When Dr. Mona Hanna-Attisha had an old college friend over for a barbecue, she wasn’t expecting to get drawn into a protracted fight with the city, the county and the state over what became known as the Flint water crisis. Up to that point, she’d believed, as she put it, that the “men in white coats” knew what they were talking about when they said Flint’s water was safe to drink.
Hanna-Attisha (“Dr. Mona”) was director of the pediatric residency program at Hurley Medical Center, the public hospital in Flint, Michigan. Only that morning, she’d told a patient she could use Flint water for mixing baby formula.
Her friend, a consultant on water systems, said otherwise. She had it on good authority that the switch of drinking water sources from Lake Huron to the Flint River was done without corrosion control. Corrosion control is standard when water is as corrosive as Flint River water, but is not a particularly expensive process. The problem was that much of the Flint water system was in lead-lined pipes. Untreated, this corrosive water could be expected to leach lead out of the pipes. This leadsd to lead toxicity levels in the tap water that are orders of magnitude higher than the EPA standard. As Hanna-Attisha points out, no level of lead exposure is actually safe, especially for young children.
Dr. Mona’s slightly altered D. H. Lawrence quote, “the eyes don’t see what the mind doesn’t know,” aptly sums up the struggle she went through to get colleagues in the public health field to take her concerns seriously. Until that point, efforts to reduce lead exposure in children had focused on lead paint and lead in gasoline. There hadn’t been that many studies on uptake of lead from drinking water. It wasn’t enough to show that there was lead in the water; she needed to show that the lead was getting into children’s blood. Luckily, she and a team of residents at the hospital were able to use the medical center’s data to show quickly and conclusively that blood lead levels had climbed significantly in Flint children since the water was switched.
But it also became clear that there was a lot more going on in the city, which was being run by an unelected “emergency manager,” and in the state government, which was being run by a Republican governor who was enforcing “austerity” on publically owned utilities. The switch in water sources was done to save money, and it was done in the cheapest way possible. When problems arose with the water — some evident, like foul taste and discoloration, and some not evident, like Legionnaire’s Disease and lead contamination — the highest levels of each government did their best to cover up the problems. Even the U.S. EPA — and this was the Obama administration — cooperated in the cover-up. Dr. Mona’s initially naive attempts to coordinate with and get data from county and state public health agencies were met with silence. The analysis of lead levels in Flint children at her hospital was met with denials, insults and misleading analysis of other data.
In this case, science won out, partly because of Dr. Mona and her colleagues’ insistence on taking the information to the public. It helped that the Detroit Free Press published its own analysis of the state’s data, showing that it supported rather than contradicted Dr. Mona’s data. Finally, the chief medical officer for the state conceded that her analysis was sound. A “state of emergency” was declared, with lead filters and bottled water distributed to Flint residents. Ultimately, the water source was switched back to Lake Huron, something that the governor had been saying was impossible. In many ways, though, the damage had been done — both to the water system and to the children of Flint.
Hanna-Attisha tells about the factors in her own background that caused her to stand up to city, county, and state governments. An Iraqi-American, her own family had a history of resistance against Saddam Hussein and earlier Iraqi tyrants, and, as she puts it, she grew up knowing that people in power are capable of doing evil things. She also gives a sense of the toll of being an activist, including neglecting her children, barely eating and losing weight to the point where most of her clothes didn’t fit. Luckily, she had a supportive hospital administration and a supportive family that saw her through it. “What the Eyes Don’t See” sometimes feels a little scattered; it takes a while to understand, for example, why Hanna-Attisha spends so many pages telling us about her family history, though it makes sense by the end; probably those parts could have been better integrated into the narrative. Still, it ends up being an inspiring story about how people in government can make a difference when they have the courage to stand up and speak truth to power.
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