Water and sewer deficiencies make regional villages more vulnerable to the spread of COVID-19

With COVID-19 bearing down on rural Alaska, deficiencies in basic infrastructure like water and sewer systems are becoming more and more pressing. In some Bering Strait villages, no water or sewer delivery infrastructure exists at all, and concern grows that the lack of water makes already vulnerable communities even more susceptible to the virus.
Joe Garnie has lived in Teller his whole life and says the village has never had any sort of water delivery system. “Nobody has plumbing,” he said. “Nobody has flush toilets.”
Instead, people use ATVs, trailers or jugs to haul water from the single communal washeteria to their homes on a daily basis. To use the bathroom, most people have a honey bucket – or a cardboard box and a trash bag, for those who can’t afford a bucket – which is collected and disposed of periodically by village employees. The washeteria has only two shower stalls for the entire village of more than 230 people. And ever since the washeteria toilets stopped working, they were replaced with honey buckets in the shower stalls.
For Garnie, the lack of care that he feels is given to his village has been infuriating. “We’ve hired people to fix that plumbing, and the best they’ve done for my community is to put honey buckets in the shower room,” he said. “And that’s disgusting. We put a man on the moon when I was in fourth grade.”
The federal Centers for Disease Control reports that the lack of running water and sewer can increase the risk of infant pneumonia and respiratory syncytial virus, as well as skin and blood infections. The CDC website also states that long-standing systemic health and social inequities have put Alaskan Natives, among other groups, at increased risk of getting COVID-19 or experiencing severe illness, regardless of age. According to CDC, as of June 12, hospitalization rates are highest for American Indian, Alaska Native and Black persons.
According to the Alaska Native Tribal Health Consortium, ANTHC for short, infants in villages without running water are hospitalized for respiratory infections at rates five times higher than the national average, and for pneumonia at 11 times the national average rate.
Although not much research has been published yet on water and the novel coronavirus, health experts agree that regular handwashing is a key component of slowing the spread of the disease. Garnie is concerned that the lack of running water prevents people in Teller from washing their hands as frequently as they should because of the labor involved in hauling water to their houses. The fact that the entire village has to share a handful of tight spaces for showering and laundry poses major barriers to even the most basic social distancing. Teller has had two positive COVID-19 cases so far. One case has been attributed to community spread and worries about a potential outbreak run high.
So why haven’t Teller and the region’s four other unserved or underserved villages – Stebbins, Shishmaref, Wales and Little Diomede – gotten water and sewer?
“Really it’s a matter of finances,” explained John Nichols, Director of Rural Utility Management Services at the ANTHC. “Because there’s so much labor and gasoline and equipment involved in delivering water to and sewer from your house, it’s very, very expensive.”
Money for rural water systems in Alaska generally comes from four major sources: the Indian Health Service, two federal agencies (the EPA and the USDA) and the state of Alaska. IHS can rarely fund the installation of a new water system on its own, and the state of Alaska matches funding from the federal agencies, so without the state’s approval the federal money won’t flow. That means the state of Alaska controls the majority of possible funds.
Funding is limited, so the state uses a suite of “best practice scores” to evaluate who can receive funding. The scores measure how equipped a community is to operate a water and sewer system on its own. Key to scoring high is having access to certified water plant operators and enough income to pay for monthly operation, which can be a very high bar.
The 36 communities statewide with no water or sewer tend to be the ones already struggling with a host of other issues from extreme poverty to environmental threats, so they rarely score high enough on the state’s scale. And a low score makes a community ineligible to even apply for funding, so small villages that don’t have the money or expertise to run a water system on their own have no chance of getting anything installed.
“It does seem sometimes that the rich are getting richer and the poor are getting no help,” Nichols said. “For these small unserved communities to compete I think there’s just got to be a tremendous amount of assistance from within the region.”
Some of that assistance is coming in the form of Norton Sound Health Corporation’s new Sanitation Department, managed by Sean Lee. Lee works to connect villages with state-level organizations like the ANTHC and the Alaska Department of Environmental Conservation’s Village Safe Water in order to help them meet their needs. In response to the pandemic, NSHC is working on producing a low-flow handwashing station that can go in homes and encourage more regular handwashing. They’ve also sent out buckets, hand sanitizer and other washing equipment, although supply chain issues have held up the delivery of some supplies.
Lee estimated that it would cost more than $34 million to install fully piped water and sewer in Teller, costing residents $114 per month in utility bills, but he said that a more detailed engineering report would be necessary to get an accurate number. He also estimated that it would take $277.4 million to address all the water and sanitation deficiencies in the region’s villages. He added that construction could take more than a decade in some cases.
In light of the huge costs of piped water systems, a number of alternatives have been proposed. One strategy used in some places is a haul system, in which houses have their own water and sewage tanks that are regularly filled and emptied via deliveries by truck, ATV or snowmachine. The relative costs of piped and haul systems depend on a number of factors, including a village’s layout and existing infrastructure, but Lee emphasized that the hygiene impact of a haul system is significantly less than a piped one, because the high cost of a tank-load of water discourages homeowners from using ample water for washing.
The Bering Strait Regional Housing Authority is another non-profit that uses grant money to build infrastructure in the region. While their main focus is housing, they also work on improving water and sanitation infrastructure, but face many of the same funding challenges as NSHC. However, they have been able to get smaller projects off the ground with emergency COVID-19 funding.
“We’re in the process, with some of our COVID-19 funding, of getting one village a water tanker that can take water to the different homes, so they don’t have to carry buckets up and down the hills,” Vice President of Operations Paul Winders said. He emphasized the importance of working with villages and other state and regional entities to develop all kinds of infrastructure.
The DEC started the still-ongoing Alaska Water and Sewer Challenge in 2013, which aims to develop cheap, innovative methods of water delivery in rural Alaska. Candidates include ANTHC’s PASS system, which uses rainwater, simple in-house water treatment and a waste-separating toilet to improve hygiene without a piped water source. This and other options are still in development as temporary, inexpensive and portable solutions to rural Alaska’s critical water needs.
Cheryl Rosa praises these efforts but insists that the biggest issue remains the cost of operation and maintenance. She heads the Alaska Rural Water and Sanitation Working Group at the United States Arctic Research Commission, another organization which aims to bring villages and various state and federal players together to make sure needs are being met efficiently. She said that most water delivery schemes, both traditional and otherwise, rely on village residents to pay the monthly upkeep on the system, and that often it’s just too expensive for village residents to pay.
 “We have been trying forever to get a way for subsidization of water and sanitation,” she said. “But it’s really hard.” Her group suggested establishing a permanent water and sanitation fund that could produce an annual dividend to help villages with operation costs akin to the PFD, but the political barriers have been insurmountable. “When you have the bulk of the population that would vote on something like that in urban areas that are not super inclined to give money to rural areas, it would be hard to push something like that through,” she said.
The Northwest Arctic Borough did help close the gap in their region in 2018 with the Community Utility Assistance Program, which cut residents’ utility bills by two thirds in some NANA villages and helped villages reach “best practice scores” high enough to apply for state funding. Nichols at the ANTHC suggested that the program could serve as a model for other regions in the state, but so far no such program exists for the Bering Strait region.
Meanwhile in Teller, Joe Garnie remains wary of state solutions. When he sat on Teller’s city council, he saw thousands of dollars spent on two different feasibility studies, neither of which resulted in any tangible action. He said that the DEC’s Village Safe Water program has had an employee in Juneau assigned to Teller for as long as he can remember, but that it’s resulted in no actual progress in his community. “It’s a very easy community for politicians to take advantage of,” he said.
In the face of COVID-19, he insisted that even a small, temporary improvement would go a long way.
In the near future, though, even small measures seem a long way off.