Dr. Mona Hanna-Attisha had hard evidence that thousands of people in Flint had been exposed to toxic lead in their drinking water. The pediatrician and public health expert figured city and state officials would share her shock and join her in alerting residents.
They did not.
Hanna-Attisha — who recounts the water crisis in a book that goes on sale Tuesday— had science on her side but not the scientific protocols of waiting for peer-review and publication. She opted not to wait.
"Kids did not have a day to spend," Hanna-Attisha told The Associated Press in an interview ahead of the release of "What The Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City."
"Eventually we did get this published and peer-reviewed. But when there's an emergency and a crisis the most important thing is alerting the people."
There's been abundant shame and blame to go around since the pioneering industrial city that's struggled with economic and racial woes for decades found itself in another disaster. Attisha, director of pediatric residency at Flint's Hurley Medical Center, lays out the breakdown across city, county, state and national lines. She includes herself in her role as a public health practitioner and advocate for initially assuring her patients that the tap water was safe to consume.
The book offers a tick-tock of the crisis, starting with how conversations with a childhood friend who became an environmental engineer got Hanna-Attisha looking more deeply and discovering widespread exposure to lead, which has been linked to developmental and behavioral problems. Hanna-Attisha goes further, railing against decades of officials in the U.S. and beyond disregarding public health, capitulating to industry, and ignoring the plight of poor, minority communities.
The story also details the wider impact once Flint's plight was brought to light and finally acknowledged by people in power: More federal money is going to lead prevention and elimination programs and more policies and high-level discussions geared toward revising standards in cities and states. With taxpayer help, Flint itself has significantly expanded the number of school nurses, early intervention programs, health centers and free, year-round preschools.
Hanna-Attisha wasn't the first to unearth the problem, which started when the city — in an effort to save money while under state control — tapped the Flint River for water in 2014 and 2015 and didn't treat it to prevent pipe corrosion. Residents complained about ailments and brought discolored tap water to meetings. Experts from Virginia Tech University and the U.S. Environmental Protection Agency sampled and reported high lead levels in water from some homes. But local and state officials insisted the water was safe.
"I was the last domino in terms of uncovering this crisis. It should have stopped when that first mom said, 'Something's wrong with my water,'" said Hanna-Attisha, whose work has been widely recognized, including by PEN America , a prominent literary and human rights group, and Time magazine's 100 Most Influential People alongside Virginia Tech expert Marc Edwards. "It should not have taken a doctor with evidence of children with elevated lead levels to stop this crisis."
State officials initially disputed and discredited Hanna-Attisha's findings after their release in September 2015, but within weeks relented and pledged action. That included switching the city's water source, declaring an emergency and getting federal help. Subsequent government testing confirmed the overall findings and warnings of Hanna-Attisha, Edwards and others.
The city slowly recovers: Water quality has improved, though residents remain wary of government. Officials are replacing lead pipes across the city, but it's taking longer than some prefer. An investigation overseen by Michigan Attorney General Bill Schuette has led to criminal charges against 15 current or former government officials.
Hanna-Attisha says she's a pediatrician, not a prosecutor, and the Iraqi-American's story "as a brown immigrant in a majority black city" can't provide justice to all. Still, she adds, the efforts to right wrongs bolster those aimed at healing Flint residents.
"We have to do everything in that same urgency as that research to make sure that these kids do not see the consequences because they did nothing besides live in a city that didn't treat its water properly," she said.
The whole episode — and the hard choices she initially had to make — brought to mind an Arabic word Hanna-Attisha knows well but deplores. It's "aeb," which roughly sounds like "eye" with a "b'' at the end. It means "shame" but goes much broader — akin to the dishonor you bring upon your family, ancestors and community when you speak or act out of line.
She finds the idea "debilitating and ugly," but it pushed her harder to make sure she wasn't wrong — and letting down Flint even more.
"That," she writes, "would be the most colossal 'aeb' of all."