This story was originally published on Sept. 22, 1992
Third in a series
Let's say that you were very thirsty and wanted to drink a glass of water and the owner of the household wanted for you to help yourself. As you take their pitcher and are about to fill the pitcher and saw the brown residue in his container, I think you'd change your mind about having that glass ofwater.
-- From a letter signed by 300 Hooper Bay residents and sent last winter to Gov. Wally Hickel, asking for upgrades to the village's water and sewer systems
HOOPER BAY -- Dominic Smith didn't realize that water from the village well was killing him. So he kept drinking.
The sicker he got, the more he drank. The more he drank, the sicker he got. All around his part of the village, his neighbors were falling sick, too.
By the next day, Smith was dead. His sister was in the hospital, critically ill.
Sometimes water and sanitation systems in Alaska villages fail. Sometimes village governments fail, too. So do government regulators.
All those failures combined Memorial Day weekend in Hooper Bay.
A system that pumps a fluoride solution into the town's drinking water badly malfunctioned, poisoning a large portion of the population. Fluoride at levels 40 times what the federal government considers safe for deterring tooth decay were measured in drinking water , and epidemiologists later concluded that it was probably the most widespread fluoride poisoning ever documented, with more than 200 people estimated to have been stricken.
And while the same kind of accident involving fluoride in other villages seems unlikely, people familiar with what happened believe the Hooper Bay incident shows, dramatically, the difficulties in providing safe drinking water in Alaska's far-flung villages.
Despite hundreds of millions of dollars spent to improve village water and sanitation systems, any number of things can go haywire and often do. Hooper Bay is just one of the worst and most recent examples.
"There are many, many obstacles to providing clean water in a place like Hooper Bay," said Dr. Brad Gessner, an epidemiologist with the Alaska Division of Public Health.
"It's not an easy thing to do at all."
POPULATION BOOM IN THE BUSH
With nearly 1,000 people, Hooper Bay is one of the largest Native communities in Alaska. Except for a couple of dozen teachers, their families and two nuns stationed here by the Roman Catholic Church, nearly everyone is Yup'ik Eskimo. They live in dozens of homes scattered several miles across the tundra in new federally subsidized boxes or in the old gray shacks bunched together on a series of low knolls, the place known as Main Town.
The village has grown by nearly one-third during the past decade, part of a baby boom in the Bush that's expected to double the Alaska Native population during the next 20 years. Advances in rural health care in the 1950s and '60s produced a surge in the number of women of child-bearing age today, and even though families are smaller than 30 years ago, the population is rising rapidly.
It's a village of children. Last year, the school had 262 pupils. Only 40 were in high school.
While Hooper Bay is larger than most villages, in many ways it faces the same problems lack of economy and opportunity, widespread alcoholism and violence facing many other rural Alaska communities today. Traditional Yup'ik life is still strong in many homes here, putting food on tables and providing a sort of social glue, but people young and old look at the future and it makes them uneasy.
The village has a 6,000-foot paved runway and microwave ovens and frozen pizzas, but for most people, no runningwater . The exceptions are the teachers, most of them white, who, as in most villages, live in modern apartments built alongside the school.
There's also running water at the village clinic and in a washeteria, which has washing machines and showers.
Like many villages, Hooper Bay wasn't settled with water and sewer service in mind. It was a good location for hunting and fishing, and grew rapidly after a Catholic mission was established early this century.
The big problem is fresh water : There's not enough. The water table beneath the permafrost is shallow, and in places is heavily contaminated with salt water from the Bering Sea.
"There's basically no way you're going to support a piped utility system in Hooper Bay," said Jim Crum, chief of facilities construction in Alaska for the U.S. Public Health Service, which has built systems in dozens of villages.
"Instead of using five gallons a day, like people do there now, you'd be using several hundred per household," Crum said. "Very quickly, you'd have no water ."
The result in Hooper Bay is that, in virtually all the houses, people haul drinking water home in buckets and use honeybuckets instead of toilets.
For most of the year, when the ground is frozen, residents haul their own honeybuckets and empty them into sewage ponds on the tundra a few hundred feet behind the school. The city provides a haul service, but few people in town pay bills and the local government is essentially broke, so service is sporadic.
People keep clean by taking steam baths driftwood-fired saunas that are a nighly ritual in many households. To give a baby a bath, you heat water in a tub over a wood stove or electric range. The school rounds up elementary school children for showers once a week.
Drinking water is drawn from two public wells one at the washeteria in a subdivision of newer houses, the other in the old town site.
It was in the old part of town, at the old well, that the water system went haywire this spring.
'A LOT OF UNHAPPY PEOPLE'
Maria Green grew up in Hooper Bay, went to college and now is a fourth- grade teacher, one of the few Yup'ik teachers here. One recent evening, she got up from the sofa, where she sat with her 3-year-old son, and walked into the kitchen and got a glass out of the cupboard.
She's lucky. She lives in a teacher apartment. She turned on the tap.
The water that came out was the color of stout beer.
The school has a separate well from the rest of the village, but like the old town well, a quarter-mile away, the water is heavily mineralized, producing brown water . This in itself isn't a problem, although some residents say it's so foul-looking that they can't stand to drink it.
The brown water doesn't taste bad , though. Some residents prefer it to the water from the the other, newer well in town, which some residents say has a salty taste apparently the result of sea water seeping in.
"A lot of these villages, we've got some problems here," said Green, who is vice mayor of the village.
"There are a lot of unhappy people in Hooper Bay. The lagoon smells. It floods in springtime. You walk along the road and it smells. We have dumpsters to put honeybuckets in. They overflow and they splash when they haul 'em off to the lagoon. Kids play where it splashes. The kids always get impetigo, that plus diarrhea. . . . There are so many flies."
Last winter, Green and Patrick Lake, a young villager and family man who works as a teacher aide, wrote a letter to Gov. Hickel and passed it around the village.
"The conditions we live in can be changed by having a water and sewer system in this village. We, the people of this village, would not take this for granted. A water and sewer system would prevent epidemics and spreading of disease throughout the village."
One of those who signed the letter was Dominic Smith.
TAINTED WELL WATER
Smith's death came during the busiest time of the year in the Yukon- Kuskokwim Delta right after seal and duck hunting and just before herring and salmon fishing.
According to residents, village health aides and a lengthy report by state epidemiologists and Alaska Department of Environmental Conservation officials who later visited the village, Smith died within hours of drinking tainted water .
Smith, a sergeant in Hooper Bay's National Guard unit, lived with his wife, Janet, and their six children in one of dozens of small wooden houses crammed together on the little rise that overlooks the bay. Like everyone else in that part of town, the family got their water from the nearby central well. Installed in the early 1970s, it was one of the oldest watering points in rural Alaska, and had been due for an overhaul this summer.
While minerals tainted its color, residents didn't mind the taste. Periodic tests found it free of bacteria and other contaminants. As in other village systems, chlorine, to kill bacteria, and fluoride were added by pump, with a village employee resupplying the chemicals. Fluoride is added in 141 water systems around Alaska, with its use advocated by federal and state health agencies that build the systems as a way to reduce tooth decay.
Smith woke up the morning of May 22 and had a glass of water , pumped from the well the previous day. Within minutes of drinking the water , he got sick to his stomach and vomited. He drank more water . Within a couple hours, according to his wife, he felt weak and needed to lie down. He continued to vomit. He drank more water .
That evening, Smith's children were sent for more water from the well. Smith drank four more glasses of water . He complained his muscles felt weak.
The next morning, Smith's wife awoke and found her husband dead.
Smith's sister, who lives nearby, drank water from the same well. She fell ill and was flown to Y-K Regional Hospital in Bethel, where she recovered within a few days. At least two other villagers reported neurological symptoms: tingling hands and feet. About two dozen other villagers went to the clinic feeling queasy. Many more said later that they felt ill.
It didn't take long to figure out the problem. Virtually everyone who had gotten sick had drunk from the old well. It was shut down. Tests of water in the well's holding tank and in people's homes showed fluoride levels much higher than the federal government's safe- water standard of 4 parts per million. Water from one home measured at more than 150 ppm.
FIGURING OUT THE PROBLEM
What went wrong in Hooper Bay?
Mechanically, a pump broke. The mechanism that was supposed to lift water up the well and into the holding tank was working only intermittently, while at the same time, a separate device to inject fluoride into the water kept going at full speed. Water levels in the tank were low, but the fluoride kept flowing in as if it were full.
But there were other problems in Hooper Bay, according to the state's investigation.
Three weeks before the poisoning, the village sent off a water sample to the regional health agency, the Yukon-Kuskokwim Health Corp., and the test showed a level of fluoride five times what is recommended in drinking water by the federal government. Agency officials called the village and told the well operator to shut off the fluoride, according to the state report.
The fluoride, state investigators later concluded, apparently was not shut off until three weeks later, after people began getting sick.
Hooper Bay, like all villages, was supposed to submit monthly water samples for bacteria to the Department of Environmental Conservation, but hadn't done so since 1990, according to DEC records. Chlorine and fluoride readings were taken more regularly and showed levels within safe ranges until early this year.
The village had been without a city manager for more than year. The water operator had little formal training.
Six weeks before the poisoning, DEC engineers doing work on the Hooper Bay well failed to notice the pump problems.
A lengthy report this summer by state epidemiologists outlined "multiple deficiencies that existed in design, operation, maintenance, training, communication, management and regulation of the water system."
The malfunctioning well was rebuilt this summer.
Smith's widow, Janet, filed a lawsuit last week against the regional health corporation seeking $3 million in damages, claiming the agency was negligent in not warning villagers of the poisoning threat earlier.
'IT'S AN OUTRAGE'
"It's easy to point at a place and say its dysfunctional," said Gessner, the epidemiologist with the state Division of Public Health.
"But if you don't have the money to hire someone who has much training to operate your system, and if you're relying on someone who basically volunteers to do the work, it's basically a situation of where people are doing the best with what they have."
Roger Adams, principal of the Hooper Bay school, said: "Sometimes I have trouble understanding how, in 1992, you can have a community of nearly 1,000 people that doesn't have something that's considered perfectly normal anywhere else in the country.
"Think about it it's hard to find a community anywhere today that doesn't have running water . Out here, it's common. It's unusual to have it.
"When you think about it, to me, it's an outrage. I mean, people aren't out here on a camping trip. They live here. We've got 1,000 people in this town and we crap in a bucket. Really, there's no damn excuse for it.
"If we can put a man on the moon, then jeez, we ought to be able to solve this."