Filthy water and shoddy sewers plague poor Black Belt counties

HAYNEVILLE, Ala. — Rain makes Charlie Mae Martin Holcombe nervous. First, her toilets start to bubble. Then, if Holcombe sees a bright red light flash on across the street, she knows the city sewer system is going to back  up, filling her yard with raw sewage.

“When the weather man goes to talking about bad storms, you worry sick that everything is going to flood up. [Sewage] was coming back in my bathtub one time. I broke down crying,” Holcombe explained.

For 32 years, Holcombe, 66, has lived outside the town of Hayneville in Lowndes County, Alabama. She pays for city sewer and installed a septic system for backup. Across the street from her house is the city's lagoon sewage system, a series of football-field-size ponds that hold waste before it is treated. For years, rain has caused the lagoon to overflow and back up into Holcombe's front yard. Every time the red light goes on, Holcombe reports the problem to the city and drives with her husband and son to a family member's house where they can use the bathroom and take a shower while the city pumps out her yard. Recently, a team of professors from Baylor College of Medicine took samples of the soil in Holcombe's front yard and cautioned her not to let the children in her family play outside.

For decades, across a region known as the Black Belt for its past as Alabama's cotton capital, poor counties have struggled with inefficient or non-existent sewer systems. Much of the soil is a chalky clay that prevents water from percolating into the earth, causing septic tanks to back up, lagoons to run over, and sewage to pool in yards and roads. According to census data from 2010, only around 20 percent of the people in Lowndes County can connect to the municipal sewer, while 80 percent must finance their own method to dispose of waste. Scientists and activists worry that the area's inability to deal with sewage poses serious health risks, including the reemergence of parasitic diseases long thought eradicated in the U.S.

In 2011, the U.N. Special Rapporteur issued a report about poor sanitation and the access to safe drinking water throughout the U.S. The report highlighted communities in California's San Joaquin Valley, in Appalachia, and Alabama's Black Belt. These are regions that have been historically poverty-stricken with little access to higher education or steady employment, and where life and infrastructure have barely improved in decades. The Alabama Department of Public Health estimates 40 to 90 percent of households have either inadequate or no septic system and of the systems that have been installed, half are failing.

When Dr. Jefferson Underwood started practicing internal medicine in Alabama in the 1980s, he saw many patients from the Black Belt who complained of nausea, vomiting and diarrhea, and encountered diseases he had only read about in medical textbooks.

“Intestinal worms. I have even seen patients who had hepatic cysts from parasites,” he said, explaining that such diseases are linked to poor sanitation and assumed to exist only in developing countries. Underwood never thought to connect the problems he was seeing to the area's lack of sewer systems. Now looking back, he wonders.

Alabama's Black Belt has long been plagued with diseases related to poor sewage, like hookworm, a tiny parasite that enters the body often through bare feet and sucks blood from the lining of the intestines. While hookworm is not deadly, it can stunt growth, cause intellectual delays and lead to anemia.

A graduate research paper from 1993 notes that at a small clinic in one county in the Black Belt, 34 percent of children under 10 were infected with hookworm [PDF].

Catherine Coleman Flowers walks behind an old trailer, where a PVC pipe drips raw sewage into marshy grass. The water runs into a small ditch and flows into a thin stream full of excrement and trash. A rectangular scrap of corrugated metal separates the polluted stream from a neighbor's basketball hoop.

Flowers is the founder and executive director of the nonprofit Alabama Center for Rural Enterprise (ACRE). She grew up in Lowndes and a few years ago conducted a door-to-door survey about sewage and sanitation across the county.

For years during the course of her visits, residents complained to Flowers about persistent nausea and diarrhea. After reading a The New York Times op-ed by Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, about how poor communities across the South are at risk for tropical diseases, Flowers asked Hotez to run tests in the Black Belt. 

In August 2013, Dr. Rojelio Mejia, a colleague of Hotez's, traveled to Lowndes to test residents for parasites and protozoans like hookworm, ascaris and strongyloides — all of which are associated with poor sanitation.

“As soon as there is an area with poor sanitation and rain, that's where I look,” explained Mejia.  He has not yet published the results of the test but warns these parasites are still an issue in Alabama.

However, state epidemiologist Dr. Mary McIntyre, who has worked for the Alabama Department of Public Health since 2011, said the state has received no complaints and no positive tests to indicate that there is any outbreak of gastrointestinal diseases in the Black Belt. She said the state would like to test the population but cannot force residents to submit to examinations.

Legally, Alabama requires that all homes have a working septic system. However, many residents cannot afford to purchase or maintain a septic tank.

“We have been trying to get help to deal with this for years. The state has been trying to go after the homeowner, but the land doesn’t percolate — [the homeowners] can’t change that,” Flowers said. “And the remedy is too expensive for the average family.”

Lowndes is one of the poorest counties in the nation. The median household income is around $26,000. There are few jobs. One-quarter of residents live in poverty, and a septic system can cost from $6,000 to $30,000, depending on the soil.

Parrish Pugh, environmental director for the Department of Public Health across several Black Belt counties, said it is the responsibility of the homeowner to install and maintain a working septic tank. In the past, lack of a working septic tank could result in a warrant being issued for the homeowner's arrest. Pugh said the Department of Health will work with residents to find affordable solutions to their sewage problem, however, if residents don't comply after several months, legal action can be taken.

“People need to understand it's not just flush it and it goes away forever,” Pugh explained. “Safe sewage disposal is most important for a community — more than safe drinking water.”

Between 1999 and 2002, 10 people in Lowndes County were charged with misdemeanors for failure “to install properly functioning sewage disposal systems” and warrants were issued for their arrests. Department of Health officials have said they no longer issue arrest warrants as of 2002; however in 2014, the pastor of a church in the Black Belt was arrested and charged with “improper sewage.”

In Alabama, the failure of sewage systems stretches across the state. An hour’s drive from Hayneville, the city of Uniontown received $4.8 million in 2012 to repair its sewage system. Half of the grant was from the U.S. Department of Agriculture (USDA), and the other half was financed by municipal bonds.

No one knows how many years the old sewage spray field in Uniontown has been overflowing into a local creek. A spray field is a method of sewage maintenance where a plot of land is fenced off and untreated sewage is sprayed into the field and absorbed into the soil. However, because the soil was not permeable, sewage water collected at the spray field's barrier and overflowed into a nearby creek. In addition, every time it rained, the local lagoon spilled over, flooding fields, cow pastures and another creek. A local farmer told environmentalists that his cows had sores on their hooves from grazing in sewage.

The city hired Sentell Engineering Inc. and approved plans to build another spray field less than a half mile from town.

However, two years and $4.8 million later, environmentalists say the problems have not been fixed and the new spray field is unusable.

When Esther Calhoun first heard about the $4.8 million grant, she was ecstatic. Calhoun grew up in Uniontown and moved back several years ago to find her hometown gutted by environmental problems. Uniontown hosts an industrial landfill, a depository for coal ash, a cheese factory, whose smell curdles the air, and a malfunctioning sewer system.

Now, Calhoun and her colleague Ben Eaton believe the $4.8 million dollar grant has been wasted. 

“We tried to tell them, ‘It's not going to work,’” Eaton, a retired high school teacher, explained. “[We told] the city officials, the EPA, USDA, the engineer, [U.S. Representative] Terri Sewell, Alabama Department of Environmental Management (ADEM). They just continued on.”

The problem, Eaton and Calhoun say, was that as with the old spray field, the soil under the newly built spray field doesn't absorb water.

“Even a child could understand it,” Calhoun said, exasperated. “If it rained, God’s water don’t go in the ground. How in the heck do you think sewage is going to go in the ground?”

Eaton and Calhoun say they have been branded “radicals” by the Uniontown city council. Eaton said he recently had his house appraised and learned it had depreciated by $50,000 because of the environmental problems in Uniontown. His brother and sister-in-law refuse to visit because of the smell.

As it nears 6 p.m., the air stagnates with the sharp smell of sewage.

“You have to think, there are cattle, and where are they drinking water from? And then they get slaughtered,” Calhoun said. The creeks that have been polluted by sewage travel past pastures and fields, past catfish ponds, and eventually into the Alabama River and out in the Gulf of Mexico. “It's everybody else’s problem too.”

Flowers believes this is a problem the U.S. should be able to fix in 2015. She has invited teams of researchers and student engineers to Lowndes County to design new, affordable sewage treatment systems.

Professor Joe Brown is originally from the Black Belt and teaches environmental engineering at Georgia Tech. One afternoon, Brown and his students surveyed the land behind a neighborhood of trailers. One of the trailers had a malfunctioning septic system, while another had a PVC pipe streaming sewage into the woods.

“It's an intractable, unsolved problem and a legacy of the post-plantation non-economy that's [in the Black Belt],” Brown explained. “These are people living at the fringes. These are not people who are well connected politically and economically. If a poor black person is complaining and there’s no politician around to hear it, do they make a sound?”

But Brown, like Flowers, is optimistic he and his students will find a solution. “I am not into futile efforts,” he said, pragmatically.

Holcombe, meanwhile, said she is waiting for the year when spring break comes and her son and grandchildren can go outside and play in their yard. Or for the night when she can fall to sleep to the sound of rain and not fear waking up in the morning.

Additional reporting by Marla Cichowski and Ash-har Quraishi