2.5 billion people do not have access to adequate sanitation, an incredibly overwhelming statistic. It also seems far away, endemic to developing countries like India. It hardly seems conceivable that in the United States of America—the richest country in the world—people could lack access to adequate sanitation services. However, in Lowndes County, Alabama, the Alabama Department of Public Health estimates that the percentage of households with either inadequate or no septic systems ranges between 40 and 90 percent. In addition, 50 percent of the existing septic systems do not work properly.
Last week, Catherine Coleman Flowers presented a talk titled, “America’s Dirty Secret: Living Amongst Raw Sewage,” here at Duke as part of the Nicholas Institute’s seminar series. Flowers is the founder and executive director of the Alabama Center for Rural Enterprise (ACRE). ACRE is a non-profit organization that works to promote sustainable initiatives to strengthen the infrastructure of families in rural and impoverished communities, emphasizing participatory involvement. She is also the Rural Development Manager for the Equal Justice Initiative, an organization that provides legal representation to indigent defendants and prisoners denied fair treatment in the legal system.
Flowers is a native of Lowndes County, located west of the capital Montgomery. The entire county’s population is less than 13,000 people and 70 percent of the county is African-American. Approximately one-third of the population lives below the poverty line and the per capita income in the county is $16,524 (2007)—about the same as Mexico.
Flowers’ presentation revealed the county’s shocking unsanitary conditions. Flowers showed a photo of a child’s ball floating in raw sewage, and photos of raw sewage trickling between homes. She described a putrid smell that many residents have become immune to.
“It is like crying in the darkness to make people aware that this exists,” said Flowers.
The soil in Lowndes County is rich in clay and does not quickly absorb water, said Flowers, and as a result, the conditions require sophisticated and advanced septic treatment systems. Valued between six and thirty thousand dollars per system, the price of a functioning system exceeds the annual income of many county residents. According to Flowers, residents have been arrested for not having proper systems. In one example, a 27-year-old single mother was arrested after failing to replace her septic system at a cost of $20,000—an impossible expense with her annual income of $12,000. In an already slow economy, an arrest record makes it even more difficult for a person to compete for limited job openings.
Many in the county have poor health, Flowers explained, and cannot afford to receive medical care. Clinics in the area are ill equipped and doctors do not often recognize the infections, rashes or diseases that residents have, because they are rare in the United States. For example, a recent study by the National School of Tropical Medicine at Baylor found incidences of hookworm in the county—a parasite thought to be eradicated in the United State in the mid-1900’s. However, healthcare services were not always available to African-Americans in the county, so perhaps hookworm was never fully eradicated in the first place.
Conditions are so deplorable in the county, that it became the subject of a United Nations Human Rights Council (UNHCR) inquiry. In 2011, UNHCR Special Rapporteur on the human right to safe drinking water and sanitation traveled to Alabama, Alaska, Michigan, Puerto Rico and West Virginia to compile a report on the “enjoyments of the rights to water and sanitation” in the United States. Last year, Flowers’ testimony was included in the international negotiations that helped determine final text for the Summary for Policy Makers, accompanying the Intergovernmental Panel on Climate Change (IPCC) 5th Assessment Report.
National and state government funds to improve sanitation in Alabama are not dispersed equally—evidence of institutional racism. For example, Flowers mentioned that a wealthy predominantly white community received an Alabama Department of Environmental Management (ADEM) loan of over two million dollars to update and improve its sanitation system and later had its loan forgiven. However, a predominantly African-African American community in Lowndes Country received less than half of what the other community received, and has to pay back the loan in its entirety.
As the United States encourages developing countries to achieve the Millennium Development Goals, particularly the target to halve the proportion of the population without access to proper sanitation, it is important that we recognize and address rampant inequality within our own borders.
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