Showdown in Choctaw County

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A heavy woman wearing a tan jumpsuit and a gold crucifix around her neck pulls back the screen door. Sara introduces her as her aunt Jesse, who has come to help them with their laundry. As the aunt makes her way to the back of the trailer, Sara whispers, "I don’t want her to know ’cause she talks too much." (Sara and the rest of her family have agreed to share their story on the condition that their names be changed.)

Rebecca has another coughing fit. As deShazo talks with Sara, Rebecca’s son, William, laughs and teethes on a closed bottle of pills. He’s fat, playful, and, at a year and a half, completely unaware that his mother is gravely ill.

DESHAZO WAS HIRED along with seven community outreach workers to canvas 32 of Alabama’s poorest rural counties, which based on their sexually transmitted disease and teen pregnancy rates appear most vulnerable for AIDS. A year and a half into the three-year project, deShazo estimates that he’s approached 300 people for testing. Only two have agreed to get into his aging blue Pontiac and head down to the local health department. This isn’t unusual. There is a long-standing shortage of doctors and health facilities in black Southern communities. And many blacks in the region distrust doctors—a legacy of the infamous Tuskegee Syphilis Study, in which black test subjects were denied treatment for decades as part of a long-term health experiment. What is mentioned less often is that, compared with gay communities, much of black America—and particularly the rural South—has been relatively ignored in the campaign to educate people about AIDS.

DeShazo was hired in part because he had an idea about how to navigate the socially conservative, religious, and racially fractured landscape of rural Alabama. He was raised in Clark County, 50 miles north of Mobile, where his father was a country doctor. His understanding of the culture, the spiritual convictions of the people, and even the subtle rhythms of their speech have allowed him to penetrate his territory more deeply than any of his fellow workers. But growing up in the segregated world of 1950s Alabama did not prepare him for the rural black world this job has allowed him to enter.

Certainly he was familiar with the unsettling questions of race and poverty. His father had separate "colored" and "white" waiting rooms. And he has a hazy memory of his mother leaning back in the family station wagon when the news came across the radio that President Johnson had signed the Civil Rights Act and wondering aloud why Northerners always had to shove ideas down Southerners’ throats. But that was just the way things were then. Mostly, he remembers the gentle black woman who helped raise the deShazo boys and how much he loved her, and he remembers rides out into the country with his dad to care for poor blacks and how sometimes they would get paid and other times they would drive home with a sack of potatoes or turnip greens on the backseat.

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