Hookworm, long considered eliminated in the United States, has seen a resurgence in poverty-stricken Alabama counties, specifically Lowndes County, due to the lack of proper sewage disposal systems.

A study published in November 2017 by the American Journal of Tropical Medicine and Hygiene stated that of 55 samples collected, more than 34 percent tested positive for hookworm. Further, the study claimed that among 24 households, over 42 percent were exposed to raw sewage within their home.

Initially, the Alabama Department of Public Health (ADPH) contested the results. In a statement released earlier this year, the ADPH said the study used “an experimental technology not FDA-approved” in order to test for hookworm.

The statement went on to say that nine of the individuals that tested positive submitted to additional testing in which “no evidence of hookworm was found in any of the residents of Lowndes County who were tested.”

The lack of proper sewage disposal in Lowndes County provides the proper conditions for hookworm to thrive. Within the county, many residents struggle with septic tanks which do not function properly or do not have one at all.

In the absence of a septic system, many residents resort to “straight piping,” in which a pipe is run directly from the home and the sewage poured untreated onto the ground outside.

The environmental group Earthjustice recently filed a discrimination complaint against the ADPH and the Lowndes County Health Department alleging that the departments discriminated against the mostly black community by not working to stem the outbreak.

“The Alabama Department of Public Health (‘ADPH’) has known about the problem of inadequate sanitation for years,” the complaint states. “Yet, the agency has failed to protect residents from this grave and urgent threat to the environment and human health, and has even affirmatively and incorrectly informed residents there is no evidence of hookworm in Lowndes County. By failing to address the inadequate access to functional wastewater treatment in Lowndes County, which has led to the proliferation of insanitary conditions and public health problems, ADPH and the Lowndes County Health Department (‘LCHD’) have caused and are causing an unjustified disproportionate and adverse effect on the black community of Lowndes County, Alabama.”

The group further alleges that only black residents are being punished for not properly disposing of waste water, a criminal misdemeanor in Alabama.

The ADPH has launched the Lowndes County Unincorporated Waste Water Project, which will be under the direction of Bureau of Environmental Services Director Sherry Bradley and work to get septic systems to poor residents.

In an article on Fox News, Bradley stated that the project has already received verbal approval for a $2.5 million grant from the United States Department of Agriculture (USDA) and is receiving donations of faucets, showerheads and toilets from Japanese manufacturer Lixil.

The program is expected to launch in January 2019 and will cost recipients $20 a month, as well as a one-time fee of $500 for a conventional system or $1,000 for an engineered system, and come with training on how to maintain the system.