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The Rockefeller Sanitary Commission for the Eradication of Hookworm (RSC) made the first comprehensive attempt to combat hookworm in the southern US. It also established a model for future public health work throughout the nation by institutionalizing services at the state and local level. Hookworm disease was a huge problem in the south, and yet it was readily treatable with a few simple measures. Hence it was an ideal test case for outreach and education in the opening years of the twentieth century.

Black and white image of a group of children holding signs that read "sleep", "dirt", "bad food", "good food", "fresh air"
The RSC was established in 1909.

The RSC was established in 1909 with a donation of one million dollars by John D. Rockefeller Sr. “ … to bring about a co-operative movement of the medical profession, public health officials, boards of trade, churches, schools, the press and other agencies for the cure and prevention of hookworm disease.”

Young girl sitting on top of a fence with a hat and no shoes on in a wooded area.
Hookworm ran rampant throughout the southeastern states.

Many people in rural areas were wary of the treatment of hookworm. This ten-year-old girl was not given treatment because her father didn’t believe in such a disease. Yet hookworm ran rampant throughout the southeastern states, causing anemia, malnourishment, and fatigue so severe that productive work or schooling became difficult.

Seven children standing in front of their home, covered in wooden singles and being held up by tree logs. All but one person in the photo is wearing shoes.
Six of eight people living in the cabin pictured here were infected with hookworm.

Hookworm infection is transmitted through human feces in soil, through the soles of bare feet, or through eating unwashed plants grown in contaminated soil. Six of eight people living in the cabin pictured here were infected with hookworm. Mississippi.

Six children standing with their mother outside of their home. Children are standing in moist soil without shoes.
The Hart family of Gatliff, KY.

The Hart family of Gatliff, KY infected with hookworm. The ground where these barefoot children are standing is soft and wet, a perfect hatching place for hookworms.

Group of eleven people standing in the front of a classroom as Professor T.E.R Davis looks into a microscope.
Professor T.E.R. Davis of the Romeo School demonstrates hookworm eggs to interested school children.

Professor T.E.R. Davis of the Romeo School demonstrates hookworm eggs to interested school children. Professor Davis rode 8 miles to a dispensary to get specimens containing the eggs of intestinal parasites to show them to his pupils. As the result of his interest, every pupil who was present submitted a specimen to be checked on the first day of the dispensary. Greene County, Tennessee.

Dr. Steele's Traveling Hookworm Dispensary of Kentucky State Board of Health. Group of 15 looking at a poster distributed by the U.S Treasury Department, with another group seated at the table with microscopes and other scientific equipment.
Kentucky boasted the largest number of examinations in proportion to the population.

Kentucky boasted the largest number of examinations in proportion to the population, and the lowest percentage of infection among southern states. Lectures by the State Registrar of Vital Statistics and local physicians resulted in the examination of specimens from practically every man, woman, and child.

Black and white comparison photos of a family of five before and after hookworm treatment.
Before and after: A family of children before treatment (left) and after treatment (right).
Black and white image of a large group of school children outside of their school building. Ages of students are varied.
A school in the Johns Station Community of North Carolina.

A school in the Johns Station Community of North Carolina. About twenty percent of these students were infected with hookworm.

Black and white image of unsanitary conditions with garbage lining the back of sheds.
Improper privy conditions.

Improper privy conditions, pictured here, were a major cause of the spread of hookworm, allowing contaminated feces to seep into surrounding soil. Much RSC work focused on the rebuilding of improper privies, such as this one in Texas.

Black and white image of a more sanitary condition of a privy and other building infrastructures in addition to a horse.
“Best grade” privy.

An example of a “best grade” privy in Marques community, Leon County, TX.

Black and white image of a family on front of their new privy.
Deacon Sid Hilliard and children.

Deacon Sid Hilliard and children, alongside their new privy. Red Oak Community, North Carolina.

Black and white image of vistors to the Free Hookwork Treatment Center. Group of indivduals stand on both the stiarwell and underneath the banne that reads "Free Hookworm Treatment Here Evey Thursday"
Traveling dispensaries, Robertson County, TN.

Traveling dispensaries were a core strategy of the RSC’s work in the south.
Treatment is fairly simple and involves taking an oral medication for 1-3 days. Robertson County, TN.

Black and white image of a group of men and children surrounding a scientist using a microscope in front of a store front.
A dispensary group in Waller County, Texas.
Black and white image of a group of visiting doctors and microscopists standing in front of a Public Health Exhibit tent in Louisville.
Visiting doctors and three microscopists at the Kentucky state fair.

A group of visiting doctors and three microscopists are pictured here at the Kentucky state fair, where they held demonstrations and exhibits on disease prevention and sanitation for health care workers as well as the public.

Black and white image of a group passing under a tent to view large prints of patients infected with hookworm.
The RSC created large prints of patients infected with hookworm.

A different method of informing community members and health workers. The RSC created large prints of patients infected with hookworm. Warren County, Kentucky.

Display of large prints of individuals from Warren County demonstrating before and after images of children, two larger groups of people, a small home, and a family.
Close up of large prints on display.

Close up of large prints on display. Warren County, Kentucky.

Black and white image of a State Board of health exhibition. Exhibition is lined with streamers from the sealing and front table. Exhibition has a small table with microscopes, chairs, and photographs.
State Board of Health exhibit in 1913. Louisiana.
Black and white image of two scientist using microscopes surrounded by other scientific equipment.
The RSC was disbanded on December 31, 1914.

The RSC was disbanded on December 31, 1914, having brought knowledge of the treatment and prevention of hookworm to the southern states. The Rockefeller Foundation, established in 1913, would begin to take up RSC work and export it internationally.

Watch: Unhooking the Hookworm, 1920


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