Reflections of a Life Scientist: The Impacts of Cities on Epidemiology

The exponential establishment of cities throughout the globe in the last century is without a doubt a marker of our technological and societal advancements as a human race. Better infrastructure and improved healthcare, are just a few of the many associated benefits of living in a city. At the same time, we cannot ignore the negative impacts of the establishment of cities. In particular, with regards to the realm of life sciences, cities have been a huge curveball for all living beings, the environment, and not forgetting the scientists who study them. Cities have introduced a multitude of new factors for scientists to consider. In epidemiology especially, there are new challenges presented every day to the scientists who already have the difficult task of understanding the complex field of diseases and their transmission. This essay will focus on the challenges and changes that epidemiologists and other scientists in the field, like myself, face as a result of the establishment of cities in the past decade.

  In the field of epidemiology, studying the of risk factors of a disease or infection is crucial in understanding its spread. As scientists, we need to be sensitive about the factors that help exacerbate or proliferate diseases and illnesses within a population in order to accurately study its transmission and growth mechanisms. With the rapid establishment of cities in the last century, we have introduced into the equation a completely new set of risk factors– the urban environment and everything else that comes along with it. For instance, the establishment of cities has brought about a change in lifestyle for people, and epidemiologists are seeing an increase in noncommunicable diseases or lifestyle-related diseases as well as mental health issues (Hubacek & et al., 2009). While it is true that cities bring better access to healthcare and technology, this has greatly changed the trends of morbidity and mortality (McKeown, 2009). In many countries with booming cities, there is a sharp rise in the ageing population (World Health Organisation, 2011).

  There is extended morbidity despite the lower rate of mortality because people in cities are living longer, but it does not always translate to a better quality of life. In developing countries where more are moving to cities, more elderly are left without informal care from their families or relatives (World Health Organisation, 2011). On the same note, noncommunicable diseases exponentially increase with age, therefore the increasing elderly population in the world is not only a societal and economic burden but a challenge for scientists to keep up with too (Yoshikawa, 2000; World Health Organisation, 2018). Hence, epidemiologists are faced with a new understanding of how cities influence this new age of diseases.

  Where there are people, there is a chance to transmit disease; Cities multiply this effect by the hundredfold, by bringing people physically closer together. Generally, cities are characterised to have a higher population density than their rural counterparts. Hence, contact with another person is much more imminent. The high population density in cities increases the propagation of infectious diseases, including those that transmit by air, bodily fluids, water and other vectors (Lee, 1994; Monteiro & et al., 2006). Cities are at greater risk of spreading infectious diseases, not just because of their high population density but their greater connectivity with the rest of the world and other cities (Alirol & et al., 2011). With over 35,000 international flights in a day, Singapore Changi Airport was dubbed the most connected airport in the Asia Pacific region (OAG, 2018). Imagine the scale at which an infectious disease could be spread to the rest of the world from there. It could easily result in a global pandemic, similar to that of the various strains of influenza in the past (Pattemore & Jennings, 2008) and more recently, Ebola virus (Park & et al., 2015). Of course, that is why health organizations and governments worldwide are so wary of such an event happening (Barnes, 2018). The greater the speed of transmission of diseases within cities is important to understand and morphs today’s modern approach to epidemiology. As diseases evolve at a terrifying rate (Leventhal & et al., 2015), scientists need to look closely at cities and how they can more accurately model the transmission of disease based on human networks.

  In the face of urbanisation, epidemiologists cannot take for granted the state of affairs when it comes to diseases. Upon reflection, my approach to learning about the transmission of diseases has changed because of the establishment of cities, more so because I live in one. As mentioned previously, there has been a shift in prevailing diseases amongst cities, a rise in noncommunicable diseases and age-related diseases. In Singapore, the ageing population is a real concern. Projections estimate that Singapore may be the fifth most elderly populated country in a matter of almost 30 years (United Nations, 2015). This makes studying the epidemiology of ageing and its associated diseases, even more, relevant for me. I have become more sensitive to the risk factors in urban environments. I have also had to change the way I perceive research and my scientific method when it comes to dealing with the confounding effects of cities on my research in this area. Being in a city, such as Singapore, I get to enjoy the comforts of better infrastructure and in turn, better technology. However, I often do not notice the over-reliance on technology as a scientist in a city. Internet connection is a ‘basic necessity’ nowadays. And as a student, it is hard to imagine a life without it, let alone having to do literature reviews and research without the vast pools of e-libraries and repositories at my fingertips. Moreover, most modern laboratories in cities are well-equipped with air-conditioning and huge freezers to store cell samples, consuming “three to four times more energy than the average building” according to a study by Eades (2018). Therefore, in the laboratory, I try my best to be more energy-saving and environmentally conscious when carrying out my research. Trying as much as possible to use glass-stirrers instead of disposables ones, and doing simples things like turning off the fume hood when not in use, I choose to reduce the carbon footprint of my laboratory.

  As much as my research is important, it is just as important to try to reduce the negative impacts brought about by the establishment of cities. If not, scientists would just be adding on to the impacts caused by cities, and we already have enough problems to face as it is. With no sign that the growth of cities is going to slow down any time soon, we should be very aware of the novel challenges that studying diseases in cities pose. I strongly believe that understanding cities is vital to understanding diseases in the 21st century, and eventually how to control them.

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We make this prayer in Jesus name, Amen.

Yesterday morning, as I was eating in the dining hall, someone came up to me and said hi. Here’s how that conversation went:

F: “Hey Jan, how are you? I saw from over there and saw you with your eyes closed for so long.”

J: “Oh, I was praying.” I smiled.

F: “What, oh sorry. Usually people pray really fast. Is there so much to be thankful for anyways?”

J:”…there’s always many things to be thankful for, especially for surviving this hectic week.”

H: “Yea, she always prays very long (before meals), and that’s a good thing.”

I’m really fortunate to be living in a time and place where I’m able to openly practice my faith. People in my RC, for the most part, are very understanding towards their Christian friends who say grace before meals. I guess the more you are around people of different race and religions you tend to become more empathetic when you understand their practices.

At the same time, I’m very fortunate to have meals with friends who say grace too, because I feel that our prayers together are so much more beautiful.

So whether or not you practice praying regularly, I just wanted to remind y’all that if you take time to reflect, there’s definitely a lot of things to be thankful for.

And there’s no need to rush through saying grace, you realise you’ll enjoy your meal a lot better.

monitor the condition

The patient’s condition has finally stabilized…*phew*

All vitals look normal. 7:45PM.

Good work everyone.

. . . . . .

What’s happening?

I’m not sure, but it was alright a minute ago! The readings are everywhere, she might go into a relapse. Her heart rate is erratic!!

I need a dose of 200mg of peace and 500mg of faith. STAT.

On it! …Patient’s condition is worsening.

Maintain the airway and breathing, we’re not going to lose that easily. Hold on, I see the source of the haemorrhaging. It’s much deeper than we thought.

Must have ruptured from the previous procedure yesterday.

Everything is going to be fine. Everything is going to be fine. Everything is going to be…

Heart rate is declining back to normal. I wonder what’s wrong today?

Didn’t she just go for healing treatment at the Ministry of Acute Specialised Surgery unit? The damage must have been pretty bad.

 

Grateful for your loss

You know the saying,

I’m sorry for your loss.

Well we all know it’s in the context of someone passing away, but what about physical objects that we lose? Most of us go into an epic panic after misplacing something, or knowing that we dropped our favourite wallet filled important cards and money, somewhere along the way home. I speak from experience, so I know I’m part of this majority. But recently, I misplaced not one, but two three things this week. Yes, that’s right.

It all started with me dropping my matric card on the way to mass last Friday. And I remember thinking, should I go for mass or turn back and look for it???? I went to mass. But my mind was in a complete state of panic (see previous post letting go), something in me was triggered by that incident, I had one of the worst panic attacks I’ve had in a while. I wasn’t necessarily worried by losing the card, but something in me was so attached to the failures and losses(yeah, pun intended) that I’ve been having over this semester, that it all came flushing back. I never let go, I merely repressed it. And that was so unhealthy.

Next to go was my folder with my tediously completed math assignment. Well this one is more of a non-loss because I thought I lost it and I really just lost my mind. I was angry and upset with myself again for making mistakes. But I’m a matter of a minute I found it in my bag. Silly me.

Last to actually say goodbye was my trusty wireless earpiece. By this point, I wasn’t really sad about the things I had lost, even though I really miss that pair. I just knew that it was gone, if it comes back it does, if it doesn’t then that’s okay.

Losing your card, doesn’t mean you lose your identity in God.

If there’s one thing to take away from all of this, it’s that I’ll always be grateful for the loss of my physical objects. When it happens because of us, that’s okay, we aren’t perfect in the things we do but we are perfect in God. When it happened because of other people, well even more reason we shouldn’t be upset and angry. I just hope that I don’t forget this and listen to the soft endearing call of God, reminding me that it’s okay Princess, those things are replaceable, but my love for you isn’t.

I’m home for the weekend, and yes there’s another pile of endless work to be done. Next week, I hope to apply for my new matric card and continue on towards finals, living life to the fullest without the worry of being sorry I lost something.

Casting all your anxiety on Him, because he cares for you. —1 Peter 5:7 NASB

Hellü friend please don’t run away

LSM2231 lab session was pretty fun today when we had to monitor the respiration behavior of mealworms and crickets. The crickets were super jumpy. One of them even jumped out and had a tour of the lab.

When crickets are kept at lower temperatures they should have lower respiration because their metabolism lowers, hence breathing less. We didn’t really get to see these results but issok I had fun.