What do you think of when you hear the phrase "the American Dream"? While the official narrative may sing with stories of glory and success, it is believed that almost 19 million Americans now live in what is considered "deep" poverty - that is, with a family income of below half of the poverty line. Of these, two million are children.
Already considered by the UN to have the lowest rate of social mobility of any rich country, many people face a life of unstable employment, run-down housing, hunger, impacted education and a lack of healthcare.
a wave of “diseases of poverty” - illnesses that are more frequently confined to areas of the developing world but are making a re-emergence in the richest nation on earth. As is so often the case, it is lower-income individuals that are being most intensely affected and paying the greatest price. And in a cruel catch-22 situation, by slowing productivity and damaging the development of new generations, they are set to entrench their poverty even further.
According to the UN Human Rights Council investigation into extreme poverty in the USA, over 12 million Americans now live with a “neglected parasitic infection”.
Among the most prevalent of these is hookworm, a parasite which causes iron deficiency, weight loss, tiredness and can lead to anemia; in children. It can also cause slowed cognitive development and stunted growth. Commonly found in parts of the developing world, such as Africa and Latin America, it was thought to have been all but eradicated in the USA by the 1980s.
Yet scientists in Houston, Texas, found that more than one in three of those screened in rural areas of Alabama tested positive for traces of hookworm,
the eggs of which are carried in human excrement and burrow into the body when infected waste comes into contact with bare skin.
The study was conducted by the
National School of Tropical Medicine at Baylor College of Medicine in partnership with Alabama Center for Rural Enterprise (ACRE), in Lowndes County, a low-income, predominantly African-American area, where almost one third of people live below the poverty line. Although small, it is now set to inspire a wider investigation into the issue.
But in 2017, in a country that boasts some of the most advanced technology in the world, should people not be
able to go about their daily lives without being exposed to other people’s faeces? Well, the dirty truth is that parts of the country are currently experiencing a sewerage crisis that UN Human Rights Commission inspector Philip Alston described as unlike anything he had seen anywhere else in the developed world.
In total, 73 per cent of the residents that took part in the hookworm study reported that they had experienced raw sewage washing back into their home and the Census Bureau estimates that thousands of people across the country may come into contact with it on their property.
And the government appears to be doing little to help: promises to repair public infrastructure are almost irrelevant when it doesn't exist to begin with. Many are scared to speak out, for fear of drawing attention to the raw sewage leaking from their homes, which is a prosecutable offence. A
ccording to The Guardian, one grandmother was jailed for a weekend for not buying a septic tank that cost more than her entire annual income.
The issue is further complicated by the often astronomical costs of healthcare, because at the end of the day, if you’re unable to afford prevention then you’re unlikely to be able to pay for treatment either. In Alabama alone, it is thought that half a million people lack medical insurance. While it is easily treatable, the average cost of a round of medication runs at approximately $400 - despite being as low as four cents in countries such as Tanzania. And given that re-infection is possible, it’s a cyclical situation.
It’s a story repeated with other tropical diseases that are creeping back into the USA: d
engue fever, which is spread by mosquitoes, has been reported in Texas; cysticercosis, a parasitic infection that is the developing world’s leading cause of epilepsy, has emerged as an increasing problem; murine typhus, a bacterial infection often linked to rodent infestations, is surfacing once more. According to Dr Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine, medication for
toxoplasmosis, a parasitic disease that affects more than a million Americans, can reach over $3,000.
And while it is easy, and to some extent not incorrect, to blame migration from Latin American countries for the re-introduction of these diseases, the reality is that they are only being continuously transmitted because of the conditions that people are being forced to live in in America itself.
As the tropical climate of the southern states combines with the poverty of low-income America - with dilapidated housing, inability to afford air-conditioning, open sewers and shrinking budgets for healthcare resources - there is little end to the problem in sight.
So although America's south may be famous for its sweet tea, legendary barbeques and impeccable hospitality, away from the splendour and serenity of the tourist brochures lies a very different reality for too many people.
For them, this is part of the "forgotten America", the one that hasn't seen the spending on infrastructure or healthcare that it needs to guarantee its residents the most basic of rights.