Hookworms in the South

Hookworms in the South


By Elton Camp



            A problem that had to be dealt with in the rural South during the early 20th Century was the possibility of people, especially children, being invaded by parasitic worms.  The stereotype of a lazy, shiftless hill person had a bit of reality when hookworms were present in large numbers. 


            The Rockefeller Sanitary Commission undertook to wipe out hookworms in the South.  Its work extended to Marshall County.  The group began with schoolchildren.  When tests revealed the presence of the parasites, workers went home with them so as to talk with their father. 


            Brad Greenberg was one of the young men recruited to work in the campaign.  His accent and speech patterns instantly identified him as being “from the North.”  As an outsider, and even worse, a Yankee, many viewed him with suspicion, especially the adults.  There were whispered rumors that he was Jewish.  The friendly youth had, however, developed a good rapport with the school children.  He spoke to them on their level and often supplied candy. 


            The Taylor children excitedly introduced their companion who had walked home from school with them.  “This here’s Brad.  He’s wif th’ Rock’feller Commission.  He wants t’ speak wif Paw.”


      Traditional southern hospitality made it almost mandatory that an invitation to “come in ’n’ set a spell” be extended.  It was imperative that Brad act in accord with local custom.  A visitor couldn’t directly state his business, but must sit and talk about the weather and trivialities for a while.  It helped defuse distrust and resentment of outsiders. 


            When he felt that he’d gained the family head’s trust, he got to the point of his visit.  “Mr. Taylor, I’m sure you don’t know it, but your children have somehow picked up hookworms.  It can happen in most any family.  I’m here to offer help.  The Institute pays me a salary, so I don’t charge for anything I do.”


            “I reckon hit won’t hurt nothin’ t’ listen,” the father conceded. 


            A detailed discussion of the parasite’s life cycle would’ve been lost on the uneducated man, so Brad confined his discussion to the main points.  The worm worked its way into the body through bare feet, it was connected with the way an outhouse was built, and it could be cured and prevented from returning. 


            To recommend that children not go barefoot would’ve been useless.  Youngsters, especially boys, looked forward to the springtime when they could start to go without shoes.  They wouldn’t accept the possibility bare feet allowed the tiny larvae to penetrate their skin and end up draining blood from their bodies.  The resulting anemia resulted in lack of energy and even stunted growth in severe cases. 


            With his host’s permission, the worker examined the privy.  It was like thousands of others.  The waste fell onto level ground underneath the toilet openings.  A heavy downpour washed the material onto the ground around the structure.  It looked like a picture from a parasitology textbook Brad had studied in graduate school.  He had to be careful, however, not to appear in the least condescending.


      “What’ll keep your kids from having problems is to dig a deep pit and then build another outhouse over it,” Brad explained.  “If you and your boys think well of the idea, I’ll be pleased to come back and help. The Commission will pay the cost of materials.” 


            The courteous approach had the desired result.  Within a couple of weeks, the main source of infection had been eliminated.  Brad medicated the children to kill the adult worms in their small intestines.  Another small skirmish in the war against hookworms had been won. 


            Milas’ children didn’t have hookworms, or if they did, the numbers were so small as to have no effect on health.  Under about two hundred of the half-inch long worms might produce no symptoms in otherwise healthy people. 


      Infectious diseases caused by bacteria and viruses were also common.  Except in the case of smallpox, vaccinations weren’t available.  The usual childhood diseases ran their course.  The victims suffered to varying degrees, but most survived unimpaired.  Almost every child had measles, mumps, whooping cough, and chickenpox.  Fortunately, survival of the diseases conferred lifelong immunity. 


            Two of Milas’ children became sick.  It started with fever, sore throat, swollen glands, and red tonsils with pus on them.  Within a day, a red, rough rash that looked like sunburn spread all over their bodies.  Scarlet fever called for drastic measures.


            The public health officer walked warily toward the house, paused a moment in the yard, then mounted the porch with firm steps.  He didn’t knock or call out.  His visit, at some homes, provoked angry words or threats.  In his hand was a large sign that he nailed to the wall.  At the top in large letters were the words “Scarlet Fever.”  Below the heading it read, “These Premises are Under Quarantine.”  The notice ordered that no person could enter or leave the dwelling.  The placard couldn’t be removed.  Penalties for noncompliance were severe: up to a hundred dollars fine (an enormous amount in those days) or as much as thirty days imprisonment were possible. 


            All in the community obeyed.  In time, both children felt better.  The outer layer of skin peeled from their bodies first and then their hands and feet.  The emergency was over.  Life could resume as normal. 


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Following the Civil War, hookworms became a serious problem
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