In a large soup pot or dutch oven, heat olive oil over medium high heat. Add onions and saute for 1 minute. Add garlic and saute until fragrant (about 30 seconds).
Add ½ cup of the water and turkey sausage. Cook while crumbling turkey sausage until sausage is browned, no longer pink, and fully cooked (about 4 to 5 minutes).
Add all remaining ingredients except spinach and stir to combine (don't forget the remaining water). Bring to a gentle boil and reduce heat to maintain a simmer. Cover and simmer for 1 hour, or until carrots are tender and rice is cooked.
Add spinach and stir to combine. Cook for an additional 2 to 3 minutes, or until spinach is wilted.