Return to the audio for How to Science episode 12, with Dr. Mona Hanna-Attisha.


Mona Hanna-Attisha: My name is Mona Hanna-Attisha. I’m a pediatrician in Flint, MI. I’m a proud University of Michigan alum. I was here in the School of Natural Resources and Environment, which is now the School for Environment and Sustainability, and I also came back after medical school to the School of Public Health, so I also have a master’s in public health from here in health management and policy. I also took the geology class out West. We drove in caravans from Ann Arbor to Jackson Hole, Wyoming. It was six-week geology class. Pretty cool. Many of my classes were in LSA.

I would like share with you a little story about what it was like to be pediatrician in Flint, Michigan before we really knew what was happening with our water.

In April of 2014, in an effort to save money, the city of Flint, under financial emergency management, decided to change our water source from the fresh Great Lakes that we had been getting for half a century to the Flint River. And the problem was that the Flint River water wasn’t being treated properly, and right when that water switch happened in April of 2014, the people of Flint—the moms—they knew something was wrong.

And they would raise concerns. It tasted weird. It looked weird. It smelled weird. And they would come to my clinic with concerns about their children. And throughout this, about 17 months, my eyes were closed to what was going on, and I was telling my patients who were coming in every day that everything was fine. 

This is Michigan. This is Flint. This is a city that is literally in the middle of the Great Lakes, the largest source of freshwater in the world. And there’s people who wake up every single day—it is their job to make sure that the water, when we turn on that tap, is safe for all of us to drink. Not just the rich kids, but also the poor kids.

So I was telling my patients that it was okay. And I remember one specific clinic day when patient after patient was coming in with a concern that was water related. A mom with a newborn, and that mom decided to stop breastfeeding. (And of course, as pediatricians, we encourage breastfeeding as much as possible.) But she had made up her mind, and she wanted to switch to formula. And the way you make formula is you mix water with powdered formula, and that water is tap water. And that mom knew something was not right with this water, and she asked me—she asked her doctor—is it okay? Is it okay for me to mix my baby’s formula with this tap water?

And I said yes, of course it’s okay. How can our water not be okay? Do not waste your money on bottled water. And that patient left. The next mom that came in was with her little baby who had a rash, and she said, “Every time I bathe my baby, the baby gets a skin rash right up to the water line. Do you think it’s related to the water?”

I’m like, “No! It’s probably some other skin sensitivity. How can it be related to the water?”

And Flint, like many of our cities in this nation, is battling an obesity epidemic. And we’re trying to encourage a lot of people to drink more water, stop drinking pop, stop drinking juice, stop drinking all these sugar-sweetened beverages and drink more water.

And this young adolescent who was overweight came in, and she was so happy because she lost about ten pounds. And I asked her, “Oh my gosh! What did you do?”

She’s like, “I’ve been drinking water—eight glasses a day—and look how much weight I’ve lost.”

So patient after patient was coming in to see me—a doctor, a credible person in the community—and I was reassuring them that everything was okay. I’d even heard that General Motors, which was born in Flint, had stopped using this water because it was corroding engine parts. I had heard all that.

But not until I heard the word “lead” in the water did I realize that there was something wrong. Any pediatrician—anybody who has any training in public health—knows what lead does. It is an irreversible potent neurotoxin. We now know through incredible science that there is no safe level of lead, and that even the lowest levels can impact a population’s cognition, behavior, rate of developmental disabilities. So we know what lead does. And from the moment that I heard there was lead in the water, I knew that I needed to use science to figure out what was going on with our children.

I knew that I needed data, I needed evidence, I needed facts in my pocket, because everybody who had gone up against the state was attacked. The water being discolored because of the iron corrosion, the very elementary science of engine parts corroding—that should have been enough. But I knew that I needed to have in my pocket proof of impact. That the lead was increasingly in the bodies of our children.

So I walked out of my clinic exam room, and I stood up at a press conference with the research that our children were being poisoned with the lead in the water. And we publicly presented this research that the children of Flint had an increase in the percentage of elevated lead levels after the water switch and that we needed to take action, that we needed to declare an emergency, and that ultimately we needed to switch back to treated Great Lakes water.

And from the moment we declared this science public, the state attacked me, attacked the science, attacked the credibility of the research. They called me a unfortunate researcher; that I was causing near hysteria; that I was splicing and dicing numbers.

When you as a scientist, as a physician, are presenting numbers and facts, you expect to be heard, and you expect to be listened to. And even though I was prepared for that blowback, nothing can prepare you for when the entire state attacks you and tells you you’re wrong.

And for a moment, I believed them. I thought I was wrong, and I thought that maybe I should have just kept my eyes closed and kept on doing my daily busywork as a pediatrician, as a mom, as a wife, as a medical educator.

And there was a fire growing inside of me, and I quickly realized that my numbers, my spreadsheets, all this data, all these facts, all this evidence, was so much more than numbers. Every single number was a child—a child that, as a pediatrician, I have literally taken an oath to protect.

So we fought back. We fought back on behalf of those kids.

And finally, the state conceded, and from that moment on we have been on a path of recovery, building hope in this community and really hoping to share our best practices to communities everywhere. Because Flint is not alone. There are kids all over this country that are suffering from the same toxicities—the toxicities of not only lead poisoning, but of poverty, of violence, of incarcerated parents, of discrimination, of racism, of crumbling schools, of neglect.

We hope that we can share what we are doing in Flint right now in our recovery with all of these other communities, so that people everywhere can open their eyes to what’s happening to our children.

This is why I wrote this book that just came out. The book is called What the Eyes Don’t See. It’s very much about Flint.

It’s about lead in water: We don’t see lead in water; it’s invisible.

It’s about lead: We don’t see the impact of lead. It’s known as a silent pediatric epidemic. But it goes so much farther than Flint.

It is about people and places and problems everywhere that we choose not to see—that we choose to close our eyes to.

And I wanted the readers to experience what I went through and really use it as a playbook for them on how to be an activist, how to be a scientist, how to use science for the public good. Because that’s what science is all about. Science is not meant to live in journals and ivory towers and to be used for publications and promotion and tenure. Science is meant to benefit the public good.

So we need more scientists to get out there. We need more doctors to get out there—to step out of their boxes. To get into a risky space and to speak up for their communities, especially our most vulnerable communities.

Monica Dus: So what do you led to not adding the anti-corrosive agent? Do you think it was a lack of empathy? Do you think it just ineptitude? Do you think it was because of racism?

MHA: Yeah, I think it’s all those things. And we don’t know. Flint’s an ongoing story. There are many investigations that are ongoing to get at that. Why wasn’t this water treated properly? And why, when they knew it wasn’t treated properly, they didn’t do anything? Many investigations that have already occurred really point to the fact that this was a case of environmental injustice. That it was the demographics of the population—poor, predominantly minority population—that caused this to happen.

I want to heard a little bit more about how you felt in two particularly instances. One, when you decided, “I’m going to risk my own reputation,” which is all you have as a scientist, as a doctor, and to speak up against how we are taught to behave as academics.

And the second thing is: After that, how did you react to being discredited?

MHA: When I found out about the lead being in the water, and really the need to find that proof of impact, moving forward was the only option. I’ve described it as a choiceless choice. There was no other way than forward.

For me, it was very much a professional obligation to these kids. But more than that, it was this very ethical and moral obligation to find out what was going on. So there was no other option than to move forward.

And it’s not something you can sit on. You can’t sit on the knowledge of this contamination and what it’s doing to children. I think anybody who was in my spot—I hope—would have done the same thing.

As a public figure, as a scientist, as a doctor, as a trusted member of the community, how do you help restore trust in something that was completely broken?

MHA: The water switch happened in April of 2014. It’s currently 2018. Flint is still under a state of public health emergency. The people of Flint still are recommended to be on bottled water and filtered water until our damaged pipes have been replaced.

It’s going to be done by 2020, which is amazing, because Flint will only then be the third city in the country that has replaced their lead pipes. Those two other cities—which are Lansing, Michigan and Madison, Wisconsin—it took them over a decade. So it’s actually something that we are really leading the nation in, in terms of our water and our pipe replacement work.

It doesn’t matter where you are or what you do or what color your skin is or how long you’ve been in this country. It is all about this borderless cause that we should all be involved in, in terms of making our communities a better place.