Gail Jarrow is the author of the new young adult book American Murderer: The Parasite that Haunted the South. Her many other books include Ambushed!. She lives in Ithaca, New York.
Q: What inspired you to focus on the hookworm parasite in your new book?
A: While researching my Deadly Diseases trilogy about epidemics during the early 20th century (Red Madness, Fatal Fever, Bubonic Panic), I kept seeing the name of government parasitologist Charles Stiles.
In 1902, Stiles identified a new species of human hookworm that he discovered was creating widespread illness in the American South. Yet the medical community denied that hookworm disease existed in the U.S. Doctors weren’t trained to recognize its symptoms or provide effective treatment.
Because of Stiles's relentless efforts to raise the alarm about hookworm infections, a government–private partnership was established to end the epidemic. The cooperation ultimately changed public health in the U.S. and throughout the world.
As a forgotten moment in our country’s health history, the story fits perfectly as the third book in my Medical Fiascoes series (Blood and Germs, Ambushed!).
Q: How did you research the book, and what did you learn that especially surprised you?
A: I approached from three fronts.
First, I extensively researched the biology of hookworms and their effects on the human body. My zoology background came in handy with this.
Second, I dug up everything I could find about Charles Stiles’s life and career.
Third, I investigated the Southern epidemic and the partnership between the Rockefeller Sanitary Commission (funded by John D. Rockefeller) and federal and state governments. I read through many primary sources from that era, including medical journals, government reports, memoirs, and newspapers.
We’ve known how to prevent, diagnose, and treat hookworm infections for more than a century. I was surprised that today an estimated 500 million to 1 billion people living in tropical and subtropical regions are infected.
The reason for these high numbers? Hookworm is an intestinal parasite, and more than 2 billion people worldwide lack access to sanitation that stops human waste from polluting their environment.
Q: The Bulletin of the Center for Children's Books said in its review, “Jarrow’s coverage of the biological mystery is well-organized and deftly explained, and she also skillfully handles the social context of a condition that largely affected marginalized populations.” Can you say more about how the parasite particularly affected marginalized groups?
A: The disease had the greatest impact on poor Southerners. Hookworms can’t withstand freezing temperatures, which explains why this was a disease of the South.
Most infections occurred in rural areas, where 80 percent of the Southern population lived in the early 1900s. Country households weren’t connected to a public sewer system, and many families used crude outhouses or just the bushes.
Because hookworms spread through soil contaminated with body waste and invade through the skin, people were infected when they walked in bare feet over contaminated ground. Shoes were expensive and going barefoot was common, especially among children.
Small farmers, including sharecroppers, already struggled financially. A hookworm infection worsened their situation. The parasite literally sucks the energy and life from its victims by draining blood from the intestinal wall.
People infected with hundreds of worms lose the strength to work. Children’s physical and intellectual development is delayed, sometimes by years, and they can’t concentrate or learn in school. The weakened body is susceptible to other deadly ailments, particularly if the victim can’t afford to eat an adequate diet.
When poor rural Southerners became sick, they had limited access to medical care and information. Thanks to all these conditions, debilitating hookworm infections affected generation after generation and trapped families in poverty.
Q: How would you compare the impact of this parasite to other health crises in more recent times?
A: As I worked on this book, I noticed parallels between the current Covid-19 pandemic and the South’s hookworm epidemic.
When a medical crisis develops, the scientific community has to learn how the disease is transmitted, what the physical effects are, which treatments work best, and how the disease can be controlled and prevented. This takes time. Meanwhile, people continue to get sick and die, and families and communities suffer economically.
But even after medical understanding increases, the challenge remains to educate the public and to convince everyone to act in ways that will mitigate the crisis. The efforts by Charles Stiles and his public health colleagues were sometimes complicated by bungled communication, confusion, misinformation, suspicion, and distrust. More than a century later, we’ve seen the same problems during the past three years.
Q: What are you working on now?
A: My next book is Spirit Sleuths: How a Magician and a Detective Exposed the Ghost Hoaxes, due out in 2024. This one combines the subjects of my two earlier books—hoaxes in Spooked! and magic in The Amazing Harry Kellar.
Spirit Sleuths focuses on the first half of the 20th century when fraudulent mediums and fortune tellers targeted the gullible—often people in mourning—by claiming to communicate with the dead.
Harry Houdini saw through these deceptions because he and other magicians used the same tricks in their stage acts. Houdini campaigned to expose the cruel hoaxes, and he hired a young female detective named Rose Mackenberg to help him do it. After his death, she dedicated her long career to chasing spook crooks.
Q: Anything else we should know?
A: My science background continues to influence my choice of subjects. Whether the topic is hoaxes, epidemics, or medical discovery, I’m drawn to true stories that highlight the importance of questioning, gathering evidence, and thinking critically.
--Interview with Deborah Kalb. Here's a previous Q&A with Gail Jarrow.
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