Nocturnal Convenience 1 : The Problem of Securing Universal Sanitation Access in Alabama's Black Belt

Alabama's Black Belt

Lowndes County is in Alabama's Black Belt region (Figure 1), which was so named for the color of its organically rich, fertile soil, supporting plantation and later sharecropping economies. It is part of a larger environmental and sociocultural region that stretches, by some definitions, from East Texas to Tidewater Virginia. ⁵ In Alabama, the Black Belt counties are among the poorest, with median household incomes of more than $10,000 less than the average for Alabama, and shorter life expectancies.^6,7 The region is characterized in part by high poverty, high unemployment, ⁸ significant out-migration, relatively high percentages of people on public assistance and disability, ⁹ and a high percentage of minorities, especially African Americans. ¹⁰ The population is aging and faces a higher than average prevalence of obesity, infant mortality, HIV infection, ¹¹ diabetes, and other indicators of poor health and well-being.^12,13 Two factors converge there that fundamentally limit access to sanitation: (1) unfavorable geological conditions for conventional septic systems and (2) a low-income, rural population that does not have ready access to alternatives for domestic wastewater. Based on extensive interviews with stakeholders familiar with the issue and local constraints, ¹⁴ this article offers a brief description of the barriers to sanitation access and potential measures that could contribute to expanding sanitation access in this challenging context.

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FIG. 1.

Alabama counties with Black Belt shaded. Not all shaded counties are included in every definition of the Black Belt region.

On-site sanitation in the Black Belt

More than 40% of Alabama households use an on-site wastewater treatment system, including many residents of the largely rural Black Belt. ¹⁵ Much of the Black Belt is unsuitable for conventional OSS^16,17,18 as the clayey soils found there limit infiltration of effluent^19,20,21 and may be classified as “severe” or “extreme” under Alabama Department of Public Health (ADPH) site classification criteria. ²² Shallow bedrock or underlying impermeable layers (such as that associated with the “Selma Chalk” formation) and seasonal flooding also affect site suitability. ²³ One study ²⁴ estimated that almost 90% of OSS systems in the Black Belt are functioning poorly or failing due to unsuitable soil conditions. According to the ADPH regulations, when “site characteristics prohibit the use of a conventional system,” including low permeability as determined in specified percolation testing procedures, an engineered system may be required. ²⁵ This includes all mound-type systems and systems with a “septic tank followed by field lines where any portion of the field line protrudes above the unaltered natural soil surface.” ²⁶

Unfortunately, engineered septic systems can be substantially more expensive than conventional systems, due to added design and construction costs, and may be more expensive or complex to operate. The Wisconsin Mound is the most common engineered OSS type in the area, with estimated costs of $9,000–$30,000, ²⁷ depending on site constraints and accessibility. While there is potential for cost-effective, packaged “off-the-shelf” systems, local knowledge of alternative systems that may work for this area and meet regulatory requirements for engineered systems is limited in practice.

Without access to alternatives, many households opt for what is locally known as a “straight pipe,” or a pipe that conveys wastewater from the toilet to a nearby pit, ditch, stream, waste ground, or other disposal area untreated and uncontained, accessible by animals or people. According to the 2000 census, 3% of all rural Alabama households and 2,511 households in the Black Belt had incomplete indoor plumbing, mostly among rural households with residents over 65 and below the poverty line. ²⁸ The relevant questions were eliminated in the 2010 census, so more recent figures do not exist, and these are probably underestimates since they rely on self-report data from householders and not inspections. Residents may not be willing to disclose straight pipes for fear of prosecution, since enforcement actions have resulted in evictions. ²⁹ A more recent study of sanitation access data from 569 randomly selected households in the Black Belt found that 3.4% of households had either no access to OSS or used a cesspool. ³⁰

The lack of functional wastewater containment or treatment options creates the opportunity for residents to become exposed to pathogenic microorganisms in the domestic environment. There are multiple possible routes of exposure linked with waterborne illness, some of which may be associated with failing OSS or inadequate wastewater services.^31,32,33,34 Exposures related to compromised or failing OSS have previously been linked to outbreaks of gastrointestinal illness in the United States.^35,36,37 Though rarely life-threatening, gastrointestinal illnesses can be serious for some sensitive populations, ³⁸ including those with HIV and other immune disorders, the elderly, young children, and pregnant women. This is particularly true where access to care is limited. One estimate from 2010 calculated approximately 1.5 licensed doctors for every 1,000 residents in the Black Belt, compared with 4.2 in Alabama outside the Black Belt. ³⁹

Technical barriers

The Alabama Onsite Wastewater Association Training Center in Livingston, Alabama has played a key role in demonstrating advanced technologies that may be suitable for the area and training OSS installers. Additional targeted research and demonstration of locally viable, low-cost OSS options is needed, however, with a view toward identifying solutions that can work for the people who most need them. Micro-wetlands, ⁴⁰ composting systems, ⁴¹ or low-cost packaged systems may prove to be more accessible than mound or other engineered solutions which are locally more familiar to engineers and contractors. Our interviews with local engineers highlighted the need for technical innovation in the sector that is informed by locally relevant experience in other states, particularly those in the Southeast where similar hydrological and geological conditions and constraints apply.

There are existing policy barriers to innovation in this space as well, however. Low-cost engineered systems that are appropriate for treating kitchen and toilet derived household wastewater (black-water), and that bypass remaining grey-water, are non-permitable under current Health Department regulations. This is largely due to a conflict with the Environmental Protection Agency (EPA) Clean Water Act (CWA) which makes it “unlawful” to discharge pollutants to “waters of the United States” without meeting certain conditions as specified under the stringent National Pollutant Discharge and Elimination System (NPDES) permitting program. ⁴² This constraint prevents the use of composting or incinerating systems that may be low-cost and highly effective in reducing potential exposure to pathogens in the domestic environment.

Accessing funding

Because the need for costly installation of alternative systems or repair/replacement of poorly functioning or failing septic systems is locally great, low-income households and communities require external funds if they are to fix the problems themselves. Under some circumstances, multiple household or small-scale community systems may be suitable. In such cases, federal and state financial assistance programs are available.^{43,44,45,46,47,48} The scope and scale of these programs vary widely and take the form of loans, grants, bonds, and tax-credit programs. For OSS, external funds are usually not available except as direct loans to the homeowner. Critically, availability of funding sources may not readily translate into accessibility of funds to some target users, particularly those most likely to have failing OSS: the poor, the isolated, the elderly, and those without clear home titles. Grant and loan inaccessibility encompasses a broad range of interconnected financial, bureaucratic, and socioeconomic barriers associated with the application for funding for infrastructure repair, replacement, and construction. According to stakeholder interviews, the three barriers of non-responsiveness, heir property, and access to credit may be the most significant. ⁴⁹

One barrier that keeps potential beneficiaries from receiving funding from some available programs is the complicated process of documenting eligibility and submitting an application, where the technical requirements for proposals are significant and the process itself is complex. Accessing and navigating the structures in place require that those eligible are sufficiently able, willing, and persistent to complete the process. Non-responsiveness ⁵⁰ —interruptions in the back-and-forth communication between potential beneficiaries and programs—has been identified by stakeholders as a major barrier to accessing OSS and community wastewater funding. ⁵¹ The problem of non-responsiveness may be particularly acute among elderly applicants, because the already lengthy application requires up-to-date information for submission from the program beneficiary (i.e., new driver's license copy, home insurance information). Providing such documents can be burdensome for elderly applicants and they may give up, and the application is dropped. If the beneficiary wants to access funds, he or she is required to start the application process over again.

The locally prevalent institution of heir property presents an obstacle to accessing OSS funding. Heir property, or land legally held by multiple individuals, usually related, is most common in the African American community in the rural South and has been linked with an array of land tenure issues and land loss.^52,53 This can lead to uncertainty about who has rights to land and homes and whose permission must be gained to access home improvement funding. When discussing the U.S. Department of Agriculture (USDA) Rural Development-504 Program, which provides loans and grants for rural home repair and rehabilitation, a respondent noted the difficulties associated with heir property in Alabama:

The thing that we find is the most difficult is clear titles. To be able to repair your home or use a federal housing program, you have to be able to prove that it's your home. A lot of elderly women we work with, if their husband died prior to 1982, they didn't inherit that home .…She may have lived there the past thirty years, but she is not the owner .…She is still not the owner of that home [but] her children are, so she can't repair it. ⁵⁴

Apart from the basic financial reality that the costs of appropriate OSS systems may be completely out of reach for many of the poorest who most need them, homeowners' credit history and access to credit also limit options for securing subsidized funding for OSS. An applicant's credit rating is a common eligibility criterion for state and federal loan assistance or subsidy programs for home repair (infrastructure repair and replacement). The inability of many households to establish a credit history or to demonstrate the ability to repay loans disqualifies many households from relevant financial assistance programs. Access to credit sources themselves for private home improvement loans are also lacking. Local financial institutions may be unwilling to provide full banking services to low-income individuals as clients, particularly for lending; many residents of the region remain “underbanked.” ⁵⁵ One respondent emphasized how the problem has become engrained and accepted as a “cultural belief that nobody will be able to access banking resources.” ⁵⁶

Priorities and sanitation literacy

For those without access to adequate sanitation, installation of a functioning system may or may not be a priority. Given the challenging task of identifying a solution that will work and completing a possibly onerous and extended process for securing funding, homeowners must be extremely motivated to pursue this problem proactively, assuming that their property rights and financial constraints allow them the option of doing so. Sanitation literacy, or basic knowledge about one's own needs and responsibilities for managing household waste, has been identified by stakeholders as fundamentally limiting the expansion of adequate OSS access in the Black Belt. Sanitation literacy plays an important role in generating demand for OSS as well as promoting the regularity of essential maintenance by households with systems. Because decentralized sanitation always requires active maintenance of the users, the notion that waste can be flushed away without further thought is not realistic, but it may be what homeowners would prefer to expect.

Regulation and enforcement

Apart from normative expectations that homeowners should have more knowledge about sanitation options and responsibilities—expectations that may not be realistic in most communities, including affluent ones—regulation and enforcement can play a role in OSS function and access. In practice, regulations in place are not sensitive to the needs of many Black Belt communities for OSS options that are workable under local economic and geological constraints. Because regulations may present unrealistic expectations of homeowners' access to advanced, engineered systems, enforcement is limited and seen as politically difficult. Responsibility for low access to functioning OSS rests also with those who are charged with crafting and enforcing regulations.

Access to adequate wastewater infrastructure varies in the U.S. ⁵⁷ Rural households are generally responsible for the capital and ongoing maintenance costs of functional on-site treatment systems themselves, ⁵⁸ usually at greater per-capita costs than for urban households that have the opportunity to connect to a centralized system. Although OSS regulation has been complex and dynamic in the USA,^59,60 two unstated assumptions seem to underlie regulation: (1) progressive settlement of rural areas is through expansion or suburbanization from urban centers,^{61,62,63,64,65} with rural areas adopting suburban and exurban regulations; and (2) homeowners can and should assume the responsibility for maintaining household infrastructure, and that this can be financed through a mortgage loan. In the Black Belt of Alabama and in the context of the rural endemic poor, these assumptions do not generally hold. Residents may be living in older homes on family land that goes back generations, certainly before OSS was common enough for sanitarians to recognize that entire communities were located in areas where conventional septic is unworkable. Real estate transactions that are coupled to the regulatory process for OSS in many places may not occur with the same frequency or with as much oversight from code inspectors. In the Black Belt in 2013, enforcement of existing sanitation laws would burden many households with an unaffordable responsibility and could lead to displacement of people who may have nowhere else to go. This is widely seen as an intractable problem: resources that could help solve the problems are not widely accessible to beneficiaries, and enforcement is not politically or morally tenable when potential solutions are out of reach. Blame for the situation is variously assigned by stakeholders, but the need for leadership in the public health and engineering communities is clear if it is agreed that all households should have access to sanitation.