The raw sewage from Pamela Rush's toilet travels through a straight plastic pipe directly into the backyard of her dilapidated mobile home. It smells badly in hot weather. Mosquitoes swarm and the children are forbidden from playing there. But when it rains, the stuff pools and it is unavoidable. Because the soil in Lowndes County, Alabama, where Ms Rush lives, sits atop a relatively impermeable base of limestone, a proper public sanitation system for the sparsely populated place would be expensive. Sanitation is left to private systems, which poor residents like Ms Rush cannot afford. Foul-smelling flooded lawns are a common sight. They are also the reason that hookworm—a parasitic disease transmitted largely by walking barefoot on open sewage—has been detected among the residents there. It is a disease most often encountered in developing countries. Yet decades after it was thought to be eradicated, it can be found in America, again.
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