Sewage is still ‘America’s dirty secret’

Lake Street Sewer A 1928 photo shows a sewer outlet pouring untreated sewage into the Mississippi in Minnesota. Nearly a century later, wastewater remains an important public health issue in the US. | Photo by Smith Collection/Gado/Getty Images

Doctors couldn’t diagnose the rash spreading across Catherine Flowers’ legs and body. But the activist thought it had to do with the day she wore a dress during a visit to a family whose yard featured “a hole in the ground full of raw sewage.” “I began to wonder if third-world conditions might be bringing third-world diseases to our region,” Flowers writes in her new book, Waste: One Woman’s Fight Against America’s Dirty Secret.

She was right. That rash led to research that found that hookworm, a parasite thought to be pretty much dead in the US, was actually alive and well in the rural Alabama county where she grew up. Without working septic systems, residents were getting sick from raw sewage. Flowers has been on a mission to change…

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