What’s in it for me? Discover the inspirational story at the heart of a national tragedy.
If you followed US news at all in 2015 or 2016, you probably heard about the Flint water crisis.
It was a disaster of epic proportions that made international headlines.
But how did the public water system of a modern American city fail so spectacularly?
This is the story of Flint, Michigan, and how this historically significant industrial city became a site of governmental collapse.
But it’s also the story of the woman who brought this crisis to the public’s attention, Dr.
Mona Hanna-Attisha – or, as she likes to be called, Dr.
Mona.
She specializes in pediatrics, and became a public health crusader to make sure that her patients, the children of Flint, were taken out of harm’s way.
In these blinks, you’ll find out how one of America’s premier factory towns became a hotbed of racial tension; how the dangers of lead have persisted in the US; and how an anti-fascist Iraqi activist became an inspiration for a Michigan doctor.
This is a story about Flint, Michigan.
But it's also a story about Dr.
Mona Hanna-Attisha, who was born in Sheffield, England in 1976.
Mona Hanna-Attisha’s family has a long tradition of activism and resilience.
Her parents had moved there shortly before she was born, and throughout her childhood they always hoped that one day they’d be able to return to their home in Iraq.
Throughout history, Iraq had been a hub of enlightenment.
Baghdad was a progressive capital city where world-changing advances were made in mathematics, medicine, and astronomy.
Its scholarly community produced one of history’s foundational medical textbooks, The Canon of Medicine, completed in the eleventh century.
This was the Baghdad that Mona heard about in stories told to her by her parents.
But unfortunately, by the late 1970s, Iraq was being taken over by the militant, fascist Ba’ath Party, led by Sadaam Hussein.
The key message here is: Mona Hanna-Attisha’s family has a long tradition of activism and resilience.
While her parents have always been outspoken, progressive-minded people who opposed the Ba’athist regime, it is perhaps Mona’s grandfather, Haji, and her grandfather’s cousin, Nuri, who best represent the family’s ongoing commitment to fighting injustice and never giving up.
Haji was one of those relatives family members love to tell stories about.
He had a great love for all people, whether Muslim, Christian, or Jewish; it didn’t matter.
Haji also had many business ventures over the years – including a perfume factory that tragically burned to the ground one day.
Haji was devastated.
But one by one, people came from all over Baghdad to tell him that he had to rebuild.
At first he thought it would be impossible.
But then they started giving him money!
They believed in Haji, and so he began to believe in himself.
One of Haji’s big inspirations was his cousin Nuri.
In 1935, Nuri had been one of the founders of the Association Against Imperialism and Fascism, an organization that had got him in trouble with what was then the Iraqi monarchy, and caused him to flee to Paris in 1937.
There, he became involved with the pre-war French Resistance movement before joining the International Brigades and fighting on behalf of the Spanish Republic in the Battle of Ebro, one of the first battles of World War II.
Though Spain would succumb to fascism under the rule of Francisco Franco, Nuri never stopped fighting.
Sadly, by the time of his death in 1980, Nuri had spent half his life either hiding or in jail, but to his relatives he will forever remain a hero.
Flint, Michigan also has a legacy of activism and resilience.
Mona didn’t stay in the UK very long.
When she was very young, her family moved to Michigan, where her father found a research position with the General Motors corporation.
Her father was a loyal GM employee for many years, but he was one of the lucky ones.
Many people ended up being fired as the company downsized in the 1980s and 90s.
Mona’s family lived relatively comfortably in the suburbs of Detroit, and Mona ended up doing four years of medical school at Michigan State University.
She then did her final two years in clinical training in the town of Flint, Michigan – and promptly fell in love with the beleaguered city.
The key message here is: Flint, Michigan also has a legacy of activism and resilience.
GM’s legacy in Flint began in 1880, the year the Durant-Dort Carriage Company was created.
In 1908, this became a Buick car factory before growing into what was, at one point, the largest auto parts factory in the world.
In the first half of the twentieth century, Flint was a thriving city for state-of-the-art manufacturing.
But in the 1930s, as GM executives were getting rich, workers were suffering under exploitative conditions.
More cars than ever were being produced, but the factory floors were an increasingly hot and dangerous place to work.
And those in the most danger had little money or protection.
In those days, there was no such thing as worker’s compensation.
If you got hurt and couldn’t work, you didn’t get paid.
So, on December 30, 1936, GM workers in Flint launched a sit-down strike, occupying the Fisher Body Plant No.
1 and refusing to leave.
For weeks, GM executives tried starving the workers, freezing them, dousing them with water from fire hoses – all to no avail.
In fact, the workers even managed to trick the management into letting them occupy another factory!
After 44 days, and intervention by US President Franklin Roosevelt, the strike ended with GM recognizing the United Auto Workers union as a collective bargaining representative for the workers.
Better pay and benefits like worker’s compensation soon followed.
The event is now looked back on as “The Strike Heard Around the World.
Thanks to unionization, factory workers in the United States could now enter the middle class and become part of the consumer economy.
Flint has long suffered from racist policies that have continued to make life difficult for its residents.
It also meant that northern cities like Flint became destinations for African Americans looking to escape the Jim Crow south and find decent employment.
In fact, from 1915 to 1960, over six million African Americans moved north in what is known as the Great Migration.
But while many were able to start new lives, it wasn’t easy.
Those who moved to Flint had an especially difficult road ahead.
The key message here is: Flint has long suffered from racist policies that have continued to make life difficult for its residents.
Following World War II, there were racist practices around housing and bank loans that kept African Americans from experiencing the same post-war economic upturn that had benefited many white families.
At the time, GM even encouraged these policies.
In Flint, there were two residential areas that were earmarked for black families.
One of these areas was directly next to a GM factory, where industrial pollution was at its worst and the houses were built out of notoriously shoddy materials.
Attempts to integrate neighborhoods and schools were met with racist campaigns such as “Keep white communities white.
” It would take many years, but eventually some policies changed for the better, while other aspects of Flint would get worse.
There were riots in 1967 in both Detroit and Flint.
They were the culmination of years of racist policies around schooling, housing, policing, and employment.
Finally, in 1968, fair housing policies were enacted both federally and locally.
But the fact that black families could now move into previously segregated neighborhoods meant that many white families worried about declining property values and moved elsewhere.
Some of this anxiety came from a practice known as “blockbusting,” which involved crooked real estate agents purposefully scaring off white families so that they could buy their property cheap and then sell it to black families at costs far above the market value.
Blockbusting went on throughout the 1970s.
And then, in the 1980s, there was the Autoworld fiasco.
The town dumped millions of dollars into an automobile-themed amusement park that failed spectacularly at attracting visitors.
It was supposed to create jobs and generate tourism, but instead, there was an oil crisis and a push towards deindustrialization that resulted in GM losing its Flint plants.
Indeed, the city of Flint was now becoming exhibit number one in evidence for the catastrophic realities of a post-industrial world.
Problems began in 2014, when Flint changed its water source to cut costs.
There’s one more factor that puts Flint, Michigan in a unique position.
When US cities are in financial trouble, there’s a provision that allows the state governor to install an emergency manager (EM).
And this is exactly what happened in Flint in 2011.
When an EM is installed, the elected mayor is essentially stripped of his power.
So while the EM is tasked with finding ways to cut costs, there’s little concern about whether these cuts will harm people.
After all, since EMs aren’t elected officials, they don’t have to answer to the people, only to the governor.
By 2013, EMs had been installed in Detroit and Pontiac as well as Flint.
This meant that 50 percent of all African American residents in Michigan lived in cities controlled by an EM.
The same applied to only two percent of Michigan’s white residents.
The key message here is: Problems began in 2014, when Flint changed its water source to cut costs.
Trying to pinch every penny, state authorities decided that Flint should change the source of its drinking water.
Prior to April 25, 2014, Flint’s public drinking water came from Lake Huron, which meant that the city had to pay to access Detroit utilities.
To cut costs, the folks in the emergency manager’s office came up with the idea of switching the water source to the Flint River.
Aside from the fact that Flint’s factories have been poisoning the Flint River with waste and runoff for generations, certain conditions need to be fulfilled for water to be safe to drink.
One of the primary ones is that the water mustn’t be corrosive.
In many cases, water can be naturally corrosive.
This means that it can cause the pipes carrying it to deteriorate and release harmful elements like lead into the water.
However, this can easily be tested, and anti-corrosive additives can be added to the source water to make sure lead doesn’t find its way into the public water supply.
Somehow, this didn’t happen in Flint.
But it wasn’t because no one knew about it.
Just six months after the switch, people at GM recognized that Flint water was causing corrosion in its auto parts, so it got a waiver from state officials to allow it to switch its plant back to Lake Huron water.
This should have been a clear red flag to government officials that Flint’s water would also be causing corrosion in the city’s pipes – which would mean one thing: lead in the water.
No amount of lead is considered safe for human consumption.
Every public health official should know about the dangers of lead.
Simply put, it’s incredibly toxic to our minds and bodies.
It poses a dangerous threat that human beings have known about for a long time.
What makes lead especially dangerous is that the symptoms of lead poisoning are not readily apparent.
Plus, the effects that it can have on children, especially infants who drink baby formula mixed with lead-tainted water, are incredibly harmful and can last a lifetime.
The key message here is: No amount of lead is considered safe for human consumption.
For starters, once lead enters the bloodstream, it can interfere with the way oxygen is carried through the body, reduce the calcium in our bones, and cause muscular paralysis and swelling in the brain.
It can also cause abdominal pains, dizziness, anemia, and headaches, as well as vision and hearing loss.
In the worst cases, exposure to lead can result in kidney failure, coma, and even death.
For children with developing brains and bodies, early exposure to lead can effectively interrupt that development and cause memory issues, attention disorders, mood disorders and loss of impulse control.
While research has not been definitive, studies do suggest that lead poisoning in childhood can lead to an increased likelihood of the person becoming violent in adulthood.
Much of this has been known for over a century.
In 1904, a lead additive used in paint was scientifically linked to childhood poisoning.
A few years later, European countries banned the use of lead in indoor paints, with the League of Nations following suit in 1922.
But things went in a different direction in the US.
Lead was big business in the US.
And in 1923, GM decided to use lead as an additive in automotive gasoline.
The additive was called tetraethyl (TEL), and it helped reduce engine “knock,” that annoying loud hiccup that was common in early car engines.
But TEL lead was even more toxic than regular lead.
It killed 17 workers in New Jersey, where the new “ethyl” gasoline was being refined, and caused others to become sick, delusional, and violent.
There were less-toxic options.
The use of regular ethanol, for example, could solve the “knock” problem.
But the use of TEL lead could be patented and made profitable.
This is why GM and Charles F.
Kettering, the head of research at the company, pushed for its continued use, despite the fact that this gasoline would release dangerous amounts of lead into America’s air and soil through car exhaust.
Protecting children means uncovering problems that the eyes don’t see.
When Mona Hanna-Attisha chose to do her clinical training in Flint, it was the first time she’d been back since visiting AutoWorld as an eight-year-old.
Despite the poor reputation Flint had garnered over the years, Mona fell in love with the city, and in 2011 she became the director of the pediatric residency program at Hurley Medical Center, one of the few public hospitals left in the country.
Why did she fall in love with Flint?
When she returned to the city and talked to the people, what she found was resilience.
She couldn’t help but admire the people of Flint and want to help them – especially the children.
The key message here is: Protecting children means uncovering problems that the eyes don’t see.
Children are some of the most vulnerable and resilient people in the world.
Their minds and bodies are still developing, which means that what happens to them during their childhoods can seriously affect the kind of adults they turn out to be, both physically and emotionally.
But no matter the hardships children face, they can also be taught to build resilience, and to learn how to cope and thrive.
For that to happen, children need caring and nurturing adults in their communities.
Some of the most significant factors in a child’s health are things we can’t see.
We used to refer to these factors as “social determinants of health,” though today they are more commonly known as “adverse childhood experiences” (ACEs), also known as “toxic stresses.
” Research shows that the more ACEs a child is exposed to, the more likely it is that she’ll develop health issues such as asthma, diabetes, heart disease, or substance abuse.
In fact, six or more childhood ACEs can reduce a child’s life expectancy by twenty years.
However, while advancements in neuroscience have shown us that ACEs can damage a child’s developing brain by reducing important neural connections, they also show us that through nurturing and building resilience, we can improve neural connections and help the brain heal.
To provide the best and most holistic care for our children, it’s just as important to understand their environmental and community factors as it is to know the symptoms of common diseases and genetic disorders.
To paraphrase D.
H.
Lawrence, the eyes don’t see what the mind doesn’t know.
So, to be able to recognize toxic stresses, pediatric doctors need to know what is going on in a child’s environment.
After Mona heard about the water problem in Flint, blood tests confirmed the worst.
Mona first became aware of Flint’s water problem on August 26, 2015, during a barbeque with family and friends.
One of the guests was Elin, a childhood friend who now works for a think tank based in D.
C.
During the barbeque, Elin pulled Mona aside and asked if she’d heard about Flint’s water issue.
There had been some items here and there in the news, but the state had been consistent in issuing statements that said they’d been testing the water and everything was fine.
Elin, however, had heard otherwise.
She told Mona about a memo that had been leaked from someone at the Environmental Protection Agency (EPA).
It revealed that water tests taken at a home in Flint showed dangerously high levels of lead.
The key message here is: After Mona heard about the water problem in Flint, blood tests confirmed the worst.
Not long after their conversation, Elin sent Mona the leaked memo, which came from Miguel del Toral, an employee at the Chicago offices of the EPA.
As Elin explained, the situation looked very similar to what had happened in D.
C.
not long before.
Between 2000 and 2004, the drinking water in D.
C.
contained high levels of lead.
The government knew about this, and worked overtime to cover it up.
This included manipulating tests in order to get the results to meet minimum standards.
It took years, but finally, through persistent pressure from reporters, activists, and whistleblowers, the water was eventually fixed.
Elin warned Mona that Flint was likely to be a similar situation, one that could take years to resolve.
Sure enough, when Mona started looking at the levels of lead in blood samples taken from children before and after the water switch, the evidence was right there.
Among children under the age of five, there was a seven percent increase in the number of kids with elevated lead levels.
This was shocking news to Mona.
Since the water switch, she’d been reassuring parents that Flint tap water was okay to use.
How could the officials, whose job it was to protect their constituents, drop the ball so badly?
The blood-sample data was a statistical confirmation of what Mona had been told, but the data set was small, coming just from the children’s clinic at which she worked.
So she immediately set about expanding the data and finding more results.
After Mona made contact with Marc Edwards, research into the crisis became more definitive.
When Mona found out about the water problem, it was all she could think about.
She tried to be present in her personal life as a wife and mother of two daughters, but she couldn’t rest while the problem was getting worse every minute of every day.
The more people continued to drink and bathe in the water, the worse off everyone was.
But it is hard for poor families to avoid tap water.
Not everyone has the budget for bottled water, especially when it comes to bathing kids.
While these thoughts were keeping her up most nights, Mona made the difficult decision to reach out to the controversial environmental engineer Marc Edwards.
The key message here is: After Mona made contact with Marc Edwards, research into the crisis became more definitive.
Elin had warned Mona about Marc, telling her that he was a divisive figure.
Working out of the University of Virginia, Marc had won a MacArthur Award for his work in fighting for clean water as a basic human right.
But his doggedness in refusing to back down during the D.
C.
water crisis meant that he’d made some enemies in government.
Elin was worried that getting Marc involved could backfire.
But there was no denying the fact that few people were more experienced than Marc in the kind of research needed to resolve the issue.
The fact was that Marc had already become aware of the problems in Flint, so when Mona reached out to him, the two were soon meeting for lunch.
Thankfully, Marc wasn't as intimidating as Elin had made him out to be.
But Mona could tell that the years of uphill battles and fighting for families dealing with lead poisoning had taken a toll on the man.
Fortunately, after their initial meeting, Marc told Mona that he trusted her.
She could tell that he did not say that to just anybody.
As Mona was compiling data for a report that would hopefully be thorough and detailed enough for public release, Marc was indeed able to provide some helpful guidance.
For instance, lead levels in water can increase naturally during the hottest months of the year, so that was something her report needed to take into consideration.
Ultimately, Marc was able to assure Mona that her new report, prepared with the help of her research coordinator Jenny LaChance, was airtight and unassailable in showing the rising cases of lead poisoning among Flint’s children following the water switch.
After Mona’s press conference, an initial backlash took its toll.
Mona presented her findings at a tense press conference on September 24, 2015.
Sure enough, one of the first responses, from the Michigan Department of Health and Human Services (MDHHS), was that the report was simply showing seasonal changes in the water’s lead levels.
They claimed that this was completely normal.
Mona couldn’t believe it.
Had they even bothered to read her report?
But it hadn’t fallen exclusively on deaf ears.
Mona received some much-needed support from Michigan senator Jim Ananich.
In particular, he liked how she had ended the press conference – by holding up a baby bottle and reminding people who the most at-risk people were in this crisis.
The key message here is: After Mona’s press conference, an initial backlash took its toll.
When Mona walked away from the press conference, she felt a rush of euphoria.
She wondered, had her whole life been preparation for this moment?
It was an amazing feeling – but it didn’t last long.
Mona knew that her report was telling certain people things they didn’t want to hear – or rather, things they didn’t want the press and other people to hear.
Mona had tried to get Flint’s mayor on board.
Sure, he was largely powerless, but his public support would have carried some weight.
Yet when shown the report prior to the press conference, he was noncommittal.
It was, after all, an election year, and it would seem his political ambitions outweighed his concern for the public.
But the mayor’s lack of response wasn’t what bothered Mona the most.
Officials at the Michigan Department of Environmental Quality (MDEQ) had been pushing back against her efforts from the beginning.
And now they were telling the press that her report had been “sliced and diced” to make the situation look worse than it was.
Officials kept repeating their lies – that the lead was the result of issues with pipes in people’s homes and not a lack of anti-corrosion measures.
They continued to tell the press that Flint water was “safe.
” Even the governor's office was trying to discredit her report.
The press was calling Mona, asking for a response to the pushback from state officials.
She could only reply that she stood by her report.
But the backlash took a toll on her.
She curled up in bed and wondered whether the public ridicule would ever stop.
Thanks to a botched response and a voice of reason within the state office, progress was finally made.
The ridicule did stop.
When Mona awoke the morning after the press conference, her sense of doom and gloom had been replaced by a steely resolve.
She knew she was right.
She knew the science was solid and could stand up to any honest scrutiny.
Ultimately, this fight had never been about her.
It was about Flint, the community, and keeping her patients safe.
She was doing her job, and there was no one who could make her feel bad about that.
In the days following the press conference, Mona continued fielding opportunities to speak to reporters.
She gave one response after another, talking to NPR, newspapers, radio, and even the Canadian Broadcasting Corporation.
Her side of the story was definitely getting out there – and before long, it seemed like the tide was turning.
The key message here is: Thanks to a botched response and a voice of reason within the state office, progress was finally made.
For starters, the Detroit Free Press ran a story backing up Mona’s findings, and Flint’s mayor finally decided to issue a lead advisory.
Eventually, schools stopped letting kids drink tap water.
Cracks quickly began to appear in the state’s official story.
The state released its own report – a tally sheet of kids with Flint zip codes and monthly totals of elevated lead levels over the past few years.
The simplistic one-page report included a much broader age range of kids than in Mona’s initial sample, some as old as sixteen, and it seemed to show that there had been no overall increase in blood lead levels.
But in fact, the report unwittingly backed up Mona’s data.
After the state revealed its own summary data, the Free Press article pointed out that the state report showed the number of lead-poisoned children in Flint trending downward prior to the water-source switch – a trend that had changed abruptly after the switch, according to Mona’s data.
At this point, Mona received a call from Eden Wells, Michigan’s chief medical officer.
Mona was wary, because Wells had just been appointed by the state to handle the water “controversy.
” But their talk felt productive as Eden asked about the science behind her research.
Indeed, the conversation with Eden appears to have been the breakthrough that Flint needed.
Subsequent Freedom of Information Act (FOIA) requests for state emails showed that Eden had been directed by her boss, Nick Lyon at MDHHS, to discredit Mona.
But after their conversation, Eden backed up Mona’s science and advised the state to take her seriously.
Once the state admitted there was a problem, positive change followed.
On October 1, 2015, Michigan state officials finally admitted to a problem.
Sort of.
They held their own press conference at which the head of MDEQ, Dan Wyant, made an unconvincing announcement.
He claimed that the state now had a ten-point plan for winning back people’s confidence in their drinking water.
However, he fell short of explaining how the state would accomplish this, aside from testing school drinking water.
Wyant continued to mislead the public by telling the press that Flint was using corrosion control when it wasn’t.
But the Genesee County Health Department did declare a public health emergency.
And on October 3, 2015, water filters were distributed to Flint residents.
The key message here is: Once the state admitted there was a problem, positive change followed.
Mona continued to press on the main issue: switching back to Lake Huron water.
In September, she was told this was “impossible.
” But something had to change, because bottled water and filters weren’t a viable long-term plan.
Thanks in part to demonstrations led by activists such as Jesse Jackson and Michael Moore, and fundraising efforts by the Charles Stewart Mott Foundation, the impossible happened.
On October 8, 2015, the governor agreed to switch Flint’s water source back to Lake Huron.
Eventually, a more thorough and precise study, co-written by Mona, was peer-reviewed and published in the American Journal of Public Health on November 21, 2015.
Through sheer perseverance, Flint’s crisis was becoming national news, and on January 16, 2016, President Obama declared a federal emergency, freeing up more money to keep the National Guard distributing filters and bottled water to residents.
Finally, politicians and policy makers were listening to Mona.
And with the support of Michigan State University and the Hurley Medical Center, Mona delivered a new public health program to guide Flint out of the crisis and into the future.
To complement this new plan, a restructuring of Flint’s budget followed.
Perhaps most importantly, over a hundred million dollars was devoted to the welfare of Flint’s children.
Thanks to Mona’s plan, the thousands of kids affected by lead poisoning would receive monitoring to chart their health and encourage healing.
All of Flint needed healing, but if there were to be any chance for a thriving future, the children needed special attention.
While changes have been made, ongoing problems require continued activism.
What was really happening behind the scenes?
Where did it all go wrong?
Thanks to persistent FOIA requests by Marc Edwards, many emails and memos from state and federal officials have become public.
They suggest that environmental injustice is still a problem in the United States.
Clearly, the kind of racist attitudes and policies that forced African Americans to live in the most polluted areas of Flint haven’t vanished.
The key message here is: While changes have been made, ongoing problems require continued activism.
Many emails show that state officials encouraged their staff to stick to talking points that minimized the problem rather than make any efforts to solve it.
They encouraged the manipulation of test results, such as letting water run for minutes at a time before collecting samples, or simply disposing of tests that came back with high lead counts.
On the federal level, at the Environmental Protection Agency, an email regarding the use of federal money to provide Flint residents with water filters led Debbie Baltazar, the Region 5 Water Division chief, to reply, “I’m not so sure Flint is the community we want to go out on a limb for.
” More systemic problems were uncovered by what was dubbed the Five Guys Committee, established by the governor’s office as a Flint water task force.
What emerged was a 112-page report that did not pull any punches.
The report linked the crisis directly to the emergency manager law and failures of the MEDQ, the MDHHS, and the governor.
The report clearly states that what happened in Flint was due in part to a loss of democracy.
But what could be called historic is that the Five Guys report explicitly cited race as a factor in the crisis.
No other government report has had the honesty to do that.
A subsequent 2017 investigation by the Michigan Department of Civil Rights arrived at similar conclusions to those of the Five Guys.
Many people have asked whether the crisis would have arisen at all if the population of Flint had been primarily white.
All this raises the question: how can we make sure it doesn’t happen again?
Mona Hanna-Attisha holds two traditions close to her heart: activism against social and environmental injustice, and the actions of public health crusaders who’ve changed the world with science.
These are the kind of people who go down in history as game-changers, and they're the kind of people the world continues to need.
Final summary
The key message in these blinks: The Flint water crisis started in 2014, when the source of the city’s drinking water changed from Lake Huron to the Flint River.
The new source was corrosive, causing the pipes of the water system to leach lead and make the drinking water poisonous.
Through dogged determination, this public health oversight was brought to the attention of the public and defended against slanderous pushback from public officials.
Subsequent investigations revealed that the crisis was due in part to the emergency manager law, which had stripped Flint of democracy.
Racial prejudice also played a part, as the city of Flint has long been mistreated as a second-class city of minority citizens.
But it is, in fact, a city of remarkable resilience.
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What to read next: Maid, by Stephanie Land If you like stories of perseverance and determination to get by in a world of inequality, then we recommend our blinks to Stephanie Land’s 2019 book, Maid: Hard Work, Low Pay, and a Mother's Will to Survive.
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This is a vital story that is often left untold, charting the day-by-day struggle to survive that many American families know all too well.
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