CAHOKIA HEIGHTS, Illinois — For most people, a glass of water and a rainy day are harmless, even comforting. For Earlie Fuse, they are a haunting reminder.
When the forecast calls for storms in southern Illinois, he knows to brace for the possibility that his block will turn into a lake again, cutting him off from the road and swallowing the basement he has rebuilt over and over.
The first time the water came for his house in 1993, he remembers opening the back door before dawn, lunch packed for his early morning shift at an auto garage, and stepping into a brown sheet of water that reached his car’s windows.
He was already in his 50s then; in his 60s, he would realize that water seeping into his home was full of sewage.
At 85, he has watched that same flood creep back again and again, chewing through five basement walls, seven hot water tanks, five furnaces, and the bathroom tiles and tub that threatened to sink through soggy floorboards.
“I’m the first one that gets flooded out and the last one for the water to leave,” he said, standing on his mold-stained floors while looking down at his flooded basement the night after a short rain storm in April. “At this point I’ve stopped trying to repair things.”
In Cahokia Heights, where the average person makes about $20,000 annually and the typical home is worth less than $45,000, Fuse estimates he has spent nearly $200,000 on repairs since the first flood.
When he turns on the tap, the murky stream looks eerily similar to the water pooling around him. Recent tests showed remnants of sewage and human waste flowed through his tap. Plastic water bottles have become his most constant companion.
“The city and county has always known, but as far as they were concerned, until we got an attorney and did all this, we didn’t matter,” Fuse said about his community, which is over 70% Black. St. Clair County, where the town is located, is 60% white.
The Illinois EPA has documented hazardous sewage contamination in the area since at least 1989.
Now, as federal agencies closed out funding orders for the town this year and the Trump administration cut programs that were supposed to steer Clean Water Act money to places like this, the prospect of change feels out of reach for some residents.
From Cahokia Heights to the Black Belt of Alabama and the back roads of Mississippi, Black communities are being asked not only to live with sewage and unsafe water, but to sacrifice their mental and physical health proving it.
“When it affects the white people, you get some action,” Fuse said. “But when it is Black people, it’s like we don’t exist.”
When proof isn’t enough to get safe water
Yvette Lyles said the hardest part is knowing the crisis is real and still feeling like no one in power believes her. The lack of concern is written not just in ruined basements but in residents’ bodies. After years of hospital visits connected to a bacterial infection, Lyles said the pain is now psychological: “It’s very disheartening … it’s like a slap in the face.”
To get anyone to believe what they were living through, Cahokia Heights residents had to turn themselves into scientists and investigators: logging every flood that turned their streets into “little rivers,” organizing seven months of water sampling in their own kitchens mimicking the federal testing process, and partnering with experts from Washington University in St. Louis and scientists who helped uncover the Flint Water Crisis to confirm E. coli and low chlorine in their tap water.
When the community brought that evidence forward earlier this year, Illinois American Water, the area’s drinking water provider, questioned the testing protocol and insisted the water met “standards.” The Illinois Environmental Protection Agency pushed for its own testing using different metrics.
People here describe the dread that comes with every drop of rain, the shame of constantly throwing out water‑logged belongings and not being able to afford to replace them, and the constant calculation of whether it’s safe to let a child drink from the tap.
“It feels like a waste to keep putting money into our homes and lives like that,” Fuse said, who stopped trying to repair his home about a decade ago. It is a level of vigilance that public health experts connect to “weathering,” the way chronic stress from racism and neglect ages Black bodies before their time.
Fuse is lucky to have made it to 85. The life expectancy in the place he calls home is just 68 years old, which is more than a decade lower than the U.S. life expectancy of 79 years old.
Public health researcher Camara Phyllis Jones describes racism not as “an individual character flaw or a personal moral failing” but as “a system of power that structures opportunity and assigns value based on how we look.” That system, she argues, “unfairly disadvantages some communities, unfairly advantages other communities, and saps the strength of the whole society through the waste of human resources.”
In Cahokia Heights, that is measured in sewage‑soaked basements and an expectation that most people there won’t live that long.
It is why physicians “can’t just tell patients to eat better,” she said. You “have to understand where they live and … the context of their social determinants of health.”
Cahokia Heights’ sewage crisis began with decades of neglected, aging sewer infrastructure that allowed raw sewage to routinely overflow into streets, yards, and homes after heavy rains because the pipes were not being maintained properly. Those same failures in the sanitary and stormwater systems meant sewage‑laden floodwater began to infiltrate cracked and poorly maintained pipes and mains. This allows bacteria like E. coli and H. pylori to travel through the distribution system and emerge at kitchen taps.
Lyles, 67, has been diagnosed with a bacterial infection from H. pylori as many as five times in the 32 years she has lived in her Cahokia Heights home. H. pylori spreads through contact with feces in food or water and infects the stomach. Research has linked long-term H. pylori infection to a higher risk of developing gastrointestinal cancer.
She is one of 80 households in Cahokia Heights that depends on donated bottled water through ongoing community water drives organized by Equity Legal Services, the law firm that has helped spearhead bringing the crisis to state and national levels.
There is an ongoing health study in the community focused on tracking H. pylori infections and intestinal inflammation, but a 2022 and 2023 health study found that 30 residents out of about 50 tested had active H. pylori infections.
Lyles has had surgery because of an infection from the bacteria.
“You can’t do citizens like this,” she said. “You cannot deprive them of what’s needed — safe water. You cannot lay back and watch us get sick and die.”
After the community-led test results found fecal bacteria in homes’ taps, Illinois American Water said it was “aware of recent media reporting that suggests contaminants may have been found by Cahokia Heights customers in their drinking water supply through informal testing.” The company said it “follows approved regulatory protocols to sample and test” water and the water “meets or surpasses all bacterial water quality standards.”
Residents took offense to the framing that their testing protocol supported by former federal water workers was “informal” and inaccurate.
Standing with the support of her walker, Lyles described to Capital B how she and her neighbors spent seven months carefully collecting water samples, following what they were told was the federal protocol: “There were no errors in the way our water was collected, and the way it was processed and sent out to the labs. And then double checked.”
That dismissal has seeped into her body as much as any contaminant, Lyles said. The years of neglect and “laid back actions” from officials while residents begged for help has left people too afraid of retaliation to speak openly about what’s happening in their homes. “Some people are scared to come up and speak because they don’t want to feel the retaliation or get the pushback of speaking out about what’s going on,” she said. The fear, anger, and exhaustion live alongside her medical charts, shaping how she sleeps and who and how she trusts the people around her.
“The body and the water pipes are intertwined,” she said. Neglect one and the other will eventually fail.
By now, she has stopped expecting Illinois American Water “to do right” or expecting compassion from City Hall.
“Personally, I don’t trust Illinois American Water. I don’t trust the EPA and I definitely don’t trust our local politicians,” Lyles said. “Would you trust them if your water was brown and making you sick?”
ABOVE: A flooded street in Cahokia Heights, Illinois. BELOW: A home in Cahokia Heights. (Adam Mahoney/Capital B)
Scottez Clark, a 26-year-old fighting to remain in the community, said the water situation reinforces a way of thinking that has long infiltrated the psyche of folks in the town: “They don’t care about the people here.”
His whole life he has watched people “abandon” the community. One out of four residents have left the area since 2000. “They are showing us that they don’t want us here,” he said.
In a way, this reality was designed into the town. Cahokia Heights was built on low-lying, marshy ground, then stitched together from several small, under-resourced towns without ever upgrading the infrastructure needed to protect it from its predisposition. The sewer and stormwater systems were laid out with too few lines and too low of a capacity as intense rainfall in the area has increased by 25% since 1970.
Every heavy rain exposes the same flaw: There is nowhere for the water and waste to go except into people’s streets, basements, and now their taps.
Clark said he understands the impacts of climate change, but Cahokia Heights residents “deserve a fighting chance to stay” and young people should be “shown that people care about them making it.”
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