BarbiAnn Maynard tossed a thick stack of blue papers, years of her water bills, on the table. One side of each water bill showed what she owed. On the other side were notices of drinking water violations—high levels of carcinogenic chemicals—found in Martin County, Kentucky's water supply. By the time she received them in the mail, the toxins had been in the water for months.

Pointing at the fine print, which warned of heightened risk for the elderly, infants, pregnant people, and those with compromised immune systems, she rattled off names of people she knew who "had cancer, broke out in rashes, or got sick" after drinking or bathing in the water.

Maynard sighed, reading aloud one of the final lines about the chemical violations: "There is nothing you need to do."

This lack of information was the main reason Maynard and more than a dozen other Martin County residents showed up to a water board meeting in Inez, the county seat, on a foggy early morning in February. They wanted to ask the board what needed to happen to get clean, reliable, affordable drinking water—something they haven't had for as long as most of them can remember.

"People don't trust the water, they don't trust the people managing it," said Nina McCoy, a retired biology teacher who started the Martin County Concerned Citizens group to address the water issues, and has traveled to nearly every meeting about Martin County's water system for the past year. "They don't even know why anymore, it has gone on for so long."

One of the creeks that runs through downtown Inez. The city—as well as Martin County—has long had problems with water quality and water infrastructure. Photo by Lyndsey Gilpin.

Martin County loses most of its water before it even reaches faucets, mostly because of leaky, aging pipes and tanks. In 2016, the county lost 64 percent—more than four times higher than the state standard of 15 percent. Residents say the water that does reach customers is often discolored, smelly, or causes skin irritations and gastrointestinal problems.

The water district is more than $800,000 in debt, a problem it primarily blames on declining demand for the services and unpaid water bills. At the February water board meeting, chairman John Horn announced Martin County Water District business manager Joe Hammond's retirement. It remains unclear who will take his place. The board, which is appointed by the county judge, completely turned over late last year and now has eight new members. They recently asked Kentucky's Public Service Commission for an emergency rate increase of 49.6 percent to stay afloat—a hike that people in these low-income Appalachian communities can't afford. In early March, the commission decided on a rate increase that will raise the average monthly bill by 28 percent, or about $11.

To make matters more difficult, a harsh cold snap that blew through the Southeast in January was too much for the system to handle, causing pumps and pipes to freeze. The district shut off about a third of the 3,000 or so customers' water for days, informing them via Facebook that it was because of "high water usage, busted meters, etc." Currently, the county is relying on rainwater to fill reservoir because the pumps that supply water from the river still haven't been repaired.

As of February, the water was flowing again and the district announced it had been back in compliance with Clean Water Act standards for half a year, but McCoy and her group, represented by the nonprofit Appalachian Citizens Law Center, are mounting pressure on state and local officials to complete an investigation of the water district, hold the district accountable, and come up with a solution that is more permanent than just patching up pipes.

"I'm really going for the gold: if we can just supply our citizens with drinking water and it meets the standards, and we don't lose more than 15 percent of our water" McCoy said. "The citizens have to get together. We know what's happening to us."

Stacks of BarbiAnn Maynard's water bills from the last two years, which warn of water contamination from carcinogenic chemicals. Photo by Lyndsey Gilpin.

Nina McCoy's husband, Mickey, runs a restaurant called "Metrobilly's" —named for what he calls hillbillies who can make it in the big city—that's located in a quiet house down a narrow back road in Inez. With its local art, incense, and liberal signs plastered all over the walls, it has become somewhat of a meeting place for Appalachians working on progressive issues, whether their cause is water infrastructure, mountaintop removal mining, or local politics.

Metrobilly's stands in stark contrast with most of Martin County, a conservative Appalachian region tucked near the West Virginia border. A sprawling place, it's home to about 12,000 people, nearly 92 percent of them white. About 40 percent live in poverty, and the unemployment rate is around 8 percent, according to the most recent U.S. Census data. The coal industry has been declining for the last decade, with mining employing less than 200 people as of late 2017.

"People are so dogged down, they say, 'that's just the way it is in Martin County," Nina, who wears thin glasses and her blonde hair high in a ponytail, said over coffee after the water board meeting. "Our worst enemies are the people who leave here and then look at us and say 'that's what you get for living there.'"

Mickey, a retired English teacher with a salt and pepper beard and a hoop earring in one ear, was born and raised in Inez. Growing up, before he left town to attend college in Lexington, he said he was always running up and down the nearby hollers, swimming in the creeks and the Tug Fork River. "I never thought bad about drinking the water, or swimming or eating fish out of the creek," he said.

But everything changed on October 11, 2000, when the bottom of a coal sludge impoundment in the county, owned by Massey Energy, broke into an abandoned mine shaft below, launching more than 300 million gallons of thick, black coal waste down tributaries of the Tug Fork River just upstream of Inez. The water supply was contaminated by heavy metals, and aquatic life within dozens of miles suffocated.

Martin County loses most of its water before it even reaches faucets, mostly because of leaky, aging pipes and tanks. In 2016, the county lost 64 percent—more than four times higher than the state standard of 15 percent. Residents say the water that does reach customers is often discolored, smelly, or causes skin irritations and gastrointestinal problems.

Massey Energy was only cited for one federal violation, and the company reported that it paid millions of dollars in cleanup, although contaminants are still found in the river 18 years later. The investigation of the spill by the Environmental Protection Agency under the Clinton and Bush administrations, which was criticized by a whistleblower and many Martin County residents for being ended prematurely, broke the town's trust of regulatory agencies, local officials—even each other.

"It woke me up to pay attention to what's going on here," Nina said. "They're not going to just fix this for these people."

That's when the McCoys stopped drinking the water. "We make coffee with [bottled] water, ice cubes with it, we cook soups with it," Mickey said.

The Martin County courthouse, located in Inez, Kentucky. Photo by Lyndsey Gilpin.

Meanwhile, the water district's troubles piled up. As the tanks and pumps aged, water often shut off at night to conserve for schools during the day; when the system turned back on, it flushed out brown water from organic matter that seeped in the leaky pipes. Some residents said the water is often yellow or milky white, depending on the day.

The chemicals the district have warned customers about on their bills are two disinfection byproducts created during the treatment process when chlorine mixes with organic matter, Trihalomethanes and Haloacetic acids. The county has been out of compliance with federal clean water standards for these chemicals on and off for nearly two decades, but water board chairman John Horn said the district was in compliance for the last two quarters of 2017.

The district adjusted where byproducts were added during the water treatment process to solve the problem, said Gary Larimore, executive director of the Kentucky Rural Water Association. Larimore and his technicians have been working with Martin County Water District and the Kentucky Division of Water to get the water quality back in compliance.

Meeting the standard took trial and error to figure out, he said, and the process is rendered more difficult because of all the stress on the aging water treatment plant and the pipes."We just looked at the treatment process and changed where we were feeding chlorine," Larimore said. "It was a fairly easy fix."

One of the other major concerns is people stealing water by purchasing "jumpers" or "cheater pipes" at local hardware stores and rigging a water line to bypass the meter. John Mills, manager of the Martin County Water District, said he has hardly any sense of how many people are doing this; stopping it would require visiting every meter and residence in the county, and making sure the district enforces the rules for everyone fairly. Doing that while fixing leaks is a tough task for a district that has five employees to cover 300 miles of main water lines and 300 more of service lines.

"We have to continually fight every day looking for leaks," Mills said in February. In 2016, the state launched the third investigation of Martin County's water since 2002. Afraid nothing would come of it yet again, Nina started the Martin County Concerned Citizens group, to get people more involved in the process. But she walks a fine line in a county that distrusts the EPA and went nearly 90 percent for Trump in 2016.

"We never mention environmental causes," she said. "That's a no-no. It's your drinking water."

Last year, lawyer Mary Cromer of the Appalachian Citizens Law Center noticed Nina's efforts and took on the case, accompanying Nina to Public Service Commission hearings in Frankfort every quarter to try to hold the state more accountable, and pushing for more transparency from the water board.

"There's such an important history with what happened after the slurry spill and the way the the community was treated," Cromer said. "They think [regulators] are out to protect the industry or water district or county officials. Getting involved is not something they would consider doing because of what had gone on before."

Currently, Cromer is gathering evidence about customers' bill increases through trips to Martin County and conversations via Martin County Water Warriors Facebook page—where most people communicate about the issue—as well as the district's water loss, and how to clean up the system. She said she's not sure how long this issue could drag on. "There's not an end point except to make sure they have reliable, safe water at a reasonable rate," she said.

The rate case will likely be decided within six months, but the investigation is open-ended. It's unclear how that will play out, Cromer said, but the ultimate possibility is the district files bankruptcy or is forced by the state to cease service. It could get to the point where disaster relief would be necessary, or wells would be dug—which may not be an option because of the county's long underground mining history.

"I learn as much as I can about Flint and other places where this has happened, but I haven't found some community that's faced this and has worked through it," Cromer said. "There are plenty of failing rural water systems that can't provide safe water to their customers. But I don't know of the template for how you fix this problem."

Mickey McCoy, an Inez native, in his restaurant, Metrobilly's. IMG_5208:Nina and Mickey McCoy, who travel frequently to raise awareness about Martin County's failing water system. Nina is the founder of the Martin County Concerned Citizens group. Photo by Lyndsey Gilpin.

Martin County's water issues can't be solved without a massive amount of capital, engineers and experts say. Larimore and the Kentucky Rural Water Association have been working with Martin County since 1979, and he says the district is struggling worse than any water district county in Kentucky, a state where the youngest water system is 50 years old. According to the American Society of Civil Engineers, small drinking water systems serve 8 percent of the U.S. population, but because they lack technology and engineering upgrades, they often fall short of federal standards.

"It's a struggle for a lot of systems, not only in Appalachia—no one likes to raise rates, just like no one likes to raise taxes, and it's particularly tough in a low-income community," Larimore said. "They can't afford it, but at the end of the day, they can't afford not to. This is what happens when you keep kicking that can down the road."

Still, many Martin County residents believe federal money will bail them out of the situation. President Trump has repeatedly said his $1.5 trillion infrastructure plan will address these types of problems, but his 2019 infrastructure budget proposal rounds out to about $200 billion, with about $50 billion in block grants for rural programs all across the U.S. Larimore said research shows fixing Martin County's water system would cost upwards of $10 million. But the proposed federal budget would actually reduce spending that's specifically earmarked for rural water system improvements.

"I learn as much as I can about Flint and other places where this has happened, but I haven't found some community that's faced this and has worked through it," Cromer said. "There are plenty of failing rural water systems that can't provide safe water to their customers. But I don't know of the template for how you fix this problem."

In lieu of federal funding, other potential options are for private companies to take over small utilities, or for utilities to regionalize or create cooperatives to pool their resources. When Larimore started his career, Kentucky had more than 2,000 public drinking water suppliers. Now, there are just over 400. Merging more water districts could unload the costs, but it could raise raises concerns about water quality and distribution.

"It doesn't matter what size it is," Larimore said. "You still need good governance and management."

Besides the rate increase proposal, the Martin County Water District plans to use about $1.2 million from Appalachian Regional Commission grants to replace water lines and meters, though the projects are restricted to a small area of the county. U.S. Representative Hal Rogers (R-KY) and Gov. Matt Bevin also recently promised $3.4 million in abandoned mine land funds to help alleviate the water crisis in Martin County. Bob Bowcock, an engineer and manager of Integrated Resource Management in California who's associated with Erin Brockovich, has been working on a 90-day action plan to study the county's problems and help officials fix infrastructure.

The problem is, money for state grants is often restricted and doesn't go as far as it should. That's where organizations like Mountain Association for Community Economic Development (MACED) come in. "We're looking at tax reform and how we can change policies at the state and sometimes at local level to benefit infrastructure changes," said Ivy Brashear, Appalachian Transition Coordinator for MACED.

As the coal industry continues to decline, she added, it creates more opportunities for new ideas, industries, and leaders. And the stereotypical narrative of Appalachia is "bundled up in these infrastructure questions," Brashear said. "We have to have a robust local infrastructure system as a part of this just economic transition, not as something ancillary to that."

Part of that means changing the image America and the rest of the world has about Appalachia, but a bigger part, Brashear, said, is changing how Appalachians think about themselves. Groups similar to Martin County Concerned Citizens are cropping up all over the region, she said.

"People are so dogged down, they say, 'that's just the way it is in Martin County," Nina, who wears thin glasses and her blonde hair high in a ponytail, said over coffee after the water board meeting. "Our worst enemies are the people who leave here and then look at us and say 'that's what you get for living there.'"

"It's about how we get local people to understand they have agency and power over what happens: how money is spent, where it's spent, who gets to control it," she said. "They can vote in elections, show up at board meetings, have a voice in these processes."

That's what the McCoys are trying to do, one meeting at a time. Cromer has applied to get the group two seats on the water board, and said she hopes that with so many people making noise, it could bring more money and shed light on rural water issues.

"It has to get better. It has to," Mickey said as he poured another round of coffee for Cromer and Nina before putting on a pot of soup for Metrobilly's two customers. "More people are standing up, and that's something that I haven't seen in a long time."

Lyndsey Gilpin is a freelance journalist based in her hometown of Louisville, Kentucky. She is the editor of Southerly, a weekly newsletter about ecology, justice and culture in the American South. Her work has appeared in The Washington Post, The Atlantic, High Country News, Vice, InsideClimate News, Harper’s, and more.