Through an agreement with the Stanford Social Innovation Review, PND is pleased to be able to offer a series of articles and profiles related to the "business" of improving society.
For the past sixty years, NGOs from high-income countries have led the charge to solve water and sanitation problems abroad. In that time, more than $250 billion in foreign aid — much of it provided by the U.S. government, philanthropies, and nonprofits — have been invested in water, sanitation, and hygiene (WASH) projects in places like sub-Saharan Africa and Latin America, with incredible results. Between 1990 and 2015, 2.6 billion people gained access to improved drinking water — perhaps the single most important contribution to the recent upswing in global life expectancy.
But U.S.-based WASH organizations have developed a blind spot in the process: While focusing on improving water and sanitation access in other countries, they have failed to recognize the same crisis in their own backyard. They have been instrumental in building a strong and effective WASH sector abroad, yet they have not undertaken a similar effort here in the United States.
Today, at least 2.2 million people in the United States don't have access to water at home. (That's not to mention the 44 million more with running water that's not safe to drink.) Across the country, Americans make do without the sinks, bathtubs, showers, or toilets that the rest of us take for granted. Perhaps most shocking, that number is growing in six states and Puerto Rico.
There is no real difference between the global water crisis and the crisis here in the United States. Both crises affect human beings, who, because of circumstances beyond their control, including geography, poverty, and discrimination, struggle every day just to get enough clean water to survive. In the rural Navajo Nation, as in rural Namibia, some women leave their homes to walk to an unprotected water source and draw out a few gallons of contaminated water that their families must use to get through the day.
The global WASH sector is a network of government agencies, dedicated funders, NGOs, and frontline communities that collaborates on strategies to improve water access. Members share best practices, set ambitious goals, and hold each other accountable. Their combined efforts have helped billions of human beings move closer to achieving Sustainable Development Goal 6: the availability and sustainable management of water and sanitation for all.
The United States lacks its own robust WASH sector, and as a result, most Americans remain unaware of the water crisis in their country. Public funding for water infrastructure has flatlined at just 9 percent of overall spending — a small fraction of what it once was — and philanthropic support for domestic water projects is limited, fragmented, and difficult to access. But if experienced U.S.-based WASH organizations were to refocus a portion of their expertise and resources here at home, we could end this crisis, and quickly.
A Willful Blindness
Why, then, don't we have our own robust WASH sector here in the United States?
I've been asking this question since 2014, when DigDeep, the global WASH organization I founded, first shifted our focus from sub-Saharan Africa to Navajo communities in rural New Mexico. (More than a third of Navajo households still lack basic access to running water.) With that shift, we became the first U.S.-based WASH organization to return home. In doing so, we lost vital support from an ecosystem of government allies, dedicated funders, and learning groups who collaborate only on projects abroad. Although hundreds of WASH organizations are headquartered in the United States, only two — DigDeep and Water Mission, a WASH engineering organization based in South Carolina — deploy domestic projects.
There are practical reasons why the United States has never had a domestic WASH sector despite vast unmet need. For example, the U.S., unlike many other countries, does not collect comprehensive data on water access, making it difficult to see (and serve) affected communities. In late 2019, DigDeep published the first national study on water and sanitation access in partnership with the US Water Alliance. We found that at least 2.2 million Americans are affected, that poverty is a key obstacle to water access, and that race is the single strongest predictor of whether you and your family can turn on the tap at home. Native American households are nineteen times more likely than white households to lack access to complete plumbing (meaning hot and cold running water, a sink, a shower, and a toilet), while African-American and Latinx households are nearly twice as likely.
Some U.S. WASH funders also believe — wrongly — that this work is too expensive at home, and that their dollars will have a more meaningful impact abroad. Everyone has a right to basic access to water and sanitation, and it costs just $3,100 to bring hot and cold running water to a family through the Navajo Water Project, a meager sum considering both the need and the context. Of course, in some parts of East Africa, that same $3,100 might provide a shallow drinking water borehole and hand pump to a community of several hundred people. These projects, however, are not readily comparable; their outputs — hot and cold running water in the home, versus basic access to drinking water on foot — are vastly different, as are their outcomes in people's lives. But after nearly sixty years working in low-income countries, U.S.-based WASH funders are not always structured to plan their investments or measure their impact in ways that can account for these differences. As a result, domestic water projects may be disregarded in favor of what's perceived to be a "more impactful" investment abroad.
We at DigDeep also feel that U.S. philanthropy and the American public are blind to the possibility that problems like water poverty can exist in a country as rich as the United States. They instead focus on low-income countries and believe Americans have a duty to export our skills and resources to solve WASH challenges abroad. After all, isn't access to water and sanitation a basic human right?
I am not arguing that to end the water crisis in the United States, we must abandon our support for the 884 million other humans without access to drinking water. On the contrary, our domestic water crisis pales in comparison to the WASH sector's collective accomplishments around the world — work that must continue. Comparing the need at home with our progress abroad proves that the U.S. water crisis is entirely solvable, probably with a fraction of the time and resources that we will continue to invest elsewhere.
If the United States is to solve this problem, we need to confront it, as we have in other countries, as an urgent public health crisis that demands an intelligent, coordinated, and rapid response. We need a domestic WASH sector with funders, implementers, and learning groups to lead this work.
WASH Funders | We need WASH funders to do at home what they've done so well abroad: define the crisis, coordinate investment, set ambitious goals, and support creative solutions that government can't or won’t fund. Within the next year, WASH funders should begin deploying money and resources such as delivery trucks and point-of-use filters that frontline organizations such as food banks and faith-based groups can use to provide interim water access. These groups would benefit most from flexible funding that could be used for both programs and overhead, without burdensome application and reporting requirements. In places where public investment is stymied by outdated laws and practices, philanthropic investments can help communities surmount barriers to government funding, alongside advocacy to remove those barriers. U.S.-based WASH funders should convene as soon as possible to begin strategizing a coordinated, long-term response.
WASH Implementers | WASH NGOs have the opportunity to adapt the tactics and strategies they've developed so successfully abroad to help U.S. communities. They can start small, with pilot projects that utilize their strengths. For example, an organization that's been effective with microlending around water access in India might consider a similar project in a Texas-Mexico border colonia. A group that has been drilling community wells in the Sahel might serve the arid Southwest, helping far-flung indigenous communities become more water-resilient.
Learning Groups | U.S.-based WASH organizations — both funders and implementers — should build a domestic network that mirrors the learning groups (or "clusters") engaged in international work. WASH clusters coordinate regional efforts by setting priorities, sharing technical knowledge, and coordinating responses to new or existing challenges. A domestic WASH cluster would allow us to develop best practices, evaluate our impact, and keep federal, state, and local governments accountable to impacted communities. We should begin by advocating for a national data collection and monitoring system. The global WASH sector has won many legislative victories in the past sixty years; we can harness those relationships to petition the federal government to restore the census question regarding access to flush toilets (removed in 2016) and to add new questions about water quality, affordability, and wastewater services that would help us sharpen our efforts going forward.
There is poetic justice to reversing the traditional model of international development. Instead of exporting WASH technologies and resources from the United States to other countries, we would be importing and adapting successful strategies for WASH that were first developed abroad. Many of the low-income countries we once felt it was our "duty" to help now have expertise that Americans need to address our own water crisis.
Until recently, the two million Americans without access to water have been on their own, lacking the support, resources, and visibility needed to solve this problem. A few lucky ones now have running water, but for most a working tap and toilet still seem like a distant dream. It doesn't need to be that way. By harnessing decades of WASH innovation and dedicating just a fraction of the time and effort we've invested abroad, we can build a future — just a few decades from now — where everyone in the United States can turn on a tap and flush a toilet without a second thought.
George McGraw (georgemcgraw.com) is a human rights researcher and advocate specializing in the human right to water and sanitation in the United States. He currently serves as founder and CEO of digdeep.org, the only WASH (water, sanitation, and hygiene) organization serving disadvantaged communities in the United States. He was the 2019 Social Entrepreneur in Residence (SEERS Fellow) at Stanford University and is an Ashoka Fellow.