Al Gore continued an environmental justice tour with a visit to poor areas of Alabama – and warned that already dire conditions are set to worsen because of climate change.

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The former vice-president met people in Hayneville, near Montgomery, and heard them describe dire sanitary conditions as open pools of sewage pockmarked their lawns after a night of heavy rain.

Later Gore told a town hall gathering that he found the conditions “shocking and tragic”. It’s all connected to the climate crisis, he told the 100-plus crowd crowd, referencing “rain bombs” from the ever-growing number of annual hurricanes hitting the south-east.

Gore visited with civil rights campaigner the Rev William Barber, and Catherine Flowers, the director and founder of Alabama Center for Rural Enterprise. Gore drew connections between poverty, ecological devastation and systemic social inequality.

Lowndes county’s open-piping sewage – and its long-term effect residents’ health – has been documented by reports from the United Nations and studies on tropical diseases which show that some illnesses such as hookworm are making a comeback in areas where it was once thought eradicated.

“This looks like the civil rights movement never took,” Barber said, staring down at the patchwork of sewage at his feet and walking around the brown liquid taking up much of the street. The area feet away from this neighborhood, Barber said, made up the route of the march Martin Luther King took from Selma to Montgomery in the 1960s.

There is very little sewage infrastructure in Lowndes county, Flowers told the Guardian, echoing similar sentiments from 2017 when she estimated 80% of the county remained uncovered by a municipal sewerage system, leaving some residents to find their own solutions.

“The problems that are visible [in Hayneville] and the solutions that would work here are integrally connected to the problems that are being seen in the world right now, and the solutions that would work right now,” Gore said, explaining why he chose to visit.

Facebook Twitter Pinterest Charlie May Holcombe, 70, sits at the top of her driveway. Photograph: Khushbu Shah

Jerome Means, a 63-year-old African American resident showed Gore the sewage running into his yard and home. Behind his one-storey brick home is a sewage lagoon, a pond full of raw, brown liquid. Gore asked him how many times it had to be pumped.

“Three times a week!” Gore shouted in disbelief when he heard the answer, his voice rising. On top of that, Means, a retired city employee who has lived in Hayneville for 20 years, pays a “sewage fee” to avoid such overflows.

“The problem is that, in these communities, they’ve applied these cheap fixes that don’t work,” Flowers said. “And with climate change it has only gotten worse.”

A sewage truck comes by every three days to pump out the mess, Meanes explained. “If not, it would fill out the yard.” As if on cue, a few minutes later, a sewage truck came by and its driver greeted Means by name.

Across the street, 70-year-old Charlie May Holcombe keeps her great-grandchildren away from their outdoor swing set as sewage covers its base. She can’t remember the last time the children were able to play outside the home. And they’re not even safe from sewage inside the house.

“I’ve replaced the carpet more times than I can count,” Holcombe, a great-grandmother, said as she sat the top of her driveway, just feet away from the sewage line. Her great-grandchildren ran toward the chain-link fence, trying to play in the brown liquid, but Holcombe shooed them away.

“Nobody cares about us,” she told Barber and Gore. Both men each took a hand and listened as she cried. “We’re going to try to get help,” Gore said.

“Almost every person is dying from cancer, asthma, heart trouble. I tell you something is wrong. All of us are suffering from the same thing,” Holcombe said. “Why is nobody researching it?” she kept asking. Holcombe has congenital heart disease.

Gore said the area needed a systemic solution – not emergency stop-gaps like sewage trucks.

“The cost of sending that truck out there three days a week instead of treating the asthma, cancer and other diseases that doctors suspect are so strongly related to these conditions … you add up all those costs, just on sheer economic ground alone, it would make sense to fix this and extend the sewage treatment infrastructure out there,” he said.

Before Means goes back into his house, he told the Guardian he was leaving his home in Hayneville but was unsure where he will go. He said he was tired of the constant struggle with sewage, the stench, the frustration.

Though Means had not told Gore he was leaving, Gore alluded to Means’ plight later in the day. “Maybe we need to treat them as environmental refugees,” he said.