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September 11, 2021 47 mins

There was a time when the lower classes of the American South were considered lazy and dimwitted, a stereotype that still somewhat survives today. But this stereotype was rooted in fact. Hookworms, it turns out, were sapping Southerners’ life force. Find out all about it in this classic episode.

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Speaker 1 (00:00):
M Hi everyone, It's me Josh and for this week's
s Y s K Selecta, I've chosen a rather peculiar
episode that peaks in on a strange and fascinating quirk
of nature and geography that changed the course of history.
A lot of the sciences and humanities are covered here,
and it is a gross episode, but it's also engrossing,

so please enjoy this one on hookworms and the South.
Welcome to Stuff you should know, a production of I
Heart Radio. Hey, and welcome to the podcast. I'm Josh Clark.

There's Charles W Chuck Bryant, There's Jerry Rowland. She goes,
she just ran away after nine years. I knew that
would happen eventually. Yep. She had her little bendel sack
over her shoulder and she's barefoot, which is dangerous. Jerry,
that was a nice little set up. Yeah, you might

get uh, what do you call it, the do itch? Yeah?
Or well that's the best one, the ground itch do,
which is way better than ground get a little discomfort
in the webbing between your toes, a little scratchy. Maybe
a few days later you're like, this is this athlete's foot? No,

that doesn't make you cough. Yeah. Plus, you're no athlete.
Don't flatter yourself, that's what they would say. And then
you start coughing a little bit, and a few weeks
after that, you're just a big dope that can't lift
an arm. Do you go stand up and do anything?
You have hookworm? Yeah? Uh, well, there you have it.

Were you told as a child like you'll get worms?
And you're gonna ask me that because I grew up
in the South, Well no, I mean I was told
that too. I don't remember hearing this stuff. I remember
being scared about uh, scoliosis, and I remember being scared
about nuclear annihilation and so as I um, and that's

about it. Razors and apples at Halloween, yeah, which is
as we've covered, not true. Any instance that happened to
that happened because of the urban legend not gi uh No,
I've never really heard of this. And what made you
think of this? By the way, I don't know you

like the parasites. I love parasites. They're interesting, especially this
particular parasite, because it turns out the hookworm might be
the most interesting of all of the parasitic worms here
on planet Earth. If you ask me. Well, agreed, because,
as you will see, the social context in the Southern
United States of what the hookworm meant over centuries never

knew about it, and it's pretty astounding. And as someone
who has long had to defend the South as not
just a backward place with a bunch of dumb yokels,
I'm just gonna from now on, I'm just gonna say, hookworm.
Look it up. Listen to our episode, and people right
now are going, what in the world. So let's well,
let's get into it. Let's remove their the fog of

curiosity and maybe irritation a little bit and start talking
about hookworms. Right, so we said you it starts with
your foot. Yeah, these are round worms. Yes, they're a
type of round worm, a nematode right, yeah, nematode phyle
um um. They're pretty young, about four million years old.

And uh, they have been described in this article you
set most commonly as a as far as the way
they look as a tube within a tube like a
pair of socks. And then at one right at and
in they have cutting plates also called fangs or teeth. Mouthparts, yeah,

mouth parts, and as Tracy Wilson would put it, and
um they use those things for sucking blood. So what
they want it's your blood because they get nutrients from
your blood and that makes them parasites. Yeah, and they
as as we sourced a few really great articles on this.
But um as one of them points out to that

a good parasite or a good hookworm doesn't want to
kill you because, as it says in this article, that
means the ride is over, right exactly. They want to
keep you alive and lazy so they can just keep
reproducing and keep sucking on your blood forever and ever
and ever. And in a very large part, fookworms have

covalved with humans, and they've done so in a way
that they get the maximum benefit out of infecting a
human um without the pitfall of killing the human and
ending the ride for themselves. Right. So um and they've
had four hundred million years to do it. And there's
two kinds of hookworms. Mainly, there's tons of hookworms. Like

from what I understand, just about every animal. Every mammal
has its own type of hookworm, but they don't infect
cross animal typically. And there's two types of hookworms that
infects humans specifically, there's the New World hookworm naricatur Americana
is very open minded. And then there's the old word

world hookworm uh and solostoma duodenale minded right, and so
both of them thrive in warmer tropical ish climates and
the an AMERICANUS in particular loves sandy, loamy soil. And

it just so happens that in the America in south
has just the kind of climate to host an American
it's and it's around. Yeah, so here's what happens. We
were kind of kidding around about Jerry walking around barefoot.
But Jerry's old like me, and she grew up in
the South. We were all we all come from sharecroppers

and uh had outhouses. So here's what would happen um
all the way up until like which is kind of distressing. Yeah,
I thought so too. You could walk around barefoot, as
uh Southern children were wanted to do. Yeah. Apparently the
chances of your of being a kid with shoes, especially

in the rural South, was like next to nothing up
until that maybe the fifties or sixties. Really yeah, Uh,
so they would like we talked about the do uh
the do it? She would walk around barefoot. These little
guys would get between your toes, uh, root into your
body through the feet, make their way to the blood

vessels and start the voyage to the lungs. This is
it's a fantastic voyage. Well for them it is. Yeah. Um,
it's like inner space. Yeah um, up through the lungs,
finally through the circulatory system to the lungs where eventually,
like you said, you then you cough it up with
a dry cough and then you swallow it into your

gut and the intestine. And that's when it's like, this
is where I wanted to be all along. And the
nuts they go up through the foot circulatory system to
the lungs, make you cough, then you swallow them and
then they finally get to the place where they're supposed
to be, the small intestine, and they latch on and
they start sucking blood. Yeah. And hookworms are interesting tape
worms or hermaphroditic, but hookworms, like a lot of around worms. Uh,

they need to do it. Yeah, I was about to
say they like to who knows, maybe a little bit
both depending on the mood. They have to in order
to reproduce. So what you do is they get into
that into ston they find a lover. They take a lover.
Excuse me, Robert Lamb in here, they take a lover
and then they attach theirselves to the intestinal wall and say,

I'm here forever. I'm gonna I mean up to I've
seen up to thirty thousand eggs a day. Right, the
female will will lay thirty thousand fertilized eggs a day. Right,
And that's on the highest end. But you know, let's
say the low end is ten thousand, and say the
low end is a thousand. It's still a lot of eggs.
And that's just one female worm. Right, you can have

dozens hundreds of these things. They found that um, the
a human can host up to about five hundred worms
and survive. You're not living a very fulfilling life, as
we'll see, but um, you you could have a number
of these worms all pumping out eggs and the worm
typically lives between one and five years in the comforts

of your gut. And they in um, you can also
be reinfected. And here's how right, So when the females
are spreading out a thousand to thirty thousand eggs, take
your pick. On a daily basis, you're pooping those eggs
out and if you're pooping in say, like uh like
by the bushes or in some sort of like outhouse. Yeah,

it's eighteen seventy five in West Virginia. You don't have
indoor plumbing, right, and let's say your outhouse isn't all
that great, or you're just again pooping in the bushes.
You are probably not wearing shoes. Those two things usually
go hand in hand. And so you're stepping in your
old fecal material that's still had eggs in it before

those eggs have since hatched into larva. Larva gone through
the first two larval stages, entered the third infective larval stage,
and now it's crawling up into your foot again, and
you're what's called worm burden is expanded even further from
one or two to ten to twenty two up to hundreds. Yeah,
and that's if you just accidentally step in old pooh,

whether it's like spread around by animals walking around or
by the rain. Um, the chances of are exponentially more.
If you have a good old fashioned poop slinging fight. Sure,
you you know you don't want to get hit in
the mouth, but oh my god, UM, the other problem
that um well, it was part of the problem was that, uh,

that was the second version of that even was that
people were using poop as fertilizer. Now it's one thing
again you can't really catch I'm sure you can catch
some worms. I know trick gnosis is a problem for
humans and that's a pork worm um. But you you
using say, horse manure is relatively safe compared to using

human manure as fertilizer in your field. That's a relatively
recent discovery. People were using human manure as fertilizer for very,
very very long time, and it was called night soil
because at night, the guys would come out and clean
your your privy out and walk the muck, your poop,

your FeCO material down the street and collect more and
collect more, and then they would turn it into fertilizer.
Would say, release the night soil right before they dumped
it exactly, and it would be fertilizer and it'd be
great to make a crops grow, but it also just
contaminate your entire field with hookworms. And then little kids
would go out and work the field shoeless and they

would become infected from that too. So there were all
these really great opportunities for people to become infected by
hookworms by but there the hookworm habitat followed a certain
a certain line from about West Virginia down to I
think East Texas. Uh, and beneath that line that was

the hookworm belt. And above it they used human manure
for fertilizer too, but they didn't have hookworm. It was
in the South that the hookworm was a problem, and
it was a big problem, it turned out. Yeah, it
just occurred to me. We walked right past maybe the
best band name of all time in here, what worm burden?

Oh yeah, Wormbirds is pretty good. Um. All right, well
that's the setup, uh before we hit you with a
social context. So let's take a little break here and
we'll talk a little bit more about my old kinfolk
right after this. Alright, so before we broke, we talked

about what the hookworm is and all the different, uh
myriad ways which it could spread, from accidentally walking in
poop to poop slanging fights, night soil nights released the
night soil rolling in it to ultimate rotically increase your
worm burden. Um. So you found this great article called

how a worm gave the South a bad name by
a woman named Rachel Newer. Um, it's on Nova. Yeah,
it was really good, and she is from the South
and kind of wrote it from that point of view. Um,
and I get the feeling like, like me, she kind
of his long head to defend the American South as Hey,
we're not a bunch of dumb, lazy yokels. Because that

was you know, for a long time, um, and still
continuing today to a certain degree. Yeah, that notion kind
of exists that if you're from the South, you're kind
of slow, you may be a little dim witted, you
may be lazy. And this was you know, for white folks,
Black folks, Native Americans, just something about the South made

you lazy and dumb, especially among the lower socioeconomic classes.
And this wasn't just like off the cuff um stereotyping.
It was rooted in fact, in reality, there was something
different about people of a of the lower socioeconomic classes

in the South. Specifically, if you put them side by
side among the same socioeconomic classes of the North, the
ones in the North would be like, let's shovel some
cold baby, and the ones in the South would be like,
I'm just gonna lay here down next to my wheelbarrow
because I can't I can't get up. And so Southerners
were came to be seen as lazy, shiftless, couldn't be

trusted to do an honest day's work, and they just
thought it was part of the Southern character. Yeah. And
this wasn't just um a perception, like they literally lagged
behind the North in terms of productivity, um economic development. Uh.
And we'll you know, we'll talk about some of these
statistics as we go. Well, Plus the Civil War didn't

help anything either. Well, Now, that was obviously a big setback, right,
so it would have buried in the South, and it
would have been for any region right at level of
devastation and um um death. But coupled with their already
predisposition to this, that what what came to be called

the lazy germ Uh it was, it just set it
back even further. Yeah. And at one point in the
American South up to fort amazingly of the population, like
you said, from southeastern Texas to West Virginia and all
the way down, um was infected with hookworm. Yes, that's

a lot of people. I mean, it's obviously not a majority,
almost a majority that would have it would have been
a dumb Southerner. I mean, that's a lot of folks.
It is a lot of folks, And that was the
culprit mind this lazy shiftlessness among the poverty stricken Southern

poor and the rural. The poverty stricken, rural Southern poor
was apparently the majority of the South from the end
of the Civil War up until the I believe the
mid nineteen or mid twentieth century. Um, you were if
you were a Southerner, it was likely that you were
poor and did not live in the city until about

the forties. And there's a pretty clear demarcation line if
you did if you were wealthy in the South, or
you were lived in the city in the South in
the nineteenth and early twentieth century, you wore shoes, you
had bed pans um, and you could probably avoid this.
But if you didn't like those are they It says

in this article that it was almost impossible to avoid
if you were poor and lived in the South, because
you also didn't have very good sanitation. No, you were
just was just perfectly set up for you to keep
getting reinfected. Um. You know, every couple of years you
shed a dead hookworm. But in that time, you probably

would have taken on several more. All right, so what
does this mean if you get hookworm, like we said,
it's it's likely not going to directly kill you. Uh,
you might die from a common cold. Um, you might
die from malaria or typhoid fever, or you know, something
else may ultimately take you out because your body is
so weakened. But what it does in large part is

it causes an iron deficiency. Yeah, if you're a pregnant
woman or a kid, iron deficiency is really bad. Um,
if you're a child, you need that iron for your
brain development. So you know, not only would you get
like physical symptoms like stomach bloat. Uh what what was
the the I thing? Like this? The dull, fishy stair

fishy i'd stare. Yeah, just sort of like they're basically
described these kids just sort of vacant, right, just staring
off into space. Um. So you know some of those
are physical symptoms, but others were literally like a lower
i Q. Right. And so they believe that an Americans
came over as a result of the Atlantic slave trade,
that it was imported from Africa. So for centuries, generations

of kids, Um, we're being born in the South who
had there, Um, they were physically and developmentally stunted by
hookworm infections. Yeah. Sometimes girls wouldn't begin menstruation. Boys a
lot of times would not even hit their growth spurts.

And not only where they had lower i q s
and learning, uh, you know, development disabilities, but they were
smaller and weaker. Yeah, and then you combine this loss
of blood. So so apparently about a hundred worms in
a in a normal adult will drink about a teaspoon
a day, which doesn't sound like that much. But if

you couple it that level of iron deficiency with uh,
pre existing malnourishment due to poverty or the lack of
availability of like good food, Uh, then it really becomes
a huge problem. And it goes from like this is
a problem to this is this is a catastrophic problem
that can keep an entire region of a country down

productive productively. Yeah. And it uh like a lot of
disease we've talked about, whether it's like famine or lack
of clean water. It's it's cyclical in nature, so it
would occur where there was poverty, and then it would
keep people from working to work their way out of poverty.
And it just kind of compounded on each other. Right,
and then think about slavery as well. Right, So, not

only have you been brought over to the US as
a slave, you're being forced to work against your will
in these horrific conditions. You're also being forced to work
and live in the same conditions that promotes hookworm. So
you're feeling lazy and shiftless. Ts for you you're a slave.
Add that to your toil and misery, right, you know,
I could just it just keeps getting worse. All right,

So I think we've made it clear, big problem in
the South, but again, no one had any idea why. Yeah,
it was just you know, the lazy South, and it's
you know, people have said that it literally set the
South back like decades and decades from the rest of
the country. No one knows what's going on. Until nineteen

o two, this dude came along and they should be
kind of a weird movie to market, but this would
be a good movie. I think the story of Charles
Styles and hookworm, it's a big roller coaster, right all right, So, uh,
nineteen o two, this guy named Charles Styles comes along.
He's a zoologist from from New York, city, educated in Europe,

no less, so he played real well in the South yeah, which,
as you'll see, it was a bit of part of
the problem. Uh. And the Department of Agriculture said, hey,
we need you to help these farmers down there keep
their animals healthy. So go down there and check things out.
And he was like he started to notice. He's like,
something's going on. These people are physically stunted. They're a
little off. Yeah, they're mentally stunted. And I don't think

they're just dumb and lazy. So he started apparently he
sounds like one of these guys that was just had
to get to the bottom of it something, you know,
Like he wouldn't just say, you know, oh well everyone's
right about how it is down here. So he really
stuck to his instinct and realized that it was hookworm. Yeah.

He literally was the guy who discovered that that was
the problem exactly. I think he um he did that
by analyzing stool samples. So he basically just hung around
men's rooms. He said like, you're going to use that,
and they'd say, no, have at it. He just I
was educating by the way, exactly, and the people would

just walk away all right, is that I went down.
I don't know how it went down. I looked, Actually,
this guy is not the most celebrated person to ever
save an entire region from an infection. Um so, there's
not I didn't find a lot of background information on
him in particular. Um So, I have no idea how

it happened. I saw somewhere that said that he became
accidentally infected, and that's how he understood. Didn't see it
backed up anywhere else. I have no idea how this
man came to say moment right, because again, you gotta
you have to be trading in fecal material here. So
like this guy had his hands on human poop at

some point, right, or thought to look there? I'm not sure.
Maybe he was in a good old fashioned poop slang. Inte.
It makes the most sense that he was. He's like
something's on to god, Oh it's a worm. Uh. The
point is, though he was not well received, local doctors
didn't want to hear it. They would listen. They dismissed

him as you know, this this carpetbag in Yankee from Europe,
who you know, educated in Europe, who's down here telling us,
you know, he's he's an animal expert, and he's telling
us about our poop making us lazy. Yeah, crazy Europe
your animal expert. Yeah. They really didn't listen to him much.
So he was like, fine, I'll just go to John

de rock Feller and tell him I'm going to tell
on you. That's basically what happened. Yeah, Rockefeller was this
is at the time when income inequality was about at
the levels it was now, and the wealthy industrialists of
the age were really really worried that they were going
to have the social order overthrown by angry people, so

they invented philanthropy. Right. Yeah, this is back when they
worried about that kind of thing, right, And Rockefeller said, well,
we can't just we can't do anything to actually support
the problems that capitalism creates, because then we'll just be
drawing attention to the fact that there are major problems
with capitalist system. What else can I support? And he

heard about Styles, and Styles took a meeting with Rockefeller
and some of his his higher up friends, and apparently
at that meeting they closed the deal, like we're funding
this thing with the million bucks right out of the gate,
which is about twenty six million today and they set
up the Rockefeller Sanitary Commission for the Eradication of hookworm disease.

That's right. But um, despite the fact that they were
trying to help Southerners, um, not only with a medical issue,
but to advance themselves as a people. Um again, the
Southerners A they didn't want a light being shown on
this problem because it's gross, uh, and it has a stigma.

But they didn't want um again. They didn't want these
Yankees coming down there and saying they can fix you,
you know. And Rockefeller said t s. He said, I've
got an oyster edition named after me, maybe the best
oyster dish besides raw. I'm glad you said that. Uh.
Should we take a break? Yeah, all right, we're gonna

come back and talk a little bit about the road
to eradication right after this whom in your body food,

don't do you good woman, your body and your food,
don't do your Lona around up, come in a night
name and we're back and Chuck, we had a not
just a jingle that was a real blues song. Yeah,

people are like, man, somebody really made an authentic old
blues sounding jingle just for this episode. No, that was
the legendary Blind Blake with his song Hookworm Blues, which
was a real song about the hookworm blues. And I
think blind Blake came up with that song in nineteen six,
I believe. And the fact that he is singing about

hookworms um starting in the nineteen twenties represents, or it
just goes to show, like how much progress was made
between the time the Rockefeller Sanitary Commission was set up
and blind Blake had his number one hit, his number
one and in between that time for for promoting this

idea that there was such thing as hookworm and that
it was a real problem. Because when the Rockefeller Sanitary
Commission was set up in nineteen nine, the South was
still in face clean the groups of reconstruction. It wasn't
the reconstruction era anymore is the Jim Crow South, but
it was still really far behind as a result of

the war, and there were not a lot of public
services available. So one thing the rock Feller Sanitary Commission
had going for it was money, and then it was
going to be money invested in public health, all right,
So this is how they went about it. Uh, it's nine.
And like you said, they Rockefeller donated a million bucks,
which is how much today? It's pretty good. Um, And

they realized, well, I don't assume this was kind of
a purposeful move, um that they got a Southerner on
board to kind of help lead the charge. Definitely. Um.
This person named Wickliff Rose, great name. If there's a
hero of this story, it's him. If you asked me,
you think so not what's his face? No? Styles? Yeah, alright,

I mean he did some great work. It was good.
But Whyecliffe Rose was the one who uh Wyecliffe. That's
how I pronounced that he was the one who made
it happen, because because Styles could have discovered hookworm all
day long, but if he didn't have the personality to
write cure people, then it doesn't really help. So this

would be Matthew McConaughey then in the movie. Yeah so
and and Paul Giamatti And this is McConaughey coming in now.
Uh So, they get this southerner east from Nashville on
board to run the organization. And they had this approach
where they would go to a town that they would

go to a town in the South with these doctors.
But before they did that, they would start this um
campaign like an awareness campaign, um in schools to get
and as I think we've talked about in other things,
you get the kids on board in schools, and they
kind of helped get the parents on board, and they
started this campaign to tell children about what's going on,
and the kids would in turn hopefully go home and

tell their parents like, you know, my pa, I ain't dumb,
I got the hookworm. Look my poop is wiggling away exactly,
and um it was you know, they had a challenge
in front of him because, um, you know, you gotta
poop in a bag or something and give it to
your teacher. Your teacher and entire schools, these one room

schoolhouses were infected. And this this one kid they talked
to later on said, uh, well he was a kid
at the time. Well yeah, he was scared, Like he said,
he had constipation for a week. He didn't want to
like you didn't want to have hookworm. I don't want
my teacher to know me in this way. Yeah, pretty
much school sample. Um boy, never mind. But that was

but that was the whole setup, right, yeah, I mean
like there was there was there was a public information
campaign that was part of it. There was community involvement.
That was a really big thing that ay Cliff Rose started.
He said, we can't do this without the support of
the local community. So they built networks with like doctors
and local health boards. They got the schools involved, um,

and it became a community thing, right. Yeah. So once
you have the public on board, they would set up
these clinics, um not permanent, these kind of temporary clinics,
and they would it was kind of a big deal
in the town. It said that they would treat it
like an event and people would bring picnics. I don't
know that's a wise thing to do at a hookworm clinic,

but they would bring picnics. And it says in here
that they some people even wanted to get married in
the hookworm tent, and I was like, that seems weird
and kind of like kitchy. But then I also was like,
I bet a lot of these people have never seen
the tent before, so they were like one chance to stay. Yeah, yeah,
can we get married in the hookworm tent? And so um,

there'd be this public information campaign leading up to the
day of the hookworm Day you can just call it,
and right young a young doctor would ride into town
on horseback and he had a microscope and everything he would. Um,
there was a couple of parts to it. There was, um,
the sanitation lecture, which was, here's how you guys are

getting hookworm. Here's how you build what's called the sanitary privy. Yeah,
like they couldn't give him indoor plumbing, but they could
at least teach them how to have a nice enough
out house, right, And there's some very very simple principle.
One is like don't don't dig your latrine down until
you hit groundwater, don't let it go out into the stream,
make sure animals can't get into it, and like spread

it around a good door, make sure your feet aren't
standing in the same pit that you're pooping in. It's
really basic stuff. But like that was a big part
of it, right, Um. And then also explaining how the
infection process worked. Right, So because they understood very early on,
um that yes, you can get rid of hook worms

fairly easily, but you can also get reinfected fairly easy.
So they had to get that part across as well. Yeah,
and like again, you can't buy everyone's shoes, but you
can say maybe don't play near the outhouse. You gotta
stop the poop slinging fights all together. Yeah, they just
have to be gone the thing in the past. That's
the number one thing. They're part of the salad days.

And then this the sample analysis would begin, and the
poor doctor would just look with his microscope at each
poop sample and say past fail, pass fail, well, and
if the bag was vibrating, they didn't even have to look. Yeah,
like that that cheese in Sardinia. I think that with

the maggots, the maggot cheese. Didn't we talk about a
maggot episode. Surely we did. We're both so um. If
you were found to be infected with worms, you would
get very simple um pharmaceutical treatment, really simple. Yeah. There's
this extraordinarily toxic stuff called thyme all yeah t H

Y M O L Yeah. And it would kill your worms. Yeah,
and it could also kill you if you took it
with the wrong combination of foods or and or alcoholic beverages.
You wanted to avoid alcohol and fats and oils on
the day you took it. And then you would follow
your dose of thyme all with epsom salt, which were

to remove the thyme all from your body. Yeah, and uh,
they said at some point, you know what, that stuff
is super toxic, so why don't we replace that with
something called carbon tectric chloride um That must be much better? Now,
it was also very lethal, I guess. I just you know,
at the time didn't have anything that wasn't also dangerous

to take, right, And that did the trick and the
fact that the EPSOM salt would get rid of it
I think helped quite a bit. Yeah, So the great
end of this story would be if the Rockefeller's money
was well spent and five to ten years later they
eradicated hookworm in the South. But that didn't happen. Um.
It was successful in a lot of ways. Awareness kind

of be in the chief way, but as we said
a few times, reinfection is kind of the biggest problem.
Like they might have gotten rid of a lot of hookworm,
only you know, to have these kids who couldn't help
but have their poop slanging fights, uh, and then get
hookworm all over again. Exactly. And so but if you
go and read the Rockefeller's um the Rockefeller Foundations um

rundown of that program, they basically say it was this
one guy who lobbied hard to like just move on.
Whatever it was. Somebody from the Rockefeller founder said, we're
done with this. We've done our work right. And they had,
like you said, in a certain way, they had set
up some of the earliest public health networks in the South.
They had convinced the South that there was such thing

as hookworm and that it was a big problem, and
that if they were able to get rid of it,
they could um catch up to the rest of the country.
And they said, now the local doctors, now the local
health clinics can take over from here. But again, yeah,
it wasn't until the forties that that hookworm really started
to be eradicated, and it had very little to do

with the pharmaceutical treatments. It was the fact that indoor
plumbing became prevalent or I mean it was literally like
better food, better plumbing, more shoes. The end of share cropping,
which was a type of um agricultural system that kept
people poor and kept people in the fields. So it
was it kept the same unsanitary conditions for hookworm infection

right there. What did you call it when they would
dump the poop night soil? Yeah, no more night soil dumping. Uh.
Mechanization started and it was kind of a combination of
all these Just the mo dternization of the American South
is really what ended it. Um. And you know, the
proof is kind of in the pudding in that today

in conditions similar to the American South a hundred years
ago plus in other parts of the world, it's still
a really big problem. It is a really problem, apparently
something like I saw up to um. In this article
The War on Hookworms by Andy Borrowitz, he says that
up to something like seven hundred and forty million people

around the world are thought to have hookworm infections, right, Yeah,
about forty fifty million of which are pregnant women, which
is you know, obviously one of the uh, one of
the worst. Like we said, kids and pregnant women is
one of the worst kind of people to get to
end the saddest, right and uh, mainly because it increases

your chances of dying during childbirth because of anemia. Right. Um.
So it is a huge problem around the world. There's
there there's this kind of moniker for um hookworm infection
along with certain other infections. They're lumped together under the
umbrella of neglected tropical diseases. And the reason they're called

that is because this is stuff that like you can
easily get rid of if you alleviate poverty in the
the developing world. But we're not doing that, and it's
out of neglect basically. Yeah, it's not. It's not the
kind of thing where you can just invent the vaccine
and it's gone again because of the reinfection, because these

people are still poor and still in those conditions. Um,
we're talking at some of the highest rates are Sierra Leone,
Democratic Republic of Congo, Nigeria, Ethiopia, India, Venezuela, Indonesia. UM.
Also interestingly, UM, China in Brazil, which kind of surprised me. Yeah,

well it's the same thing as like the South back
in the day, where you have very very um or
well off urban areas and very very very poor rural areas.
Same thing in parts of China and Brazil today. Yeah,
and I think another reason, UM, at least this article
you sent kind of makes the argument that it's uh
still a problem. In fact, since nine it's declined globally

by just five Yes, despite the fact that something like
four hundred and fifty million people have been treated for hookworm,
But that declines it's only gone down five percent. And
all what that's saying is as long as there's the
unsanitary conditions, there's going to be hookworm, right, So we
have to alleviate the unsanitary conditions, and you do that

by alleviating poverty. And there's a group of of foundations
like the Bill and Melinda Gates Foundation, World Health Organization,
they've gotten together to create this End seven program and
that's they're trying to end seven of the neglected tropical
diseases by and hookworm is one of them. And there's treatments,

there's it's really easy to get rid of hookworm. There's
actually a couple of ironic treatments for hookworm. One medication
for getting rid of hookworm UM prevents the hookworms from
creating a t P, which is like an energy source,
so they become lethargic and die, just like they make
you lethargic. The other medication, UM attaches the to the

hookworms intestines and prevents the hookworm from absorbing nutrients, so
they die of malnourishment, just like they make people malnourished.
I don't know if it's ironic or if they're like,
we're going to get these things back, you know. So,
like I was saying a minute ago, part of the
big problem uh with eradicating this is that it's not, um,

it's not a big news item. Like you know, a
lot like Ebola comes along, it grabs all the news
and all of a sudden you have a lot of funding. Um,
hookworm isn't you know. I don't want to say a
sexy disease because that's gross, but it's not. It's kind
of just off forgotten, and so they don't have a
lot of funding. I'm glad that gates Is are involved

because that, you know, that makes it much more high profile.
But um, you know, it's still a big, big issue,
and uh hopefully you know this will help raise a
little bit of awareness. Sure well, if if hookworm is
eradecated by twenty we'll have played a rather large role
in that. Uh. But now we have a final twist. Yeah,

there's this really great quote from the sixties from a
Rockefeller um parasitic worm specialist who said that, um, we
needed the eventual helmntic defaundation of man saying getting rid
of worms from the human race entirely right. And he

said that for only in a society made up of
parasite free individuals. Well, we know of what the human
being is capable. Basically saying like, we have no idea
how much we're being held act as a as an
entire race, Yeah, by worms, So we need to get
rid of them. But there's this growing body of research,
chuck that's showing that we actually need to be infected

by hookworms. It looks like, well, if it can potentially
treat a few types of disease. UM, I don't. I
wouldn't say that humans need it, but right now there's
some experimental research going on and specific to hookworms, it
seems that it might help asthma. Okay, Um, there are

other worms that they're using that could help with everything
from ulstra to colitis, to Crohn's disease to multiple sclerosis.
But when it comes to the little hookworm, they think, um,
it might help asthma. Uh. They're not experimenting on humans
yet the United States, I don't think. I think only
in the United Kingdom right now are they using this
in humans. Um. But because it's hookworm, that side effects

are basically all the things we've been talking about. Um,
you know, every everything bad about the hookworm is going
to happen to you. Right. The thinking behind it though,
because that makes zero sense, Like why would that help
is that for some reason worm parasitic worms prevent the
human immune system from going overboard somehow, right, and that

the reason why we have autoimmune diseases like multiple sclerosis
or um Crohn's disease are because of a lack of
parasitic worms in our bodies. Because we've eradicated them. So
now these other diseases that are autoimmune diseases have been
able to rise. So it kind of is a like

you said, a weird little twist. Yeah, we'll see. I
mean right now, they're mainly working in mice and rats. Um.
But like anytime you're working with mice and rats, it's
can't exactly extrapolate that onto humans. So we shall see,
it's only one way to find out for you, and
I volunteer. Well they you know, I did see some
experiments not for this, but um, when they were doing

hookworm experiments period, they would infect people with hookworm and
you know volunteers. Yeah, and again, I mean like, it's
not like a hookworm's gonna kill you. And if you
are not going to get reinfected because you wear shoes
and use like a toilet with running water. Um, it's sure.
Why not you do it for science and money? Yes?

Are you got anything else? I do not what we
want to recommend the articles how a Worm gave the
South Bad Name by Rachel Newer and war on Hookworms
from Andy Borrowitz. They're both well worth reading. Uh and Uh,
since I said they're well worth reading, it's time for
listening to mail. All right, I'm gonna call this uh

follow up from a very sweet couple I met at
the airport. I think I talked about them after our
one I think the Midwestern Tour UM or No, no, no,
it was Louisiana New Orleans show. I met this very
nice couple who had been to the show. Um. They
were I think one of our more veteran and wise

UM listeners and show attendee's. They were wonderful. Uh, and
they stopped me in the airport. We talked for a
little bit, and this is from them. Hey, Chuck, I
wanted to follow up after the show in New Orleans.
We talked to you at the airport while we were
waiting for our flight back to Minneapolis. You were very
gracious talking to us when we had clearly interrupted you

on your way to do or get something, probably head
to poop. We told you our new hobby was going
and following you guys around the country. Uh, and making
vacations that out of your shows on tour, remember that,
m But we haven't made it to a live show since. Um,

we haven't done a lot of shows since it. Uh,
that's true. Well, we've done a handful. We've both been
slacking both parties. Yes, but we're gonna hit the road
for some shows later this year, by the way, Uh,
stay tuned for that. So you and Josh did, however,
inspire us in our new venture. We started a podcast
just before we left to drive to Alaska, and May Joyce,
who is the lady in the couple, UM, downloaded a

bunch of podcasts on how to make a podcast. By
the time we got back to Minnesota, we were well
on our way to starting Tall Tales and Travel, our
podcast about adventures in the outdoors. Uh. Lair and I
don't know if it's l A R R E. And
I can't remember if it was Lair or Larry Layers
probably short for Larry. Maybe it was short for Lawrence,

so it's doubly short. I'm gonna call him Lair just
l Uh. He has decades worth of stories which have
mostly taken place in Alaska. He's been a bush pilot,
charter boat captain, a police officer, and general outdoorsman to
name a few adventure settings. Yeah, that's a layer. If
I've ever heard on Lair. It does most of the
talking and Joyce does most of the behind the scenes tasks.

It's a division of labor that we've mastered over the
last thirty odd years together. We have a website, Tall
Tales and travel dot Com where we post photos and
videos from Lair's huge archive. Now that we're up and running,
we'll be putting more work into sorting and sharing the
collection more regularly. By the way, we used square space.
Thanks for the tip. Nice anyway, guys, were just writing

into thank you for the inspiration to let you know
that we haven't given up on seeing you live again.
We're going to keep our ears open and here we're
stuff you should know will be up next. Plan an
adventure to see you there. All the best that is
Joyce Olsen and Lair Broward and again check it out
at um Tall Tales and Travel dot com or at

Tall Tales and Travel dot libson l I B s
y N dot com and they were just really sweet
and nice and supportive. And the notion that these bowl
in their retirement would follow us around the country just
kind of knock my socks off. Yeah. So I haven't
listened to show yet because it just came in, but
I'm going to give it a whirl. Yeah, thanks you guys,
and congratulations. It's pretty awesome. Um and uh, I guess

if we've inspired you, like Joyce and Lair to do
something neat, let us know about it. You can tweet
to us at s y s K podcast. You can
join us on Facebook dot com slash Stuff you Should Know.
You could send us an email. This stuff podcast at
how Stuff Works dot com and has always joined us
at our home on the web with Stuff you Should
Know dot com. Stuff you Should Know is a production

of I Heart Radio. For more podcasts my Heart Radio,
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