LOWNDES COUNTY, Ala. (CIRCA) - Open, raw sewage sits on top of the ground in Walter McMeans yard. Next to his neighbor's house is a pit of waste flushed down the toilet as early as that morning, and just beyond the pit kids are playing outside.
"Nobody should have to live like this. I mean, I don't wish this problem that we having for even my worst enemy," McMeans said.
Nearly one-third of residents in Lowndes County, Alabama live below the poverty line, and some sleep just feet away from exposed, raw sewage, which last year led researchers to test for traces of hookworm in the community.
Hookworm is a parasite that can cause anemia and hinder mental development in children, according to the Centers for Disease Control (CDC).
“You would expect to see this in India. You expect to see it in places on the African continent. You wouldn’t expect to see this in the richest country in the world,” said Catherine Flowers, who grew up in Lowndes and now advocates for people in poverty like McMeans.
It is estimated at least 50 percent of rural residents in Alabama have trouble with their septic systems, causing possible exposure to raw sewage, or do not have a septic system at all, according to Dr. Kevin White, who has done research on the issue in several rural Alabama counties.
“At Walter’s house, for example, Walter has a septic system, but his septic system has failed. That’s why we have the water here on the ground,” Flowers said.
Heavy rains often flood the area and the dense soil has low permeability, making a typical septic system impractical.
“When it rains, it's just like a swimming pool out there. Water just sits on top of the ground and it takes a while for it to soak in, because like I said, that ground just holds water," McMeans said.
“The soil there in the black belt is just not very permeable, so a conventional sewage system that might cost, you know, three or four or $5,000 is going to cost, you know, 15 or 20 or $25,000 because it has to be engineered,” said Dr. Scott Harris, Alabama’s state public health officer.
The median household income in Lowndes is just about $28,000, according to the United States Census Bureau.
Feet sink into the moist ground with every step walking through McMean's yard. Even in the early summer morning when the sun has not been up long, it is almost unbearably hot, which does not help the constant odor coming from the sewage.
“Here, you can actually see the toilet paper,” Flowers said as she points to the open, winding trench of sewage snaking its way through Walter and his neighbor's yards, spreading out the waste.
McMean's neighbor, who is also his son, has a broken septic tank too. He uses a PVC pipe to lead the waste out of the house and into a pit just feet away from the trailer, otherwise referred to as straight piping.
“People have thought that this problem was solved because most people when they flush their toilets they don’t see it anymore, they don’t think about it anymore, but here, clearly, and in other parts of the U.S. this is a problem,” Flowers said.
And the idea of McMeaan's grandkids getting sick from the open sewage is one of his biggest worries, and the threat of illness is what led Flowers to team up with researchers at Baylor College of Medicine last year to see if anyone from Lowndes was actually carrying any diseases.
“I didn’t even know what hookworm was at the time, so we ended up doing a study where we collected fecal matter, water and blood samples. And it’s well known now a third of the people who participated in the study tested positive for hookworm and other tropical parasites,” Flowers said.
The study, published in 2017 in The American Journal of Tropical Medicine and Hygiene, found 19 of the 55 people they surveyed did test positive for hookworm.
The rates of hookworm infection in Alabama in the 1950s were as high as 60 percent in the poorer communities, but overtime the problem was thought to have been resolved, the study said.
"Previous studies found a correlation between treatment and substantial gains in long-term income, as well as improvement of school enrollment, attendance, and literacy after hookworm eradication programs," according to the study.
The Alabama Department of Public Health did help out with the study, but Dr. Harris said after it was completed his office reached out to the CDC to confirm the findings, and the agency did not find any evidence of hookworm in the community.
"We would have thought that if a third of all the people in Lowndes County had hookworms, we could have found one person that actually had a worm, you know. We haven't done that,” Dr. Harris said.
But Dr. Harris said the issue is not really whether there is hookworm present in the county or not.
“If you have people that have poor sewage problems, that's a big deal, and they are at risk for infections, or they're at risk for health consequences, and I totally get that," said Dr. Harris.
“At the same time, we're a regulatory agency, and the only way we find out about someone with a failing septic system is when we respond to a complaint. So we're not out looking for people who have problems with sewage on their property unless they ask us to do so,” he said.
McMeans said he has not reached out to the state health department and does not plan to.
"I know what they gonna do," McMeans said. "They gonna come out here and condemn everybody and come up with these outrageous price and building raised beds and stuff like that. And they gonna give you a certain amount of time to come up with it and if you don't, then you gonna have to move. And see that's gonna cause me problems."
“We're accused of criminalizing poverty, and we're arresting poor people who don't have resources, and that's absolutely untrue. We work very closely with the legal authorities, including the judge in that county, in letting them know we are not interested in arresting people,” Dr. Harris said.
“But ultimately, as a regulatory agency, we don't have another option. If someone is breaking the law because they're not repairing their system, then we will cite them because that's what we're required to do by law. But we don't have people arrested,” he said.
Dr. Harris said his office has been monitoring the situation in Lowndes and is working with the county engineer and other experts to brainstorm solutions to the decade-long problem, but it will not come cheap.
Catherine said she is working with groups like Engineers Without Borders and universities to come up with long term solutions to this problem.
“It’s not a black problem, it’s not a white problem, it’s a problem where the technology simply doesn’t work and this is what mother earth gave us in terms of the land. That’s not going to change what we have to change is the technology and find something that will work. But the problem is there hasn’t been a wheel to do it because it’s been in rural communities. And had it been in urban communities there would have been a solution a long time ago,” Flowers said.
“I want these children to have better than what I've had. Nothing less, but better, and anybody can have if they try, but they gotta try. All my life I've been trying and trying and trying and crying and sometimes I stay awake, even now, you can't sleep without thinking about the situation out here and the problem here and Lord, I don't know how much more of this I can take," McMeans said.