Girls Who Green the World

Mona Hanna-Attisha
Health Activist, and Pediatrician at Hurley Medical Center
The Erin Brockovich of Flint, Michigan
I AM ODDLY GOOD AT: puzzles
I AM ODDLY BAD AT: all domestic duties
MY GREATEST FEAR: not doing enough
THE TRAIT I MOST DEPLORE IN MYSELF: my gray hair
AN OCCASION WHEN I LIE: to protect my kids
A WORD OR PHRASE I MOST OVERUSE: “awesome”
A HABIT I’M TRYING TO GIVE UP: nail-biting
SOMETHING I USED TO DO BEFORE I REALIZED HOW BAD IT WAS FOR THE ENVIRONMENT: use lots of plastic
On April 25, 2014, city and state officials gathered at the Flint, Michigan, water treatment plant for a photo opportunity. The mayor counted down dramatically—five, four, three, two, one—and then pushed a black button, switching the city’s water source from the Detroit Water and Sewage De­partment, which gets its water from Lake Huron and the Detroit River, to pulling from the Flint River. So much money would be saved by transition­ing to the newly formed Karegnondi Water Authority, which was build­ing a pipeline to transit water from Lake Huron. This interim step using delicious and clean Flint River water was how the city would bridge the change during two years of construction, cheered government officials. For the cameras, Flint’s mayor lifted his glass of Flint River water and took a gulp. He would come to wish he hadn’t.
Pretty much immediately, Flint residents started reporting rust rims around their sinks and toilet bowls. Their tap water looked like pee, or worse. Demonstrations proliferated, with angry locals holding up bottles filled with yellow-brown water. Save a few “boil alerts” issued here and again, the mayor, other city officials, and the governor ignored every cry.
At first, pediatrician Mona Hanna-Attisha was racing through rounds at Flint’s public hospital, too busy to pay attention. If the government said the water was fine, the water must be fine, she told her childhood best friend, once an investigator at the Environmental Protection Agency, in August 2015 while catching up in Mona’s backyard. Elin Warn Betanzo, the friend, shook her head. Elin had just moved back to Michigan from Wash­ington, DC, where she’d been focused almost exclusively on water pollu­tion issues. Once upon a time, Elin and Mona had been proud members of their high school’s environmental club, mixing their “grungy, R.E.M.-listening, Doc Marten” vibe, as Mona put it, with real action like fighting to shut down an incinerator spewing toxic pollution one town over. They both retained their stay-and-fight attitudes. Elin had inside information showing that Flint’s new water wasn’t being properly treated. An essential anti-corrosion element wasn’t being added, which meant Flint’s water was likely leaching lead out of the water pipes, poisoning everyone in town.
Lead is a neurotoxin, meaning it affects the brain. In kids, it lowers IQ levels. In pregnant women, it can lead to miscarriage. There is no minimum safe threshold to stay below. The safe amount is zero. No amount of lead is ever remotely okay.
That night, Mona couldn’t sleep. Every hour brought a new emotion: fear, disappointment, anxiety. By morning, the feelings had distilled into just one: anger.
The Flint children that Mona treated at the hospital had already been facing a long list of issues associated with poverty—crumbling schools, irregular diet, and unemployed parents. The idea that their most basic need, water, couldn’t be met was unconscionable.
Then Mona had a breakthrough. She thought of a way to get to the bottom of the situation. When the Clean Water Act was passed in 1972, a requirement was instituted to protect the poorest, most vulnerable chil­dren. Because poisoning from lead paint was such a problem in old homes and buildings, all kids whose families were on Medicaid were to be blood-tested for lead at ages one and two. To Mona, this meant one thing: the ready existence of extensive lead-level blood tests for young Flint kids. She immediately contacted the Genesee County Health Department and requested the results of recent blood tests. But instead of having a helpful researcher call her back, she got a vague email suggesting that perhaps the county health department could start a study of lead levels in youth blood samples the following spring. The following spring? While kids con­tinued to be poisoned for months and months? Her anger shot to fury.
She picked up the phone and called the state health department. A year earlier, she had met a nurse who worked in the department’s Childhood Lead Poisoning Prevention Program, and she had dug up her number. Unexpectedly, the woman answered. After hearing Mona out, she said that, well, yes, actually, they had observed a spike of late in the lead in blood tests. She would email Mona the data right away. All afternoon, Mona refreshed her email over and over, and all evening, and again all the next day. But no data. Then, in a fit of rage, she had a flash of brilliance. Wait a minute, she could work this problem—prove a jump in lead levels—from inside her own hospital.
All county data was processed through the Hurley Medical Center, where she worked. She ordered a data dump of her clinic’s pediatric pa­tient data. She then set about figuring out which time periods exactly to compare, and how to deal data-wise with kids who had been tested mul­tiple times. Just 270 kids had been tested in her clinic in the three months before the water changeover, and 71 since. Still, these numbers told a story, and it wasn’t pretty. A tiny sample, yes, but lead in children under age five was up over 400 percent in the period following the switch to the Flint River, relative to the same period before.
Mona was tempted to pull the emergency brake right then, call the media, and announce her findings. The consequences of delay were grow­ing graver with every additional hour. But she knew that the larger her sample size, the more bulletproof her evidence. Yes, those 341 blood tests were ringing alarms, but getting a lead-level reading on every kid in Gen­esee County (where Flint River water flowed) would add much more heft. Her hospital came through. If she entered a formal research proposal requesting the results, and the review board sanctioned her study, she would get the numbers. At a big university, the process normally takes several months. But luckily, she worked at a small teaching hospital where decision-making could happen quickly. The reviewers at Hurley turned the request around in a day. Boom, she got her data. Now she had the results for two thousand tests. Depending on what age grouping she used, and which zip codes, she saw a jump in lead levels as large as 200 percent after the switchover.
“Do no harm” was part of Mona’s Hippocratic oath as a doctor. But it wasn’t just her medical background that had led her to this crucible mo­ment. Mona had been born into a family of progressives and pacifists in Iraq. When her dad, an engineer, had been told he’d need to go to work making nuclear weapons for the repressive Ba’athist regime, he’d taken the family and fled, first to England, then to Michigan. Mona’s parents didn’t shield her from the harsh truth of chemical weapons attacks, air raids, and millions dead in the needless Iran-Iraq conflict. “We were always hoping to go back, thinking the time was coming, but then we never could,” she reflected, sharing her backstory now, six years after she blew the whistle on Flint. She considers this family history her “superpower.” “It gave me a heightened antenna for injustice,” she said.
Several months into her lead-poisoning investigation, Mona learned that General Motors (GM) had quietly made a deal to switch away from Flint River water at their Flint plant. Reason: Flint River water had been corroding metal parts. Another rain cloud to add to Mona’s gathering storm. Still, she worried the media and bureaucrats would find a way to make her look like the boy who cried wolf. She tried to imagine every pos­sible way they might attack the facts that she had compiled. She ran her stats a dozen different ways, adjusting for factors like weather or instances of kids having multiple blood tests.
On September 24, 2015, just after one p.m., Mona stepped up to the mic in her hospital’s conference room. For forty minutes, before a crowd of a hundred politicians, press, and distraught citizens, she slowly revealed the evidence. She explained, as Elin had told her back in August, that the Flint River water wasn’t being treated to prevent lead pipe corrosion. She ended with a clear directive: an immediate switch to Lake Huron water was critical.
The blowback took mere minutes. The city’s public relations (PR) head called the media, accusing Mona of “slicing and dicing” data. He deemed her conclusions “irresponsible.” A counter-spin press conference was hast­ily arranged, and officials repeated in various forms: The water is safe. The water is in compliance. The water meets state and federal standards.
Only the work of an intrepid Flint Journal reporter digging into Mona’s numbers and replicating her findings managed to turn the tide back to­ward truth. The reporter revealed so many cover-ups: city managers who had manipulated water tests to hide the lead; a regional water administra­tor who had said, by email, “I’m not so sure Flint is the community we want to go out on a limb for”; a Flint government office that was having bottled water delivered daily.
Flint families were drinking Lake Huron water within weeks of Mona’s announcement. But it would take until January 2021 for Rick Snyder, the governor of Michigan during the water crisis, to be charged with a federal crime—neglect of duty. The sentence, if he’s convicted, could mean jail time.
Mona isn’t stopping with Flint’s enablers. To her, the Flint water scan­dal is just one example of something far more pervasive—environmental racism. In communities with low tax bases and poor, disenfranchised citi­zens, environmental protections are almost nil. There are still ten million lead pipes running through predominantly poor neighborhoods in the US. What happened in Flint would not have “happened in Birmingham or Grosse Pointe [rich, white communities]. Race and demographics played a part in this story,” Mona stressed, as they do in so many other stories like it. She is pressing Congress and the US Food and Drug Administration (FDA) for policy upgrades and health-based lead standards. She’s not merely a pediatric doctor anymore; she’s a justice warrior.