What the Eyes Don't See_A Story of Crisis, Resistance, and Hope in an American City

by Mona Hanna-Attisha

  Filters were prioritized for pregnant moms, formula-fed babies, and zip codes where the water was known to be the most toxic.

  We worried about long wait lines. We worried about running out. We even worried about riots. Flint residents were rightfully angry.

  But the lines moved quickly, peacefully. The filters were distributed. It was happening, finally happening. At the time, I thought it might be the most we could hope for.

  I sent Jenny a text.

  ME: Jenny, we did it. Kids are going to be protected.

  SO MANY OF THE THINGS WE found out later were troubling.

  Exchanges between state officials in 2015, released through FOIA, many of them Marc’s requests, show how they defended their flawed science. In shockingly flip and derisive language, they spent so much time creating extensive “talking points” to explain why they were right and everybody else was wrong. They made no attempts to get to the bottom of anything; their only goal was to recast and massage their lies.

  We found out later that in January 2015 state officials, while telling Flint residents that their water was safe to drink, were arranging for water coolers to be delivered to the Flint State Office Building so state employees wouldn’t have to drink from the tap.

  We found out later that as early as March 2015, the governor’s office was exploring the distribution of water filters in Flint. Later it finally worked with two companies to donate to the Concerned Pastors for Social Action, which began handing out filters on September 1. At that time the state was still officially denying the water problems to the media, to outraged citizens, and to me.

  We found out later that the city, controlled by the state, had deliberately manipulated the water samples from Flint homes so they wouldn’t have to notify the public about the presence of lead, per the federal rules. To ensure a low percentage, they collected samples in such a way that caused less lead to be detected: they pre-flushed, removed faucet aerators, used smaller bottle mouths, and tested in homes without lead service lines or lead pipes. When high-lead samples came back, they were thrown out, including those from LeeAnne Walters’s home.

  We found out later that after Miguel Del Toral’s testing at LeeAnne’s home in April 2015 found hazardous-waste levels of lead in the water—and after he raised the alarm to his agency, the EPA, and MDEQ—he was dismissed and discredited and criticized for involving himself in matters that didn’t concern him.

  The EPA would eventually conclude that MDEQ should have supervised optimized corrosion control as soon as Flint switched to Flint River water. This was the critical failure. But instead MDEQ, once alerted, hunkered down to dismiss the problem and lie about it. The drinking water office at MDEQ seemed determined to approve permits above all else, not to evaluate the science and public health implications.

  No one really knows why corrosion control wasn’t added to the water—it would have cost only eighty dollars a day. Or why the pump to deliver corrosion control was never installed, or why so many other shortcuts were made and so many people were ignored who tried to raise red flags.

  But we do know that in July 2015, an MDHHS analysis showed that blood-lead levels had spiked in the summer of 2014. Having missed it for a whole year, the MDHHS had an analysis done—with real science and fancy stats and fancy graphs—and then promptly dismissed and covered it up. This is the spike Karen Lishinski had inadvertently revealed to me—the results that were never shared with me when I asked for them.

  When our work challenged the department to take action, Wesley Priem, a manager of the MDHHS Healthy Homes Section, responded by writing to a department colleague: “Yes, the issue is moving…at the speed of rushing water….This is being driven by a little science and a lot of politics.”

  We found out later from the emails that as early as December 2014, red flags were being raised about a strange escalation in cases of Legionnaires’ disease, a severe, often lethal lung infection caused by waterborne bacteria sometimes found in water towers of hospitals, hotels, and large institutions. The number of Legionnaires’ cases quadrupled after the water switch—also related to the lack of corrosion control—yet nothing was done. Two top staff in the governor’s office were notified as early as March 2015 and recommended action, yet no action was taken and the issue didn’t become public for another nine months. The county health department, which also knew about the increase in cases, did not bother to alert providers or the public to be on the watch for Legionnaires’. This led to eighty-seven cases in 2014 and 2015, at least twelve deaths, and an uptick in pneumonia mortality.

  Again and again, the state and federal officials’ disdain for Flint was shocking.

  At the EPA, when asked about using federal money to buy water filters for city residents, the Region 5 Water Division chief, Debbie Baltazar, wrote to the regional administrator and others, “I’m not so sure Flint is the community we want to go out on a limb for.”

  The pointed cruelty. The arrogance and inhumanity.

  Sometimes it is called racism. Sometimes it is called callousness. And sometimes—when the Legionnaires’ disease outbreak that left at least twelve people dead was tied to the water switch, something the bureaucrats knew about for a full year—it can be called manslaughter.

  * * *

  —

  THE NEXT BATTLE WAS the “impossible” one: getting the water source switched back to Detroit. Every time we raised it, we were totally shut down. Everybody said it was impossible. Never going to happen, never. It wasn’t just about money, they said; it was about engineering and ownership of the pipes, legal liability, and forget it, never going to happen. But we weren’t going to give up. They had lied about so much already. They could be lying about the water switch too.

  So we hunkered down for a long fight.

  Distributing filters and bottled water was not enough. Government had to provide a long-term solution. People cannot live on filters and bottled water forever.

  The excuses we were given—that the pipe was already sold, that it was too expensive—turned out to be paper tigers.

  The media grew more vigilant and critical—specifically the Detroit Free Press, which in October 2015 called the water crisis an “obscene failure of government.” Flint residents and activists said far worse and were finally heard. Everybody now knew there was something wrong with the water—and specifically what was wrong. Flint residents got even more angry, organized, and mobilized, especially since the harm was focused on young children.

  The activists held bigger and bigger demonstrations, where Jesse Jackson and Michael Moore made appearances. Residents channeled their anger into bottled water distribution and into Karen Weaver’s campaign for mayor; the election was just a couple of weeks away, on November 3.

  The Charles Stewart Mott Foundation’s new president, Ridgway White, knew me—we had worked together for the past year building our new clinic atop the Flint Farmers’ Market. As soon as he saw the findings of my research, he called the governor and pushed him to switch Flint’s water source back to Detroit water. He even offered the assistance of the foundation, a private grant-making organization with $2.7 billion in assets.

  Shortly afterward Natasha Henderson and Howard Croft hosted a heated technical advisory committee meeting, where two good scientists from the EPA, Darren Lytle and Mike Schock, colleagues of Miguel’s, recommended the switch back. But the decision had already been made.

  I was with Allison in the clinic on October 8 when Governor Snyder announced that the water would be switched back to Detroit. Allison was seeing patients, coming and going between exams. I was glued to the live event on a computer monitor. The “impossible” water switch was actually going to happen, maybe within a week, the governor said, and it would be accomplished with a combination of funds—city, state, and a generous $4 million donation from the Mott Foundation.

  Andy wrote to me and Marc: “There is no way t
hat this ever would have happened without the two of you, so thank you for all the lost sleep and incredible work you have done on behalf of Flint residents.”

  Melany wrote, “You should get a cape!”

  Marc wrote, “You are the woman of the hour.”

  I was numb, watching in foggy disbelief. Is this really happening? Exactly two weeks before, I had stood in the Hurley conference room, presented my study, then curled up in a ball on my bed while the governor and his henchmen made what seemed like a coordinated effort to destroy me. Now there he was, the head of our state, speaking in his businesslike way about the water switch and taking way too long to say it. His words blew over me like a rush of hot air. I tried to hear what he said and believe he cared. I tried to absorb the victory and feel rewarded. But there was nothing victorious about it.

  During the same press conference, another announcement followed: toxic levels of lead had been found in the water in three Flint schools. Immediately afterward, Eden Wells came forward and spoke for what felt like thirty minutes about all the usual sources of lead—paint, paint dust, and so on—and the need to vacuum and mop and clean windowsills. Talk about a confusing message.

  I couldn’t believe it. Right on the heels of admitting that there were toxic levels of lead in the school water, she was talking about vacuuming. I was furious. I thought we had been making progress. I thought we were past blaming the victims. I thought we were teaching people about lead in water. Why is she going on about paint?

  Kirk texted me immediately.

  KIRK: 3 elementary schools, 1 over 100 ppb

  ME: Holy shit

  KIRK: watching live. Heartbreaking.

  ME: I’m watching now. I hate them.

  I should have been happy about the water switch, but how could I be? Three schools with toxic levels of lead. I walked to my clinic office, closed the door, and tried to keep myself together. My hands were shaking, my whole body was shaking.

  That same day, I was hosting a group of pediatricians who had arrived in Flint for an AAP grant site visit. Without a chance to reflect, I dried my eyes and tried to pull myself together.

  And it was almost time for my resident conferences.

  My residents, all twenty-one of them, were another group besides my immediate family who suffered from my absence. I didn’t know this year’s first-year residents as well as I usually did by now. And the second- and third-year residents probably saw the biggest change, having known both pre- and post-Flint-crisis Dr. Mona. Since the end of August, I just hadn’t been around or involved as much as in the past. I told myself now, finally, with the water about to be switched back, I had to explain, apologize, and make up for losses.

  Earlier in the week, I even sent them an impassioned group email:

  FROM: Mona Hanna-Attisha

  TO: Pediatrics Residents; Combined Internal Medicine/Pediatrics Residents

  SUBJECT: This is our fight song!

  All,

  It’s been a crazy month, and I wanted to apologize to all for being preoccupied. I’m so sad I missed the Peds retreat yesterday! As you all may know, I have been consumed by the lead in water issue. Many of you have been at the front lines of this issue, especially the Community Peds residents.

  This has been an incredible example of our power and credibility as pediatricians. When the pediatricians spoke (armed with data—yeah, research!), we changed the game and inevitably, the future of Flint’s kids.

  “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” Margaret Mead

  This story is not done and our research/activism continues. We are now doing really cool geospatial analysis thanks to MSU public health research superstar Prof Sadler, we are busily writing a manuscript for publication (thanks to Allison), and we have a whole list of subsequent research projects planned. If anyone is interested in participating in anything, let me know!

  This is our fight song!

  Mona

  * * *

  —

  LATER ON, MANY CELEBRITIES, athletes, and politicians would stop in Flint to show support. We saw President Obama. We saw Hillary Clinton and Bernie Sanders, who had a presidential primary debate in Flint. Even an orange-haired Republican candidate for president turned up later.

  But the first visit was from Senator Debbie Stabenow, who came to Hurley on October 16, the day the water was switched back. Her visit was, in many ways, the most important.

  I had been wanting to meet Senator Stabenow for years. My brother, when still an undergrad, had worked on her first campaign for Congress. And Elliott worked closely with her on children’s health initiatives, related to his mobile health work in Detroit schools. Senator Stabenow, whose mother was a nurse, understands public health issues and understands lead and its pervasiveness. And as a former social worker, she has always been a strong advocate for children.

  Melany and I spent an hour with the senator, sharing my research. She was very upset about what the lead exposure meant for kids, but also at how disenfranchised Flint was, its fate in the hands of an unelected emergency manager and an indifferent state. I summarized the issue in a practical one-page takeaway sheet—something all good advocates learn to do—that described potential next steps and specific things she could do to help on the federal level.

  Senator Stabenow got visibly angry and wanted the governor to make a “disaster declaration,” which would free up more state and federal resources. She also supported a full investigation, forcing the state to take full responsibility. But that alone wouldn’t be enough. The Flint water crisis was a national emergency, she knew, requiring the nation’s collective help. She promised to fight for federal funding for long-term support.

  All these steps were critical but also far off—months or more down the road. I wanted something right now, something that would make a big difference immediately. I knew Senator Stabenow sat on the Senate Agriculture Committee and was a big supporter of WIC and expanded nutrition programming.

  So I made my request, for Nakala and all the other babies in Flint who currently subsisted only on formula mixed with Flint water: “We need your help to get ready-to-feed formula for our babies.” It would require a federal waiver from the USDA. She promised to put the weight of her office on making it happen. When we said goodbye, I had to give her a hug.

  Many politicians came to Flint after that, and I made a point of giving them all hugs. Somebody started calling it “Hug Diplomacy.”

  That same day, October 16, the EPA reversed course and acknowledged the water crisis. It established the Flint Safe Drinking Water Task Force—with Miguel on it—to help develop and implement a plan for secure water quality in Flint. It eventually issued a directive to prevent state water agencies from fraudulent testing methods that purposely minimized lead content.

  WITH SENATOR STABENOW, OCTOBER 16, 2015

  * * *

  —

  I COULDN’T HELP BUT think of all the excuses we had been given for why the water couldn’t be switched back.

  All those reasons, explanations…

  “The pipe has already been sold.”

  “It’s prohibitively expensive.”

  “Impossible!”

  It happened at 5 P.M. on October 16.

  With a simple flip of a switch, noncorrosive water once again flowed into the taps of Flint homes.

  AS SOON AS THE WATER WAS switched back, our drumbeat shifted to demanding that a state of emergency be declared. The switch alone wasn’t enough to deliver clean, safe water to the city. Eighteen months of corrosive water had done great damage to the underground network of water pipes, and it had also corroded the pipes and appliances in residents’ homes. The water was not yet safe to drink. Much more remediation was still needed.

  I dove headfirst into two all-
consuming projects. One was perfecting my list of science-based demands and recommendations for Flint kids. It had grown long and unwieldy and needed to be focused. The other project was producing the final, unassailable, and more accurate publication of elevated blood-lead levels after the water switch, using geospatial software.

  The rules of academic research didn’t allow my original study to be peer-reviewed and published in a journal because it had already been presented and made public. But a new study, using GIS, could be. An article with a scholarly stamp of approval would make the crisis real in terms of science. And once it was published in an academic journal, it would be cited and referenced, much harder for anyone to shoot down.

  Rapidly, over the course of the following week, Jenny and I doubled our team of researchers. Rick Sadler, working with GIS software, created incredible maps, even better than the previous ones, that presented unforgettable images of the impact of corrosive water on the blood-lead levels of Flint children. My resident Allison, now our appointed lead water researcher, spent every free moment reading the available literature, swamping our medical librarian Sharon Williams with requests for articles. Jenny and I began writing while continuing to dig, working with new numbers for the specific neighborhoods where the water tested highest for lead.

  Marc Edwards, between his academic obligations at Virginia Tech and his research, never stayed in one place very long. Even after he left Flint, he stayed in touch and guided us when we needed him. He made another contribution too: infectious paranoia. His stories about working on the D.C. crisis were disheartening and scary. He told us about an incident when study figures had been stolen from his lab, and another when a member of his research team was discovered to be an industry mole. Because of what Marc had gone through with federal agencies—they dismissed his work for years and tried to deny that lead in water could harm children—I decided not to reach out to the CDC, worried that their response would be impossible to predict.