A pool of sewage outside a home in Lowndes County, Alabama.

A pool of sewage outside a home in Lowndes County, Alabama. Catherine Coleman Flowers


Filthy Water: A Basic Sanitation Problem Persists in Rural America

Residents of Alabama’s Lowndes County lack adequate wastewater systems and must contend with sewage backing up into their yards and homes. Environmental activist Catherine Coleman Flowers says this problem affects many low-income, rural parts of the U.S. and can no longer be ignored.

Lowndes County, Alabama lies at the heart of the civil rights movement. Situated between Selma and Montgomery, the rural county is home to most of the route that Martin Luther King Jr. and thousands of activists followed on their historic five-day march in 1965. Beyond its civil rights legacy, however, the county — one of the poorest in the United States — is now becoming known for something far less noble: Up to 90 percent of households have failing or inadequate wastewater systems, causing raw sewage to back up into homes, pool on lawns, and spill into nearby streams and rivers.

Environmental justice activist Catherine Coleman Flowers has spent 20 years bringing attention to what she calls “America’s d­irty secret.” Residents in poor, rural U.S. communities like Lowndes County rely on septic systems to dispose of household wastewater. But as Flowers, founder and director of the Center for Rural Enterprise and Environmental Justice, explains in an interview with Yale Environment 360, these systems are expensive to install and maintain — the cost of a new septic system can exceed $20,000, more than many low-income households earn in a year. Federal, state, and local governments don’t invest in rural wastewater infrastructure, leaving homeowners on their own to deal with the problem and vulnerable to low-cost contractors and faulty equipment. The result is a public health crisis similar to that found in many developing countries. And climate change — with its more intense rainstorms, sea level rise, and heat — is only exacerbating the problem.

Catherine Coleman Flowers.

Catherine Coleman Flowers. Credit: John D. and Catherine T. MacArthur Foundation

“It’s not just Lowndes County,” says Flowers, the recipient of a 2020 MacArthur “genius grant” and author of the new book Waste: One Woman’s Fight Against America’s Dirty Secret. “This is a problem throughout rural America… Poor communities across the U.S. are pretty much left to their own devices [when it comes to sanitation].”

Yale Environment 360: You’ve spent 20 years working on what you call “America’s dirty secret” — the lack of basic sanitation in many poor, rural communities, and the public health consequences. When did you first become aware of this problem?

Catherine Coleman Flowers: I first became aware of the problem of sanitation, or the lack of it, in 2002. When I was growing up in Lowndes County, we would have problems with our septic system backing into the home. But we all thought it was essentially a plumbing problem, because no one had done the kind of deep dive that was needed in the community to figure out how many people were dealing with the same problem and what were the factors that contributed to it.

In 2002, [urban policy expert] Bob Woodson came to visit Lowndes County to learn about the challenges of economic development in the region. We were asked by one of the county commissioners to take a detour and go and see a family she wanted me to meet. As we turned off the paved main road onto a dirt road where this family lived, you could see the raw sewage running down the road. The family’s mobile home sat on an incline, and we were coming from downhill, and we could see it.

The first person we met was the minister of the local church next to the family compound. He was crying. They had stopped them from having services at his church because he didn’t have a functioning septic system. And later we met the family, and they had been arrested, the husband and wife, and were scheduled to go back to court because of this failing septic system. We thought that that was an extreme way of trying to address this, instead of trying to find some solution.

“People in rural communities are held responsible for putting in their own wastewater treatment. So if they can’t afford it, they can’t get it.”

e360: In your book, you state that as many as 90 percent of Lowndes households have failing or inadequate wastewater systems. How did it get to this point?

Flowers: It’s not just Lowndes County. I think we have to be clear about that. This is a problem throughout rural America, and since the book has been published, I’m finding other places in suburban areas and in some cities where they use septic systems that are having problems very, very similar to the type of failures we’re seeing in Lowndes County. Poor communities across the U.S. are pretty much left to their own devices [when it comes to sanitation] or they don’t have the support of the state. If they do get these long grants to build or maintain systems, they’re not getting the same quality of service or equipment as you would find in more affluent areas. So they tend to get something that may or may not work, may or may not last, and that is what we’ve seen.

Lowndes County, Alabama is 715 square miles. That’s a large area. It’s bordered by six counties. It is not densely populated. There are about six to seven towns in Lowndes County that are incorporated. Most of it is unincorporated. It’s a poor county. Because it’s a poor county, it doesn’t have the tax base to pay the cost to connect or control municipal sanitation systems. Then the other issue is that because people are not that close together, people in rural communities are held responsible for putting in their own wastewater treatment in a lot of cases. So if they can’t afford it, then they can’t get it.

e360: As you mentioned earlier, not having a functioning septic system, at least in Alabama, is a criminal misdemeanor, and that residents can be fined $500 for a citation or evicted or arrested. This seems like a system that would perpetuate the already striking inequality of this issue.

Flowers: I agree. We have to get away from these punitive measures so we can find some real solutions. Being punitive, as we’ve seen, has not provided any solutions, because then it puts all the responsibility on a homeowner who is forced to buy something that first of all, they can’t afford, or second, that simply is not working. And it doesn’t make sense. It’s a vicious circle.

A house in Lowndes County, with sewage seeping into the back yard after a septic tank failure.

A house in Lowndes County, with sewage seeping into the back yard after a septic tank failure. Courtesy of CREEJ

e360: In 2017, your work helped to expose the presence of hookworm in residents of Lowndes County — a parasite found in countries without clean water and adequate sanitation, but that scientists had long believed to be eliminated from the U.S. How shocking was that finding to you?

Flowers: Yes, I was shocked, but even more so, I felt it was almost akin to what people would call a smoking gun for why this issue is so important. Until that time, people were still pushing the narrative of blaming the residents as opposed to understanding that this is an issue that we all need to grapple with. There are places around the country that are dealing with the tough impacts of failing sanitation systems or the lack of sanitation. It’s not just in the South, not just in Lowndes County.

The [hookworm] finding helped to raise the level of concern and awareness. For example, one of the first people to reach out to me outside of Alabama was Senator Cory Booker, who actually gave me a call and wanted to come and visit and see for himself. And a lot of people have followed since then. It was also shocking to the rest of the world; it was a mirror that was held up to why in the richest country in the world do we allow this level of inequality to exist? And why haven’t we tried to find solutions before now?

“We have to examine how the lack of sanitation and water justice is creating more health barriers and more vulnerabilities.”

But I think it’s imperative that we do, because ultimately, now that we know that you can actually test wastewater to see the existence of Covid-19, I’m wondering if anyone has tested raw sewage to see whether Covid exists and whether or not there’s a level of exposure that exists in untreated sewage that would not normally exist, especially in rural communities. Lowndes County, Alabama, as it relates to Covid per capita, had the highest death rate and highest infection rate in the state. If you look at Navajo Nation, a place where they have no water infrastructure in some places, which means they have no sanitation infrastructure either, they had high death rates, too, and high infection rates. So we really have to examine how the lack of sanitation and water justice is creating more health barriers and creating more vulnerabilities.

e360: How has climate change, specifically rising seas and more intense storms, exacerbated and will continue to exacerbate this issue?

Flowers: Wastewater disposal technology simply was not designed to take climate change into account. In places like Miami-Dade County, for example, they’re already having problems with failing septic systems because of sea level rise. We’re going to find that in coastal regions around the country. And then of course, septic systems and the way they function are tied to what’s coming from the sky — and we’re going to have more deluges of rain. That’s part and parcel of climate change. Septic systems can only hold so much water. Once they get full, it pushes that sewage back into the house or something has to break somewhere. It’s either going to be on the house, inside the house, or out on top of the ground. There’s been evidence of septic systems actually contaminating the drinking water of people that have wells. And the water tables are rising. Lowndes County had a high water table in the first place. Now, with climate change, it’s getting even higher, and the type of wastewater disposal systems that are being prescribed by the state still do not take into account climate change.

And then of course, the extreme heat. You have raw sewage on the ground in heat, and that’s a hotbed of toxic contaminants that could create additional problems in terms of disease.

“Grants and philanthropic support would be a great start — but really this issue needs to be addressed at the government level.”

Right now rural communities are the canary in the coal mine, because they’re hidden away from view. That’s why I think it’s so hard for folks to make policy and try to give suggestions on what they think the solution is — they don’t have any clue on what a rural community really is. They have not been there and they’re trying to judge it through the lens of an urban area.

e360: What is the solution here? What kinds of partnerships or technology are needed to tackle inadequate wastewater infrastructure in rural communities?

Flowers: Number one is we have to implement the principles of environmental justice — listen to people in the community. I wouldn’t be talking to you now if it wasn’t for the fact we went from house to house and we talked to over 2,000 residents in Lowndes County to find out what the problems were. We need to teach people in the engineering community, especially in colleges and universities and others who want to partner and be collaborators in finding solutions, how to engage with the community. What does that mean? It doesn’t mean going in, doing a survey for a day, and saying, “This is how we fix it,” without really doing the deep dive that’s necessary. I’ve been there, I’ve seen that happen, and people were right back where they were before.

Grants and philanthropic support would be a great start — but really this issue needs to be addressed at the government level. A lot of these local governments can’t handle it because they don’t have the funds to do it; they don’t have the tax base. But we have to make sure that this is addressed, as a public health issue, an environmental justice issue, a social justice issue, an income inequality issue – all of these issues intersect at wastewater. The consequences are too great to ignore.

This interview has been edited for length and clarity.