Abstract
Even in high-income countries, significant water inequity exists, particularly in marginalized and rural communities like the Black Belt, an 18-county region arcing through south-central Alabama in the southeastern U.S. Originally named because of the rich, dark soils that fostered cotton production in the Antebellum South, the region has long since fallen on hard times, with a median household income ∼50% of the national average. In addition, the once-rich soils also have layers with substantial shrink-swell clays, making conventional onsite wastewater treatment systems/septic systems inadequate. As a result of failing or sometimes even non-existent septic systems, a substantial fraction of rural homes in the predominately Black region have raw sewage on the ground. The situation has been deemed “America’s dirty secret,” and the sanitary conditions have been likened to a third-world country. However, a recent agreement between the U.S. Department of Justice and the Alabama Department of Public Health in Lowndes County has arguably shifted the burden of providing proper sanitation to the State of Alabama, at least presumptively. Although laws governing water and sanitation are complex, the U.S. government does not explicitly recognize the human right to water as a civil right, and the provision of sanitation has heretofore largely been largely a matter of individual responsibility. Birthplace of the U.S. civil rights and voting rights movements, this proud region is once again pioneering the advancement of civil rights with the right to adequate sanitation.
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