People, Parasites and Places: Biological and Social aspects of human hookworm infection and eradication in British territories, c.1900-1936

This thesis discusses disease eradication, extinction, and the interactions of parasites, environments and societies through studies of hookworm in Jamaica, the Windward Islands Association (St Vincent, Grenada and St Lucia), and Cornwall in the early 20th century. I take an interdisciplinary and comparative approach, drawing together biology and history, to discuss hookworm (Ancylostoma duodenale and Necator americanus), a soil-transmitted parasitic worm which feeds on blood and can cause anaemia in its hosts.
Comparisons across the three case studies reveal that the social meanings, understandings and experiences of hookworm varied across and within contexts.
Likewise, its biological transmission dynamics and even clinical presentation were shaped by socioecological context. Both environment and socioeconomic institutions affected its prevalence. Hookworm had an ambivalent relationship with colonial and capitalist modernity, with plantations and mines both providing opportunities for it to spread and problematizing its existence, helping drive efforts to induce its extinction. While extinction is generally considered a tragedy of modernity, in the context of hookworm eradication, extinction was conceptualised as a product of social and civilizational progress and as a means to produce a hygienic modernity. However, hookworm was understood differently by different actors, and the eradication programme in Jamaica in particular benefitted from the support of a wide section of Jamaican society. Some saw hookworm treatment as a way to improve their own quality of life, and were persuaded of its effectiveness both by its expulsion of a more visible parasite (Ascaris) and biomedical use of a time-honoured folk remedy (Chenopodium), while others saw hookworm treatment as a means to improve and modernise Jamaica and its people both physically and morally. Attempts to induce the extinction of hookworm highlight the ambivalent role of modernity in extinction, while also showing that hookworm was shaped by socioecological context, by people and environment in many different ways.