On March 16, 1964, President Lyndon Johnson went to Congress to declare war on the sources of poverty in our nation. The child of a father who failed financially, LBJ knew intimately the haunting insecurity and shame of poverty. It was only a few hours after the assassination of President Kennedy that Johnson learned from chairman of the Council of Economic Advisers Walter Heller that Kennedy had been exploring possible solutions to the conditions that kept 20 percent of Americans in poverty. Johnson ordered the work accelerated, and within four months declared unconditional war on poverty. In an interview on NPR, Johnson biographer Robert A Caro addresses LBJ’s fondness for the phrase “war on poverty”:
He loved that phrase, and it was part of his hatred of poverty. Johnson could be a very ruthless man. I wrote [in Passage of Power] he knew what to do. He says [the causes of poverty may lie] "in a lack of education and training, in a lack of medical care and housing, in a lack of decent communities in which to live." These were to Johnson real-life foes, and Johnson knew what to do with enemies: You destroyed them. So he loved the word "war."
His war to eradicate the causes of poverty was fought on multiple fronts as he called for a job corps, work-training programs, and work-study programs. He also wanted funding for local communities to address poverty in their own areas, and to provide loans and guarantees for businesses to hire the unemployed. The war on poverty would be fought by volunteers under the direction of the newly created Office of Economic Opportunity, led by Sargent Shriver.
I had hoped to write about the status of poverty in America this week, more than 50 years after LBJ declared unconditional war against it. But I got stuck in Alabama. And not because the world changed there on Tuesday night, although it did. And not because it was once again black women who led the charge to reclaim our shared vision, although they did. But because I stumbled upon a story about a visitor to Alabama. He was a visitor from Australia sent there by the United Nations to look at poverty in America. What he found in Alabama shocked me. It should shock you as well.
Hookworm is a disease that we had pretty much eradicated by 1980 through waste water treatment, education, and industrialization. For the last 30 years, at least, it was considered an ailment of the undeveloped nations of the world. Today it is making a comeback—in Alabama.
Scientists in Houston, Texas, have lifted the lid on one of America’s darkest and deepest secrets: that hidden beneath fabulous wealth, the US tolerates poverty-related illness at levels comparable to the world’s poorest countries. More than one in three people sampled in a poor area of Alabama tested positive for traces of hookworm, a gastrointestinal parasite that was thought to have been eradicated from the US decades ago.
The hookworm enters the human body through the skin and finds its way to the small intestine where it attaches itself and sucks blood from the victim, leading to ailments like iron deficiency anemia. In children, this can stunt their physical and mental development and sap their energy. The CDC classifies it as a neglected tropical disease. Baylor College released a study earlier this year that examined the disease’s prevalence.
The study, the first of its kind in modern times, was carried out by the National School of Tropical Medicine at Baylor College of Medicine in conjunction with Alabama Center for Rural Enterprise (ACRE), a non-profit group seeking to address the root causes of poverty. 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.
NPR’s Marc Silver and Nadia Whitehead reported on this study and interviewed experts in the field:
"I was very surprised by this," says Dr. David Diemert, a hookworm expert at George Washington University. "There has not been any documentation of people being infected in the U.S. for the past couples of decades."
Interestingly, Lowndes County is the home of Attorney General Jeff Sessions. The county is part of the black belt which was named for the rich, dense soil that retains moisture, making it ideal for growing cotton. It is not so good at absorbing human waste, and too many residents of the county and other Alabama counties do not have access to sewage treatment, and must rely on septic systems. However, most residents of this county, one of the poorest in the nation, do not have septic systems. So they improvise:
Unable to afford a septic system, residents concoct their own sewer line using PVC piping, the researchers observed. The pipe runs from the toilets in their homes and stretches off some 30 feet above ground until it reaches a small ditch.
"This seems safe to [the residents]," says Dr. Rojelio Mejia, a pediatrician and infectious disease specialist at the Baylor College of Medicine who led the hookworm study. "But Alabama is very hilly and any drizzle of rain causes flooding, so whatever they delivered to the site spreads to the entire area, including their neighbors' area."
Often it flows into their own homes as well. And too frequently, the PVC pipes carrying fresh water to their homes cross the open ponds and ditches filled with the raw sewage, risking contamination.
According to a UN report published in 2011, the "Alabama Department of Public Health estimates that the number of households in Lowndes County with inadequate or no septic systems range from 40 to 90 per cent; it has reported that 50 per cent of the conventional, on-site septic systems are currently failing or are expected to fail in the future."
Rather than receiving any kind of government assistance to help them get their homes hooked up to municipal sewer lines or fix their septic systems or install new ones - which often cost between $10,000 and $30,000 each in the Black Belt - the residents are held entirely responsible for such work. But good-paying jobs are hard to come by in the economically distressed region, and many people survive on meager fixed government incomes.
Worse yet, children play near these areas where the worms lurk. The microscopic parasites latch onto bare skin and penetrate the body’s defenses through a hair follicle.
In Alabama. In 2017. Our children are playing in soil contaminated with human waste.
The UN has sent special rapporteur Philip Alston, who specializes in poverty, to look into poverty and the criminalization of homelessness in the United States. His travels have included Alabama, California, Georgia, West Virginia, Puerto Rico, and Washington DC. From his comments on Alabama:
A United Nations official who tours the globe investigating extreme poverty said Thursday that areas of Alabama's Black Belt are suffering the most dire sewage disposal crisis of any place he has visited in a developed country.
"I think it's very uncommon in the First World. This is not a sight that one normally sees. I'd have to say that I haven't seen this," Philip Alston, the UN's Special Rapporteur on extreme poverty and human rights, said as he toured a Butler County community where raw sewage flows from homes through exposed PVC pipes and into open trenches and pits.
His full report is due out in the spring, but he did have this to say last week:
“The idea of human rights is that people have basic dignity and that it’s the role of the government — yes, the government! — to ensure that no one falls below the decent level,” he said. “Civilized society doesn’t say for people to go and make it on your own and if you can’t, bad luck.
On Tuesday, the voters of Lowndes County went for Doug Jones in a big way, giving him 79 percent of the vote. Out of a population of 10,580, 4,767 turned out to vote, which is huge for a special election. It is clear that the people of Lowndes County need help and are looking to Democrats to provide it. It is also clear that electing one Democratic senator isn't enough to obtain that assistance.
We owe them a blue wave in 2018. We especially owe it to the black women, 98 percent of whom voted for Doug Jones and protected the United States Senate from yet another pedophile. Ninety-three percent of black men voted for Jones as well. Together, their vote offset the very white electorate that found voting for a pedophile preferable to voting for a Democrat.
It is not enough to say thank you to the black women who have led the charge, although it is important that we do so. Nor is it enough to elect black women like Georgia’s gubernatorial candidate Stacey Abrams, although it is essential that we do so. We have to take back our government to ensure that the wealth of this nation is not squandered by those who can afford to buy legislation. We have to return our government to the task of making this a more perfect union and to ensure that our prosperity is widely shared. And we must reassume the burden of eradicating poverty.
Because it is right, because it is wise, and because, for the first time in our history, it is possible to conquer poverty,