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November 04, 2019
America Dissected
Unleaded

In This Episode

The Flint Water Crisis dominated national headlines when it emerged in 2016—focusing national attention on the hazards of lead poisoning. Newark, New Jersey is facing a similar crisis today. But Flint and Newark are only the tip of the iceberg of an epidemic of lead poisoning facing urban communities across the country. Dr. Abdul El-Sayed visits Flint to speak with Dr. Mona Hanna-Attisha, the pediatrician and researcher who uncovered the Water Crisis to understand how Flint’s history shaped the government failures that led to the crisis—and how distrust can devastate public health for poor, marginalized communities all across the United States.

 

_________________________

 

ABDUL VO: Flint, Michigan. Just an hour’s drive from Detroit – I spent a ton of time there as a kid. It’s where my Mom and Grandma, and Grandpa went to college, where both of my parents worked for most of my childhood. It’s a place that helped shape the person I am today. 

 

Of course, most of you know Flint for very different reasons.

 

ARCHIVAL: Flint Water Crisis headlines (very clear about crisis, lead, etc.) … dissolve into silence, then come up into… 

 

VERITE – MARKET: [some sounds of the market… ]

 

ABDUL VO: It’s been 5 years since the crisis started. The cameras are gone. The spotlight has dimmed. But the people of Flint, the 100,000 of them who call it home – they still can’t trust their water. The same lead piping that leached poison into their children, remains in the ground. And the same government who told them it was safe to drink before the crisis became public–is saying the same thing today. 

 

So I decided to make a visit to this city in my own backyard, to check in on folks at the Tuesday Farmer’s Market.

 

MKT – AMBIENT: Sounds from the market in the background 

 

ABDUL VO: That’s where I met Kira… 

 

MKT – ABDUL How did the Water Crisis affect you?

 

MKT – KIRA It affected my child more so than me. With her,

 

MKT- ABDUL  How old is she?

 

MKT – KIRA: She’s seven now. When it first started she was I think for about three or four. Just a condition of her skin. Just getting sick all the time. It all starts to take a toll….she started having a little spots on her back and you can just tell that something wasn’t right.

 

MKT – ABDUL: And since then the government’s been been trying to address. You think you think they’ve done enough?

 

MKT – KIRA: No… You know, you just don’t feel safe drinking water you, you never know if the pipes are getting fixed. They fix certain pipes on certain streets. They leave your streets tore up…. And then it’s like they go back to wherever they live and our streets are messed up. Our pipes are still messed up. 

 

MKT – ABDUL:  And if you could tell folks all over the country about what they need to know. What would you say? 

 

MKT – KIRA:  I would say you need to know that this is still a problem. We are still living through this we are still going through this, you know, don’t just forget. About us because you don’t see us on TV anymore and you know just a few weeks ago.

 

A lot of the politicians that was supposed to represent us through this thing. They got let off the hook  with nothing happening and I just say that we need to continue to sit together and fight for what is right. 

 

ABDUL VO: Kira’s story is not an anomaly. Most folks I talked to that day shared her distrust – of the pipes, of her government’s ability to help. And that distrust–it’s what will last well after the last lead pipe is removed. And that, in and of itself, is dangerous.

 

See, trust is fundamental to just about every topic we’ve talked about in this series. Because trust is the basic ingredient of public health: without it, there is no science and no government.

 

We trust science, and by extension, scientists and doctors, to faithfully answer questions that are literally the difference between life and death. 

 

And government? Well, when Thomas Jefferson wrote the Declaration of Independence, he said, and I quote, “governments are instituted among men” — and of course, that should really read “people” — “deriving their just powers from the consent of the governed.” 

 

That means we have to agree to be governed. And why do we do that? Because we trust that our government will act in our best interest. 

 

But what happens when government betrays that trust–when they withhold that science – in matters of life and death? This is the story of Flint.  

 

Today, we’re going beyond the headlines, beyond the same story you’ve been hearing about Flint. Instead, we’re bringing you the deeper story–connecting the dots between a poison and the people who suffer it, between science and socioeconomics, and between history and health–revealing a web of causes and consequences that extends well beyond Flint City Limits… even all the way east to Newark, New Jersey. 

 

ARCHIVAL – short piece about Newark crisis

This is America Dissected with Abdul El-Sayed. I’m your host. Stick around.

 

  • SERIES TITLE AND THEME

 

ACT 1: The Stories of the Flint Water Crisis 

 

INTV – MONA: [08:05] People think of Flint and they think of brown water. They think of the Water Crisis but really – Flint has this incredible history that we talked about – of prosperity, of cars!

 

ABDUL VO: That’s Dr. Mona Hanna-Attisha the pediatrician who uncovered the truth about the crisis, forcing the world to pay attention. We got to work together in 2016 on several commissions set up in the wake of the crisis.

 

INTV – MONA: [5:59] My name is Mona Hanna-Attisha. I am a Pediatrician in Flint Michigan. I work for Michigan State University in Hurley children’s hospital. And I founded and direct an initiative called the Pediatric Public Health Initiative, which is a model public health program to mitigate the impact of the Flint water crisis.

 

ABDUL VO: Dr. Mona – as she’s affectionately called–is selling herself short. She’s a Michigander through and through, and she’s been serving Flint Kids as a pediatrician since she was a resident. Her parents were scientists who fled Iraq as refugees. And she was the doctor who led the studies that ultimately demonstrated the colossal crisis in Flint. She’s the reason why the massive national spotlight turned to this City in need. 

 

ARCHIVAL – Christiane Amanpour or Terry Gross0

 

But that’s the part of this story you’ve heard. And here’s where we take a different path. Because to truly understand the Flint Water Crisis, focus less on the water–and more on Flint. And the history of this quintessentially American city. 

 

Flint, Michigan – mid-20th century – the place to be.

 

ARCHIVAL – 1937 “From Dawn to Sunset” Auto Workers Film

 

ABDUL VO: There’s an old postcard of Flint from the late 1800s. In wrought Iron, it says “Flint Vehicle City.” That’s because it was. 

 

Flint was one of the world’s leading automotive manufacturers–with much of GM’s Buick Line rolling out of factories in the City. At one point in the 1950s, GM employed 80,000 people in Flint. Hell, there was even a car called the Flint at one point. 

 

You get it. But Flint wasn’t only at the center of one of the most important manufacturing industries in the world–it was also at the center of the movement to protect the very workers who made it all possible… 

 

INTV – MONA: [8:12] … more importantly than kind of cars coming off the assembly lines, Flint was the birthplace of resistance and disobedience it is the place where in 1936 Auto Workers stood up for what is right – and actually sat down! – the historic sit-down strikes – were in Flint Michigan in the 1930s… where for 44 days Auto Workers literally sat, occupied all the car plants, stopped production, and demanded their fair share of prosperity.

 

[09:05] the UAW was born and the middle class was literally born in Flint and that lead to something called the Grand bargain which brought in living wages and benefits and Health Care and housing and great education and that that action in Flint then spread throughout the nation and informed wages throughout the nation for decades.

 

ABDUL VO: Flint was a pulsing center of manufacturing and social reform, attracting folks from all over the world who wanted a share of the American Dream…  

 

INTV – MONA: [06:22] Flint in 1950 was the place to be. Flint was a Promised Land immigrants from all over the country African Americans in the Great Migration North came to Flint for great living wage jobs for great schools for great infrastructure Flint at one point had the highest per capita income in the entire nation. That was Flint just a few several decades ago. 

 

ABDUL VO: So how did Flint go from being synonymous with prosperity – to being synonymous with crisis?  

 

INTV – MONA: [6:59 ] So the history of prosperity, of the birth of the middle class and labor is incredibly important, but we often kind of gloss over what happened next and that’s as important because it’s a history that was dark.

 

It’s a history. That was also driven by man-made policy choices that led to disinvestment and unemployment. People who had the power and the privilege to leave the city left the city and Flint became a place where things like poverty and violence became epidemic.

 

[7:28] General Motors left its birthplace and then also coupled with racist decisions. There was things like blockbusting and redlining that further segregated the city and then a lot of the people who were predominantly white to leave the city.

 

[10:55] there was this loss of regionalization where there was white flight and that left the city largely segregated and poor and pretty much abandoned highways were built so that the folks in suburbs could easily zip in and zip out and no longer contribute to the core of that City and this is not unique to Flint, this is in Detroit and many other cities.   

 

ABDUL VO: If this story sounds familiar – it’s because you heard a similar one last episode, when I was talking about Detroit’s failing social infrastructure. Flint’s only about 50 miles away, and the same economic, regional, and racist forces were in play in both communities. 

 

To recap what Dr. Mona just shared– In Flint, as in other rustbelt cities, as Black folks migrated to the city for work during the great migration, whiter, wealthier people… left. They moved to nearby suburbs in nearby communities, ironically facilitated by the cars rolling out of factories in the cities those people were leaving. Eventually, with the effects of globalization, whole factories would leave, too. 

 

One of Michael Moore’s first documentaries — Roger and Me — was about how GM forsaked Flint… 

 

ARCHIVAL – Roger and Me tape

 

ABDUL VO: So, what happens when a city’s businesses and a city’s wealthiest residents just up and leave? 

 

INTV – MONA: [10:18] So when Flint’s population population was cut in half they lost their tax base yet the infrastructure was built for a population twice his size with no longer the size nor the affluence to support those infrastructures. 

 

ABDUL VO: As the poor and working people still living in Flint struggled to keep their municipal government afloat, the State of Michigan passed a series of draconian “Emergency Manager” laws, robbing municipalities in financial distress of local control, basically installing an all powerful czar–who replaced all aspects of local government, with one goal. To cut costs and reduce debt.

 

ARCHIVAL – Headlines about second emergency manager law.

 

ABDUL VO: Not only were these laws anti-Democratic, but they were applied extremely unequally. At one point in the early 2010s, the majority of Black Michiganders were living under a state-appointed emergency manager. And that, of course, included the folks in Flint.

 

[18:17] the emergency managers came in in 2011. And like I said, there was a series of four of them and they had really like one job and that job was austerity. It was cut costs cut costs cut costs and they look to public employees to cut costs – for example cutting pensions, but they also looked at Public Utilities….and that’s where they turn their attention to our water system.

 

ABDUL VO: And this is where the Flint Water Crisis – as we know it – took off, with some fateful decisions by these emergency managers… 

 

INTV – MONA: [18:45] So Flint Purchases water from Detroit. It’s Great Lakes water. We have been purchasing this water for about half a century     We have been on Fresh Great Lakes treated water that we purchase from Detroit and when the emergency managers came in they decided that hey this, this is too expensive now for this city this poor predominantly minority near bankrupt City and to Save A Buck they would change our water source to the Flint River as a temporary move until a new pipeline to the Great Lakes was to be built.

 

INTV – ABDUL: [19:18] And what happened then?

 

INTV – MONA: [13:16] the water switch in Flint happened in April of 2014 and there was a lot of kind of noise in the media. Oh, you know the waters switch happened, the mayor toasted with a glass of water and you know, everything seemed to be fine. 

 

ARCHIVAL – Archival of Flint Mayor toasting water.

 

INTV – MONA: [13:28] There was some concerns about bacteria, but then there were boil advisories. There was all these like little news articles and local media, but at the end of every article there was reassurance that everything is okay that there’s nothing to worry about everything is in compliance coming from the state level. 

 

ARCHIVAL – Archival of reassurance from local officials about boil water advisories.

 

INTV – MONA: [13:45] So I had no reason to kind of doubt any of that because hey, there’s scientists and there’s rules and there’s laws and those regulations that are making sure that when I turn on my tap here in Flint or Detroit, wherever I am, my water is safe.

 

ABDUL VO: Okay, so a city down on its luck – having hemorrhaged much of its population due to the loss of industry and white flight needs to cut costs. These Emergency Managers come in and just say, water from the Flint River will do. they say, it’s safe! It’s fine! And the local news media, they echo that call. 

 

But every local knew the Flint River wasn’t safe to drink. Hell, it wasn’t even safe to swim in. GM had been dumping its waste water in that river for decades. In the 80s, every single one of GM’s plants had been flagged by the EPA for their dumping practices. 

 

And either way, brown water that smells funny coming out of your tap doesn’t lie… 

 

INTV – MONA: [19:44] Every home is different but there was discolored water. People said it tasted weird. It smelled weird. We had bacteria issues. There was boil advisories…. They added so much chlorine, which is a necessary disinfectant to kill that bacteria people felt like they were drinking a cup of bleach because of all the added chlorine … So red flag after red flag really almost immediately from the Water Source change, but throughout this whole period there was reassurance and reassurance.

 

ABDUL VO: Trust us, officials said. 

 

But something was definitely off. And here’s the crucial thing: as Dr. Mona came to discover, when the state’s emergency manager switched the city’s water source from Great Lakes water to Flint River water, they had made a critical error.

 

INTV – MONA: [22:59] The Flint River wasn’t the problem. I mean, it was part of the problem. It’s not an ideal water source. You should never go from a higher quality water source to a lower Quality Water Source, it would have been difficult to treat even if it was treated properly. But the problem with what happened in Flint is that it was missing an important ingredient called corrosion control and to me like a doctor I think of it like a medicine that you put in the water treatment and it prevents whatever’s in the pipes from coming out of the pipes and coming into our drinking water. It’s not a hundred percent foolproof. It’s not a hundred percent guarantee that we will have lead free water.But  it prevents the majority of blood release. So that wasn’t added.

 

ABDUL VO: To save $150 a day, the Emergency managers skimped on Corrosion control–which is critical for the drinking supply.

 

See, the Flint River Water was more acidic than the Great Lakes Water. And without corrosion control, the water started to, well–corrode the pipes–literally eat into them, leaching the contents of the metal in the pipes into the water.

 

And those pipes, now corroding into the public drinking water? They were manufactured a long time ago… using something that used to be *elemental*… 

 

INTV – MONA [21:11]  So do you remember the elemental symbol of lead? PB, it comes from the Latin plumbum, which means Plumbing.

 

ABDUL VO: Boom. 

 

So let’s talk about lead for second. It’s been used for centuries to create all kinds of things – toys and toothpaste tubes and makeup and paint and yes, pipes. Here’s why: aside from the fact that it’s literally poison, It’s a pretty incredible metal from an engineering perspective. It’s super malleable, but it doesn’t rust like iron or steel. Perfect for plumbing.

 

You know who were big fans of lead? The ancient Romans. Used it in damn near everything. They even purposely drank it. See, lead is sweet to the taste, so they used it to flavor their wine! Some historians think that this widespread use of lead had some pretty important historical consequences for Rome.

 

INTV – MONA: [21:29] There’s actually strong theories that the demise of the Romans is because they used so much lead in their plumbing… 

 

ABDUL VO: It’s pretty wild, but lead *has* been found in the bones of skeletons from that time. 

 

But while the Romans back in the day didn’t know it was dangerous, here in the US, we got wise to its dangers as soon as the early 1900s.

 

In a bitter historical twist of irony, the movement to ban lead from all products in the US ran right through the heart of Flint – through GM. At the time, lead was widely used in gasoline, it was used to keep engines from knocking. You know, when your car does this: 

 

ARCHIVAL: engine knocking 

 

It’s not used today – unleaded gasoline, anyone? – because of the advocacy and leadership of another passionate Michigan physician – not unlike Dr. Mona… 

 

INTV – MONA [36:23]  Even back then in the 1920s, we knew that lead was a poison and my favorite hero of all time is a woman named Alice Hamilton. She was a physician. She was a badass. She was a social justice Visionary…and in the 1920’s she was our nation’s expert on lead poisoning… So she went after General Motors with all her might in the 1920s and it’s reported that in a meeting with the Surgeon General, she confronted Charles Kettering in the hallway and called him out… 

 

ABDUL VO: That’s Charles Kettering – then CEO of General Motors.  

INTV – MONA: [37:12] And she said you’re nothing but a murderer isn’t this good stuff like public health history is awesome.

 

INTV MONA: [22:10] So there’s a long history of the well-known consequences of lead and water issues. But also a long history of our lack of any political will to do anything about it. So there’s lead our plumbing. The lead industry was powerful. It was evil; they had the upper hand.

 

ABDUL VO: Like the oil industry today, or big pharma, or wall street — the lead industry was super powerful back in the day — they lobbied the government to keep their interests protected. Which is why lead was used widely in all kinds of products. And why it took a long time to take the industry down.

 

But eventually we did. After efforts by many other scientists and activists, we got lead out of almost everything, like gasoline and paint and even plumbing… But not nearly as fast as we should have… 

 

INTV – MONA: [22:28] Lead in plumbing was allowed in our service lines until 1986. And those are the lines that go from a water main to the front of your house. But get this – lead in plumbing was allowed in brass fixtures  … and faucets until 2014. Nothing in Flint has been built after 2014. 

 

ABDUL VO: An outdated system of managing a poisonous substance meets an aging infrastructure in a city without the means of fixing it. State autocrats change their water supply and leave out the corrosion control to save a few bucks. That’s Flint.

 

One GM factory stopped using water from the Flint River after the Summer of 2014, way before the crisis broke–after they found that the Flint River water was rusting their engine blocks. Because they were the edge of Flint City Limits, they just hooked up to the neighboring community’s water supply. That’s something most Flint residents wished they could do.

 

If the water was rusting engine blocks, imagine what it was doing to the insides of every single resident of Flint…  

 

INTV – MONA:[23:41 ]  So the protective scale that had to built in around these pipes started coming off and the folks at the EPA said It was almost like we were drinking through a lead painted straw. And you never knew when a piece of the lead scale was going to come off those pipes and into the drinking water and into the bodies of our children.

 

ABDUL VO: After the break – Dr. Mona discovers what’s going on, confronts a government trying to cover it up, and forces the world to pay attention.

 

MID ROLL BREAK  – Here 

 

INTV – MONA: [14:28] Lead is well known to be a silent pediatric epidemic… I love to kind of trick my medical students and my trainees I’m like, how does a kid lead poisoning present and they’ll be like, oh, they have headaches and stomachaches and they’re doing bad in school or they have like whatever issues and the answer is no children would lead poisoning present with nothing it’s asymptomatic. We don’t see the consequences of lead exposure for years, if not decades down the road… 

 

[27:41] Lead in water is different. Lead in water is in a vehicle made for us to ingest the the peak risk exposure.

 

ABDUL VO:  Before we get deeper into how much of a badass Dr. Mona is, I want to talk a bit more about lead — because, in order to understand why this crisis is so devastating, you really need to understand what lead does to the human body – why Dr. Mona is about to go to some extreme lengths… 

 

As I explain this, I need you to appreciate something: lead is one sneaky bastard. 

 

SOUND DESIGN / MUSIC

 

See, lead is what we call an ionic metal. There are tons of really healthful ionic metals — they’re the usual suspects on the back of your vitamin bottle: calcium (for your bones), magnesium (for your brain and muscles), and iron (for your blood).

 

Lead is NOT one of those metals. But to the body, it does look like one. And once it’s inside the body, it disguises itself as one. It flows through the body, going to the parts those metals go, and then pretending to be them, replacing the other metals in the cells that use them most. But where those other ionic metals are necessary for our cells to function, lead poisons them. And it does this in some of the body’s most important tissues–the heart, the kidneys, the blood, the skin, and most importantly, the brain.

 

And that’s where lead is most dangerous for kids. Most of the time, the brain is protected from contaminants by a special barrier called the blood-brain barrier. But lead – that sneaky bastard – it passes through, disguised as calcium. There, it wreaks havoc – programming cells to automatically self-destruct.

 

This is really bad for everybody – but it’s particularly bad for kids, whose brains are still growing and developing. You can imagine what happens when, instead of building and making connections, brain cells are going into automatic self-destruct mode. Kids who are exposed to lead will bear the consequences their whole lives – with substantial IQ reductions.

 

And oh, once lead is inside the body, it doesn’t just leave. No, it sticks around. Disguised as calcium, it settles into the bone and hangs out there–leaching out slowly over time, continuing to poison the body for years to come.

 

Because lead damages the body slowly, it’s hard to detect. Real sneaky. And that’s why it’s often hard to detect large-scale poisoning until some years down the line, when it’s already too late… 

 

END MUSIC / SOUND DESIGN

 

Okay, so back to 2015 – 18 months since the state changed the city of Flint’s water source from the Great Lakes to the Flint River. The authorities are still saying the water is fine, don’t worry – but the people know, something’s off. 

 

So, a group of citizen activists reach out to researchers at Virginia Tech who had exposed other massive municipal lead crises, like the one in Washington DC in the early 2000s. They begin conducting research in Flint homes…

 

INTV – MONA: [16:58] incredible scientists from Virginia Tech University were doing working hand in hand with the citizens of Flint using citizen science where they were sampling, you know water throughout the city in every ward and finding lead in the water throughout the city. 

 

ABDUL VO: And that’s when Dr. Mona started to put two and two together.

 

INTV – MONA: [14:13] That was the summer of 2015. So almost a year-and-a-half after the water switch was the very first time that I heard about the possibility  of lead being in the water… 

 

[15:03] once I heard about the possibility of lead being in the water every patient was treated differently. So every and then there was also this possibility that everything that I was seeing in my patients could be attributed to the water. Like was that kids ADHD that I just diagnosed couldn’t have been related to the water or was this kid skin rash related to the water or should I stop telling that Mom to you know, drink water instead of pop. So everything that I was doing in my daily practice became altered after I heard about the possibility of lead in water.

 

ABDUL VO: Just imagine this for a minute – being a pediatrician and realizing that all this time, to get them to avoid soda and juice, you’ve been telling your patients’ parents to have them drink more water–and now having to rethink what that might have meant. Imagine knowing that every time those parents gave their kids bath, or mixed their formula with water, or rinsed off their cut or scrape–they could be poisoning them.

 

As a clinician, seeing patients one by one, Dr. Mona wasn’t gunna be able to solve this–she needed to figure out how to prevent the lead poisoning in the first place. She needed to answer the question that was now on everyone’s mind: was the State of Michigan’s decision to change the water source causing lead poisoning in Flint kids? 

 

INTV – MONA: [24:20] Yeah, so I knew I knew that I would need science. I knew that I would need data and evidence to make a dent in the story through kind of my past experience and career. I knew that whenever I had data in my pocket it, you know, it was easier to make an argument and kind of present a case.

 

ABDUL VO: Dr. Mona is also an epidemiologist–trained to interpret and perform large-scale studies to identify what makes us sick. Think back to John Snow, who I introduced you to at the beginning of this series–he used maps and early statistics to ask if there was something in the water that was causing cholera. Dr. Mona was now using the same set of tools–albeit far more advanced–to ask if there was something in the water causing lead poisoning. But she needed the right data…

 

INTV – MONA: [24:39] So I knew that all blood levels that we do in our state are part of surveillance program. So I am just one pediatrician in one clinic in Flint. I cannot tell you what’s happening at a population level that’s really kind of the crux of the difference between medicine and public health. You know, I can’t tell you about trends or tell you if things are getting worse or better like at a big population level, but fortunately we have surveillance programs. We have them for things like the flu and other kind of big issues. I tried to get the data the blood level from those surveillance programs both at the county and at the State Health Department level I was unsuccessful. So then I was stuck.    

 

INTV – ABDUL [25:19 Why were you unsuccessful?

 

INTV – MONA: [25:19] Because they didn’t want to share that information. The County Health Department actually said they could give me like one PDF of one child at a time. I’m like that is that is not Public Health. This is like epidemiology 101. 

 

[25:51]  So I was stuck I wanted to get this information. So then I realized that my hospital here the Hurley Children’s Hospital is kind of the only shop in town  and not only. Do we process labs for my clinic which does see the most kids it actually processes labs for most of the clinics around our hospital.

 

So we went through the proper approvals something called IRB, which is the institutional review board, which makes sure that we’re doing things ethically and protecting patients. We went through all the proper processes and  was able to retrieve all the lead levels of children. We compared the levels before the water switch to lead levels after the water switch.

 

ABDUL VO: By now, you already know what she found.

 

INTV – MONA: …after the water switch the percentage of children with lead levels five micrograms or greater within the water limits had doubled. There was no change outside of the city water limits and in areas where the water lead levels were the highest we also saw the greatest increase in children blood lead levels.

 

 [26:31] What we found was not surprising it was heartbreaking and it was saddening and it made me mad…

 

[28:55] Yeah, that was a moment that I literally wanted to scream from the top of Hospital’s roof. Like I wanted to stand up there with a megaphone and say this is a big problem.

 

ABDUL VO: Yeah, big effing problem. 

 

The findings were conclusive. Dr. Mona needed to get the information out to the world, but there was an issue… 

 

INTV – MONA: [29:18] The peer review process age-old process really important that your peers check your work. How long does that process take? 

 

INTV – ABDUL: [29:23] Months if not years…

 

INTV – MONA [29:26] Months if not years, but our Flint kids literally didn’t have another day. 

 

ABDUL VO:  As we discussed, science is a process. And that process can be slow, requiring the back and forth of peer-review. Her findings did eventually get published in the American Journal of Public Health–a full 8 months later. Flint Kids didn’t have that kind of time. So she went right to the press herself.

 

INTV – MONA: [29:34] I did an academic no, no, like I literally walked out of my clinic with a white coat on and I stood up at a press conference, which is not what doctors and scientists do 

 

ARCHIVAL: Mona presser

 

ABDUL VO: Yeah, Dr. Mona is a badass… She put her academic reputation on the line to ring the alarm bells. She went out of her way to put Flint kids above herself. 

 

You’d hope a doctor putting that much on the line to ring the alarm would have politicians beside themselves —that they’d be spurred to action by the truth of this science, and the integrity of this doctor. 

 

Nope. 

 

INTV – MONA [30:38] Anybody who had said anything of concern was was attacked. So I was sort of prepared for that but nothing can prepare you for when the state and almost every arm of the state comes out and tells you you’re wrong that your science is wrong that you were slicing and dicing numbers that you’re an unfortunate researcher that you’re causing near hysteria and at their numbers and remember they had the numbers they had those surveillance numbers and they said their numbers were not consistent with my numbers.

 

[31:09] I felt defeated. I felt small. I felt scared.

 

ABDUL VO: The scientific process moved a lot slower than the moment demanded, but government — the other half of this public health equation — they moved quite quickly… but instead of doing anything about it, they tried to deny they did anything wrong.

 

Archival: Officials denying anything was wrong.

 

No one at the state, no one at the emergency manager’s office, no one at the county, no one at the city wanted to admit that government had poisoned kids. They denied any problem even existed — even though Dr. Mona knew the state had this data. Though in the footsteps of many a strong woman, nevertheless, Dr. Mona persisted. 

 

INTV – MONA [31:33] And then I realized that they can go after me all they want, that this had nothing to do with me – but everything to do with my kids, my children, who as a pediatrician, like I have literally taken an oath to protect.  So I quickly kind of recouped and we fought back with more numbers, more science, more evidence. A growing team was at my side media journalists from all over started to pay attention…

 

ABDUL VO: And that opened the avalanche of coverage that would come to dominate headlines for months. 

 

ARCHIVAL: Major network nightly news reporting from Flint

 

ABDUL VO: You know all about that version of the story, cause you saw it – it was hard to miss. The spotlight shined brightly on Flint. And though it brought action…it still wasn’t as much as Flint needed.

 

The state began providing bottled water and they switched the water source back to the Great Lakes. But with the pipes already leaching lead into the water, simply switching the water back wasn’t enough. And though both the state and federal government passed a few aid packages, it really wasn’t enough to quickly solve the source of the problem: getting the leaded pipes out of the ground. 

 

Even today, in the fall of 2019, Flint still has lead piping. And what about the bigger issue? What about providing every single person in Flint who was poisoned the healthcare support, the financial support, and the educational support they need to heal? We’re still far, far away from that.

 

The recovery from the Flint water crisis deserves its own ten episode podcast series… but I want to step back. Because in shining the spotlight exclusively on Flint, we’ve missed something bigger. 

 

INTV – MONA: [33:45] You know how that the story of Flint is not an isolated story, you know, it’s really about kids all over this nation who wake up to the very same nightmares black brown white rural urban all over kids are waking up to the same situations where their zip codes literally are the greatest predictors of their trajectories.

 

ABDUL VO: The story of Flint sounds a lot like the story of Detroit–because it IS that story. It’s the story of low-income, predominantly black and brown communities throughout this country whose children are poisoned by lead. It’s a story we could tell in SO many American cities–and now, it’s a story we ARE telling about Newark, New Jersey, which, in the Fall of 2019, is dealing with its own lead in water issues 

 

ARCHIVAL: headlines from water press conference in newark

 

See — Flint and Newark are the tip of the iceberg – we see them because what happened was egregious enough to rise above the surface. But often with icebergs, the deadliest part is the part you can’t see, sitting below the surface.

 

In Detroit, there are zip codes that have three times the prevalence of lead poisoning than Flint did–at the height of the crisis. And that’s the story in too many other major cities, too. Who suffers? Kids who are disproportionately black and brown. That lead is rarely ingested through water – instead, it’s usually leaded paint that chips off the walls of old homes, there from the time before it was banned. But either way, the victims are marginalized people in segregated communities, whose children are being poisoned by a substance we’ve known is dangerous for over a century.

 

INTV – MONA: [34:50] our carrier kids in Flint already had higher levels just like kids in Detroit and Chicago and Baltimore on Philly and all these places where our children are already struggling with every kind of toxicity of life…

 

[35:02] It persists. It is nestled in our soil under layers of paint and delivering our drinking water throughout this country. So we continue to live with the lingering Legacy of lead and really with the industry and profit-driven corporations that that put it into all this all these uses.

 

[38:25] lead has silently poisoned generations of children, and this is an industry that has yet to be held accountable. 

 

ABDUL VO: Preventing disease isn’t just about having the knowledge that something is dangerous. It’s about having the means and the will to prevent it. 

 

That requires a government you can trust to protect you, a government you can trust to work in your best interest – in short, a government that works like it’s supposed to, like we consented to in the first place.

 

See, the rich and powerful in society, they can usually provide themselves the means of prevention. Their wealth and privilege protects them. But for poor folks, for marginalized folks – their health is so much more a consequence of government decisions. And when government fails – whether in an instant, like in Flint, or over decades, like in Detroit, these folks suffer. 

 

That bears out in lead. But it also bears out in asthma, and diabetes, and heart disease. And it bears out among the old–and the very young, whom we’ll discuss more next episode.

 

And these effects compound over the course of a life. If the lead doesn’t get you, the asthma might. If you dodge both of them, watch out for the diabetes. 

 

Worse, the consequences of government failure reverberate. Long after solutions are proposed and debated and…even implemented, the fundamental trust that died with that initial failure, it doesn’t just come back to life. 

 

INTV – MONA: [39:22]  I think part of the reason we got into this Water Crisis was because of long-standing attacks on government. That big government is bad that you know, these austerity driven policies that had stripped a lot of our bureaucracies over Decades of their institutional memory of their expertise.

 

Of funding which is arguably one of the reasons that we got into this crisis. I’m not saying we need big government, but we need smart government and we need transparent government and we need government that is representative of the people and I think that’s one of the greatest lessons of this crisis.

 

ABDUL VO: In Flint, the consequences persist today. Government officials like to tell Flint residents that Flint water has tested within normal limits for a few years now–but there is no safe amount of lead in water. And those lead pipes are still in the ground. And the government’s said all this before. So Flint residents… well, I’ll leave it to them.

 

MKT – JAMAR:  As much as I trust everything else about the government so enough.  Enough. 

 

MKT – ABDUL: Do you trust the water?

 

MKT – JANET:   No, I still don’t 

 

MKT – ABDUL and what do you do for water? You drink the water from the tap?

 

MKT – JANET: We have buy it from the store…

 

MKT – ABDUL Do you trust the water?

 

MKT – SANDRA:  Do I? Just as much as I trust Governor Snyder and I don’t I wouldn’t trust him….I don’t why would I can’t even trust him with my life.  I know I don’t trust the water. I don’t know at all. I don’t even give it to my dog’s I don’t even water my plants with this water. I use bottled water to water my plants. 

 

ABDUL VO: Public health – it’s all about trust, in science, in government. And that trust is long gone.

 

But there are good people fighting the good fight. They’re working to heal kids in places like Flint–and in Newark and Detroit and Pittsburgh and DC and Chicago. They’re building institutions to provide kids healthy fruits and veggies that can mitigate the harmful effects of lead in the body. They’re building comprehensive early childhood education centers to combat the effects of lead on the brain. And they’re building awareness to make sure that something like Flint never happens again.

 

But for now – if you’d like to support the work being done to support the kids of Flint, check out Dr. Mona’s project – go to flintkids.org.

 

America Dissected is a production of Crooked Media. Our producers are Austin Fisher, Cary Junior II, and Katie Long. Andrea B. Scott is our story editor. Our sound designer is Daniel Ramirez. Production support from Alison Falzetta (Fall-ZET-ta), Elisa (AY-lisa) Gutierrez, Kara (CARE-ah) Hart, Daniel Porcerelli (PORE-sir-el-ee), and Tara Terpstra. Fact-checking by Dr. Nicole Aiello (aye-YELL-low). The theme song is by Taka Yasuzawa (TAAK-ah Yaas-oo-ZAH-wah) and Alex Sugiura (SOO-ghee-er-ah). Our executive producers are Sarah Geismer (GUISE-mer) and Mukta Mohan (MO-haan). Special thanks to Jon Favreau, Jon Lovett, Tanya Somanader (SOW-men-ay-der) and Tommy Vietor. And I’m your host Dr Abdul El-Sayed. Thanks for listening.