A United Nation team’s tour of Alabama last week exposed what many Alabama residents have known for decades: residents of the state’s Black Belt region are suffering in social conditions most frequently encountered in Sub-Saharan Africa and Southeast Asia. Notably, Lowndes County, the home of Attorney General Jeff Sessions, suffers from poor sewage disposal and resultant hookworm infection otherwise unknown in the United States.
Phillip Alston, the UN’s Special Rapporteur on extreme poverty and human rights, witnessed communities where raw sewage flows into open pits or into surrounding creeks and streams.
“I think it’s very uncommon in the First World,” Alston said to reporters as he toured Butler County in South Alabama. “This is not a sight that one normally sees. I’d have to say that I haven’t seen this.”
Alston visited communities in Lowndes and Butler Counties last Thursday, accompanied by local activists. These counties are located in the so-called Black Belt, named for the rich loam that stretches throughout the Deep South States.
The region’s fertile soil, along with its steamy, subtropical climate, made it the epicenter of the Antebellum South’s cotton-growing industry. Today, it is known for its entrenched poverty and appalling social conditions. The lack of sewage disposal and the related occurrence of gastrointestinal pathogens in the Black Belt are but two startling indicators of those conditions.
In Lowndes and Butler Counties, residents frequently struggle with gastrointestinal diseases such as E. coli. Many of those who are not diagnosed have reported in the past to health officials that they suffer from frequent or protracted bouts of vomiting, stomach pain and diarrhea.
Lowndes County activist Aaron Thigpen took Alston and his team to a property inhabited by members of Thigpen’s extended family. The house had no functioning septic system; the family, which includes two minor children, relies upon PVC pipes to direct the household sewage into an open-air, aboveground pool.
As Thigpen pointed out, the main water line lies in close proximity to the improvised sewage system. Should the water main become open, everyone in the house “gets sick all at once,” as Thigpen told Alston.
He also took Alston to a community in Butler County, where he showed the UN team an entire community where man-made ditches carry effluent into a nearby creek.
“It’s really bad when you’ve got a lot of kids around like there are here,” Thigpen told AL.com. “They’re playing ball and the ball goes into the raw sewage, and they don’t know the importance of not handling sewage.”
Another Butler County resident showed Alston where his outdated septic system leaches raw sewage into the soil and bubbles up into his yard. A significant flood would send this raw sewage into the house, exposing all residents therein to coliform bacteria and parasites.
In September, the National School of Tropical Medicine (NSTM) at Baylor University published a study that revealed serious sanitation deficits in Lowndes County. Three-quarters of study participants reported that raw sewage had managed to reenter their houses, either because of heavy rainfall or clogs in improvised sewage disposal systems.
The problem is not entirely unknown: in 2011, the Alabama Department of Public Health reported that the number of households with no sewage disposal or inadequate sewage disposal ranged from 40 to 90 percent. The ADPH further reported that 50 percent of homes with on-site sewage containment systems had systems that were failing or expected to fail within the near future.
The loamy soil and hot, humid weather that made cotton farming such a profitable endeavor in the Deep South provides a perfect breeding environment for Necator americanus, a species of hookworm that lays its eggs in the intestines of those it infects. In a place like Lowndes or Butler County, where raw sewage seeps into poorly draining soil, the eggs deposited through sewage have a warm and hospitable locale to incubate, hatch and reproduce. A person unwittingly walking through a soil where hookworms have incubated can become infected when one or more worm enters their body, usually through bare feet and exposed ankles.
According to the NSTM study, 19 of 55 participants tested positive for the parasite, which causes stomach pain, vomiting and diarrhea. As infection progresses, severe anemia frequently leads to fatigue and cognitive disabilities; in some cases, particularly among the very young, the very old, and the immune-compromised, it leads to death.
Hookworm infections were largely eradicated from the United States between the 1950s and the 1980s due to social programs that addressed both sanitation infrastructure and community health. The parasite is mainly associated with extreme poverty in South America, Sub-Saharan Africa, and Southeast Asia, and many infectious disease researchers had assumed that it no longer existed in the US at all.
The Baylor study would not have occurred had Catherine Flowers, the founder of the Alabama Center for Rural Enterprise in Montgomery, Alabama, not prevailed upon the NSTM to investigate the situation in Lowndes County.
“Hookworm is a 19th-century disease that should have by now been addressed,” Flowers told the Guardian in September, “yet we are still struggling with it in the United States in the 21st Century.” As NSTM researchers pointed out to the Guardian, the discovery of hookworms in Lowndes County highlights the need for further research throughout the United States.
The incidence of hookworm is clearly tied both to poverty and to blatant malfeasance on the part of local, state and federal governments. In Lowndes County, the annual median household makes a mere $30,225 yearly. According to the 2010 US Census, over 25 percent of county residents live below the poverty line. For a family that earns less than $2000 a month, the cost of a new septic system—which can cost up to $15,000 to install—is prohibitively high.
Speaking to the Guardian in September, Aaron Thigpen pointed out that, while people are “disgusted” by having to live near raw sewage, “there’s no public help for them and if you’re earning $700 a month there’s no way you can afford your own private sanitation.”
Thigpen also pointed out that between 2002 and 2008, the State of Alabama prosecuted many residents who could not afford to install septic systems. Thigpen recounted the case of an elderly woman who was jailed for a weekend after she was unable to install a new septic tank; the installation would have cost more than her annual income.
“People...don’t like to speak out as they’re worried the Health Department will come round [sic] and cause trouble,” Thigpen stated.
Flowers reported that 80 percent of Lowndes County is without municipal sewer systems. In the absence of such systems, people are required to install and maintain their own septic tanks. In a location such as Lowndes County, however, very few people can afford to install any septic system—much less one sophisticated enough to deal with the water retention of the area soil.
The poverty and lack of infrastructure in Lowndes County is neither incidental nor accidental, and the urgent state of its sewage disposal issue is not the only evidence for that.
Lowndes County was known as “Bloody Lowndes” during the Civil Rights struggles of the 1950s and 1960s, home to a large proportion of disenfranchised African Americans whose demand for voting rights was met with police violence and the state’s intentional destruction of roads, ferries, and public transit that might allow poor residents to make it to the voting polls. Older residents recount how the homes of black residents were shot up or set on fire to dissuade them from voting; law enforcement either turned a blind eye or actively encouraged such acts.
Voting rights remain an issue in Lowndes County. Philip Alston and his team made their final stop in Alabama at the home of Pattie Mae Ansley in Fort Deposit. The 96-year-old Ansley told Alston how her house was “shot up” in 1965, after the Voting Rights Act was ratified. Her children spoke to Alston privately about their experiences with obtaining a voter ID card and the difficulty of getting to the polls.
Flowers pointed out that access to the polls is not the only issue. “People are frustrated because people are getting into office who aren’t doing what the people elected them to do,” she told AL.com.
Alston rightly points out that access to decent sanitation, like voting rights, is a human rights issue. However, the Republican Party stands poised to pass a tax bill that will overwhelmingly place the country’s tax burden onto the backs of the poor while subsidizing the wealthiest, exacerbating the social problems seen in Alabama.
Moreover, the budget proposed by President Donald Trump drastically cuts spending for creating new infrastructure or for upgrading outdated infrastructure; to the contrary, it places social infrastructure at the mercy of private entrepreneurs. Lowndes County and its abominable lack of sewage disposal stands as an example of how such a system, which Alabama’s government has faithfully embraced since the 1960s, utterly fails to addresses even dire social issues.
As this article was being written, Alabamians were waiting for the results of a special election to determine whether Republican Roy Moore or Democrat Doug Jones would take the hotly contested US Senate seat vacated by Attorney General Sessions. Moore is an openly fascistic, antidemocratic candidate, well-known as a highly partial judge who supports restricting voting rights.
Nevertheless, the Jones campaign refused to mount an attack upon either Moore’s viciously antidemocratic positions or the failure of the Republican Party’s history within the State of Alabama, which has orchestrated massive cuts to public programs.
The NSTM released its study in September. Jones’ campaign has had ample time to answer to the damning report on social conditions in Lowndes and Butler Counties. Nevertheless, the Democrats persisted in running a right-wing pro-business campaign against Moore focused solely on allegations of sexual misconduct, ignoring the poverty that will only continue to fester in the Black Belt along with hookworm and E. c oli infections.
The reason for such an abject lack of concern for the conditions of workers in the Democrats’ campaign in Alabama is clear; it does not concern them, and they cannot offer an answer to it. Neither party represents the interest of Alabama’s working-class residents. To resolve the social problems they confront, workers in Alabama and throughout the US must reject both parties of big business just as surely as those parties have rejected them, and stand united with their counterparts worldwide in fighting for a socialist program.