I just needed time to think, to figure out what was happening.
—Lois Gibbs, Love Canal: My Story (1982)
I.
Before a trio of flagpoles on the lawn outside Flint’s city hall, the same place that had been the site of innumerable water protests over the past year, an unusual ensemble of people—activists, scientists, professors, students, preachers—stood before a small army from the media. It was Tuesday, September 15, 2015, and this group was ready to formally present the findings from the citywide water test. The numbers were scary. But they had more than a few ideas for what to do about them.
“Thank you all for coming. Today is a huge, huge day for the water fight in Flint,” said Melissa Mays, her silver jewelry shining in the sun.1 The confirmation of lead in the water was “a strong punch,” exposing what had been done to Flint’s citizens and what had been covered up. The activists clamored for redress: the city should immediately return to the cleanest, freshest water possible—Lake Huron water from Detroit; the MDEQ should distribute free lead-certified water filters to every house; Flint needed to warn every resident connected to a lead service line about the risk and replace all those lines at no cost. Marc Edwards said that his team estimated the amount of lead in the water of about five thousand Flint homes exceeded standards set by the World Health Organization. Someone in the audience gasped.
The biggest response of the afternoon—applause and cheers and emphatic nods—came when Curt Guyette called for a full, independent investigation into how the city conducted its own water tests. And LeeAnne Walters said that there had to be a complete philosophical turnaround in environmental oversight. “Basically, the bottom line is, stop trying to come up with ways to try and hide the lead,” she said. “You should be looking for the high lead. That is your job as the DEQ. When you find it, you tell us.… Do your job, the way the EPA intended for you to do it.”
At the Saints of God Church later that day, the wooden pews were packed with a diverse swath of Flint residents. They wore orange baseball caps and straw hats, blue-collared shirts and white T-shirts, turquoise jackets and tank tops. But their faces were universally grim as they took in the details of the test results. Most of the lead was found in the central belt of the city. Many samples exceeded 100 ppb, and as a whole Flint’s water measured at an astonishing 27 ppb. That was almost twice the federal action level, and what’s more, it presented an extreme picture of what calculated disinvestment looks like in the modern day. Flint’s neighborhoods were no longer graded one by one by federal assessors, with African American communities (and those who lived too close to them) redlined. Now that black people made up the majority of Flint, and close to half the population was impoverished, the city as a whole was effectively redlined. The test numbers showed excessive lead in every zip code–—some more than others, certainly, but all experiencing the disturbing consequences of being a shrinking city. Flint wasn’t being demolished for a new highway as St. John and Floral Park had been. It was being demolished by neglect.
“Don’t drink the water,” the coalition said again—it couldn’t be emphasized enough. If the water must be used, it should be flushed first at a high flow (for exactly the same lead-clearing reason that makes this a suspect tactic for sampling in water tests). Infants who drank formula made with Flint’s tap water were at especially great risk. The Flint Water Study group set up a crowdfunding campaign to get lead-certified filters to residents. They were hoping for $25,000; so far, they’d raised $520.2
People like Sonya Lee were beginning to wonder what the water crisis might have cost them. It wasn’t just the itchy rash on her arm, which she treated with Vaseline. And it wasn’t just that when she washed with the water that came out of the faucet “there is like a slimy film that comes on my hair. Of course, me being African American, that is not good.”3 What hurt most was that her two beloved German shepherds, Kizzy and Soldier, had gotten sick. “We never gave them bottled water. It was always from the faucet.” One day, Sonya’s son Kendrick told her, “‘Momma, Soldier’s not gonna last long.’ And I said, ‘Ken, don’t say that!’ And he said, ‘Well, I just want you to know because his head is shaking like he’s got Parkinson’s.’ And I just, I was just, kinda devastated.” Kizzy died on a Saturday night. Within a month, Soldier died as well. “I believe with the lead and whatever the contamination was, that affected them,” Sonya said. (She said that her home tested at 68 ppb of lead.) “Who would’ve thought that we were poisoning them ourselves, with the water?”
II.
For more than a year, the concerns of the people in Flint hadn’t been taken seriously. Now, with Miguel Del Toral’s memo and the Virginia Tech study, they had another level of authority backing them up. But even that wasn’t enough to turn the state around—at least, not publicly.
This group “specializes in looking for high lead problems,” Brad Wurfel, the MDEQ spokesperson, told Ron Fonger of the Flint Journal.4 “They pull that rabbit out of that hat everywhere they go.” Members of the Virginia Tech team were outsiders who had “just arrived in town and quickly proven the theory they set out to prove … while the state appreciates academic participation in this discussion, offering broad, dire public health advice based on some quick testing could be seen as fanning political flames irresponsibly. Residents of Flint concerned about the health of their community don’t need more of that.”
Wurfel held fast to the old claim that the lead levels in LeeAnne Walters’s house had nothing to do with the source water or city pipes. To the Michigan governor’s office, which was fielding questions from a U.S. senator, Wurfel said that Walters had had an “EPA lead specialist come to her home and do tests, then released an unvetted draft of his report (that EPA apologized to us profusely for) to the resident, who shared it with the ACLU, who promptly used it to continue raising hell with the locals.”5 Folks in Flint were upset, Wurfel added, “because they pay a ton for water and many of them don’t trust the water they’re getting,” and they were confused “because various groups have worked hard at keeping them confused and upset. We get it. The state is trying like mad [to] get the word out that we’re working on every aspect of the health [and] safety of local water that we can manage, and the system needs a lot of work,” but, he said, “it’s been rough sledding with a steady parade of community groups keeping everyone hopped-up and misinformed.”6
Still, behind the scenes, the state seemed to be hedging its bets. The governor’s office quietly tapped an unnamed donor to purchase fifteen hundred faucet filters. The Concerned Pastors for Social Action distributed them on September 1; the filters were gone in three hours.7 But the news wasn’t made public until weeks later—the governor’s staff had asked the organization not to talk about it. While the state stood by the safety of Flint’s water, a spokesperson for the governor’s office later explained, the filters were a way to relieve the discoloration and odor problems, and the state was respecting the wishes of the donor by not making a big deal out of the gift. But the Reverend Alfred Harris was quizzical. “If the water was okay, why would the governor work with someone to provide the filters?” he told a reporter. “I think the state working with the private donor is an admission the people needed some help.”8
Meanwhile, in the Michigan Department of Health and Human Services, there was discussion about how its representatives ought to talk about the water problems in public. One person in the department emailed a colleague: “It may be a good time to float the draft [plan] out to the others because if we’re going to take action it needs to be soon before the Virginia Tech University folks scandalize us all.”9
III.
It was supposed to be a social dinner, just among friends. Elin Betanzo and Mona Hanna-Attisha had gone to high school together in a Detroit suburb. As teenagers, they both joined the environmental club and protested a polluting trash incinerator. They went to different colleges, but both designed their own majors in environmental science and health. Years later, Betanzo played the piano at Hanna-Attisha’s wedding. And in August 2015, when a mutual friend from school was passing through town, Hanna-Attisha invited them all to dinner at the West Bloomfield home she shared with her husband and two young daughters.10
As it so often does, the kitchen conversation turned toward work. Betanzo was a hydraulic engineer who specialized in drinking water. She had worked for nearly ten years at the EPA’s Office of Ground Water and Drinking Water in Washington, D.C., overlapping almost exactly with D.C.’s. lead crisis and its ignoble aftermath. After a stint at a water utility, Betanzo moved back to southeastern Michigan. She had children now, her parents were aging, and so she found a job with a D.C. think tank that allowed her to telecommute. Her job these days involved a lot of tedious research, she told her friends at the dinner party, and it felt like she never left the house.
“At least you don’t have to commute,” Hanna-Attisha said, as Betanzo remembered it. “I have to drive an hour to Flint every day.”
Betanzo sat up straight. As a water expert who had been horrified by the lead crisis in D.C., she’d kept her eye on Flint. At the time, local headlines were tracking the water test by citizen scientists, but only preliminary results had been released. It was all eerily familiar. Betanzo remembered the community activism in D.C., and she knew about Marc Edwards, not only from her time at the EPA but as a graduate of Virginia Tech. She had no doubt that if he was on the case, there was a real problem. But in D.C., Betanzo had also learned that it was not enough to prove your case scientifically. It didn’t matter if you broke environmental law, apparently. Nobody would do anything about it unless you could show that people were getting hurt.
“You’re in Flint? A hospital in Flint?” Betanzo exclaimed. Hanna-Attisha must have thought her crazy; her friend well knew that she’d been working as a pediatrician at Hurley Medical Center for years. “Do you have access to all the medical records in your hospital?”
“Yeah. That’s my job!”
“Oh, my God,” Betanzo said. And she proceeded to tell her friend that there was something she had to do.
In D.C., it took years for independent researchers and community organizers to get medical data about how the lead-saturated water had affected people. That’s why there had been a raft of new investigations and coverage years after the water was first contaminated and after the Washington Post first broke the story. At the dinner party, Betanzo realized that her old friend Mona had that crucial information at her fingertips. She directed Hurley’s pediatric residency program and she taught in Michigan State University’s College of Human Medicine, which was headquartered in Flint. For children on Medicaid, blood-lead levels are supposed to be checked during a child’s routine medical screening, so records must have been on file documenting the lead absorption of thousands of Flint children. There were also blood-lead records for Genesee County children, which could be compared with Flint’s. Somebody just needed to put the pieces together to see whether leaded water was causing health disparities between children who lived inside the city and those who lived outside of it. If Flint’s drinking water was causing harm, the health records would tell the story.
Betanzo caught Hanna-Attisha up on what had happened in D.C., what was at stake in Flint, and why these data were such an important piece of the story. She sent her all the important documents, including the infamous CDC report denying the harm done by high lead levels in D.C., the story of the CDC backpedaling that claim, and Miguel Del Toral’s memo about Flint. The pediatrician was all in.
But that didn’t mean it was easy. Hanna-Attisha turned to the Genesee County Health Department and asked for its blood-lead data. The records came in individual patient files, one PDF for each child, which made it difficult to analyze for broad trends. She also asked the state for its data—data that Brad Wurfel cited on Michigan Radio to tamp down the fears about lead, saying that there hadn’t been a spike in Flint children’s blood-lead levels. Meanwhile, Hanna-Attisha and her research assistant worked late in the evenings to sort through Hurley’s 1,746 test results for Flint children and 1,640 records for children elsewhere in Genesee County.11 She and Betanzo went back and forth with the data as well, looking at the numbers in different ways.
Betanzo also realized that the think tank she worked for had congressional contacts. She arranged to talk to an environmental staff member who worked for Representative Dan Kildee, the district’s leader in Washington, to tell him what was going on. Residents had been barraging the congressman’s office with calls about the water, the staffer told her, but no one knew what to tell them. Betanzo helped fill in the blanks and connected Hanna-Attisha with Kildee’s office. She also put her in touch with Virginia Tech’s Marc Edwards. The three of them met for the first time on the day of the September press conference at city hall. While the Coalition for Clean Water and the Flint Water Study group kept pushing back against the voices undermining their credibility, a new force was about to enter the politically charged atmosphere.
On Thursday, September 24, about sixty people crowded into a drab room at Hurley Medical Center. Hanna-Attisha, wearing a white lab coat and brown-rimmed glasses, stepped to the front of the room, though not before texting Betanzo: I think I’m going to throw up. The wooden podium was weighed down by a glut of computer screens and microphones, an imposing arrangement that seemed like it might swallow the petite doctor whole. She began to speak.
Since the water switch in April 2014, there was not only more lead coming out of Flint’s taps, but also much more lead in the blood of Flint’s children. In just eighteen months, the percentage of children under age five with high blood-lead levels had jumped from 2.1 percent to 4 percent—it had almost doubled. When she looked at two zip codes that had registered especially high lead in their water, she saw that there was even greater harm, with the proportion of children with high blood-lead levels rising to 6.3 percent. Both were mostly poor areas with large African American populations, 67 percent and 46 percent, respectively. Altogether, as many as twenty-seven thousand children were vulnerable to persistent lead exposure. “This research is concerning. These results are concerning,” Hanna-Attisha said. “And when our national guiding institutions tell us primary prevention is the most important thing, and that lead poisoning is potentially irreversible, then we have to say something.”12
Melissa Mays was in the room. She had more knowledge about Flint’s water than nearly anyone. But still, when she heard the numbers, the measurable harm that the water was causing to children like her own, she pressed her palm to her mouth and froze.
As a pediatrician, Hanna-Attisha advised the community to breast-feed rather than use formula. If formula had to be used, avoid tap water. Pregnant mothers should also avoid tap water. In addition, she called for a public education campaign about how using flushed water and cold water could help minimize lead exposure. (Lead dissolves more easily in hot water than in cold water.) “And,” she added, we should “advocate for a connection to a Lake Huron water source.”
Like those who came before her, Hanna-Attisha understood that there was zero room for error. She checked her data “a zillion times,” knowing it would come under scrutiny.13 And it did. A spokesperson for Governor Rick Snyder alleged that she had “spliced and diced” the data.14 Brad Wurfel called her claims “unfortunate.” He repeated his defense of the earlier water tests and accused Hanna-Attisha of spreading “near hysteria.” Wurfel’s communications counterpart at the MDHHS said that the doctor’s data were “not in line” with its own, and that a surge in blood-lead levels was “seasonal and not related to the water supply.”15 It’s true that lead levels usually rise in the summer—people drink more water, for one thing—but this didn’t fully explain her findings.16
The portrayal of Hanna-Attisha as reckless ran counter to all evidence. The thirty-eight-year-old pediatrician, born in England to Christian Iraqi parents who had fled Saddam Hussein’s regime, had lived a life of considered purpose. As an undergraduate at the University of Michigan, she helped organize a campuswide environmental theme semester. She had been recognized even then as “very competent and talented.”17 Hanna-Attisha first came to know Flint from a professor who was a native of the city and had created the university’s environmental justice program. While in medical school, Hanna-Attisha did her clinical rotations in Flint. She began working at Hurley in 2011, the same year the city was assigned the first of its consecutive emergency managers. She trained emerging doctors and treated some of Flint’s poorest families. She decorated her office with children’s artwork: a watercolor giraffe, tissue-paper butterflies, a shiny pink-lettered sign that read “This is my fight song,” a lyric written by one of her young cancer patients.18
After the press conference, Hanna-Attisha still felt sick. Her numbers had been checked and rechecked and checked again, but the swift counterclaims by state authorities made her anxious. However, there were others who took her study seriously. Genesee County’s health officer asked the MDHHS for evidence to support its claim that the state’s analysis was more accurate and more comprehensive than the Hurley study. And the City of Flint issued a lead advisory urging residents to use water only from the cold tap for drinking, cooking, and making baby formula. The notice cited concerns from the medical community—Hanna-Attisha, apparently—but it still claimed that the water was in full compliance with federal drinking water laws.
Significantly, the afternoon after the Hurley press conference, emails exchanged at the EPA in Chicago discussed using money from its Drinking Water State Revolving Fund to purchase home filters for Flint residents. But there was fretting about Flint’s financial practices. Buying filters would “not send a good message to all the cities that properly manage their water and sewer fees,” as it could set a precedent that the EPA wasn’t prepared to defend, according to an internal briefing. “Many other older communities have similar problems with lead in pipes. Using the set-aside funds for this purpose” could prompt them to ask for aid, too. One EPA official said, “I don’t know if Flint is the kind of community we want to go out on a limb for.”19
The Detroit Free Press helped break the stalemate. It got access to the data the state used to dispute Hanna-Attisha’s claims about rising blood-lead levels, analyzed it, and, in a stunning report, it showed that the MDHHS was misinterpreting its own findings.20 The state’s own numbers showed that Flint’s blood-lead levels had worsened since the spring of 2014. The MDHHS study looked at children under sixteen (a larger sample size, since Hanna-Attisha had limited her study to younger children) and found that the percentage of children with high lead levels had grown from 2.37 percent before the water switch to 3.21 percent afterward. That’s an increase of almost a third in eighteen months, and it counted only the number of children with five or more micrograms of lead per deciliter of blood, the amount most likely to cause damage. The uptick was especially significant because lead poisoning in children in the city and across Michigan had been dropping for years.
Dr. Eden Wells, the state’s chief medical executive, began communicating with Hanna-Attisha. Her staff compared the two studies, and the agency’s epidemiologists revisited their research. At 7:30 a.m. on Thursday, October 1, exactly one week after the Hurley press conference, Wells found a yellow Post-it note stuck on her office keyboard. It was an alert: her staff had come to agree with the pediatrician. Wells headed down the hallway to let the department’s director, Nick Lyon, know that they were about to make an extraordinary reversal. At a news conference that same day, they said, yes, the pediatrician working in Flint was right after all. This was the state’s first serious accession to what residents had been saying all along: the water was poisonous.
That day, the Genesee County commissioners declared a public health emergency, citing Hanna-Attisha’s study, the Free Press report, and Governor Snyder’s cautious concession that “it appears that [water] lead levels could be higher or have increased” and that there were “probably things that weren’t fully understood when the switch was made.”21 Flint city hall went further, flatly telling residents to stop drinking the water. But community groups were way ahead of them. Volunteers were already delivering bottled water to schools that had turned off their water fountains, and over at the Mission of Hope homeless shelter, Reverend Bobby Jackson was running a water distribution site while working to raise the $1,700 that the shelter owed in unpaid water bills.22 Even the Genesee County sheriff had begun providing the inmates housed in a Flint jail with bottled water and with food that required no water to cook.23 “We’re just in a heck of a bind,” the sheriff said.
Hanna-Attisha’s head spun. She was fielding congratulatory messages one moment and the next she was asked to detail the awful harm of lead poisoning in children.24 She felt both exhausted and vindicated, she told a reporter. “At times I want to cry and then I’m so happy.”
The afternoon following the reversal, Governor Rick Snyder, Mayor Dayne Walling, MDEQ director Dan Wyant, and a number of other officials stood before a throng of reporters to bear the most blunt of their questions and to reveal their ten-point plan to fix the crisis. Some of it seemed promising, such as a $1 million commitment to purchase filters; and some of it, such as free water testing for Flint residents, wasn’t even new. There would also be no widespread notification campaign. The public notice requirements of the Lead and Copper Rule were never triggered because, technically, the MDEQ had never issued any lead-in-water violations to the city.
Hanna-Attisha listened to all this from the back of the small room. Brad Wurfel was there, too. The pediatrician leaned over and whispered to him. “You called me irresponsible.”
He told her he was sorry.
“I had the opportunity to apologize,” Wurfel later said, and “I was grateful for the opportunity to do it. I will be the first to say, I came on a little strong on this because I believed the numbers we had in the moment.”25 It was a candid admission. Outside the news conference, as Hanna-Attisha and Wurfel conferred, and as the mayor spoke, having only recently regained the authority of his elected office, about thirty residents were gathered. Holding up hand-lettered signs, they called for clean, safe, affordable water. Some wore homemade biohazard suits. One sign read “Not Your Lab Rats!” Together they chanted, “Flint lives matter!”26 They hadn’t been allowed in the room.