Mark Mitchell is a preventive medicine physician specializing in environmental health and an Associate Professor of Climate Change, Energy, and Environmental Health Equity at George Mason University
If you ask Dr. Laura Eichelberger, Senior Epidemiology and Health Research Consultant at Alaska Native Tribal Health Consortium (ANTHC) how climate change is impacting Alaska, she will explain to you that things are very different in our 49th state.
For starters, Alaska has 229 Federally recognized tribes in over 200 rural communities across the state. Whereas running water is a scarce commodity, each community is required by the federal government to have a water treatment facility to produce fresh water that may or may not be piped into nearby houses, a school with showers, washeterias (which are laundromats with showers), and landing strips for airplanes to deliver provisions and supplies, since many communities are so remote that they are not connected by roadways.
Similar to environmental justice communities, small island nations, and other frontline communities, Alaska Native communities are being hit first and worst by climate change, and are developing innovative, culturally adapted approaches to addressing their unique challenges, despite the fact that they have contributed little to the problem of greenhouse gas emissions.
Climate change is hitting the Arctic more than almost anywhere else on earth. Over the past 60 years, Alaska has warmed more than twice as fast as the rest of the United States. Average annual temperatures have increased by 3 degrees Fahrenheit and average winter temperatures by 6 degrees Fahrenheit. With sea level rising and the permafrost melting, coastal villages are sinking into the ocean.
Against this backdrop of change, one of the early catastrophic impacts in these villages is the compromise of their water supply to those households that receive piped water service. Above ground heated water and sewer pipes going to the homes in the villages have begun breaking due to the shifting and sinking land. In addition, some communities have lost their source of fresh water due to erosion or saltwater entering fresh water supplies because of melting permafrost and sea-level rise.
These changes in the local environment are adding to the number of rural households that have no indoor plumbing and are “water insecure.” ANTHC defines water insecurity as: “…the inability to benefit from adequate, reliable, affordable safe water and sanitation to meet all domestic, health, and cultural needs.” They state that this is a health equity crisis across the United States that is growing worse with climate change.
The result of these threats to health is that many rural Alaska communities, where most of the residents are Alaska Natives, are on the list to be physically relocated as their land becomes uninhabitable. However, the time it takes to actually move is often years to decades. Once the decision to relocate a village has been made, it is virtually impossible to get funding to maintain and rebuild an expensive village water system that needs major repairs. As a result, members of more families, often young boys, must now haul in the necessarily limited amounts of freshwater and haul out the human waste year-round—sometimes in extreme weather conditions. The high rates of respiratory, skin, and gastrointestinal illness observed in these rural communities may be the result of reusing water in shared handwashing basins, as well as the handling of human waste.
These unique challenges provided the impetus for ANTHC to develop a novel system of individual household water purification and sanitation for homes without a reliable source of water. The new system, the Portable Alternative Sanitary System, is designed to improve health in a culturally appropriate manner. Instead of hauling limited amounts of treated water from the centralized water treatment facility or from sources of unknown quality, tribal households can filter and disinfect any source of fresh water—such as rainwater, snow melt, springs or river water— so that the water becomes drinkable. In addition, the system is engineered for use in permafrost and high water table conditions.
The convenience of using onsite or nearby water supplies translates into a better chance of having access to larger amounts of potable water. This, in turn, means that people will have more clean water to drink and wash their hands rather than reuse water multiple times in a common hand washing basin.
With this Robert Wood Johnson Foundation grant, ANTHC hopes to document how the Portable Alternate Sanitary System affects water security, health, and well-being, as well as whether this system increases household water security in culturally, economically and environmentally sustainable ways. ANTHC is uniquely positioned to do this because it is at the hub of the Alaska Tribal Health System (ATHS) – a statewide voluntary affiliation of Tribal Health Organizations (THOs) providing public health and medical services to Alaska Native people. Through this comprehensive, integrated system, they can detect and document small changes to the health of their populations and compare similar communities in a way that is not possible in most small rural communities in the U.S.
Does the sanitary system make a difference in health status? Through health system records, along with surveys of 17 of the user households, ANTHC has preliminary data that households using the system report less gastrointestinal, respiratory, and skin disease than similar rural Alaska unplumbed households. Under this grant, ANTHC will conduct a more rigorous evaluation to document the physical, social, and cultural effects to Alaskan households using this system.
As climate change devastates more communities and threatens water supplies, there needs to be set of solutions developed that are flexible and customizable to specific geographical and cultural niches. ANTHC seems well-positioned to provide evidence on the effectiveness of one such solution.