Over the past four days, we have brought you stories that go out into the field for an in-depth look at Alaska’s rural sanitation situation – a series we call “Kick the Bucket.” We have seen how the lack of modern sanitation is linked to disease as people strain the limits of their clean water supply. And we have looked at the implications of decreasing funding and looming maintenance expenses in villages with a limited cash economy. Today we’ll wrap up the series by trying to look into the future.
As he watches his two-year-old Brandon race around, Adolf Lupie, of Tuntutuliak said his grandson is pretty much recovered from pneumonia after being medevac’d to Anchorage.
“I’m a grandfather now. He’s my first boy grandchild. So I’m really proud of my little grandchild,” Lupie says. ”He gets sick. I know my parents used to tell me that when they’re kids, they’ll get into sickness in their younger days. But when they get older they’re more immune to sickness.”
In communities without running water and flush toilets, children develop pneumonia 11 times more than other Alaskans, and some develop complications that can lead to lifelong respiratory problems. High rates of respiratory and skin infections are due to the shortage of clean water needed for frequent hand-washing.
Federal and state funding isn’t keeping up with the need, and the situation is likely to get worse due to climate change. Colleen Swan, of Kivalina, said villagers had seen the effects on the sea ice that protected the village from fierce fall storms. But they were shocked by the tidal surge and flooding that slammed their small barrier island and carried away acres of land.
“We know there is a huge problem. It’s getting worse,” Swan says. “It’s going faster. It’s like a huge train that is picking up speed. Our train hit in 2004 and we have been dealing with the aftermath of that. So even if people are in denial, that doesn’t change the fact that it is a reality.
Gavin Dixon, with the Alaska Native Tribal Health Consortium said melting permafrost is affecting existing systems – with flooding that’s affecting water sources, and high algae growth clogging filters.
“We’re having homes where we have connections to homes with Arctic pipes,” Dixon says. “Homes will settle and the pipes don’t so there’s differential settling and the pipes will break away from the houses.
In Alakanuk the Yukon River is eating away at the shore, leaving residents wondering what will become of their water and sewer system.
Village Safe Water facilities program director Bill Griffith said agencies are working with the communities with the highest public health risks first, such as communities that have already lost critical elements of sanitation systems.
“We’ve got communities that have lost their water sources or lost the water line that used to be on the beach that’s eroded. We’re trying to get after those first, but it’s almost like a triage situation right now,” Griffith says. “We don’t have the funds to be able deal with everything we know is going to be affected over the next 20 years so we’re trying to work with the ones that are affected right now.”
Rural communities are also struggling to cover maintenance and operating costs. Dixon said a big part of those costs is fuel. He said spending some money up front would save more later.
“We estimate it will take $80,000 per community to reduce and save $15,000 each year, for new controls, parts replacement,” Dixon says. “The benefit to communities is pretty real.”
The consortium is working on using new construction methods to save money. Dixon cites a building that was first built, and then broken into modules for transport and re-construction in a village.
“This is going to be just over a million dollars for this project here. Traditional methods of constructing entire water treatment plants like we’ve done can be anywhere upwards of three to five million dollars, depending on the size of the community. Akiak’s fairly small so it’s probably on the low end of there,” Dixon says.
“Another advantage of this is that in a community where they may have a water plant that is in danger of eroding or they have to move,” Dixon says. “You can cut the pipes off and move the water plant. You can’t do that with traditional construction methodologies.
In Kotzebue, Maniilaq hospital administrator Paul Hanson said modern sanitation will do a lot to improve public health, but he notes good health is also linked to jobs and to culturally appropriate care.
“I think the biggest challenge that we face is really being able to care for ourselves,” Hanson says. “When I say that I mean not only just actually our daily habits and that sort of thing but developing our own work force, and having folks from our region taking care of people from this region”
Meanwhile, Yukon-Kuskokwim Health Corporation president Dan Winkelman hasn’t lost hope that Congress, or the state legislature will come through.
“That’s why it’s even that much more important right now to get the policymakers out here so they can actually realize that we’re getting so close,” Winkelman says. “We only have 4,500 more homes in the state of Alaska and we’re getting so close to closing that gap.”
Innovation has been slow to come for rural sanitation in Alaska, and just as it has begun to appear, so has a dramatic reduction in state revenues. Everyone talks about planning for more “resiliency” in the face of climate change, but those who actually work with the problem speak more in terms of “triage.” Whether they will end up gaining ground or losing it remains to be seen.