Alaska Natives suffering from unhealthy water

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WASHINGTON - Lack of in-home running water is still an issue facing approximately one-third of Alaska Natives, and it's literally making them sick, according to new study findings.

Health advocates in the region are calling on policymakers to become better aware of the problem and fund initiatives to enhance the lacking water infrastructure in rural areas of Alaska.

''People here are hopeful that government agencies will attend to their basic housing and sanitation needs,'' said Paul Sherry, CEO of the Alaska Native Tribal Health Consortium, based in Anchorage. ''Regardless of where they live, people believe they should have access to certain basic services. And I don't think people are asking too much.''

The new research, conducted by the Centers for Disease Control and Prevention's Arctic Investigations Program in conjunction with the Alaska Native Tribal Health Consortium, found that a lack of running water in the home is linked to severe respiratory infections and lung and skin infections among Alaska Natives.

Infants who live in villages with the lowest numbers of in-home water service have a five times higher rate of hospitalizations for lower respiratory tract infections and respiratory syncytial virus than infants who live in homes with water service. Compared to the overall U.S. population, they experience an 11 times higher rate of hospitalization for pneumonia.

The new findings could help explain why the rates of respiratory illness among Alaska Native infants are sky-high. A whopping 75 percent of all hospitalizations among Alaska Native and American Indian children in the state are due to respiratory problems.

Researchers also found that elders age 65 and older living in lower water service areas were twice as likely to be hospitalized for pneumonia or influenza. For all age groups, skin infections were significantly higher in areas with lower water service rates.

Alaska Natives without in-home water have no easy way to take a shower, wash their clothes, or even go to the bathroom. Families in rural areas regularly make lengthy treks via snowmobile to fill up five-gallon buckets of water to bring home, heat up, and use to wash their dishes.

Troy Ritter, a senior environmental health consultant for ANTHC who helped conduct the study, notes that people who have to haul water in a bucket from a remote point use about 1.8 gallons of water per person each day. The average American uses between 80 and 100 gallons of water each day.

''When you have a commodity that you have to work very hard to obtain, you tend to ration it, conserve it, or maybe even reuse it,'' Ritter said.

The findings are believed to be a first to link lack of water to respiratory illnesses, according to Ritter. Studies from more than 100 years ago found that limited access to clean water can lead to negative gastrointestinal symptoms.

According to U.S. Census data, 99.4 percent of all American homes have complete sanitation service in 2000. In Alaska, 93.7 percent of homes have complete sanitation, and the proportion of homes without such services was much higher in rural Alaskan villages. The state ranks last in the proportion of homes with in-home water service.

Between 40 and 50 Native communities throughout Alaska still lack modern sanitation facilities, including running water, bathrooms and flush toilets.

''It's been surprising to us when people have asked in recent years, 'Where's the evidence that building water systems really helps?''' Sherry said. ''We pointed way back in history, noting, well, the reason they built water treatment systems in New York City was to increase the health of its citizens.''

Those kinds of inquiries, he said, were actually the impetus for the current study, which he believes provides resounding evidence that a sanitation infrastructure in rural Alaska is desperately needed.

The cost estimate to bring running water to all Native homes in the state currently stands at upwards of $600 million - a price that continues to fall over time as more houses have plumbing installed and technology costs decrease. Water projects costing between $60 million and $70 million are currently under way in rural areas.

The goal, Sherry said, is to sustain similar investments from state and federal legislators over the next 10 years to help get all homes on the water grid.

Still, even staunch in-home water advocates note that they face uphill challenges. Of the communities left to receive water service, many are expensive to reach and work in. These communities also have economies that would make it difficult to sustain costly water facilities, and they are located in some of the harshest weather condition areas in the United States.

The main contributors to water development projects thus far have been the Department of Housing and Urban Development, the Environmental Protection Agency, the Department of Agriculture, IHS and the state of Alaska.

''It's becoming harder and harder to get sustained support from state and federal agencies,'' Sherry said. ''However, it is appropriate, fair and reasonable to keep making those investments.''

Health advocates believe medical costs of treating perennially sick patients end up outweighing the cost of getting all homes up to date with in-home water.

Turnover in state and federal legislatures often makes the task of completing the work more difficult. Groups like the ANTHC spend much time getting current legislators up to date on the dire needs of rural Alaska Natives, only to see staff turnover in government sectors, which leads to the need to re-educate all over again.

''The problem is that for most Americans and most people in Congress and governmental agencies, this part of Alaska is kind of out of sight, out of mind,'' Sherry said. ''It's not something you run into every day, and so it's hard for us to keep this front and center on people's minds.''