At the dawn of the twentieth century, many Arkansas business and political leaders had high hopes for progress and prosperity for the state in the coming years. But as Arkansas attempted to move forward, it faced an old scourge that steadily held back its progress.

Hookworm had infected thousands of Arkansans, steadily wearing down their health and vitality. Hookworm was a parasite that often infected individuals walking through soil or sewage contaminated with hookworms. Infections could last for years. The parasites would burrow into the intestines of the host, causing fever, coughing, nausea, and even anemia and heart problems.

Dr. Charles Stiles, a New York native and European-trained doctor, had been conducting a study of hookworm in the South at the turn of the century and became alarmed at how common the disease had become. He pushed for health officials to respond to this public health crisis in a 1903 paper.

John D. Rockefeller, the wealthy industrialist, became interested in the situation. Partially through the efforts of Stiles, Rockefeller donated $1 million to the creation of the Rockefeller Sanitary Commission for the Eradication of Hookworm Disease in 1909. The task ahead was difficult. Arkansas was an extremely poor state in spite of being blessed with an abundance of agricultural products. Roads in rural areas were often impassable, if they existed at all, and it was difficult for people in outlying areas to reach a doctor, much less afford one.

Nevertheless, the state was persuaded to take action. In 1913, the Arkansas Department of Health was established, with its top priority being the eradication of hookworm.

Reports on the extent of the problem were shocking. The Rockefeller Commission reported that some counties had infections rates of over 60 percent. Union, Nevada, and Columbia counties reported infection rates of over 66 percent. Hot Spring County reported a 75 percent infection rate. Some schools had a 100 percent infection rate. The ADH reported that in one study, 31.3 percent of all Arkansans were infected. The ADH added that at any given time, 10,000 people in the state were so badly infected that they could not function at any kind of job.

The Rockefeller Commission and the ADH set up free clinics across the state to treat the infected. A treatment of Epsom salts and thymol were prescribed for treating the condition. Doctors working with the Rockefeller Commission, however, noticed the problem leading to hookworm. They noticed that many of the infected, particularly children, did not have shoes and would often have to walk to flooded outhouses where the soil was contaminated with hookworms. Health officials began insisting that children have to wear shoes outside and that outhouses be redesigned in a way to prevent soil contamination.

By 1914, the epidemic, called the "damnation of the age," had passed, and the Rockefeller Commission disbanded. Hookworm all but disappeared throughout the United States, with children ever since being reminded to wear shoes while outdoors.