title: The search for an alternative to piped water and sewer systems in the Alaskan Arctic.
abstract: Forty-two communities in rural Alaska are considered unserved or underserved with water and sewer infrastructure. Many challenges exist to provide centralized piped water and sewer infrastructure to the homes, and they are exacerbated by decreasing capital funding. Unserved communities in rural Alaska experience higher rates of disease, supporting the recommendation that sanitation infrastructure should be provided. Organizations are pursuing alternative solutions to conventional piped water and sewer in order to maximize water use and reuse for public health. This paper reviews initiatives led by the State of Alaska, the Alaska Native Tribal Health Consortium, and the Yukon Kuskokwim Health Corporation to identify and develop potential long-term solutions appropriate and acceptable to rural communities. Future developments will likely evolve based on the lessons learned from the initiatives. Recommendations include Alaska-specific research needs, increased end-user participation in the design process, and integrated monitoring, evaluation, and information dissemination in future efforts.
authors.affiliation: Alaska Native Tribal Health Consortium, 4500 Diplomacy Drive, Anchorage, AK, 99508, USA. khickel@anthc.org.
authors.forename: Korie A
authors.initials: KA
authors.lastname: Hickel
authors.affiliation: Civil Engineering Department, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 99508, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Dotson
authors.affiliation: Alaska Native Tribal Health Consortium, 4500 Diplomacy Drive, Anchorage, AK, 99508, USA.
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Thomas
authors.affiliation: Alaska Native Tribal Health Consortium, 4500 Diplomacy Drive, Anchorage, AK, 99508, USA.
authors.forename: Mia
authors.initials: M
authors.lastname: Heavener
authors.affiliation: Cold Climate Housing Research Center, 1000 Fairbanks Street, Fairbanks, AK, 99709, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Hébert
authors.affiliation: Alaska Native Tribal Health Consortium, 4500 Diplomacy Drive, Anchorage, AK, 99508, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Warren
mesh_terms: D000413:Alaska; D060766:Drinking Water; D005191:Family Characteristics; D006801:Humans; D011634:Public Health; D059027:Recycling / Q000639:trends; D012424:Rural Population; D012499:Sanitation; D012722:Sewage; D014865:Waste Disposal, Fluid / Q000295:instrumentation / Q000379:methods*; D060753:Water Quality; D014881:Water Supply / Q000191:economics / Q000379:methods
chemical_list: D060766:Drinking Water; D012722:Sewage
keywords: Alaska; Infrastructure; Rural; Sanitation; Underserved; Water