This is an article from the fall 2016 issue of LSA Magazine. Read more stories from the magazine.
Taking the Lead
“There are people whose main job is to make sure that your water is safe, that populations are healthy, to track these things,” says Dr. Mona Hanna-Attisha (B.S. ’98, M.P.H. ’08). “Why were they not doing their job?”
Hanna-Attisha is naturally vocal on behalf of her young patients. “My role as a pediatrician is to be an advocate,” she said at a talk on the Ann Arbor campus. “It’s part of my job description.” She became a whistleblower on the water crisis in Flint when she released her research on elevated blood lead levels of children in the city.
But well before that, way back in high school, Hanna-Attisha had already begun fighting for environmental justice, with her friend Elin Betanzo. The pair grew up in Royal Oak, Michigan, and nerded out taking honors math together, participating in drama club, and joining the environmental group at school.
“There was an incinerator in Madison Heights, an adjacent city, right next to an elementary school. The people in that neighborhood had higher asthma rates and chronic obstructive pulmonary diseases,” says Hanna-Attisha. “We helped elect a state rep who put a sunset clause on it and closed it for good. That was our first exposure to environmental health and to the world of advocacy.”
After high school, college: Hanna-Attisha at U-M and Betanzo at Carnegie Mellon University. Hanna-Attisha sought bench research studying environmental health. She wrote an honors thesis on the impact of environmental toxins on pregnancy. Betanzo majored in piano and created a custom environmental science degree, which required her to take courses at another campus. The two reconnected when Betanzo chose to spend a summer at LSA’s Biological Station. There, she and Hanna-Attisha got an early taste of immersive research that would come in handy later on.
While Betanzo made a career as a drinking water expert with the Environmental Protection Agency (EPA) and other agencies, Hanna-Attisha became a clinical physician and medical school professor. But they remained pals, with Betanzo even playing piano at Hanna-Attisha’s wedding.
One night last summer, Hanna-Attisha sent Betanzo a last-minute dinner invitation by text. They got to talking about how families in Flint were complaining that their water had started looking gross, smelling gross, and tasting gross, and Betanzo remembered an experience she’d encountered at the EPA.
“I worked at the EPA during the D.C. lead crisis,” Betanzo says. “In 2004, the Centers for Disease Control and Prevention reported that no children were harmed with elevated levels of lead in their drinking water, but they later corrected that report in 2010. When they made the corrections, it was clear they had excluded thousands of records from their initial analysis, which had led to a different conclusion.”
Betanzo suggested that Hanna-Attisha take a close look at the blood lead levels of her own patients in Flint. “When Elin first told me about the possibility of lead in the water,” Hanna-Attisha says, “That’s when I started not being able to sleep.”
Working in the Flint hospital, Hanna-Attisha had access to exactly the data that would confirm whether the environmental danger of lead in the city’s water—which had already been demonstrated, most gallingly by lead concentrations in one family’s home that measured well above hazardous-waste level—translated as a danger to human health.
And what Hanna-Attisha saw in the data scared everyone. After Flint made changes to their water supply, the toxin nearly doubled in most kids’ blood, and it increased even more in particularly disadvantaged neighborhoods. For almost two years, Hanna-Attisha says, kids essentially drank through flaking lead-coated straws.
“There aren’t a lot of individuals who had access to the necessary data to be able to do this study,” says Betanzo. “Mona was magically in the right place at the right time, with the ability to do it. So the fact that we got connected is pretty amazing.”
“It’s like higher forces were at work,” agrees Hanna-Attisha. “When somebody that you trust and have known for decades, who has an inside connection to all this, tells you something, it’s hard not to believe it, and it’s hard not to act on it.”
Now, Hanna-Attisha directs a new public health initiative that will continue to evaluate the impact of lead levels in Flint’s water, monitor the affected children long-term, and provide early interventions to keep kids healthy.
“Our story is not over,” Hanna-Attisha says. “In 10 or 20 years, and hopefully less, you won’t remember Flint as the city that had this disaster. That’s not how we are going to be defined; rather, we’re going to be defined by what we were able to do afterward.”
Photo by Bill Pugliano/Stringer/Getty Images
Yesterday, Today, Tomorrow
Anna Clark (A.B. ’03) understands what a huge responsibility it is to tell the story of the Flint water crisis.
Over the summer, Clark interviewed people on all sides of the issue: government officials, community activists, and people whose lives—and families—have been affected firsthand by catastrophically high levels of toxic lead in people’s drinking and bath water. Now her focus is starting to sharpen on the specific stories that she wants to follow and tell as part of a book-length examination of the Flint water crisis that she is writing.
“Humanity is the core of the project,” Clark says. “I want this to be a book that offers a very full, contextualized picture of what happened. People tell me again and again, ‘It’s not just the water crisis.’ This is part of a larger set of consequences caused by chronic disinvestment in cities like Flint, which ununfortunately isn’t alone in a lot of ways.
“A lot of people feel that if the water crisis is the only story that’s told about their city, then it’s missing something,” Clark says. “I want to be a listener for those kinds of stories so that this book can honor that.”
The tentative title for the book, Water’s Perfect Memory, comes from an essay by Toni Morrison. The quotation goes, “All water has a perfect memory and is forever trying to get back to where it was.”
Clark likes the line’s specific connection to water, and also to the struggle to return to something.
“For me, the title suggests how powerful memory is in shaping what happens next in Flint,” Clark says. “Flint is really, really broken, and people are trying to figure out how to build up a city when you have such a deep suspicion of decision-makers’ respect for the people who live there. It’s devastating.”
Photo by Bill Pugliano/Stringer/Getty Images
Master of Disaster
The basics of survival are simple: You need food, shelter, clothing, and—of course—safe water.
That’s why, when the city, state, and federal governments finally validated Flint residents’ concerns and complaints about the water coming out of their taps, thousands of Flint residents, NGOs, and volunteers swung into action. Amelia Hoover (A.B. ’14) was one of them.
A disaster program specialist with the Red Cross in Detroit, Hoover manages emergency response and recovery operations for Wayne, Oakland, Macomb, and St. Clair counties. Her specialty is helping families displaced by house fires, ensuring, first, that they have food, clothing, and shelter, and then starting the casework for their long-term recovery. But sometimes her focus scales to large disasters, such as the water crisis in Flint.
Hoover’s work in Flint began on the weekends when she worked as a volunteer, but the Red Cross quickly deployed her to Flint as the assistant director of information and planning. Hoover’s main goal was identifying which residents couldn’t regularly get water from the distribution centers and setting up systems to make sure the water got to them.
In any recovery operation, Hoover says, her role can vary.
“It can range from liaising with the city to ensuring that people have enough cots and food or warming water to wash babies,” she says. “We wear many hats.”
One of the most important hats Hoover wears is data management.
“Converting the findings from our ‘boots on the ground’ work into clear and accurate data is crucial,” she says. “Data management tells the story of a disaster and justifies a relief presence, showing both the need and how to meet it.”
There is no map to follow. Each family’s long-term recovery plan differs as much as each crisis, but there are clear priorities.
“Generally we meet the client’s temporary emergency needs,” Hoover explains, “and then we create an action plan with resources and steps specific to each client’s circumstances and ability.“
Good casework requires an encyclopedic knowledge of resources available combined with an open ear. You must be fully present.”
In Flint, as in most disaster operations, the pace was frantic and the resources were scarce. Dirty boots and red vests were in abundance and phones were ringing off the hook. Volunteers were there at all hours, loading trucks with supplies and struggling to deliver them through a winter that brought ice storms and several feet of snow. Reminders of their purpose were everywhere.
“We were constantly surrounded by cases of water,” Hoover recalls. “Water was everywhere you looked. There were walls of it.”
In Flint, the challenges include both individuals’ need for water and the massive cost and time it will take to make necessary infrastructure improvements and repairs. Hoover is forced to balance the urgency of these ongoing needs with those of new emergencies that continue to crop up.
“I never doubt the importance of what we do,” she says. “It becomes more evident every day. Doing the job well can mean the difference between a family becoming homeless after a disaster or making a full recovery.”