•  Carrier


Grassroots Public Health

From the nation’s capital to the Canadian border and Alaska villages, U.S. Public Health Service engineers are advancing health and safety through research and development, sanitation facilities and water and utility system construction, pollution prevention and environmental stewardship.


By Rear Adm. Randall J.F. Gardner, P.E., USPHS 


 (Left) Water tank construction on the Navajo Reservation, Junction Overlook, Ariz.

Water tank construction on the Navajo Reservation, Junction Overlook, Ariz. PHOTOS COURTESY INDIAN HEALTH SERVICE

America’s Surgeon General, Vice Adm. Vivek Murthy, USPHS, is committed to improving the public’s health, which stretches to the basic needs for infrastruc­ture in this country and around the world.

Engineer officers in the Commissioned Corps specialize in traditional chemical, electrical, mechanical and civil engineering disciplines as well as emerging biomedi­cal, computer and environmental fields. U.S. Public Health Service engineers play key roles in the efforts to accomplish the service’s mission “to protect, promote, and advance the nation’s health and safety.”

These engineers design, construct and provide technical assistance to local opera­tors of water supply and waste disposal systems serving Native American homes and communities. Others manage a wide array of facility design, constructions, renovation, operation and maintenance activities in Indian Country and at Public Health Service research and laboratory facilities and public health centers.

Some of our engineers protect the public’s health by testing biomedical devices for safety and efficacy, including artificial heart valves, implants and joint replace­ment devices, as well as various sources of ionizing and non-ionizing radiation, such as television sets and microwave ovens.

Many people are touched by work we do to improve workplace safety through iden­tifying and quantifying levels of exposure to hazardous materials and designing means to minimize or eliminate those hazards. Commissioned Corps engineers also work with other health scientists to develop state-of-the-art biomedical instrumentation and information processing systems for use in advanced medical research.

Commissioned Corps engineers primar­ily serve throughout the Department of Health and Human Services with the National Institutes of Health, Centers for Disease Control and Prevention, Food and Drug Administration, and the Indian Health Service.

Others are detailed to the U.S. Environmental Protection Agency, National Park Service, Department of Homeland Security and Department of Defense.



The foresight nearly 60 years ago of Tribal Leaders, the Public Health Service and Congress has helped a generation of American Indian and Alaska Native (AI/AN) children to escape the hardship and poor health that accompany life without a safe and adequate water supply. Today, most elderly Indian people on reservations need not fear becoming unable to carry water into their homes. A major step toward addressing this deficiency was enacted on July 31, 1959, when President Eisenhower signed Public Law 86-121, which created the Indian Health Service (IHS) Sanitation Facilities Construction Program.

The law gives the Sanitation Facilities Construction Program the authority for providing water supply, sewage and solid waste disposal facilities for AI/AN communities. Efforts by other public health specialists such as nutritionists and nurses are much more effective when safe water and adequate wastewater disposal systems are available in the home. In addition, the availability of such facilities is of funda­mental importance to social and economic development, which leads to an improved quality of life and sense of well-being.

IHS is responsible for providing federal health services to AI/AN communities. The agency is the principal federal health care provider and health advocate for Indian people and its goal is to raise their health status to the highest possible level. IHS provides a comprehensive health service delivery system for approximately 1.9 million AI/AN people who belong to 562 federally recognized tribes in 35 states.

The Sanitation Facilities Construction Program is the environmental engineer­ing component of the IHS health delivery system. The program provides technical and financial assistance to AI/AN tribes and communities for the cooperative devel­opment and continuing operation of safe water, wastewater and solid waste systems, and related support facilities.

This past year, Capt. Mark Calkins, USPHS, became Director of the Division of Sanitation Facilities Construction in the Office of Environmental Health and Engineering, where most Commissioned Corps engineers are assigned. In partner­ship with the tribes, the Sanitation Facilities Construction Program provides a range of services and support. 

  • Develops and maintains an inventory of sanitation deficiencies in AI/AN communities.
  • Provides environmental engineering assistance with utility planning and sanitary surveys.
  • Coordinates multi-agency funded sanitation projects and assists with grant applications to leverage IHS funds.
  • Allocates funds appropriated for water supply and waste disposal facilities;
  • Provides professional engineering, design and construction services for water supply and waste disposal facilities.
  • Provides technical consultation and training to improve the operation and maintenance of tribally owned water supply and waste disposal systems.
  • Advocates for tribes during the devel­opment of policies, regulations and programs;
  • Assists tribes during sanitation facilities emergencies.


A new micro wind farm, including three wind turbines with a rated output of 2.4-kW each, will help moderate energy costs for local residents in Goodnews Bay, Alaska.

A new micro wind farm, including three wind turbines with a rated output of 2.4-kW each, will help moderate energy costs for local residents in Goodnews Bay, Alaska.



Congress requires IHS to identify the universe of sanitation facilities needs for existing AI/AN homes by documenting deficiencies and then proposing projects to address those needs. These projects include providing new and existing homes with first-time services like water wells and onsite wastewater systems or connecting homes to community water and wastewater facilities. The universe of need also includes projects to upgrade existing water supply and waste disposal facilities and projects to improve sanitation facilities operation and maintenance capabilities in Indian country.

As of December 2014, the list of all projects to correct documented sanitation deficiencies totaled approximately $3.4 billion. IHS estimates that almost 53,200 AI/AN homes, or almost 13 percent, are without access to safe water or adequate wastewater disposal. This is a significant concern given the proclivity of waterborne illness and other health-related issues as a result of unsafe drinking water.



The FY2016 budget request proposes an increase of about $180 million over last year’s $468 million for IHS facilities to support construction projects and other work across Indian Country. The FY2016 IHS facilities budget allocation includes $185 million for Health Care Facilities Construction, $115 million for Sanitation Facilities Construction, $227 million for Facilities and Environmental Health Support, $98 million for IHS’ Maintenance and Improvement Program, and $24 million for Medical Equipment.

The requested buildings and facilities allocations for the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration are in line with the enacted FY2015 amounts of $129 million, $10 million and $9 million, respectively. These collective investments will help us continue to improve the health and well-being of AI/AN communities and others around the world as we, serving “on the land and the sea for humanity,” strive for greater health and safety for all.



Rear Adm. Randall J.F. Gardner, P.E., USPHS, is Chief Engineer Officer, U.S. Public Health Service. He can be reached through Lt. Diana Wong, Ph.D., USPHS, at This email address is being protected from spambots. You need JavaScript enabled to view it..