According to The New York Times, statistics from the Census Bureau show that about half a million households in the U.S. don’t have hot and cold running water, a bathtub or shower, or an operating flush toilet — a problem that disproportionately affects the rural poor.

The Times article highlights Dorothy Rudolph and other residents of Lowndes County, Alabama, where public infrastructure and other factors make it very difficult to get plumbing up and running.

Indeed, having a septic tank put in would cost about $6,000, which is more than half of Rudolph’s family income. Other plumbing problems, like minor leaks, which account for 100,000 gallons of water waste a year, could be detrimental to poorer households.

In lieu of a formal count of residents in Lowndes, a survey by Kevin White, an environmental engineering professor at the University of South Alabama, was cited. The survey took place in a neighboring country, and found that 35% of homes have failing septic systems. An additional 15% had no plumbing at all.

Another problem in this area is the quality of the clay soil, which doesn’t allow for good drainage. “Rural wastewater is usually managed with a septic tank and a drain field, which slowly infiltrates the wastewater into the ground,” Professor White said. “Well, it won’t go into the ground here. Period.”

White noted that “There are some options that may be available, but it’s going to cost thousands of dollars, and most people here can’t afford it. The answer, quite frankly, is not out there yet.”

In the meantime, at least something is happening in some of the areas with the worst lack of plumbing. The town of White Hall received funding to connect dozens of homes to sewer lines — and residents and officials in the area continue to push for their rights to access to proper plumbing and sanitation.