interviews
Call It What It Is
by LaShyra Nolen
July 1, 2020
This interview with LaShyra Nolen, Harvard medical student, and the first Black woman to become class president, was conducted and condensed by franknews.
frank | You've written and spoken about your experience within a dual reality – of being both a medical student at Harvard, and a person committed to your own identity and equity.
LN | The dual reality is you're training at the best medical school in the world, but there is so much suffering going on in your community. And whatever knowledge you gain still isn't going to necessarily translate to the improvement of the condition of Black people. For example, I could go on to become the best surgeon in the world. I could save the life of a Black patient. But they can go outside, drive home, get stopped by a police officer, move too fast, and get killed.
That is the dual reality. You're learning, but you're not necessarily getting to the root cause of the suffering of your people.
You always have to think about it from both of those perspectives, that of a student and that of a Black person in America.
In addition, you go into class and you are expected to maintain professionalism. You are expected to just talk about the science and to talk about the assignment at hand – when that same morning you watched yet another police lynching of a Black man. You're trying to deal with those emotions, and you have no idea how it's going to be taken if you say, "Hey guys, I'm really not doing that well. Another Black man was killed. Racism is pervasive in our country and we're all complicit in it." It is a challenge that all Black professionals have. You have to walk in and put on this face, even though internally you are dealing with the turmoil and hurt of your community.
What does this moment feel like at Harvard, as a student?
As a medical student, I feel like I can speak out more than my mentors or faculty members who are more ingrained into the system of medicine. Academic medicine is very hierarchical. The higher up you go, the more you have your hands tied, and you can't speak as much truth because you're trying to move up to an associate professor position so that you can finally start to use your voice. I know that there's a risk that comes with speaking up, but I, personally, can no longer just pretend like everything's okay, and allow people to continue to suffer in silence. Even the most brilliant people have been complicit in racism, and some of them genuinely have never even thought about it.
They've grown up in a bubble, their entire lives, and all this is happening and they're just like,
"Oh my gosh, I'm a good person. I'm not racist." And you kind of have to be like, "No, but you really are though."
These brilliant people who are excellent in their field, are just now realizing they're complicit in this system.
Again, I am happy that's occurring, but I'm always just like, look how much it took for us to get here. NASCAR is just now removing the Confederate flag. Suddenly now I have Juneteenth popping up on my Google calendar. I'm like, what?
My classmates and professors have really been amazing actually. We are all from different backgrounds. Some are fourth-generation physicians, and some grew up on reservations and are bringing medicine to indigenous folks. All of them realize that the system needs to change, and they have been so supportive. Beyond just talking the talk and posting the black box on Instagram, they've been reaching out to me saying, “Here are the notes from class today. I got this recording for you because I know you've been putting in work on the advocacy front.” That's true allyship to me. I've really been pleasantly surprised and happy to see the support that I've gotten from my classmates.
There has been a widespread acknowledgment that COVID is affecting communities and people of color at much higher rates. I am curious if you think there has been an appropriate conversation around why that’s the case?
I think that in order to understand that we have to look at our history, and at policy. The original ill was, of course, chattel slavery. This country has not valued Black lives. The policy reflects that, and policy ties into our healthcare. That history of systemic discrimination is important to look at to examine the current landscape of COVID-19.
Redlining decided where people live in this country, and which communities our government and our local city councils were going to invest in. Black communities were not invested in. As a result, Black communities have not had access to the basic resources that they need to survive and thrive. They don't have access to healthy food. They don't have access to safe places to exercise. They are exposed to environmental pollution. They have less access to education. I mean, then you look at who is more likely to be an essential worker - Black people are overrepresented.
It doesn't end there. Once people get into the clinic, they have to deal with the biases and systemic racism in the hospital system. There are studies that have shown there are medical students and residents who still think that Black people have a higher pain tolerance.
We can take maternal mortality as an example of treatment differences. Black women, at all income levels, are dying disproportionately compared to white women. When they get to the hospital, doctors don’t believe their pain. I mean, it happened to Serena Williams. It is safer for Black women to not engage with the healthcare system because of the violence and harm it causes.
How do you think mistrust of the medical system compounded the COVID crisis?
I think it all comes back to this conversation of access, right? When COVID-19 first hit, the testing centers were predominantly located in affluent communities, and a lot of Black communities were left without access to testing. The lack of Black physicians and Black health care professionals means that when Black patients come in and say they have COVID-19 symptoms, they are less likely to get treatment compared to white people.
If you know there are no testing centers in your neighborhood, you know there is no representation in the hospital, and you know that you are going to be discriminated against once you walk in that door, you know your life is being devalued. That knowledge prevents Black people from seeking care from our healthcare system. With anecdotes of horror coming from your community, of course you are going to be nervous to trust the healthcare system.
What does a better understanding of investment into public health look like to you?
I think we need to turn all of the conversations that we've been having into public health initiatives. Racism was declared a public health emergency in Boston. That is the direction I think we should be moving in.
We need to move beyond equality to think about equity. We need to recognize that not everyone is on the same playing field. We need to truly make sure everyone's specific situation is taken into consideration. We do that by investing in those communities, and by looking at how we make sure they have access to good education, access to health care, access to housing, access to good food. Improving the conditions where people live, work, pray, play will improve their healthcare outcomes and our healthcare system.
Of course, we need things like the physical exam, but often patients go into that physical exam with preexisting chronic diseases caused by disparate suffering. Going as upstream as possible will lead to better healthcare outcomes and in the long run, improve healthcare costs. Even if investing in public health didn't improve healthcare costs, I still think that it's the moral thing to do. I think we're too driven by what's going to save money in our country. We need to do what's right.
Everyone deserves to have the basic resources they need, to live out a viable, joyous life. Right now we are doing nothing to guarantee that.
Someone said to me once, we’re too focused on raising the ceiling and not at all focused on raising the floor in the American healthcare system. Do you feel like this starts as a medical student?
I can definitely speak to that culture. As a medical student, I'm really passionate about community activism. I am passionate about making sure that everyone has access to healthcare, and ensuring that we're teaching medical students anti-racism so that they don't go out and further harm communities. I can spend two years doing that – serving on committees, writing up reports, and changing curriculum at my institution. But my peers who are spending the same time publishing papers on very specific proteins and disease processes might have a better chance at residency.
In medicine, you're not incentivized to do work that you don't get credit for. You always want to be able to publish, and activism isn't always publishable.
It has been the responsibility of Black students, students of color, and indigenous folks to improve their institution. They do the work so that they can thrive and survive, and so the next generation can do the same. But at the same time, they still have to do everything they have to do as a medical student to get to the next level. I'm literally trying to improve the very environment that I'm suffocating in, while also trying to handle everything else that medical students are expected to.
There was a letter early on from public health officials advocating for protest as it’s needed to fight racism within the healthcare system. Does that feel new or was it already a part of the conversation?
I think it's always been a part of the conversation for those who have been oppressed.
But that is what is special about this moment. We literally had a global pandemic that exposed the disparate suffering of Black people across the country, across the globe. And then on top of that, you have back to back to back killings of Black people. It's heartbreaking that it took this much for us to start having these conversations, but we are having them, and people can’t run away from them.
There are no distractions. We're not going to get anywhere if people don't name systemic racism for what it is.
We need to say Ahmaud Arbery. We need to say Breonna Taylor. We need to say their names, and we need to name the issue at large.
Big-name organizations are just finally starting to realize that this is something that they need to get on board with. It’s hard to know if it's really genuine or not. I think that people don't want to be on the wrong side of history. Regardless, learning is still happening. I'm very happy that anti-racism is becoming the status quo and that we are having these conversations. We need to continue to push the envelope to get people things they need to live a good life.
interviews
What Does the Future of Global Plastic Pollution Look Like?
by Katherine Shayne
January 29, 2019
Katherine is an environmental engineer, UGA College of Engineering faculty, and Co-founder & CEO of Can I Recycle This, Inc. Focusing on solutions to the ocean plastic pollution problem, Katherine serves as a SOA Youth Ocean Leader where she chairs a committee to inform international governments about youth-led solutions to marine debris.
I'm an environmental engineer, I do environmental research consulting, working with companies around the issue of global plastic pollution, and ways in which we can find solutions to the problem. One of the companies that I'm currently working with is Parley for the Oceans. They take what is deemed ocean plastic, and turn it into products that consumers can buy and reuse. It's what some people call an upcycling mechanism, so you're taking something that is virtually trash, and you're making it into products that are sellable in the global market. Which is a big part of recycling in that when products are recycled, if they don't have a market value, they tend to become trash. Non-valuable materials are taken to the landfill, which ultimately actually costs the recycling system in many ways, through transportation and fees at the landfill.
One of the biggest things we see is that there isn’t enough market value for the post-consumer plastics we're creating. We've developed a company called Can I Recycle This, which uses artificial intelligence, specifically image and voice recognition, to inform consumers about the end of life of their products. Therefore reducing contamination in recycling centers if people are putting the right things in their recycling bin.
For example, you could say, "Hey Alexa, ask Green Girl ..." Green Girl is like our Alexa, she's our personality. "Hey Alexa, ask Greengirl if I can recycle this coke bottle." First she's going to figure out where you are, because you have location services enabled, and then she'll come back and say, "Is it plastic or is it glass?" If you say, "Plastic." Then most of the time, your city is going to take plastic PET Coca Cola bottles, and then if you say glass, you actually might not be able to recycle that, depending on your location.
What we found is that every city, every county, or what we call an MRF shed, takes different products and materials. Recycling is not the same across all boundaries in the United States, it's actually very different. Right now in Athens, where I live, glass is something that's taken by the recycling center, whereas in my hometown of Columbus, Georgia, it's not taken. But most consumers don't know that, so we've developed this technology to help consumers, and we're still in the process of developing the business; it’s in the bootstrap stage. We are self funded currently.
Beyond that, partnering with big box stores and online marketplaces would be our next step. Something is shipped to you, say you get a box from online, within your packaging, on your receipt, it'll tell you, "Based on where we shipped this package, x is recyclable, and x unfortunately has to be thrown away." We want to put that language in there, unfortunately, because we really don't want things, like precious materials to end up in the landfill. Beyond that, if we want to go into the zero waste mindset, instead of having it on a printed receipt that's in the box, have it in the email that comes when it says, "Your package has arrived." And just have it in the email somewhere.
This concept comes out of my research and the research from the Jambeck Research Group. I was a part of the Jambeck Research Group for five years at the University of Georgia. Jenna Jambeck is one of the co-founders with me for Can I Recycle This, so I still am very much involved with the research group, but in a different capacity now. We know that mismanaged waste is tied to what goes into the ocean.
It's key from land, because that means that there's something that's being mismanaged in waste systems, for those materials to end up in the ocean, especially plastic. This concept of how do we manage our materials better, how do we inform consumers? Really hits home, because it does tie into what gets out into the ocean. And now the recycling markets have been turned upside down with China’s implementation of their National Sword policy.
Amy Brooks published a paper about how much plastic would be displaced by 2030 because of the National Sword policy. We used to ship all of our plastic scrap to China.
This has already had implications. Plastic has been stockpiling on coasts in mostly developed countries around the world. Because it wasn't just us, it was other countries that shipped their waste to China. This type of policy makes the US, and other developed nations rethink their recycling schemes.
We have to figure out how we can have less contamination in the recycling stream. Because if you have a lot, say you have a bale of PET bottles, and 10% of those are actually replaced by foam plastic, like your styrofoam containers, because those were accidentally put into the stream, immediately that bale becomes way less valuable than it was if it was just PET bottles. We found that companies like Coca Cola, Unilever, Proctor Gamble, these big companies that produce a lot of these products that use plastic have goals for the future about using recycled content in their products.
By 2030, Coca Cola has said that they're going to use 50% recycled material, post consumer plastic in their products. To be sustainable, there has to be a stream of recycled content that comes from recycling facilities around the nation. That's where contamination is a big problem, because it can't use those bales that are contaminated.
I guess this is one of the reasons I really like waste, and products and waste management, is because it has this inherent human factor that we consciously have to think about what we purchase, what we throw away on a daily basis, and we're in contact with these things. It’s one of the only civil infrastructure systems that you really have to have a personal connection.
Do you think infrastructure is enough? Considering the mass amount of plastic we’re producing?
No, I definitely do not view waste management and solid waste infrastructure as the end all be all to our massive waste problem. I promote reduction of waste practices. And research has shown that small, individual acts of reduction and reuse actually make a tangible difference in decreasing waste into the ocean. Reusing bottles and things that you have, or purchasing reusable bottles, things that you can refill, because ultimately the water that you're drinking out of a plastic bottle is just tap water, so why not drink something we already have for a very reduced cost? In the US that's very possible, however I do a lot of international traveling for research, and in many countries this is not necessarily the case.
There are a lot of countries that rely on using bottled water, rely on using packaged materials for hygiene, because they don't have clean drinking water. So in these places, this isn't something they can necessarily do. Changing that type of infrastructure is important as well. Having refill stations, or places that do filter water stations. Solid waste infrastructure is different in every country. Informal waste sectors are very much prevalent in other countries. They are still here in the US, we still have informal waste, and people that are going and searching out valuable materials, but it's much more prevalent in other places around the world.
Waste management is not necessarily the end all be all, but it's a key solution. Definitely the reduction of waste in the first place, the reduction of plastic production and use has to be part of that solution as well.
To put this into context, this would be the equivalent of 25,000 Empire State Buildings by weight. We’ve produced 6300 Million Metric tons of plastic waste and only roughly 9% of what we generate of plastic waste is recycled. We're throwing away tons of plastic that could actually be valuable. Not only that, but we're producing a lot of plastic to replace material like glass, wood, metal, and other materials that we could definitely continue using. We would just have to figure out how to use them in a sharing economy.
If you have a glass bottle, make it accessible to refill stations or places that sell in bulk. Instead of having everything packaged in plastic, have grocery stores and wholesale stores sell in bulk quantities, where you can refill bottles, or containers with what you need. We've seen some of this change, but it's still a very niche market change. We are always open to larger marketplaces, making this something that is more mainstream. Right now we're seeing it in very mom and pop shops, or places like Earth Fare, where it might not be economical for someone in a lower socioeconomic level to shop. Making these market changes to where these services are available for everyone is another place I’d like to see change.
There's the reduction side and reuse side, but we have to start looking at new materials as well. That's also a solution. We've moved to plastic for packaging overtime because of the weight and the cost of shipping that, but what can we use besides plastic? Instead of this more or less toxic material, why aren't we looking at more bio benign materials, biodegradable materials? I think on the packaging side we're going to see more, and on the food packaging side especially, we're going to see more materials that are being made with properties not harmful to the environment, harmful to people, and are easily managed.
We do some of this research at UGA, at the New Materials Institute, and we're looking at the biodegradability of certain types of bio-based polymers, and how this fits into a consumer composting scheme. If we produce these materials, how do we let consumers know that these are compostable materials? Because they look and feel like plastics. Are there composting infrastructures for collection? Because you can produce these materials and make them biodegradable, but if people don't have access to a composting facility, they're going to end up in the landfill or in the recycling. This would actually cause contamination because they're not the same type of plastic as other packaging.
Alternate materials are something I see happening for large store, food packaging and online marketplaces. With online shopping and shipping, I foresee an increase in post consumer packaging waste that isn’t recyclable. Packaging can become more circular through implementation of a thoughtful design process. Companies can employ green design principles, where end of life is thought of at the beginning of the design process, and products and packaging are made to be easily disassembled. New materials could fit into this design process. Image if you could just compost all the packaging your products, food, etc. was shipped in?
When you really start to research plastic, a lot of the information comes from people like you, from places like the Jambeck Group. What is it like watching reporters, civilians, politicians, interpret then promote or disregard your work?
When I first started, the space for waste management and plastic discussions was kind of crappy. You could put something on Twitter about a turtle ingesting plastic, and no one really cared, which was sad. Now the climate is totally different. I think that plastic use, plastic generation, the work that's being done around it ending up in the ocean, the attention that it's getting is just astronomically different now, compared to what it was five or six years ago. I'm even a newcomer in this space compared to some of the people I admire, who have been doing this work for 20+ years.
That's really exciting for me to say, because people are starting to realize that we can't continuously use and waste everything. It's not going to work. We have to use our resources wisely, we have to think consciously about what we put in our bodies every day, what we put on our bodies, what we use. I think that trend is not something that's going to go away anytime soon.
Some of it can be doom and gloom, like we can never clean up the ocean, we can never stop this from happening, we can't reduce our waste generation, and sometimes you just have to realize who might be putting out that content, and kind of fight against it. Because this is a very visible issue, it's something that's tangible, it's something that people can see and connect with. Even if they're not by an ocean, they've probably been to a body of water once in their life, and can somehow connect with polluting our waterways and polluting our ocean. It is so intrinsically tied to humans and tied to our daily routines and our daily habits that it's something that people can connect with, and I really love seeing that part of it.
Do you think with other countries following in China’s footsteps a solution for US production of plastic and waste will be forced?
Yes. For sure. Yes. Countries have already started to do that. I know Malaysia's one, Thailand's another one that said, "No more. We're not taking your waste either." It’s already forcing the US to reevaluate our system and our recycling and say, "What are we doing wrong? How can we reduce contamination, and how do we inform citizens?" Plastic scrap is accumulating and I think we're going to have to find markets to use it. We should be asking ourselves, “How do we makes these materials valuable? What companies, start-ups, etc. could develop products to use these materials?” I think that is a solution which will happen quickly in the US.
What does your future research look like?
Understanding composting in the US, because I do believe that a lot of our packaging is going to be shifting towards biodegradability, and then how we manage that, so I think that composting is going to be something that is on the rise in the US.
Secondly, we're doing some work with specific community assessments. Essentially looking at a community and figuring out what are the inputs into a community, how do they use their materials, how do they use the resources, and then what are the outputs? Then, where's the leakage to the environment? This research is being done in the group by one of my colleagues, Amy Brooks, right now, and it's something that can be applied globally.
Then thirdly, I'm currently heading a group through the Sustainable Ocean Alliance, which is a collection of global ocean youth leaders, looking specifically at the plastic pollution problem, and identifying solutions in specific countries. The Sustainable Oceans Alliance Group is made up of representation from 50 countries by youth leaders. I developed this group to develop white papers to for government and figure out what solutions are working in their specific countries. We’re going to make them aware that there is a youth presence in their countries who have actionable solutions to implement.
We are always looking to research sustainable waste infrastructure, and how to integrate then into developing economies. Like I mentioned before, there are cultural and social contexts to developing these systems that are inherently part of design process. They can’t be excluded, and I firmly believe that. So it’s exciting to see what we can learn from the informal waste sector, and community led initiative around solid waste management for reuse and reduction to curb input of waste into the ocean.