Sewage is still ‘America’s dirty secret’

Doctors couldn’t diagnose the rash spreading across Catherine Flowers’ legs and body. But the activist thought it had to do with the day she wore a dress during a visit to a family whose yard featured “a hole in the ground full of raw sewage.” “I began to wonder if third-world conditions might be bringing third-world diseases to our region,” Flowers writes in her new book, Waste: One Woman’s Fight Against America’s Dirty Secret.
She was right. That rash led to research that found that hookworm, a parasite thought to be pretty much dead in the US, was actually alive and well in the rural Alabama county where she grew up. Without working septic systems, residents were getting sick from raw sewage. Flowers has been on a mission to change things for her community ever since. She is now a recent MacArthur Foundation “genius grant” awardee, and she founded the Center for Rural Enterprise and Environmental Justice (CREEJ).
With her latest book, available on November 17th, Flowers is expanding that fight to places across the US which lack the basic infrastructure that many city-dwellers take for granted. Two million Americans lack access to indoor plumbing, a 2019 report found, and that has huge implications for their health. The Verge spoke with Flowers about what she’s seen and how COVID-19 and climate change are piling on top of what’s already a shitty situation.
This interview has been edited for length and clarity.
For someone who isn’t familiar with the issues that you’ve brought light in Lowndes County, Alabama and other rural communities, can you paint a picture of what the problem is?
I’ve seen three different types of problems. One problem is where people don’t have the infrastructure at all. They have a toilet in their home, they flush the toilet and the effluent from the toilet, the wastewater goes out through a PVC pipe into a pit or ditch that they dig or just runs out on top of the ground. Those are people that can’t afford that infrastructure, because this is in places like Lowndes County where it’s so expensive. One of the families that we’re working with recently, we found that it was going to cost $20,000 for a wastewater treatment system because when they went down 25 inches, they struck water.
The second problem that I’ve seen is when people can afford it, but when they buy it, it doesn’t work. Whenever there is a lot of rain or extreme weather conditions, the systems break down. And when it breaks down, it pushes the sewage back into the home.
The third problem that I’ve seen are big systems and very expensive systems that have been put in place — with wastewater treatment plants and lagoon systems — that fail. And when they fail, again, we have raw sewage either coming into the building or it’s out on top of the ground. And in some of those instances, we’ve seen that people are paying wastewater treatment fees and the systems are not working.
Untreated wastewater can carry the virus that causes COVID-19, although researchers still don’t know if a person can get sick from being exposed to it. The CDC says, “At this time, the risk of transmission of the virus that causes COVID-19 through properly designed and maintained sewerage systems is thought to be low.” But you’ve seen a lot of sewage systems that are not properly designed or maintained. Do you have any thoughts about the current situation?
It is a concern to me. Most people are not concerned about it because they don’t come in contact with waste, but I’m concerned about those people that do. I can tell you that Lowndes County has the highest per capita COVID-19 infection rate [1 in 13] in the state of Alabama, and also has the highest per capita COVID death rate in the state of Alabama [1 in 335]. I pray that there are no more deaths because I know too many people that have died as a result.
COVID isn’t the only global disaster that these communities are facing. Can you tell me a little bit about how climate change impacts the wastewater issues faced by rural areas like Lowndes county?
Climate change has an impact on everything. It has an impact on wastewater technologies, too. Most wastewater technologies are not designed to deal with climate change. The water table is actually getting higher. We’re getting more rain. So far this year, we’ve had at least four storms to come ashore. That’s going to continue to be a problem. The clay soil that we have that holds water will continue to hold water. That’s not going to change either. The technology needs to change.
This is the time for us to lead globally and find technologies that will better address climate change and wastewater. There are partners that are working with us on trying to find new technological solutions because we realized that it’s bigger than Lowndes County. Lowndes County is not the only place in this country that has raw sewage on the ground. Alabama is not the only place in this country that has raw sewage on the ground. So, obviously, it’s a bigger problem. A fix is not just to put in a few septic tanks in Lowndes County and think that we solved this.
I wrote the book because I wanted people to understand that it’s not just Lowndes County. That’s why it’s America’s dirty secret. Lowndes’ County is not America’s dirty secret. The waste water problem in the US is America’s dirty secret.
Despite the fact that a lot of people that live in Lowndes County are descendants of people who may have come to this country as slaves, Lowndes County citizens have always fought for justice, the right to participate in the democratic process, and for economic opportunity going back to the sharecroppers union. This fight, in terms of people stepping out front and sharing their personal struggles with wastewater with the world, it’s just a continuation of that history of being on the forefront of positive change that can benefit everyone.

How do you really feel about the moniker, ‘Erin Brockovich of sewage,’ that I’ve seen used to describe your work — even though your work stands on its own?
Yes, it does stand on its own, but if I had to be compared with someone, it’s great to be compared with Erin Brockovich. I had seen the movie many years ago, and I’ve always been a fan of hers. We’ll meet virtually for the first time — we’re appearing on a panel together at the Texas Book Festival, Saturday.
Doctors couldn’t diagnose the rash spreading across Catherine Flowers’ legs and body. But the activist thought it had to do with the day she wore a dress during a visit to a family whose yard featured “a hole in the ground full of raw sewage.” “I began to wonder if…
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