Infrastructure neglect and poverty lead to parasites in the Mississippi Delta

FFor years, Marecitta Dorsey’s four children – ages 7 to 14 – regularly suffered from nausea, vomiting and stomach pain. Their unexplained symptoms were so bad that they missed school a few days a month.

“My oldest said to me, ‘It feels like my stomach is burning,’” Dorsey recalls. “Every week I took at least one child to the doctor because of something in the stomach.”

She suspected that their ailments had something to do with the water. Her children, she said, never had stomach problems before moving to the Delta.

Dorsey and her family lived in Shaw, Mississippi, a town of 1,400 people about 110 miles (175 kilometers) north of Jackson. The area is plagued by sanitary problems – residents of Bolivar province have reported it half a dozen complaints last year to state officials about wastewater leaks and burst pipes that exposed them to raw sewage.

Now researchers warn that these problems likely contribute to widespread intestinal infections and parasites such as hookworm, roundworm and tapeworm.

“There’s this whole idea that the U.S. has eradicated these things (parasites),” says Tara Cepon-Robins, an anthropologist at the University of Colorado, Colorado Springs. “But no one has actually eradicated anything.”

In fact, approximately 12 million Americans They are believed to have “neglected” parasitic infections – called neglected because of their prevalence, disabling symptoms and links to poverty. These diseases can spread through contaminated water and contact with feces and often thrive in areas with high levels of poverty and poor sanitation.

Officials previously believed the U.S. had rid itself of such parasites through investments in sanitation and public health, but in recent years research has revealed alarmingly high infection rates, especially in the South.

“These are chronic, debilitating conditions,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College. Hotez, who has been studying neglected tropical diseases in the region since 2008, said the findings by Cepon-Robins and her colleagues were in line with what he expected. “It is actually the poor living among the rich in the G20 countries who are responsible for most of the world’s neglected diseases,” he said.

Cepon-Robins and her team have been collecting blood and stool samples in Bolivar province since 2019 in an effort to demonstrate the impact of poor sanitation infrastructure on public health. The team results, published last year in the American Journal of Human Biology were “concerning,” said Cepon-Robins research partner Theresa Gildner.

The researchers found that 38% of children in their first sample had intestinal parasite infections and 80% had high levels of intestinal inflammation, a common symptom of parasites. (The initial sample included 24 children; they have since collected samples from another 150 residents, whose results are still pending.) These figures are consistent with a landmark 2017 study led by Hotez and his colleague Rojelio Mejia, which More than a third of residents in Lowndes County, Alabama tested positive for hookworm spores.

Hotez said there is “no doubt” that exposure to raw sewage was a factor in the infection rates Cepon-Robins and Gildner found in Bolivar province.

The presence of these types of parasites “can determine how your body responds to things throughout your life,” says Cepon-Robins. “It can determine whether you have allergies or autoimmune diseases,” and cause nutrient deficiencies, stunted growth, developmental delays, a decreased ability to work or learn, and in severe cases, anemia and malnutrition. Cepon-Robins and Gildner also found that children with high levels of inflammation were more likely to be underweight than their peers.

When the researchers expanded their study, they found that 73% of adults surveyed also had increased rates of inflammatory bowel disease.

Few U.S. healthcare providers are trained to recognize or treat parasitic infections, which likely results in many cases going undiagnosed, Gildner said. She was recently giving a talk about her research when a doctor in the audience said, “You won’t find anything,” she recalled, laughing incredulously at the memory.

‘The overall environment is brutal’

About 63% of Bolivar Province residents are black, many descendants of enslaved people. Today, the median household income in the county is just under $29,000, and so is life expectancy six years shorter than the US average.

“The overall environment is unforgiving,” said Dr. Jason Coker, the founder of Delta Hands for Hope, an education nonprofit in Shaw that connected the researchers with residents.

Coker, who grew up in Shaw, said he “100%” expected researchers to find the presence of parasites in residents’ test samples. He attributed the city’s decades-long water problems to white flight that began in the 1960s and left Shaw without a tax base to fund infrastructure maintenance.

In 1971, black residents of Shaw successfully argued in federal court that local officials practiced discrimination by failing to provide sewer, drainage and water services in predominantly black neighborhoods. The court ordered Shaw officials to submit a planned “program of improvements that will, within a reasonable time, eliminate the disparities that weigh so heavily on the black citizens of Shaw.”

But more than fifty years later, black communities in the South, including Shaw, have done just that poorer access of clean drinking water and functional sanitation than wealthier, whiter communities. “The water is brown, people don’t cook with it, they don’t drink it,” said Chiquikta Fountain, executive director of Delta Hands for Hope.

Shaw Mayor Evereth Stanton denied any problems with the tap water and noted that Shaw has been tested water samples complied with the Safe Drinking Water Act, although he acknowledged, “You get an odor when the chlorine runs out.” He added that Shaw officials were upgrading the city’s chlorination system.

The American Society of Civil Engineers gave Mississippi’s wastewater infrastructure a D- on its latest Infrastructure Report Cardciting a $2 billion backlog in necessary repairs or upgrades. “This increases the likelihood of wastewater leakage into the environment, endangering the public,” the authors wrote.

In Bolivar province alone, with a population of 29,000, residents have filed 107 complaints since 2008. They have reported backyards being flooded by raw sewage and homes being torn down to avoid the stench, headaches and nausea that come with the smell.

Charlene Gray, who lives in Choctawabout 4 miles from Shaw, said every few months a county sewage pump near her property is overrun by debris, sending raw sewage outside her home. “The sewage is overflowing,” she said, pointing to a field of brown-stalked cotton next to her plot. Sometimes it seeps into her garden, near her peach and plum trees. “And then the smell becomes very strong.”

The Mississippi Department of Environmental Quality oversees wastewater system operators across the state. “(The) MDEQ is aware of issues related to the sewer system serving the Choctaw community,” said Jan Schaefer, MDEQ communications director, in response to emailed questions.

“We are in ongoing discussions with the Choctaw community, Bolivar County officials and their legal counsel to ensure the long-term operation and maintenance of a viable wastewater treatment system,” she said, adding, “Our efforts include working to ensure that responsible parties are identified and held accountable for the maintenance and operation of wastewater systems.”

Schaefer did not respond to questions about whether infrastructure problems and the backlog in funding for necessary repairs or upgrades could be contributing to parasitic infections in Bolivar province.

She directed questions about parasitic infections and their possible causes to the Mississippi State Health Department. Officials there declined to comment.

Coker, the local advocate, said he believed the Southern states’ “decades of water problems” would likely only be solved with an influx of federal investment — but he was skeptical that the incoming administration of Donald Trump, which has made massive budget cuts promised, this would solve. Prioritize communities like his. “Trump will do nothing for rural America when he is president,” he said.

Last year, Dorsey decided she had had enough. She and her family moved to the outskirts of the county, where she said she no longer feared exposure. Now, “they haven’t had stomach problems in a while,” she said. “At first I thought it was a stomach flu. But this water – it’s ridiculous.”