This article focuses on women’s grassroots organisations and their role in confronting waste-induced water, health, and development challenges in low-lying tropical coastal areas. As a case study, the article will focus on women’s waste management and plastics recycling organisations in Yucatán, Mexico and their role in preventing water-borne diseases and educating the community on the links between garbage and human health. Women educate the community on the links between garbage and human health; challenge exclusionary gender norms by increasing women’s participation in community sustainable development, and improve urban conditions in the coastal wetlands. I draw from over 400 surveys with coastal residents and 14 oral histories with coastal women, to underscore the muddy links that connect sanitation to gendered responsibility and the exclusionary spaces of urban development and ecological restoration in the swamps. The information shared through the histories and broad surveys emphasises how gendered roles and expectations are critical variables in shaping social difference, ecological degradation, and human health in low-lying coastal areas and cities.