Jake May/THE FLINT JOURNAL-MLIVE.COM VIA ASSOCIATED PRESS
On a cold Tuesday afternoon, Kiara Settle walks into the gym at Eisenhower Elementary School, sits down on a set of bleachers and begins bouncing her two-year-old son Kristian on her lap. The room is loud with music and the happy shouts of children. A local health-care company is giving out balloons twisted into the shapes of swords and crowns. On the other side of the room, volunteers are serving sandwiches, juice packets and bags of chips.
While the kids run around and dance, the adults are watchful. They recognize this gathering for what it is: not a school event or a community get-together, but a way to gauge the level of lead in their children's blood. Outside the gym, a line of parents waiting for the necessary forms stretches into the adjacent auditorium. Down the hallway, children shuttle in and out of a classroom where health workers prick their fingers with needles.
Before starting to talk, Ms. Settle, 24, takes a steadying breath. Kristian was born in 2013, the year before Flint switched the source of its water supply in order to save money. That decision, combined with negligence by government authorities, allowed lead – a toxin that can cause brain damage, particularly in children – to leach from pipes and faucets into the city's drinking water. Nearly 18 months would pass before any official warning about the risks.
Unlike in some other homes, Ms. Settle's water never turned brown; until several months ago, she was using it for cooking, baths, to brush teeth and occasionally to drink. Back in October, Kristian had his first test for lead – and the doctor informed her that the results showed an elevated level in his blood. Kristian, a toddler with wide eyes and a toothy grin, squirms as she speaks. Ms. Settle begins to cry.
"I'm hurt, I'm angry," she says. "Any damage is irreversible. My baby didn't have a chance out of the gate."
Born and raised in Flint, Ms. Settle wants to leave the city behind, and maybe move to Grand Blanc, a nearby suburb. "I don't think it's safe for my children to be here," she says, wiping tears from her cheeks. "They should be able to drink the water, to bathe in the water."
In some ways, this is a quintessentially American town: built to greatness on the back of the car industry, hollowed out by the decline of manufacturing, plagued by high rates of poverty and crime and unemployment – but trying, slowly and haltingly, to recover.
Then came the water crisis.
Flint – a poor city, a majority African-American city – had found itself at the mercy of decisions made by an unelected official, an emergency manager, whose goal was to cut costs. Then the complaints of its citizens about the quality of the water were repeatedly dismissed, belittled or ignored: Residents protested that their drinking water looked, smelled and tasted awful, only to be told by their mayor and state officials that it was perfectly fine. That kind of lack of concern, some say, could have happened only in a city disadvantaged by the race and class of its citizens.
In this fractious political season, 10 months before a presidential election, there is unanimity that what happened in Flint was a betrayal of the most basic functions of government. Last week, representatives of a right-wing militia in Michigan – who rarely set foot in this heavily Democratic city – handed out bottles of water on the street in a show of support. Candidates from both major parties, who agree on little else – Ted Cruz, Hillary Clinton – have expressed their outrage.
For the 100,000 residents of this beleaguered midwestern city, already struggling with high rates of poverty and crime, the future is filled with unanswerable questions. No one is sure when the water will be safe to drink again, or how much it will cost to repair the city's infrastructure to ensure public health. It is unclear how many people, tired of lies and neglect and worry, will move out of the city. And most of all, it is impossible to quantify, for now, the true extent of the exposure to lead among the city's children.
"The bottled water, the filters – that's a Band-Aid," says Mona Hanna-Attisha, a pediatrician in Flint who played a central role in exposing the water crisis. "We need to think about tomorrow, because this is an issue that we will be dealing with for a long time to come."
"Our kids have every obstacle to their success," she says. "And then we gave them lead."
JAKE MAY/THE FLINT JOURNAL-MLIVE.COM VIA ASSOCIATED PRESS
'TRYING TO KNOCK US OUT'
That a man-made disaster should strike Flint is a source of deep anger and grim humour to its residents, who have grown accustomed to misfortune.
"It's like they're trying to knock us out; that's how it feels," says Ryan Thorn, 27, a lifelong resident of the city. "Whether it's systemic or an accident, that doesn't do anything to soften the blow."
Investigations are under way into what state and federal authorities knew, why they failed to respond promptly, and whether their actions were illegal and possibly criminal. But alongside the issues of illegality are questions about a failure of the political system.
The roots of the crisis go back to October, 2013, when Rick Snyder, Michigan's Republican governor, appointed an emergency manager in Flint for the third time in three years. By law, the manager takes control of the city with the mandate to repair its dire finances.
To cut costs, the emergency manager approved a change in the water supply, from Detroit, an hour to the south, to the Flint River. Chia Morgan, 29, a local social worker, says the switch became the butt of jokes among her friends. The Flint flows right through town and was considered a polluted relic of the city's industrial past. When people start acting crazy, Ms. Morgan and her friends said, it'll be because of that Flint River water.
After the switch in April, 2014, people immediately noticed the difference. The water smelled like rotten eggs, Ms. Morgan says, at times with a yellowish tinge, like "the colour of butter on grits." Another resident said the water had an odour like a science project gone wrong; others said it would turn cloudy, or reddish, or brown. Some people got strange rashes, or broke out in hives.
At various points in 2014, state authorities instructed people in Flint to boil their water, since they had detected the presence of E. coli. To tackle the bacteria, more chlorine was added. That led to the presence of trihalomethanes, or THMs, a carcinogenic by-product of chlorine. Elderly people and infants were advised to temporarily avoid drinking the water.
Those incidents were only the tip of the iceberg. Municipal water is often treated with anti-corrosion additives to keep it from wreaking havoc with older plumbing systems made of iron and lead. Yet, when Flint switched to its new water source, state authorities failed to ensure the continued use of such additives – even though the river water was several times more corrosive than the city's previous supply. The result was that, with each passing day, the water corroded Flint's aging plumbing, leaching iron and lead into the water supply.
During that period, there was also a spike in cases of legionnaires' disease, a bacterial infection that causes pneumonia. Ten people died. Officials are now investigating whether the outbreak can be traced to the change in drinking water.
JAKE MAY/THE FLINT JOURNAL-MLIVE.COM VIA ASSOCIATED PRESS
HAD SHE SEEN THE REPORTS?
On a recent morning, Dr. Hanna-Attisha sweeps into the pediatric emergency ward of Flint's Hurley Medical Center clutching a large coffee. The daughter of Iraqi immigrants, she arrived in the U.S. at the age of 5 and grew up in Royal Oak, a suburb of Detroit. Ever since a fateful dinner party back in August, the water crisis has taken over most of her waking hours.
On that evening, Dr. Hanna-Attisha was enjoying an impromptu reunion with two friends from high school. One of them – a water expert who used to work for the U.S. Environmental Protection Agency – pulled her aside. Had she been following the reports of lead in Flint's drinking water issued by researchers at Virginia Tech? Dr. Hanna-Attisha had no idea what her friend was talking about.
Alarmed, she resolved to seek out answers. The State of Michigan wouldn't make available its data on lead levels in children's blood, so her hospital's research department found an alternative. Hurley acts as a clearinghouse for blood samples from around the city, sending them to laboratories and receiving the results. Dr. Hanna-Attisha and a colleague analyzed that data, which they believe represents about 70 per cent of the testing performed on children in the city. They worked late into the night, checking and rechecking their numbers.
A month later, she was ready to share her findings with the public. On Sept. 24, she stepped up to the podium at a packed press conference and announced her results: The percentage of Flint children with elevated levels of lead in their blood had jumped after the switch to the new water source. In some areas, the percentage of children with elevated levels had doubled or tripled; in one hard-hit ward northwest of downtown, 15 per cent of children had elevated readings.
Dr. Hanna-Attisha believes, however, that the data used in her research underestimates the exposure: Lead in water has a greater impact on infants, and routine testing doesn't start until age 1. Later that afternoon, the spokesman for the Michigan Department of Environmental Quality, which is responsible for ensuring the safety of drinking water, denounced her research and called Dr. Hanna-Attisha an "unfortunate" researcher who was stoking hysteria.
A few hours later, she was at her daughter's school for a curriculum night. She recalls feeling "physically ill" – her heart was racing, her hands shook. When she got home, she curled up in bed, full of self-doubt.
"When the state tells you that you're wrong, how can you not second-guess yourself?" she recalled. "They have a team of 50 epidemiologists. This was me and my co-worker."
The press conference created a public outcry. While a handful of activists, parents and academics had warned of rising amounts of lead in Flint's water, no one had looked at the impact on all the city's children. Now a well-known doctor in the community was confirming residents' worst fears.
CHELSEA PURGAHN/ASSOCIATED PRESS
One person paying close attention to Dr. Hanna-Attisha's conclusions was Bilal Tawwab, the school superintendent in Flint. He immediately thought of his obligation to protect the 5,500 children in his care. Then he wondered how on earth his financially strapped school district – already attempting to eliminate a deficit – was going to pay for bottled water. Two days after the press conference, Mr. Tawwab had all the water fountains in Flint public schools shut off or blocked. (In the hallway outside his office, there is one covered in tape.)
And then, one week after it rejected Dr. Hanna-Attisha's findings, the state reversed course. Health authorities said that their data confirmed the trend evident in her research. It is unclear why they did not sound an alarm earlier. Around the same time, they began to test the water in the schools. The federal standard for taking action on lead in water is a level above 15 parts per billion. Three schools in Flint had water above that level, Michigan authorities said in October. One, Freeman Elementary, reported a sample with 101 parts per billion.
Bruce Lanphear, a professor at Simon Fraser University who is an expert in environmental toxins, says that "the particular tragedy of Flint is that it was wholly preventable with very little cost." From the kind of lead exposures seen in Flint, Prof. Lanphear says he would expect to see an increase in low-birth-weight babies and miscarriages. Then, when today's infant and toddlers enter school, he says, "You'll start to pick up some of the kids struggling a little bit with reading and math and behavioural issues."
"You may not notice it if you don't look for it," he adds. But "this is sufficient elevation [of blood-lead levels] that you would, if you measure it, find a noticeable difference in the reading levels or intellectual abilities" in this cohort of children compared with prior ones.
There is no treatment to reverse lead poisoning, only interventions that can mitigate its impact. In some cases, they're the same things that should bolster the development of any child – good nutrition; high-quality, universal preschool; early literacy programs. In other cases, they will be special services for children who need extra help.
I ask Mr. Tawwab if he is confident schools will get the financial resources they need to support kids who have had elevated levels of lead in their blood. He smiles ruefully and tells me to check back in two months.
"You're talking about potentially a generation of kids – that's huge," he says. "It definitely keeps you up at night."
JAKE MAY/THE FLINT JOURNAL-MLIVE.COM VIA ASSOCIATED PRESS
CAMOUFLAGE AND COMBAT BOOTS
Along Flint's uneven roads, dotted with potholes, there are new signs telling motorists to reduce their speed: Water Pickup Ahead. All the city's fire stations, together with a number of its churches and government offices, are now water-distribution points. At Fire Station 3 on Martin Luther King Avenue, members of the National Guard in camouflage uniforms and combat boots – all volunteers from other parts of Michigan – carry cases of bottled waters for the elderly and infirm.
KeyKey Phillips, 37, walks back to her car with a case on her hip. "It's just horrible to know your city did this to you," she says. She and her mother, who is 58 and has suffered two strokes, recently watched a movie made in Nigeria, which she found enlightening, in an ironic way. "They have to walk to the river to go get the nasty water, then figure out a way to purify it," she adds.
Ms. Phillips is using bottled water for all her cooking and to bathe her three-year-old daughter, while she takes quick, cold showers (lead levels are likely to be higher in hot water). "All I want is a major fix," she says. "Just fix it."
In mid-October, Flint switched its water source back to the Detroit system. But lead levels in the water remain elevated in some homes because of the earlier corrosion. Authorities are handing out filters and lead-testing kits, but the confidence in the efficacy of such measures is non-existent: Many residents I spoke with didn't believe the filters actually worked to remove all of the lead, a reflection of their mistrust in any assertion by the government.
Daniel Giammar, a professor of environmental engineering at Washington University in St. Louis, says that returning to the Detroit water, which is treated with anti-corrosion additives, will help the pipes start to repair themselves, but the process will take time. "In terms of getting back to where you were, one year is not unreasonable," he says.
Prof. Giammar adds that, while Flint is a cautionary tale, he would love to see it turned into an example. "Flint would be a nice case for the U.S. to say, 'It's not that big of a city, let's see what the benefits are of removing every lead pipe in Flint.'"
Dr. Hanna-Attisha also believes that, with the right combination of resources and effort, Flint could defy the worst-case scenarios for its future. She is helping to build a public-health initiative that will assess the extent of the lead exposure, monitor its consequences and intervene to lessen its impact.
She recently spoke with Karen Weaver, Flint's newly elected mayor. "Like me, she feels that we can flip this," says Dr. Hanna-Attisha. "Sometimes you need a disaster to rise from the ashes, and I see that's what's going on right now."
On the streets of Flint, however, there is no such optimism. Ryan Thorn, who lives with his wife, Krystle, and his seven-year-old stepdaughter, says the family wants to leave to city or find a house with its own well: "It's really just a nightmare that nobody's waking up from any time soon."
The apologies from Gov. Snyder don't feel sincere, he adds, not after the neglect that made an entire community feel "unwanted," he says. "We feel 'less than,' " interjects Ms. Thorn.
One afternoon, I run into a federal official who is part of the emergency-response team now in Flint and asks not to be identified. I ask him how the government can regain the confidence of the people of Flint. "If you figure it out, will you let me know?" he asks. It was only partly in jest.
He says he believes that, in a wealthier community, one with greater political power, the original decision to switch to the Flint River – a manifestly lower-quality source of water – would never have happened in the first place.
Back at the lead-testing event at the elementary school, Marguita Hall, 28, is filling out the forms for her five children, the youngest nine months and the oldest age 10. Two of them, Jalon, 8, and Jakayia, 6, have already tested positive for elevated levels, months ago.
Ms . Hall watches as Jakayia, her braids in pigtails, runs around the gym and dances to the music. "I don't think that there's no solution to it," she says. "There's no certain way to get it out of the kids. You gotta pay for water that you can't drink. We don't even feel like we're in America. Everyone has it better than us and they're watching us struggle."
Joanna Slater is the U.S. business correspondent for The Globe and Mail.