It draws on a rich archive of state health publications, Rockefeller Foundation archives, local letters, and petitions to show how peasants, workers, and women were cast as either sanitary citizens worthy of redemption or unsanitary subjects whose lives were expendable. Yet ordinary people were never simply targets. They received, reinterpreted, and openly contested the discourses of hygiene and modernity directed at them, sometimes reinforcing existing hierarchies of class, race, and gender, and sometimes challenging the state’s narrow vision of health and rights altogether.