In cities a great deal of attention is given to sanitation. Sewage is carried off by public sewers. Householders are required to place garbage in sanitary cans, whence it is collected and disposed of in such a way as not to pollute the soil. Ashes and refuse are carried away from homes and shops, and the streets are cleaned daily. In rural communities such matters are left almost entirely to the householder.
FLIES AS DISEASE CARRIERS
Exposed garbage, improperly built outdoor toilets, and stable manure are breeding places of flies; and flies are notorious carriers of disease. Yet, out of more than 3000 homes in one county in Indiana only 31 made provision to prevent stable manure from breeding flies, and the same was true of only 1 out of more than 2000 homes in a county in North Carolina, and only 86 out of nearly 5000 homes in an Alabama county.
DANGER FROM MOSQUITOES
Malaria is widespread in the United States and imposes a heavy toll upon the nation's health. It is carried from one victim to another by a certain kind of mosquito, of which it is comparatively easy to get rid by proper drainage of breeding places, by treating the surface of pools with kerosene, by screening, and by seeing to it that rain barrels are covered and that tin cans and other receptacles of water are not left lying around. But flies and mosquitoes do not stop with fences, nor do they recognize city or county boundaries. Hence, individual effort without community cooperation is likely to be useless.
POLLUTED SOIL AND HOOKWORM DISEASE
The terrible hookworm disease so prevalent in our southern states is caused by a minute worm that infests soil polluted with sewage. It penetrates the soles of the feet of those who go barefoot and the palms of the hands of those who work in the soils, finds its way through the blood to the intestines, and thence to the soil again. An investigation in 770 counties in 11 states where hookworm disease is prevalent showed that out of 287,606 farm homes only six tenths of one per cent disposed of their sewage in such a way as to prevent soil pollution.
Out of 305 homes in a little community in Mississippi, only 4 properly disposed of sewage. When the first investigations were made, there were 407 cases of hookworm disease out of 1002 residents. Besides, there had been recently 12 cases of tuberculosis, 47 of typhoid fever, 184 of malaria, and 384 of dysentery.
Safe methods of disposing of sewage were introduced, houses were screened, an artesian well was bored for a public water supply, and the community cleaned up generally. After these improvements the various diseases almost entirely disappeared. Similar results were obtained in 99 other communities in the southern states.
[Footnote: Report of the Rockefeller Foundation, 1917, pp. 136- 138.]