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
Becoming Prosumers Of Energy
by Ruth Santiago
February 16, 2019
This interview with Ruth Santiago, a lawyer who works with community and environmental groups in southeastern Puerto Rico, was conducted and condensed by frank news.
How do you think of energy democracy?
Energy democracy stems from the effects of energy coloniality and how certain jurisdictions have been used for extractive and exploitative practices and have become sacrifice zones for operations that create great wealth for other people over time.
How did you get involved in this work?
I got involved because of proximity. We have this saying in one of the groups I work with that says, "The environment unites us and identifies us." Not just the subtropical dry forest, and mangrove forest, and salt flats, and offshore cays, but also things that impact that environment – they also unite us and define us.
I was raised to a certain extent in Salinas. I spent my formative, adolescent years here. I was born in the South Bronx, my parents were part of the return migration to Southeastern Puerto Rico. They were from a municipality that's a little bit further east of Salinas, but very similar in many ways in terms of being part of the sugarcane monoculture, a high concentration of Afro descendent people, and real situations of struggle and survival. They decided to return to Puerto Rico when I was 12. I was raised along this Southeastern coast on and off from that time. One of my memories of growing up here as an adolescent was the Aguirre Power Complex being built in the early 70s. It was something that came to us. We did not come to the nuisances. Nuisance was built where we are.
The government of Puerto Rico tried Operation Bootstrap. Rapid industrialization and a very intense industrialization program that affected Guayama with industry coming in. First, light manufacturing and then the petrochemical industry. Then, pharmaceuticals, which are still very present. These energy plants were meant to serve more than the communities. These big, central station, fossil fuel plants were meant to provide energy to those heavy industrial uses that consumed and required a lot of energy.
What we saw in two places in Southern Puerto Rico, one here in Salinas and the other over in Guayanilla in Southwestern Puerto Rico, was how the power plants were set up very close to the petrochemical industries. We had the Phillips Puerto Rico Core Petro Refinery. Aguirre Power Complex was basically in service to that and other heavy industrial users. People were told they would get jobs. They said, "Oh, we're going to generate upwards of 2,000 jobs." People were a little skeptical and concerned about how that would impact the possibility of safe fishing at least. They were told it would not be impacted. Ultimately, what happened was Phillips did not generate anything close to 2,000 jobs and folded after a few decades, but did leave a terrible legacy of contamination to air, water, and land. People lost a lot of their ability to do the subsistence fishing even.
Aguirre Power Complex came in stages. They had two power plants in one. In 1972, they set up what was known as the Thermoelectric Plant. Again, people were told they’d get jobs from this. Again, the plant does not hire many local residents. It’s estimated there was 20-25% local hires, and the rest came from all over, anywhere but Salinas and Guayama. The same thing with the Combined Cycle units, because as I said, it's two plants in one.
At the dawn of the 20th century Puerto Rico got its first coal-burning power plant and the only coal-burning power plant that was established by AES. They're a Delaware corporation with their headquarters in Arlington, Virginia, but they do business all over the world. In November 2002, they started a brand-new, so called clean-coal power plant. It's been disastrous. Again, people were told, this is going to be beneficial in terms of stimulating the local economy and bringing down the electric rates. None of that happened. What has happened is that people are getting more and more exposed to pollutants and heavy metals and public health is being impacted.
Your work seems two-fold. One is dedicated to producing energy that is actually clean and that will not leave a legacy of toxicity. The other is in trying to invert the power structure of how that energy is produced and sold. Correct?
Absolutely. Absolutely.
Can you talk about your work in both areas and how they come together?
We have done a lot of resistance work, and a lot of work to promote community alternatives on energy and sustainability issues. There's a long history of activism here. I became more active in energy issues around 2003. We started participating in the monitoring of the Aguirre Power Complex and how it impacts public health, air quality, and water. Both the sea water and the potable water. The only source of potable water here is the South Coast Aquifer. That was monitoring.
We started participating in different administrative proceedings with a group called Comite Dialogo Ambiental, the Environmental Dialogue Committee. Then we participated in proceedings against PREPA, the Puerto Rico Electric Power Authority, but also the AES Corporation.
I've done both administrative proceedings and litigation in courts related to different impacts from those plants, and most recently a company called Excelerate Energy out of Texas was proposing to build what they call an offshore gas port and a marine natural gas pipeline, that we just defeated. It would have been running right through the middle of Jobos Bay National Estuarine Research Reserve and impacted corals and seagrass beds and offshore cays and all kinds of things, and the ability of people to do subsistence fishing and ecotourism and otherwise just use and be in the environment.
We've done a huge amount of work with respect to the coal combustion residuals or coal ash waste related to the AES Power Plant. The coal ash waste is a concentration of heavy metals, toxic heavy metals that were being spread all over, and is now being accumulated at the AES Power Plant site in Guayama, Puerto Rico.
That summarizes the energy resistance work that we've done. In terms of going beyond resistance and seeking to build the solutions and the alternatives, we've done a lot of environmental education, both with Comite Dialogo Ambiental Inc. and another group, an umbrella organization called, Eco Development Initiative.
Prior to the hurricane in conjunction with IDEBAJO and a community board called Junta Comunitaria del Poblado Coqui, in Salinas, we helped start what is known as the Coqui Solar project. It's a community solar initiative. It was started with lots of workshops and consultation and collaboration with professors, like Efrain O’Neill from the University of Puerto Rico at Mayagüez, which is the technical campus here.
It was, for years, before the hurricane, quite a struggle to get people to understand, to want to move towards solar energy, especially rooftop solar communities. It was going very slow. We were certainly doing the education work and the policy work, but not getting very far on the ground in terms of actual implementation of the first steps, the pilot project for the solar community. But right after the hurricane when it became clear to, I think, everyone in Puerto Rico and probably anyone familiar with Puerto Rico that the current electric grid does not work for the people of Puerto Rico. People have been much more receptive to the Coqui Solar project and initiatives of solar communities and other alternatives to central station, fossil fuel generation.
Can you tell me how a solar community works?
That's something that's being developed right now. The way people in Coqui Solar envision it is people who have the appropriate rooftops, usually cement, which is not the case for everyone, are able to come together to think about and work on generating energy using PV systems on their rooftops. It's certainly much more than just everyone in the community having PV equipment. This is beyond just a technological solution. It's about the social agreements necessary to make that energy and that technology serve community needs in the most efficient way.
Are you seeing a lot of progress in new ways of approaching energy? From the community, but also from a municipal government level?
That's really hard to answer. Certainly with the mind set and attitudes. There's much more receptiveness to the things that we've been talking about for years about solar communities. That has definitely changed and there's a lot more interest and it's a very dynamic situation with respect to energy. After the hurricane, honestly, people realized we're basically on our own here and the government, local, federal, municipal, comes to help us. We have to figure out these solutions.
We're seeing a lot more on the formal scale. A group called ACONER, the Association of Renewable Energy Consultants and Contractors, say they're doing five to six times the number of installations they were prior to the hurricane.
Things have definitely changed. We don't know exactly how much.
There is what can be called, lip service. A lot of lip service about renewable energy which is dangerous, especially with the government of Puerto Rico. They're saying they're adopting the 100% renewable energy goal for 2050, and I think 50% by 2040, but their actions are promoting lots of natural and fracked gas. It's a tricky situation in that sense because you hear everyone saying we adopt renewable energy, but not only are they putting the money elsewhere, they're also talking about a kind of renewable energy that's not community-based,.
What we're seeing is that the government is being pushed by every energy company you can imagine. It seems everyone has an interest in doing some kind of project here, including at utility scale. That it is not the same as the kind of alternatives we're talking about in terms of solar communities.
Why is this an urgent issue for you right now?
We saw here in Puerto Rico, that it's a matter of life or death. People need to take this into their own hands, energy by and for the people. Become more than just passive consumers but actual producers of energy and control their means of production.
We knew before the hurricanes, and we experienced it afterwards. This huge and deadly hurricane was compounded by this terrible electric infrastructure system. It's not serving the people of Puerto Rico in a real way. Maybe that was the best we could do at some point, but that's no longer the situation here and we an opportunity to do things differently. To do better. Much better.