This story is the second in a series on ways communities are addressing the rise of poverty-related tropical diseases related to poor sewage infrastructure in the rural South. Read the first here.

There are times when you walk outside Hayneville, Alabama's Family Dollar and smell the sewage, its stench hanging thick in the Black Belt air.

Mary McDonald has seen schoolchildren steer their bikes through it, dark streams spider-webbing the cracked asphalt as rubber wheels splash through.

Charlie Mae Holcombe has heard it, an ominous gurgle from her toilets and sinks after heavy spring rains.

"It's been so bad, it's come up through my bathtub," Holcombe said. "When it really storms, my yard is like a river. It's terrible. You can smell it through the walls. It purely stinks."

In the best case scenarios, Holcombe's grandchildren play inside for a spell, avoiding a front lawn-turned-swamp pooling with sewage from a clogged septic system. In the worst case, the raw waste creeps through pipes inside the Holcombe home, ruining yet another carpet and forcing the family to stay in Montgomery while everything dries out.

Charlie Mae Holcombe, left, and Mary McDonald stand by the cover to Holcombe's septic tank at her home in Hayneville, Alabama. Holcombe has had decades of flooding and sewer problems at her home. Credit: Mickey Welsh/Montgomery Advertiser

Holcombe and McDonald are just two of thousands of Alabamians living with inefficient or failing wastewater treatment systems — a problem that has persisted for decades in both rural and urban areas. Holcombe has been dealing with waste flooding her front yard since the late 1980s when it was built.

For a time, Catherine Flowers, a Lowndes County native and rural development manager for the Equal Justice Initiative, said she felt as if she and a handful of other activists were shouldering this heavy burden alone. But their steady and consistent work in recent years has pushed Alabama to the forefront of American poverty and wastewater infrastructure discussions, marking Lowndes County as a canary in the coal mine for a public health crisis. As light is shed light on the issue, it has pushed public officials to lobby for increased infrastructure funding and incentivized academic experts to rethink conventional engineering methods.

"I think we're going in the right direction," Flowers said. "This isn't a partisan problem. The land is bipartisan."

Engineering a new approach

The swath of Alabama counties that make up the Black Belt are largely rural, their wastewater infrastructure cobbled together or nonexistent. Some have small community municipal systems, though most households rely on individual septic tanks or straight-pipe sewage into yards.

The rich topsoil that gave the area its name and led to forced slavery in the 19th century is made of layers of clay and chalk — productive for crops but bad for water absorption because of its poor percolation. Mainstream septic systems are inefficient at best.

Special septic systems for this soil are out of the question for the poorest communities in the state; the median household income falls under $28,000 in Lowndes County, according to 2016 U.S. Census Data.

"Normally, it might cost $2,000 to put in a septic tank and a drain field in Mobile or Tuscaloosa," said civil engineer Kevin White. "But in the Black Belt, with the poor soils, the system has to be so large or so complicated that we're talking $8,000 to $10,000 or even more."

For decades, White has been working toward more innovative and affordable Black Belt wastewater solutions. He led a study for the University of South Alabama more than 10 years ago in Bibb County, which found that half of rural households had raw sewage pooling on the ground. He and other researchers are now studying Wilcox and Hale counties, where similar onsite wastewater systems fail at a rate of roughly 50 percent.

"I think we're going in the right direction. This isn't a partisan problem. The land is bipartisan." —Catherine Flowers, rural development manager, Equal Justice Initiative

"We have decided, as a society and an engineering profession, that the best way to transport human waste is via water," White said. "We build toilets that flush using water. But when we're in a situation like the Black Belt, where we have to soak water into soil that won't percolate — maybe this is the wrong way of doing things."

White said that fundamentally changing how we think of wastewater — any used water in a home — could be part of the solution to this crisis. Waste from toilets, or black water, is the most likely to cause environmental and health issues. Gray water, or waste from kitchen sinks and showers, isn't clean but also doesn't pose the same dangers. Treating gray and black water differently could significantly reduce the sizes of septic disposal systems, he said.

The Alabama Center for Rural Enterprise, founded by Catherine Flowers, is serving as a model for how to address infrastructure issues in rural communities across the South. Credit: Lyndsey Gilpin

Other options are outhouses — an ideal engineering solution, but not as socially acceptable in modern-day America — compost toilets, and more expensive and efficient toilet systems that use air and small amounts of liquid to flush. Plumbing manufacturer American Standard sent a team of engineers to Lowndes County last year and is in the initial stages of developing potential product solutions for rural septic issues.

At Duke University, Flowers has established a collaborative research partnership with environmental policy and management professors and students. The team is looking at policy challenges, funding mechanisms and septic system engineering design from a multidisciplinary approach, looping in humanities-based academics and on-the-ground activists to ensure Lowndes County residents have a voice in possible solutions.

"There's something particular about this place that's important for us to tend to. And we hope talking about our solutions in a larger frame can ultimately have a greater impact and a wider resonance with other places across the country that struggle with wastewater issues." —Ryan Juskus, doctoral candidate at Duke University

Flowers said she hopes to put faces to the problem by convening academics and policymakers on Lowndes County front porches.

"A lot of people think that solutions made to fit urban areas should fit rural communities," Flowers said. "That's not the case. Rural communities should be recognized and acknowledged."

Lowndes County is not the only rural place in the U.S. dealing with these problems — Flowers said she's spoken with communities from Alaska to New Jersey grappling with similar issues — but it's serving as an example for other communities.

"The civil rights marchers from Selma to Montgomery slept on the property of some of the families we visited [in Lowndes]," said Ryan Juskus, a doctoral candidate at Duke University who is working on the partnership. "This land isn't just any old piece of land with a wastewater issue. There's something particular about this place that's important for us to tend to. And we hope talking about our solutions in a larger frame can ultimately have a greater impact and a wider resonance with other places across the country that struggle with wastewater issues."

Coordinating with local governments

Because of its violent racial history from slavery to the Civil Rights era and decades of exploitation and pollution from industry, Black Belt residents are often mistrustful of government intervention and fearful of rumored consequences, like being arrested if they come forward with mismanaged home waste systems.

The National Memorial for Peace and Justice in Montgomery, Alabama honors victims of lynching throughout the U.S. Credit: Lyndsey Gilpin

Improving conditions will require collaboration with local health department and municipalities. State officials say funds have been appropriated to small towns in the past, but White said part-time city government leaders have lacked the know-how of creating comprehensive action plans.

"There could be some decentralized type sewer and treatment systems that could be implemented," White said. "Somebody would have to manage and operate those systems. That's one reason we're trying to …put together some steps to help counties establish a utility."

He added that the county governments could initiate some of these efforts to provide managed sewers through grant funding.

Local health departments are shifting their focus to these types of initiatives, starting with building new relationships in the region.

"We're involved because it's important to us that people have adequate sewage," said Scott Harris, the Alabama Department of Public Health's state health officer. "At the same time, we're not the Alabama agency that builds sewer systems. We're not funded for that. But we're invested in seeing that happen for people, and we're trying to facilitate it the best we can."

Earlier this year, the Alabama public health department, with the help of the Centers for Disease Control and Prevention, surveyed 192 households. They found a majority indicated sewage and sanitation were problems in Lowndes County, with 31 percent reporting "sewage backing up into the home, off-color or foul-smelling water from faucet, and standing sewage or run-off near the home" occurring in the past year.

Sherry Bradley, a longtime state health department employee and Black Belt native, is developing public information campaigns to educate residents on proper septic maintenance as well as encourage individual reporting of onsite sewage failure. Tasked with regulating everything from restaurants to tattoo parlors to septic tanks, the department says its budget limits how proactive it can be without citizens alerting them to ongoing problems.

The agency is buying billboard space, attending church functions, and organizing town halls like one held in late May with Congresswoman Terri A. Sewell (D-AL) and Senator Doug Jones (D-AL), where Jones apologized for the neglect Lowndes County has experienced.

Health officials are also working to counteract rampant rumors that the department locks up residents who resort to straight piping. Though residents can be cited and fined, Harris said it's a last resort that usually happens a year or more after the Alabama health department tries to work with the resident. According to Lowndes County Circuit Clerk records, seven people have pleaded guilty to similar citations since 1996.

"There's a narrative that we're looking to lock people up. We're not. We don't want to do that. We just want to protect public health with adequate sewage," Harris said. "You have to get people to trust you, and that doesn't happen if they don't know you. We're trying to have a presence."

State lawmakers have vowed to address the issue. Jones cosponsored legislation in the Farm Bill that would expand a U.S. Department of Agriculture grant program for rural households installing or maintaining decentralized wastewater systems.

This kind of partnership is key, said White. The engineering solutions his team is working on at South Alabama — low water waste transfer, different treatment of shower versus toilet waste — are promising, but they're also outside the bounds of current standards in the U.S. He is working with the health department on regulatory flexibility options, like relaxing certain septic system standards to test these options.

"We're going to work closely with the health department so they know what we're doing and how effective it is," White said.

After a lifetime in rural communities where they have witnessed poor sanitation and other impoverished conditions, Flowers and McDonald say they understand Alabamians who feel ashamed to call attention to the problem. But they're not afraid to speak out to help those living in their home soils and beyond.

"You have to get people to trust you, and that doesn't happen if they don't know you. We're trying to have a presence." —Scott Harris, Alabama Department of Public Health

"I just thought it was something we did wrong. But it's not just a Black Belt problem. There's no one-size-fits-all solution to this," Flowers said. "I think what we're putting together is a template for how these different entities can and should work together to find solutions. We're working on a life-giving and life-sustaining solution."

Melissa Brown is a reporter for the Montgomery Advertiser. This story, and the series it's a part of, came to Scalawag from Southerly, an independent media organization that covers the intersection of ecology, justice, and culture in the American South. The series is supported by the Solutions Journalism Network, a nonprofit focused on reporting about responses to social problems.

Melissa Brown is a reporter for the Montgomery Advertiser. An Alabama native, Melissa has previously covered higher education, health and politics in the state.