By George McGraw, originally posted on October 201, 2016

LOS ANGELES — Most Americans take safe water for granted: Turn the tap, and there it is. But recent protests against the Dakota Access pipeline on the Standing Rock Reservation in South Dakota are a reminder that some Americans still worry every day about having enough clean water to survive.

As events in Standing Rock and Flint, Mich., capture national attention, long-running water emergencies fester in near-total obscurity elsewhere across the country, many of them on native reservations.

Nearly 24,000 Native American and Alaska Native households somehow manage without access to running water or basic sanitation, according to 2015 figures from the Indian Health Service, living in what my organization calls “water poverty.” About 188,000 such households were in need of some form of water and sanitation facilities improvement.

Perhaps the worst case is on the sprawling Navajo reservation in the Southwest, home to about 170,000 people.

I found this out only inadvertently, though I run Digdeep, a nonprofit group focused on improving access to clean water in some of the places you might expect: South Sudan and Cameroon. But not in the United States.

In 2013, a woman called our office to make a sizable donation, with the stipulation that we spend it in the United States. I told her that her gift would be better spent in the developing world, but she was adamant that we use it on the Navajo reservation in New Mexico.

So I drove the 10 hours from my Los Angeles home to Thoreau, N.M., part of the Navajo Nation. The reservation is the country’s largest, covering parts of Utah, Arizona and New Mexico.

There, I was greeted by Darlene Arviso, a Navajo known as “the water lady.” I rode with her in a 3,500-gallon tank truck, and we delivered water free to 10 households across the arid high-desert plateau.

The first home we visited belonged to Lindsay Johnson. The house had no running water or electricity; a car battery powered the TV. Ms. Arviso took out a hose and everyone grabbed cups, bowls, buckets and barrels to store the water.

There’s not much water in the high desert — and much of what’s there is bad. Large parts of the reservation lack any water-supply equipment. The low population density makes building a water distribution system economically unfeasible. Tribal members rely on surface water and shallow aquifers, many of which have been poisoned by uranium mining.

Ms. Arviso explained that because of high demand for her service and the remoteness of the Johnson home, she is able to deliver only 400 gallons of water to the family each month. That amounts to less than three gallons of water per person, per day. (The typical American uses about 100.) The Johnsons use the same water to wash dishes and their hair, and finally pour what’s left into the toilet tank. They invariably run out of water before Ms. Arviso’s next visit.

Benjamin Lewis, a retired miner, lives 30 miles from the Johnsons. Before Ms. Arviso began delivering water, Mr. Lewis relied on a water trough meant for sheep that is supplied by a well pumped by a windmill. That water tested positive for uranium in 1976. More recent tests have been positive for nitrites. Some neighbors still use the sheep tank in emergencies.

While about 6 percent of American Indian and Alaska Natives live in water poverty, the problem is not confined to the reservations. About a half a million American households lack basic plumbing amenities like hot water, a tap or toilet, according to the Census Bureau. As in Flint, they are disproportionately poor and minority.

In the Coachella Valley, southeast of Los Angeles, for instance, low-income and undocumented farm workers living in trailer parks endure open sewage ditches and contaminated drinking water.

I visited one of the worst of these parks, Duroville, before a federal court closed it in 2013. More than 4,000 people lived in a park built for 500. Tenants complained that they were forced to pay their landlord up to 30 percent of their income for delivery of drinking water that made them sick. While most of these families have been resettled, similar conditions persist in the nearby localities of Thermal and Mecca.

Pockets of water poverty exist in nearly every state, particularly in rural Appalachia and New England, and in the “colonias” along the border with Mexico.

These conditions shouldn’t persist. Even relatively inexpensive and simple solutions can have a profound impact.

In Thoreau, we optimized Ms. Arviso’s delivery route, outfitted a second water truck and hired a new driver, doubling the delivery capacity for only $64,000. Last winter, we began installing cisterns and electric pumps for 204 homes; when the project is finished, hot water will flow from taps and showers at a cost of less than $4,000 per household. This spring, we will break ground on a 1,500-foot-deep well close to the Johnsons’ house, expanding water delivery to more homes.

Ending water poverty in the United States will require a concerted effort. Nonprofits can play an important role by working with communities to develop low-tech, low-cost solutions. These programs should be managed with the communities to ensure they are sustainable. Federal and state government should focus on water-supply and sanitation projects with the goal of making these local programs unnecessary someday.

With dedication and money, water poverty on the Navajo Nation could be eradicated within a decade. That would be a powerful start.