's peers or other peer-reviewed works-- potentially another anthropological book. 

The report includes information gathered by both authors during the course of their own research, including citing several of their own publications within the report. Moreover, as a review article, the report includes work from other prominent epidemiologists, psychologists, and organizers of disaster relief; additionally, there appear to be several reports from various emergency response agencies providing data for prevalence of various mental disorders