Monday, April 27, 2020

U.S. COVID-19 Responses Must Prioritize Sanitation for Rural Communities

In the U.S., Black, Latinx, and indigenous communities that have historically lacked access to sanitation will be hardest hit by COVID-19, and will have the most difficult time recovering.

By Bamisope Adeyanju & Aroosa Khokher, Columbia Law School Human Rights Clinic, New York

The COVID-19 pandemic makes it clearer than ever that access to water and sanitation is vital for public health. To protect against the virus, and prevent its spread, everyone must have access to these basic rights, regardless of race or socioeconomic status.

The World Health Organization recently warned that a lack of safe water and failing sanitation systems allow coronavirus and other diseases to fester and spread. Containment of the virus requires handwashing and sanitary disposal of fecal matter. For this, affordable access to water is essential.

This is bad news for the United States. Across the country, more than 1.5 million people lack the water and sanitation systems necessary for preventative steps, such as handwashing, and are exposed to feces on a regular basis. Wastewater infrastructure is failing, inadequate, and in some cases, non-existent — earning the U.S. a D+ grade in 2017. The municipal infrastructure meant to service the majority of homes is crumbling. One in five households are responsible for their own on-site sewage systems. These are costly to install and maintain, and prone to failure. Those who cannot afford on-site systems often resort to “straight-piping,” constructing makeshift pipes that direct waste from homes into yards. The burden of securing sanitation falls heavily on residents who often lack the means to afford the systems or repairs they need. Residents of Centreville, Illinois, Lowndes County, Alabama, and Riverside County, California — all majority-Black and Latinx — have seen raw sewage back up into their households and yards. Residents of the Alaskan Native community of Kivalina have no septic system, instead emptying their waste into pots multiple times per day. These communities are the rule, not the exception; we see the same conditions nationwide in Kentucky, Louisiana, Michigan, and the Navajo Nation, among others.  

Recent news has highlighted that rural communities that lack access to water and sanitation are especially susceptible to COVID-19. A study from the Journal of the American Medical Association released in March found live specimens of the COVID virus in feces. Water shutoffs in response to late payments — which disproportionately impact communities of color — further contribute to the spread of coronavirus. Measures to stop the virus must reflect a deeper understanding of how we got here.

Rural communities that lack access to adequate and affordable sanitation faced health risks long before COVID-19 reached the United States. In Martin County, Kentucky, inadequate sanitation is tied to high rates of disease and bacteria. Data from Lowndes County reveals that exposure to raw sewage correlates to tropical diseases like hookworm, thought to have been eradicated in the U.S. Exposure is also linked to reproductive and developmental harm, acute infections, and diarrhea. Individuals living in constant proximity to the parasites and bacteria in human waste are more likely to develop dementia, diabetes, and cancer in the long run.

Without a federal framework that protects and prioritizes the rights to water and sanitation for all, the drastic disparities that put lives and health at risk will continue. Failure to take action now will amplify the impact of COVID-19 and resign communities to poor health outcomes as a matter of policy.

 While the situation is dire, positive momentum illustrates that change is possible. Already, 90 U.S. cities and states have suspended water shutoffs during the coronavirus pandemic. This is welcome, but it is not enough. The federal government must incentivize all states and localities receiving federal funds to end water shutoffs, and eliminate any fees for ongoing service. It is also essential to ensure that those denied water and sanitation before COVID-19 can enjoy these basic human rights. Funding to improve municipal and on-site systems should be increased, and actually accessible to small communities and households. Broader solutions must account for those that are homeless or housing-insecure, for whom water and sanitation are constantly out of reach. California has already recognized the human right to water in state law. A number of cities have also developed water affordability schemes.  States and cities should follow these examples and continue to pave the way towards durable solutions. 

Bamisope Adeyanju and Aroosa Khokher work to advance racial justice & economic and social rights in the United States as members of the Columbia Law School Human Rights Clinic, under the supervision of JoAnn Kamuf Ward, director of the Human Rights in the U.S. Project at the Law School’s Human Rights Institute. The Clinic co-authored the 2019 report, Flushed and Forgotten: Sanitation and Wastewater in Rural Communities in the U.S.

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