Georgetown University’s Medical Humanities Initiative, a collaborative program between the College of Arts & Sciences and the Georgetown University Medical Center, organized a synergetic conversation with two interdisciplinary scholars on their recent research Feb. 5.
Libbie Rifkin, a teaching professor in the English department and associate director of the disability studies program, spoke about her forthcoming paper on the social dynamics behind AIDS Coalition to Unleash Power (ACT UP)’s Philadelphia chapter. Jordan Wilson, a bioarchaeologist and postdoctoral fellow at the Earth Commons — Georgetown’s institute for environmental and sustainability studies — followed up with an overview of her paper on an epidemic of malaria in ancient Roman communities.
ACT UP is an international organization working to end the intertwined epidemics of AIDS and social injustice through direct action. Rifkin said ACT UP’s Philadelphia chapter had a decisive role in establishing services like the President’s Emergency Plan for AIDS Relief (PEPFAR), a fund that has saved 25 million lives globally since its inception in 2003. She added that recent freezes in U.S. aid could potentially cause massive harm.
“The hard-won, lifesaving gains of activist researchers and doctors may be reversed in a callous instant,” Rifkin said at the event.
Rifkin said that while people with good access to health care have seen vast improvements in preventative measures and treatments for HIV since the start of the epidemic, the fruits of these benefits have not been equally reaped by all.
Rifkin said she was first introduced to ACT UP’s mission while living in Philadelphia as a graduate student.
“I’m fascinated by this group’s endurance against the idea of the AIDS crisis as something that has come to an end,” Rifkin said.
Using archival evidence including the Critical Path Project, which activist Kiyoshi Kuromiya founded to spread awareness about HIV, Rifkin explored social relationships, especially caregiving relationships, within ACT UP and among people impacted by HIV/AIDS.
Rifkin said that in the future, she wants to examine relationships between patient activists and caregivers, including health care workers, using documentation from prominent hospitals in Philadelphia where many HIV/AIDS patients have been treated.
“I think it’s often thought that there was a contentious relationship between doctors in the middle days of HIV/AIDS and people who thought of themselves as patient activists, but I think there was also collaboration,” Rifkin said.
Wilson spoke next about her research in paleopathology, the study of health and disease in ancient humans based on skeletal remains, historical records and other archaeological and anthropological evidence. She is a champion of the concept of “one paleopathology,” which emphasizes the interconnectedness of human, animal and environmental health.
Wilson said the way to understand these circumstances is by evaluating multiple determinants of health in conjunction.
“To truly understand people in the past and health in the past, the focus cannot be purely on the physical, biological body,” Wilson said at the event. “It has to be a more biosocial perspective on not only the interaction between the physical self and the biological environment you interact with, but also the broader social context in which you exist and how your individual identity collides with the human environment to inform what kind of access to health care and nutrition you might get.”
As examples of malaria’s persistent coexistence with humans, Wilson referenced the thalassemia minor and sickle cell trait, both of which confer some degree of protection against malaria in their carrier forms –– less severe manifestations of the corresponding diseases.
Wilson said these are indicators of genetic selection in regions of the world with historically high malaria mortality and morbidity rates.
“Malaria affects very vulnerable segments of the population in parts of the world where it remains endemic,” Wilson said. “It has exercised an outsized impact on the trajectory of human history and evolution.”
Wilson’s research methods included investigating bones from a Roman infant cemetery for lesions indicating malaria-induced anemia. When combined with supplementary evidence such as the type of cemetery and biomarkers of stress, injury and malnutrition, these clues can help piece together what an individual’s social status was and how it could have shaped their disease experience.
Timothy Newfield, associate professor in history and biology and a co-author of Wilson’s paper, said historical sources can provide helpful context for anatomical evidence.
“There are a number of Roman medical treatises that refer to the distinctive symptoms of malaria,” Newfield said during the event. “Biologically speaking, there are six different types of malaria in human beings. Some of them cause very distinct, cyclical patterns of fever, and you can see those in ancient Greek and Roman medical texts.”
Wilson said she hopes her research can contribute to a shared understanding and vocabulary so that future researchers from different disciplines can efficiently collaborate.
“Datasets from the past are available and can be powerful,” Wilson said.
