Remember when Flint, Michigan garnered international attention because water in the city was making people sick? Well, there are communities like that around the country and the world. And while Flint gained attention because of its failing infrastructure, there are places where water and sewage infrastructure is absent.

"Too many Americans live without any affordable means of cleanly disposing of the waste from their toilets, and must live with the resulting filth," writes Catherine Coleman Flowers, an environmental health advocate, in her book "Waste: One Woman's Fight Against America's Dirty Secret," published by The New Press in November. (Read an excerpt here.)

"They lack what most Americans take for granted: the right to flush and forget," Flowers continues.

For nearly two decades, Flowers, a recent awardee of the MacArthur Foundation "genius grant," has been bringing attention to failing water and waste sanitation infrastructure in rural areas.

I spoke with Flowers in mid-December over Skype. Below is a transcript of our conversation, lightly edited for clarity.

Deonna Anderson: You are the woman mentioned in the title of your book, which chronicles your life and also your work as an environmental justice champion. For those who have not read the book, can you give an overview of what the "dirty secret" is in the title?

Catherine Coleman Flowers: The dirty secret is that there are many Americans living with waste that comes from their toilets, whether it is through straight piping, in which [waste from] the toilets comes straight out on top of the ground or into a pit, or whether it is through a failing septic system, which means that when it fails, there's sewage from their homes, usually from their toilets, of course. I just want to be graphic because that's what it is. 

And it ends up either out on top of the ground or comes back into the home, sometimes into their bathtubs. Or they're part of these community systems that are supposed to be managed but were built in a way in which they were not sustainable. And consequently, people have sewage coming back into their homes or into their yards.

Anderson: Throughout "Waste," you write about the tours that you take people on to see all the waste and the lack of infrastructure in Lowndes County, Alabama. And that's where you grew up. First, how many people have you taken on these tours over the years?

Flowers: That's a good question... In some cases, it would be one or two people and in other cases, there may be groups. So I would say on the small number, maybe close to 100 people, at least, that I've actually taken around to see this firsthand over the years, because I've been doing this since 2002.

Anderson: What has been the tangible impact of people going to see what happens in Lowndes County?

Flowers: Well, first of all, this is not on a lot of people's radar. When I wanted to talk about this before, I couldn't get media interest. I was told that this was not sexy, nobody would be interested in it. But since that time, I've had the opportunity to speak before Congress, active members of Congress, the Senate, who've actually come to Lowndes County to see for themselves and have been working on policies to try to address this issue in rural communities.

I had the opportunity to visit Geneva, because the U.N. Special Rapporteur on extreme poverty came to Lowndes County and made it a major global issue. The first real coverage we get from it from a newspaper actually came from The Guardian. So now there are other people that are interested as well.

And the fact that I can even write a book about it. ... I'm thankful to The New Press for giving me an opportunity to tell this story. I'm excited that we have seen and have heard from people from around the country that are indeed interested in knowing about this, and also people that are interested in what the potential solutions are.

Anderson: That's actually a really good segue to my next question. Towards the end of the book, you talk about how solutions haven't really come fast enough. And I'm curious if there's anything that you hope happens in the next year or so, to address the sanitation issue in rural communities all over the country?

Flowers: I think the first thing that should happen within the next year is to find out how many people are impacted, because we're not going to have any real solutions until we really know how many people are impacted by this. Because I think for some people, a solution is to go to a place like Lowndes County, put in a few septic systems and say, "Problem solved."

The problem is not solved. And whatever systems are put in place have to be monitored — because of climate change, a lot of them simply are not working. And then we're going to see what we've already seen: the failing septic systems, which exist around U.S. It's not just in in Lowndes County.

We could develop a vaccine for the coronavirus in less than a year. Just imagine what we could do if we put that same type of know-how and ingenuity behind coming up with some real wastewater solutions.

The first thing is trying to quantify how many people are impacted by this and where they're located. So when we talk about solutions, we're talking about getting solutions to all the people that are impacted by it. Then the second thing that I'd like to see within the next year, is to actually to have the work on the type of innovation that's needed to have long-term solutions to this problem, because obviously, it doesn't exist. If it existed, everybody would have it, or they could go buy it and it's not available. So we need to find something that's sustainable, that takes into account climate change, and also is affordable so that we can that people could maintain it if they have to.

What I envision is within the next five years coming up with a system that treats wastewater to drinking water quality that can be done on a household level. Because we're going to have to talk about how we rebuild differently, and how we build differently. And as people have to move away from the coasts, and they move into these unincorporated areas, or they move into these areas where they don't have big pipe systems, or have systems that are failing, we have to have something to be able to address that. And I think in terms of being forward thinking, we have to start working on that technology now.

And I believe that it's possible because we could develop a vaccine for the coronavirus in less than a year. Just imagine what we could do if we put that same type of know-how and ingenuity behind coming up with some real wastewater solutions that reuse and reclaim.

Anderson: A few weeks ago, you were in conversation with Khaliah Ali Wertheimer. During your conversation, you mentioned how you would love for more rural communities to be included in conversations related to the Green New Deal. And I'm curious if you can share why it's an important thing to include rural communities in these conversations?

Flowers: I think oftentimes what we do — and it's unintentional — is we frame our solutions or our conversations with an urban perspective that inadvertently is biased against rural communities. It leaves them out, when in fact, people in rural communities probably saw climate change before the people in the cities did, and may also have some type of knowledge about the solutions, and especially if we're going to talk about agricultural solutions, solutions around soil. People in rural communities, especially [those] living in these agricultural communities that are very close to the soil, have some understanding that a lot of people don't have because they have to pay attention to the natural elements in order to be successful in those environments.

And I think, also, there are some common sense solutions that can come from rural communities. When we talk about green infrastructure, of course, we talk rightfully so about transportation systems that will move large amounts of people from one place to the other. And we talk about the grid and how the grid could connect cities.

What I envision is within the next 5 years coming up with a system that treats wastewater to drinking water quality that can be done on a household level.

But we need to connect those places in between as well, because even right now, a lot of people don't have access to broadband and internet services. There are some parts of the country, especially in rural communities, where people's cell phones might not work, because there aren't cell towers nearby. So all of these kinds of things that we just assume that everybody has is not true. That's why I believe that people from rural communities should be part of any discussion that we have about a Green New Deal and green infrastructure. They can also inform that conversation and how we get [resources] to those areas that have been left behind from what we currently have. We don't need to keep skipping over these communities.

Anderson: I'm curious if there has been any legislation over the years that has really helped improve the lives of rural communities that you can think of. And can you paint the picture of what the ideal would be when it comes to making sure that rural communities are thought about in conversations about climate change?

Flowers: I haven't really done a deep dive search but with the legislation that I have seen, I haven't seen what I think is the model yet. I think in order to have a model, it would involve going into these communities and having people that are experiencing these problems sitting at the table and helping to draft the legislation because oftentimes, people are well intentioned and want to do it, and I applaud them for that, but you can't do that by just visiting for a day and thinking you have the answer. 

It's unintentional — we frame our solutions or we frame our conversations with an urban perspective that inadvertently is biased against rural communities.

Using the principles of environmental justice, that means having the people in the community sitting at the table — not having a top-down approach. The top-down approaches, as we know, have failed. That's why we have this problem. That's why we're having this discussion. The model includes using the principles of environmental justice — and letting the people in the community be part of designing the policy to address these issues — because sometimes even the language in the policies get in the way — for example, language such as "town," when a lot of these areas are unincorporated. There are no towns. Or putting in a limit or a minimum of 500 or more people. What does that do? Exclude the smaller towns or the smaller communities who may not be part of the town. And I think that's one of the reasons that we have the problem that we have. 

It's something that I call a rural lexicon and what the rural lexicon is is understanding the language of rural communities, so that when we write policy, it is not always written from an urban perspective. I'm not saying that urban communities should not have access to services. They should, but we should all have access to services, whether rural or urban.

Anderson: When I was listening to you talk, it reminded me that when solutions to issues are dreamed up and implemented, the people doing the work need to be deeply embedded with the communities in which they're working in order to really understand and make sure that everyone is included. With that in mind and because the GreenBiz audience is mostly corporate sustainability people, I'm curious about how companies can help rural communities and support organizations like yours.

Flowers: Companies come with expertise that we don't have and they can also help expand our capacity — and they can contribute to organizations like ours, so that we can do the work. Some of them can serve as board members; some can serve as advisers. They can host seminars to educate their staff about these issues. Some of them could also visit as well, when it's feasible to visit again. And certainly there are services that they offer that people in rural communities want as well. 

In some cases, some of these smaller areas cannot have sustainability offices. Wouldn't it be great if some of these companies will partner with communities that don't have that? They can actually go in and help them develop more sustainable practices in those communities. There are lots of things that can be done and I'm sure if you talk to somebody else from a rural community, that they would have other ideas.

I used to teach social studies so I remember teaching state and local government and history, and we know that there are three branches of government. We know that there are some other unofficial branches of government like the media, but I think the business community plays a key role as well. And the business community can be very helpful in states and pushing for the state governments to not leave out rural communities and to make sure that there's infrastructure in place for these rural communities.

Companies come with expertise that we don't have and they can also help expand our capacity — and they can contribute to organizations like ours, so that we can do the work.

When I was an economic development coordinator, I couldn't recruit a lot of businesses to Lowndes County because they require certain things that we did not have in terms of just basic infrastructure. By pushing for those things to happen, and pushing for states to provide the infrastructure, not just in the places that already have it but also in places that need it, that can go a long way.

Anderson: Now that your book is out in the world, what is the life you hope the book has? What do you hope the people who read the book take away from it and put to action?

Flowers: The first thing I want them to do is to read the book. And then the second thing I want them to do is not just look at Lowndes County. Look in their own communities, look in their own states. Throughout the United States, there's this problem — United States and U.S. territories. So look at those areas and help us to identify where those areas are and what those problems are so together we can come up with a solution. 

That's what I'm asking people to do because a lot of people want to come to Lowndes County. You're passing by situations in your own state and that's not helpful. What we need to do is make sure that everybody gets help, and that people are not left behind. I ultimately hope that what will come of this book, or at least writing and telling the story, is that we'll be able to look back and say this was the impetus to end this problem in the United States of America, and potentially globally.