Small Town, Big Struggles

Creek in Millstone

Small Town, Big Struggles

Today we leave the big cities behind and ask: How does rural America manage its water infrastructure? After all, one in five U.S. households isn’t connected to a sewer system. We visit the rolling mountains of Letcher County, Kentucky. There, in the early 1900s, coal mining firms built company towns with little attention to long-term infrastructure. Decades later, local residents are dealing with the consequences. We hear from former coal miner Carroll Smith about his push in the 1990s to bring clean drinking water and safe wastewater disposal to communities across the county. And we learn where he ran into challenges.


  • Upmanu Lall, Director of the Columbia Water Center at Columbia University

  • Carroll Smith, former Judge Executive of Letcher County, Kentucky

  • Allan Tuggle, retired miner

  • Edna McBee, Millstone resident

  • Mark Lewis, General Manager, Letcher County Water and Sewer District

Photo: Britta Greene