Most people believe hookworm to be a disease of the past. Known as “the germ of laziness,” hookworm ravaged the American South in the early 20th century causing developmental issues in children, fatigue, and intestinal problems like diarrhea. In Alabama, the tropical parasite forced stricter public health regulations, and a law requiring wastewater treatment was passed in 1927.
However, when Catherine Coleman Flowers developed a mysterious rash after visiting a rural Alabama home mired in wastewater a few years ago, she knew something was awry. Flowers later learned that she had been infected with hookworm, a century after the state required action to limit its spread.
Research found that hookworm was far from foreign in Lowndes County, a rural community in Alabama situated between Selma and Montgomery. Hookworm thrives today because of widespread wastewater management failures and an increasingly tropical climate due to rising temperatures. Over a third of the county’s residents had been infected with hookworm, which only takes skin contact to spread from wastewater to people.
This epidemic might not have been known without Flowers’ advocacy, detailed in Waste: One Woman’s Fight Against America’s Dirty Secret. In the part-narrative, part-autobiography about her fight for racial and environmental justice, Flowers brings a personal and historical perspective to the water infrastructure problems plaguing rural America.
Catherine Coleman Flowers by Audra Melton (via New York Times)
A native of Lowndes County, Flowers is an environmental activist whose mission is rooted in the need to “challenge structural racism no matter where it appears.” The predominantly Black Lowndes County, also known as “bloody Lowndes,” is a community in Alabama’s Black Belt that suffers from a violent history of racism and white supremacy. Flowers’ upbringing in Lowndes during the Civil Rights Movement influenced her from a young age to challenge the systems that perpetuate racism.
To underscore the importance of raising awareness of the water issues rural America faces today, Flowers points out “Flint gained attention because infrastructure failed. In places like Lowndes County, however, there’s no infrastructure in the first place.”
Many rural communities in the US from California to West Virginia rely on septic systems, or standalone ways to treat and store wastewater due to the lack of municipal water infrastructure. As many as 20% of Americans use a septic system to manage waste.
Septic systems consist of a tank where the water is treated, and a drain field where the water gets discharged. However, this process becomes complicated when the soil in the drain field does not allow for adequate water drainage, like in Lowndes County. Not only does its high clay content affect the water filtration process; climate change and the rising underground water table cause septic systems to fail more frequently.
An estimated 90% of residents in Lowndes County do not have working septic systems, partly due to their high cost. Septic systems cost upwards of $15,000 in Lowndes County where the average household makes $30,000 annually. Even with the investment, new septic systems can fail, forcing residents to discharge untreated sewage straight onto their own property. Homes that are connected to a municipal system in the area also report of sewage getting backed up into their homes.
Not only are people forced to live in the unsanitary conditions of wastewater if they don’t have a working septic system; they can be fined, or even jailed. Though these laws may have been initially implemented to increase compliance, they criminalize poverty because it penalizes people for not having enough money to set up a working septic system.
The appalling wastewater conditions in rural communities are an issue of human rights and dignity. At the same time, it is one that is difficult to understand unless experienced personally. Flowers recounts the homes she would visit with yards littered with children’s toys and human waste, feces clinging to the walls outside of the house, and the overpowering smell of raw sewage.
Flowers standing by a hole filled with sewage (via WSFA 12 News)
To raise awareness and secure funding, Flowers brought journalists, corporate executives, and US senators, from Bernie Sanders to Jeff Sessions to Lowndes County. Despite their political differences, Flowers was able to connect with Sessions based on their shared experiences growing up poor in rural Alabama. Flowers’ working with Sessions provides a powerful perspective on how to build coalitions and enact change no matter the political climate.
Waste brings to light the system struggles of rural American poverty and the conditions it forces people into. Inadequate water infrastructure is only a symptom of this larger, structural issue. Black rural areas lack not only the infrastructure but also the political and economic power to make their environments livable. Flowers ends on a note of hope, and a call to action for all of us to work for change that’s not only powerful, but personal, as well.