A deeply personal, unsparing analysis of how neglected diseases disproportionately affect marginalized peoples in the world's richest country-and why they need not.While Covid-19 continues to circle the globe and wealthy countries clamor for vaccines, dozens of "neglected tropical diseases" are ravaging more than 1 billion people living in developing regions of Africa, Asia, and the Americas. The treatments for some of these are available, but accessing them can be difficult or impossible. When these diseases appear in developed, Northern Hemisphere countries, they are rarely diagnosed accurately by doctors, who did not learn about them in medical schools, and sociocultural barriers, political choices, and racism further limit options for care. In her latest, Hernández, a professor of English and former New York Times reporter, explores her family's struggles with Chagas disease, better known as "kissing bug disease." The author highlights how poverty, policies that limit health care for immigrants and marginalized peoples, and the worldwide neglect of public health infrastructure all contribute to the 10,000 deaths among the 6 million cases of Chagas disease in the Americas, 300,000 of which are in the U.S. The heroes of this story are not only the doctors, nurses, public health professionals, and volunteers who work tirelessly testing for and treating the disease-as well as identifying and controlling infestations of kissing bugs (Triatoma species) and the Trypanosoma parasite that causes the illness-but also the patients and support groups who have increased awareness of it, especially in Texas and California, where it is most prevalent in the U.S. And, of course, the tireless family members–cum-caregivers like Hernández. The author's Tía Dora, who lived with and died from Chagas disease, changed Hernández's life. Her story, ably rendered by the author, should open readers' eyes to a persistent plague.A compelling indictment of our failing health care system and the people falling through its ever widening cracks.

Hernández (A Cup of Water Under My Bed), a creative writing professor at Miami University of Ohio, blends family memoir, scientific inquiry, and journalistic exposé in this poignant study of Chagas disease, an insect-borne tropical parasitic infection that can cause lifelong heart and intestinal problems if left untreated. After the death of her aunt Dora, who came to the U.S. from Colombia to seek treatment for her intestinal issues, Hernández poured her grief into exploring the history of Chagas disease. She lucidly describes the parasitological research that brought it to light in the early 20th century, and documents the chronic presence of insects, including the -kissing bugs- that spread the disease, in poor households in Latin America and the U.S. Profiles of other immigrant families who struggle to access adequate health care, and discussions of experiments on Black asylum patients in the 1940s and price-gouging by pharmaceutical executives add weight to Hernández-s searing indictment of the U.S. medical system, which fails to routinely screen for the infection, despite knowing that it is widespread and that presymptomatic treatment is the only cure. This vivid, multidimensional account brings an ongoing medical injustice to light. (June)