Nobody cares

In America, the world’s richest country, hookworm, a parasitic disease found in areas of extreme poverty are rampant.

The US tolerates poverty-related illness at levels comparable to the world’s poorest countries. More than one in three people sampled in a low-income area of Alabama tested positive for traces of hookworm, a gastro-intestinal parasite that was thought to have been eradicated from the US decades ago.

“We now need to find how widespread hookworm is across the US,” said Dr Peter Hotez, dean of the National School of Tropical Medicine. Dr. Hotez, has estimated that as many as 12 million Americans could be suffering from neglected tropical diseases in poor parts of the south and mid-west.

 In a survey of people living in Lowndes County, an area with a long history of racial discrimination and inequality, it found that 34% tested positive for genetic traces of Necator americanus, better known as hookworm. The parasite enters the body through the skin, usually through the soles of bare feet, and travels around the body until it attaches itself to the small intestine where it proceeds to suck the blood of its host. Over months or years it causes iron deficiency and anemia, weight loss, tiredness and impaired mental function, especially in children, helping to trap them into the poverty in which the disease flourishes.

Hookworm was rampant in the deep south of the US in the earlier 20th century, sapping the energy and educational achievements of both white and black kids and helping to create the stereotype of the lazy and lethargic southern redneck. As public health improved, most experts assumed it had disappeared altogether by the 1980s. But the new study reveals that hookworm not only survives in communities of Americans lacking even basic sanitation, but does so on a breathtaking scale.



“Bloody Lowndes” was called so in reference to the violent reaction of white residents towards attempts to undo racial segregation in the 1950s. It was through this county that Martin Luther King led marchers from Selma to Montgomery in 1965 in search of voting rights for black citizens, More than half a century later, King’s dream of what he called the “dignity of equality” remains elusive for many of the 11,000 residents of Lowndes County, 74% of whom are African American.



The average income is just $18,046 a year, and almost a third of the population live below the official US poverty line. The most elementary waste disposal infrastructure is often non-existent. 73% of residents reported that they had been exposed to raw sewage washing back into their homes as a result of faulty septic tanks or waste pipes becoming overwhelmed in torrential rains. Aaron Thigpen, a community activist who assisted with the hookworm study remarked, “This is the reality of how people are being forced to live. They are disgusted about it, they’re sick and tired of living like this, but there’s no public help for them here and if you’re earning $700 a month there’s no way you can afford your own private sanitation.”



 Alabama, between 2002 and 2008, launched a spate of criminal prosecutions  against residents who were open-piping sewage from their homes, unable to afford proper treatment systems.  One grandmother was jailed for failing to buy a septic tank that cost more than her entire annual income.



 Catherine Flowers, Alabama Center for Rural Enterprise (ACRE), a non-profit group seeking to address the root causes of poverty.  founder, who encouraged the Houston scientists to carry out the review after she became concerned about the health consequences of having so many open sewers in her home county. “Hookworm is a 19th century disease that should by now have been addressed, yet we are still struggling with it in the United States in the 21st century,” she said. “Our billionaire philanthropists like Bill Gates fund water treatment around the world, but they don’t fund it here in the US because no one acknowledges that this level of poverty exists in the richest nation in the world.”



“This is the inconvenient truth that nobody in America wants to talk about,” Dr. Hotez said. “These people live in the southern United States, and nobody seems to care; they are poor, and nobody seems to care, and more often than not they are people of color, and nobody seems to care.”