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Mona Hanna-Attisha, M.D. 6.22.18 — Transcript

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0:00production and distribution of city club
0:02forums on ideastream
0:04are made possible by the generous
0:05support of PNC and the Raskin Family
0:09Fund with additional funding from Robert
0:12Conrad Cleveland State University the
0:15Chautauqua Institution the Cleveland
0:18Clinic and the United black fund of
0:20Greater Cleveland incorporated
0:37you
0:46good afternoon
0:49oh and welcome to the City Club of
0:58Cleveland I'm Len Calabrese the press
1:01president of the city club's board of
1:03directors and proud to be a member and
1:07I'm pleased to introduce today's program
1:09our speaker the director of the
1:12pediatric residency program at Hurley
1:15Medical Center in Flint Michigan and
1:17author of what the eyes don't see a
1:21story of crisis resistance and hope in
1:26an American city dr. mona hanna-attisha
1:29today marks the 49th anniversary of the
1:32Cuyahoga River Fire of 1969 that fire
1:36did two things it put Cleveland in the
1:39pages of Time magazine and a widely read
1:43report on the state of our nation's
1:45environmental problems which led to the
1:48passage of the Clean Water Act and the
1:52first Earth Day celebration and it began
1:56a conversation on environmental
1:58stewardship and social justice that has
2:01endured for decades it seems appropriate
2:04then that we're here today to discuss
2:07the implications of another water crisis
2:10that captured the nation's attention the
2:14lead poisoning endured by the residents
2:16of Flint Michigan due to toxins in the
2:20tap water
2:21most of us here remember that moment
2:24about three years ago when the national
2:26media descended on Flint Michigan a
2:29switch in drinking water sources from
2:32Lake Huron and the Detroit River to the
2:35Flint River had caused nearly 100,000
2:38residents to be exposed to dangerous
2:41amounts of lead those most affected were
2:44children whose blood levels doubled led
2:49blood levels doubled or in some cases
2:51tripled
2:52after the switch was made resulting in
2:56developmental and behavioral problems
2:59the research that revealed that crisis
3:02was conducted by today's speaker dr.
3:06mona hanna-attisha a first-generation
3:08Iraqi immigrant and Detroit raised
3:11pediatrician paved the way for
3:13government officials in Flint to
3:16acknowledge the extent of the lead
3:19crisis in the water resulting in 100
3:23million dollars in federal and 250
3:26million dollars in state funding to
3:29address the failing infrastructure that
3:31caused the crisis and to combat its
3:35effects personally she remains committed
3:38to ensuring the health of Flint's
3:40children as the director of the
3:43pediatric public health initiative and
3:45founder of the Flint child health and
3:49development fund for her efforts dr.
3:52hanna-attisha has received countless
3:54awards including being the co recipient
3:58of the first MIT Media Lab disobedience
4:02award for embodying the idea that quote
4:12the idea that quotes science and
4:15scholarship are as powerful tools for
4:18social change as art and protest unquote
4:22her fight against environmental
4:25injustice how the residents of Flint
4:27prevailed and what we can do to prevent
4:29future public health crises as outlined
4:33in her book which was published just
4:35this week what the eyes don't see a
4:38story of crisis resistance and hope in
4:42an American city
4:43ladies and gentlemen members and friends
4:46of the City Club of Cleveland please
4:47join me in welcoming to our podium
4:49today's speaker dr. mona hanna-attisha
5:00thank you it is great to be in Cleveland
5:03it is great to be at your city club I
5:05loved hearing about the history of this
5:08place its long-standing history the
5:09incredible speakers you've brought in
5:11your commitment to dialogue and to being
5:14educated and informed so it is an honor
5:16to be here with you so thank you thank
5:18you Cleveland and I am super excited to
5:20share with you my story the Flint story
5:23very much a story of crisis but even
5:27more so a story of resistance and even
5:30more than that a story of hope and I
5:32very much want to share the hope that we
5:35are building and that same kind of hope
5:37that we can build for all of our
5:39children everywhere so besides being
5:42really kind of an action back an
5:43action-packed retelling of the water
5:46crisis Oprah just put this book on her
5:48summer reading list and she said it was
5:51a Grisham style
5:52like you know page-turner so it is it is
5:55a little bit of that so yay Oprah but
5:58the book like the title alludes is is
6:02about it's about people it is about
6:05problems it is about places that we
6:07choose not to see you know that's
6:10happening to those people who are far
6:13away in a certain demographic and the
6:16book is a charge for all of us to open
6:18our eyes and to see these problems and
6:22not only to be awake to what's happening
6:24but but to make a difference the book is
6:27very much in this story is very much a
6:29testament to the idea that individuals
6:31especially working together in a
6:34multidisciplinary team can truly make
6:37make a difference so as you hopefully
6:39know by now when I was mentioned Flint
6:41is kind of the story of really the most
6:43emblematic environmental and public
6:46health disaster of this young century so
6:49actually the Flint River caught on fire
6:50twice in our history - but that's not
6:53what made us famous recently and it is
6:56it's a story of what happens when the
6:59very people are responsible for keeping
7:00us safe for keeping our children safe
7:03care more about saving money care more
7:07about power and control
7:08the
7:09they care about us so our crisis very
7:11much manifested in our water so you guys
7:14all have water in front of you we to
7:16this day we can't do that in Flint we
7:18still cannot drink our tap water so our
7:20crisis manifested in our water in the
7:23bodies of really the most vulnerable
7:24among us and the children who ate and
7:26drank that water and the babies who
7:29guzzled bay bottles and bottles of
7:31formula mixed with that top tap water
7:34but what happened in Flint is not an
7:36isolated story is not unique to Flynn
7:38what happened in Flint really speaks to
7:41the deeper crises that we are facing
7:43right now in our nation the crises of a
7:46breakdown and democracy from voter
7:49disenfranchisement a crisis and the in
7:52the breakdown of critical infrastructure
7:54we we think our roads and our bridges
7:56are bad what's underneath is probably
7:59even worse it is a crisis of ongoing
8:03environmental and justices everywhere
8:05Flint is not the first time we've had in
8:06a known case of environmental injustice
8:08it's ongoing they plagued many of our
8:12most vulnerable populations
8:13predominantly our poor and minority
8:15populations what happened in Flint is is
8:18an example of disrespect for science
8:21which we are seeing nationally right now
8:24the science of climate change the
8:26science of vaccines the science of
8:29Public Health regulations that protect
8:30our air and water are under attack right
8:33now
8:35Flint is also a story about the
8:37abandonment really of our civic
8:40responsibility our deep obligations as
8:43human beings to care and provide for all
8:47of us and I don't think this is I mean
8:50what's happening this week is a reminder
8:52of how this is happening in our nation
8:54right now in regards to how we care we
8:57care for children if we stop believing
9:00that government can protect our public
9:02welfare and keep all of our children
9:05safe not just our privileged ones all of
9:07them but what do we have left it begs
9:10the question who are we as a society so
9:14in in my book there's a lot of history
9:17in my book there's public health history
9:19and lead history and some family history
9:22and it
9:22so important for us to learn history
9:25because we are so good at repeating our
9:27mistakes and I want to touch a little
9:30bit on how Flint is a reminder of how
9:33intimately connected our environment is
9:35to our public health and public health
9:38as as the history of public health the
9:40role of government in public health is
9:42fairly new it's fairly new that
9:45government became involved in protecting
9:48the public health of its citizens so as
9:50a field of science public health rose up
9:52with our cities so as people kind of
9:55crowded into smaller areas diseases
9:57spread faster wood and coal kind of
10:00fires polluted the air running water was
10:03rare sewage
10:04sewers even rarer you know sewage wasn't
10:07seat so so that's when Public Health
10:08started getting involved really the time
10:10of the Industrial Revolution and when I
10:13think of that time I think of one of my
10:15favorite heroes in the world of Public
10:17Health it's a guy named John snow has
10:18anybody ever heard of John snow not the
10:21game of thrones John snow so okay it's
10:23different John snow so okay there's a
10:24few public health folks here so John
10:26snow was like this rebel of his time in
10:2919th century London he's the Broad
10:32Street pump guy so he he bucked he
10:36bucked the common conventional wisdom of
10:3919th century London so at that time
10:41everybody thought that these raging
10:44cholera epidemics were because London
10:46had stinky air so there was something
10:48called miasma in London which literally
10:50meant stinky air so the air really
10:52smelled and the public health community
10:54and the doctors are like we need to get
10:57rid of this stinky hit air so they took
10:59it people's cesspools like where they
11:02went to the bathroom and they dumped
11:03that water they made the sewage and
11:05drainage systems that went right into
11:07the Thames like where they got their
11:08drinking water and he's like you know he
11:10was an anesthesiologist by training and
11:12he's like a jack-of-all-trades like as a
11:14master physician epidemiologist and he's
11:17like well I don't think it's stinky air
11:18that is causing people to have cholera I
11:21think it's actually contaminated water
11:23and I think you know there's a certain
11:25pump that's contaminated I think it's
11:27it's being spread that way and I think
11:28our solutions are actually creating or
11:30worsening the problem and he used SIA
11:35to to literally speak truth to power and
11:39to prove through mapping that it was
11:42this actually this contaminated pump
11:44that was causing this disease to spread
11:46something else that he understood which
11:50we increasingly in this day fail to
11:52understand is that science the purpose
11:55of science is to improve our communities
11:57and to improve the human condition the
11:59purpose of science is not to live in
12:02ivory towers it is not to live in
12:05publications that no one reads it is not
12:07to live in journals and in with grants
12:10and and tenure it is meant to serve
12:13communities our science needs to work
12:16hand in hand with communities to improve
12:19vital problems that we face and and he
12:22fundamentally got that and because of
12:24his work
12:26we now have safe safer drinking water we
12:28don't have cholera epidemics he saved
12:31countless countless lives because he
12:33bucked a trend and he used science to
12:36fight the status quo so also during that
12:40same historic time in the nineteenth
12:42century the time of the Industrial
12:43Revolution I have another hero Charles
12:46Dickens so he was a novelist see he was
12:48a social critic but he was also a child
12:51advocate his eyes were always kind of
12:54wide open to the dark alleys of the
12:56Industrial Revolution he he wrote about
13:00the inequities that children's face that
13:02the injustice is and they were always at
13:03the center of his stories so I want to
13:05read you something that he wrote from
13:07from Great Expectations
13:08in the little world in which children
13:11have their existence there is nothing so
13:14finally perceived and so finally felt as
13:17injustice it may be only small injustice
13:21that the child can be exposed to but the
13:24child is small and the world is small
13:27the feelings of children are as
13:30vulnerable as their health and those in
13:33Justices during Dickens time played out
13:35over over their lifetime actually played
13:38out over their life expectancy so back
13:40back in that day the average life
13:42expectancy of an upper-class gentleman
13:45in London was forty-five years the
13:48average
13:49tradesmen lived up to the age of 25 them
13:52a member of the working poor lived up to
13:54the ripe age of 16 of reported deaths of
13:58that time 62% were kids under the age of
14:01five so we've come a long way right so
14:04our urban environments the places that
14:07our children go up are absolutely less
14:10lethal than they were absolutely we have
14:13we have made tremendous problems
14:15tremendous progress we've also made
14:16problems we've made tremendous progress
14:19but but our children continue to face
14:21insurmountable and Justices because to
14:25this day the environments of the cities
14:27that we live in the dirt the air the
14:30violence the hopelessness the stress the
14:34water literally can still predict how
14:37long we have to live literally the
14:40number of minutes allotted us to in in
14:43this earth so let's get back to Flint
14:46and and what happens happening to our
14:48environment so it was the summer of 2015
14:52and I was going about my my usual job as
14:54a pediatrician I'm a medical educator I
14:57teach medical students and residents I
14:59have one of my former medical students
15:00here wave she's tweeting she's a former
15:03tweeter she's out amazing tweeter so I
15:07my job it's a train future pediatricians
15:10I was busy with my home I was it might
15:13have two little kids and we just moved
15:14our clinic and my husband just had
15:16shoulder surgery so I was busy just like
15:18you're all busy with your home and your
15:19work and I was kind of in my own little
15:21isolated bubble of my life like we often
15:23tend to be and when out of pure
15:27serendipity a high school girlfriend
15:30came over for a last-minute barbecue two
15:32high school girlfriends and with our
15:34little kids and we're having fun we're
15:36eating glass of wine in our hand and my
15:39high-school girlfriend happens to be a
15:41drinking water expert and she happened
15:45to work formerly at the EPA and she
15:48happened to have seen a memo released by
15:50her former colleague at the EPA raising
15:53red flags about Flint water and she
15:56turns to me she's like Mona she's like
15:57you're in Flint I'm like yeah and she's
15:59like um the water is like something's
16:01wrong with your water but a lot
16:02I'm like it's okay Idina I see patients
16:04every day and my patients ask me about
16:06the water because it smells weird and
16:08tastes gross and it looks funny and we
16:10had bacteria in it but but the state
16:12said everything was ok so I keep telling
16:14my patients every single day that
16:16everything is ok and not to waste your
16:19money buying bottled water I just suck
16:21you know it's just just yesterday I told
16:23her are you not a kid I'm mom she wanted
16:25to stop breastfeeding I told her you
16:26know stay keep breastfeeding but you
16:28know is she wanted to know if she should
16:29use the tap water and I said yes use a
16:31tap water there is nothing wrong with
16:32the tap water because this is America
16:34this is not 19th century cholera
16:36epidemics there's laws and there's rules
16:38on the book but most of all this is
16:40Michigan so any Michiganders here native
16:43Michigan ok so those of us from Michigan
16:45we are the mitten stay you got the
16:47handout so point to where you're from in
16:49Michigan so awesome so so here is
16:54Detroit and Ann Arbor and Lansing and
16:56Grand Rapids and we also have an Upper
16:57Peninsula but we forget about them but
16:58but with so this we are the minton state
17:01so why are we the men state what are we
17:02surrounded by water and we share that
17:05water with you guys so we are surrounded
17:07little Sharon so we are surrounded by
17:09the Great Lakes ok the Great Lakes are
17:12the largest source of fresh water in the
17:14world so like how is it how can our
17:15water not be ok but despite all that
17:17despite even being in Michigan we have
17:19we have laws right and we have
17:21regulations and we have people whose
17:24fundamentally their only job is to make
17:26sure that when we turn on our tap our
17:27water is ok ok and like I'm not totally
17:31naive how can our water not be ok and
17:34she told me she's like well it sounds
17:36like Flint's not treating their water
17:38properly first of all nobody goes from a
17:40great water source like the Great Lakes
17:42to a poor quality water source like the
17:44Flint River who likes to caught on fire
17:45twice it was a kind of legacy of
17:47industrial pollution but despite that
17:49it's not it was it's not being treated
17:51properly with something called corrosion
17:52control and I'm like what the heck is
17:54corrosion control my pediatrician I
17:55don't know about water testing or
17:58quality or treatment and she's like well
18:00without corrosion control there's gonna
18:02be lead in your water and that was the
18:06very very first time I heard the word
18:08lead I heard about our bacteria and the
18:11odor and the quality the color issues
18:13and but I was reading I was reassured
18:15just like
18:16everybody in government was reassuring
18:18us but at that moment I heard the word
18:21LED and when a pediatrician or anybody
18:23in public health
18:24here's the word LED we kind of freaked
18:26out because we know what LED does it is
18:29a known form of environmental injustice
18:31a form of environmental racism it
18:34already disproportionately impacts our
18:36Flint kids just like it impacts Detroit
18:38kids and Cleveland kids and Chicago kids
18:40and Baltimore kids and Philadelphia kids
18:43we have learned so much about lead in
18:46the last few decades we know it is a
18:48potent irreversible neurotoxin it
18:50impacts cognition and behavior impacts
18:54almost every organ system and we know it
18:56can alter a child's entire life course
18:59trajectory this incredible science has
19:01now taught us that levels we thought
19:02were really okay back in the day are not
19:04okay anymore and we now know that there
19:07is no safe level and once you detect it
19:10in a child it just tells you that
19:12there's an environmental problem so our
19:14focus needs to be detecting it in the
19:16environment before children are tested
19:18and exposed so knowing all this was
19:23really kind of my call to action to see
19:25what was going on and so very quickly
19:26how did this happen so Flint was in an
19:29almost bankruptcy State we lost
19:31democracy we were under state-appointed
19:34emergency management the emergency
19:36managers only job was austerity to save
19:38money no regard for public health
19:41environmental health children's health
19:42and Ana cost-cutting move decided to
19:45switch from the Great Lakes to the Flint
19:47River until a new pipeline was to be
19:49built so our the water we were getting
19:52from the Flint River was 19 times more
19:55corrosive than the water that we had
19:57been getting from the Great Lakes it was
19:58so corrosive that just a few months
20:00after our water switch General Motors
20:02which is was born in Flint and still has
20:05plants in Flint stopped using this water
20:08because it was corroding their engine
20:10parts so think about this our water just
20:12this was a full year prior to my
20:14research off their water was corroding
20:16our engine parts so imagine what it was
20:18doing to our aging infrastructure that
20:20was predominantly LED based Jesse
20:24Jackson called Flint a crime scene
20:25Michael Moore who's who's from from
20:28Flint said the water crisis was not
20:31calling it a racial crisis that would
20:33not have happened in a richer or wider
20:35community but there is another part of
20:38this story and there's another side of
20:40Flint and they're ours another lesson
20:42that needs to be learned
20:44because Flint is also the story of how
20:47we came together and how we fought back
20:49and how we resisted so before this water
20:52crisis what was Flint famous for cars so
20:56cars birthplace across an extra-credit
20:57who knows what was even more famous for
21:00after the birthplace of cars
21:06so once cars started being made the auto
21:12workers were taken advantage of and they
21:17started to demand a role in the
21:19prosperity that the industry was was
21:22benefiting from there was no protections
21:25for occupational health they were losing
21:27limbs there was no benefits there was no
21:28disabilities so in the late 1930s Flint
21:31was almost also famous for the historic
21:34sit-down strikes where Auto Workers
21:36literally sat down stopped General
21:39Motors production and for 44 days
21:41demanded dignity and demanded decent
21:45wages and demanded occupational health
21:47and safety and what happened in Flint
21:49created the UAW and created the birth of
21:54the middle class in America it was
21:56called the grand bargain and people
21:58began to have benefits and great schools
22:01and great infrastructure and what
22:03happened there informed wages across the
22:05country for decades at one point Flint
22:07had the highest per-capita income in the
22:09country immigrants and folks from the
22:12south and the great migration North came
22:14to Flint for great living wage jobs so
22:18that is our history and that is our
22:20legacy and that is the pride and that
22:22steel-plated resilience of the people of
22:24Flint it's a place where many people
22:26have have been pushed down before and
22:28many have risen where many have thought
22:30that good fight and many have won so we
22:33took a line from their playbook and we
22:35resisted so when I heard about the
22:37possibility of Ludden water I thought
22:39about all my Flint kids because as a
22:40pediatrician I got lots of fellow
22:42pediatricians here
22:43it's
22:43job to make sure that kids are healthy
22:45today we take care of their ear
22:47infections and we do their well baby
22:48visits but more importantly our jobs as
22:50pediatricians is to make sure that our
22:52kids have the brightest future ahead of
22:54them so much of what we do is prevention
22:56we literally took an oath as physicians
22:59to stand up to be healers and protectors
23:01for our children and what was happening
23:04in the water was really threatening the
23:06tomorrow's of all of these kids so I did
23:08something that doctors and academics are
23:10not supposed to do and this is why I won
23:12that crazy
23:13MIT disobedience award which was really
23:14difficult to explain to my children that
23:16I got a disobedience award so III
23:20released this research before it was
23:23peer-reviewed before it was published
23:25and that's like an academic nono but
23:27doing that going through that process
23:29takes months and months and months and
23:31our kids did not have another day so I
23:33literally walked out of my clinic and I
23:35stood up with the evidence that our
23:37children were being exposed to lend
23:39their water and just like everyone else
23:41in the story the moms the activists the
23:43pastors the journalists the water
23:45scientists I was I was attacked and I
23:48was dismissed and I was discredited the
23:51states that I was wrong they called me
23:53an unfortunate researcher that I was
23:54spreading near hysteria which is great
23:56because also for sexist and and for a
24:00minute I I believe them I'm like oh my
24:02god I'd made a terrible mistake every
24:05the whole state says I'm wrong and they
24:06actually have more data than I do and I
24:09was scared and I felt sick and there was
24:11literally a knot in my stomach that
24:13wouldn't go away and I stopped eating
24:15which was a good side effect and it was
24:17but then but then I I knew that this
24:20this was not about numbers so so often
24:24as academics we work with numbers and
24:26statistics and you know all this
24:28evidence and every single one of those
24:30numbers that was in my research was a
24:32kid it was a child and probably a child
24:36I had cared for in the last year or so
24:38and it was those kids that that woke me
24:41up and that enabled me to keep fighting
24:44and it was finally our science our
24:47persistence our disobedience that spoke
24:50truth to power and the state finally
24:52conceded that yes there was a problem so
24:54to this day in Flint we are
24:57on filtered and bottled water as our
24:59damaged corroded lead pipes are being
25:01replaced we will soon be the only the
25:04third city that is has replaced their
25:07lead pipes there is lead in plumbing
25:09everywhere including in Cleveland
25:11especially in the Northeast and the
25:12Midwest we didn't restrict lead in our
25:15plumbing until 1986 in our service lines
25:17which are the lines that go from our
25:19water main to our homes but get this we
25:21didn't restrict lead in our brass
25:22fixtures until 2014 so Flint schools had
25:26no lead lines but we had some of the
25:28highest water lead levels because the
25:30fixtures were leaching lead and that's
25:33why week after week we are now hearing
25:35about more and more schools that are
25:37testing in more and more cities that are
25:38testing it has awakened the nation's
25:40conscious and reminded the nation that
25:42we actually have an ongoing lead issue
25:44that we have to address but in Flint we
25:47are moving forward it is a city that a
25:49very resilient City where we have rolled
25:51up our sleeves and we have come together
25:53to make sure that our children not only
25:55recover but both rive we are building
25:58this model public health program which I
26:00am so lucky and privileged to be able to
26:03lead where we are leaning on this
26:05incredible science of brain development
26:07and toxic stress and resilience to
26:10buffer the impact of this crisis
26:12Flint kids already had so many obstacles
26:15that our development we have about a 60%
26:18poverty rate one of the most violent
26:20crime rates in the city
26:21no full-service grocery stores crumbling
26:24schools depopulation lack of safe places
26:27to play all of these things are
26:29developmental obstacles for kids all
26:31these things are are known as toxic
26:33stresses for children which when you
26:36have so many of them it can cause it can
26:40alter a child entire life course
26:41trajectory and really mess up their
26:43brain development and and their risk of
26:45chronic diseases and even their life
26:46expectancy so we are addressing all of
26:50that and sometimes I say in clinic
26:53especially that I'm writing now
26:54prescriptions for hope but it's not just
26:57words our hope is not just you're gonna
26:59be ok it is with real science based
27:02interventions so in Flint now we have
27:05doubled the capacity of our home
27:07visiting programs supporting parents and
27:09caregivers
27:10evidence-based interventions in our
27:12clinics that also support parents and
27:14caregivers huge expansion of early
27:16literacy I'm so excited that your book
27:18seller is supports early literacy that
27:21is a big part of our work in places like
27:23Flint and maybe in Cleveland kids have a
27:26word deficit often in some of these
27:28places by the time they've reached the
27:30age of three they've heard thirty
27:31million less words by the time you know
27:33they're in kindergarten that achievement
27:34gap is already there so we need to
27:36support them with a rich word rich
27:39environment I'm now in Flint every kid
27:42gets a book mail to them every single
27:43month from the ages zero to five huge
27:46expansion of reach out and read which is
27:47an evidence-based clinic program the NBA
27:50who's been phenomenal the especially the
27:52National Basketball Players Association
27:54the union of athletes has just funded a
27:56newborn literacy program every baby born
27:58the hospital gets a bundle of books and
28:00developmental Tory's and gets signed up
28:02for home visiting early intervention we
28:05have two brand-new high quality child
28:07care centers year-round free highest
28:10quality child care center with a blend
28:12of state and federal dollars one is an
28:14edgy care center which is this really
28:16awesome high quality child care center
28:17which offers parenting support and
28:19family engagement we have expansion of
28:21Medicaid and mental health services
28:24mindfulness our kids in Flint schools do
28:26like yoga and meditation every single
28:28day which is really really awesome
28:30mobile grocery stores and all of these
28:33are things that all kids need this is
28:35not this is not like rocket science this
28:36is these are things that all kids need
28:38at a population level to make sure that
28:41they succeed and then we're also working
28:43on the bigger things because one of the
28:45most important things I can prescribe is
28:47living wage jobs for parents so our
28:49recovery is bringing in jobs and we now
28:51are hiring school nurses and researchers
28:54and developmental specialist and early
28:56on folks and plumbers and pipefitters
28:58it's bringing back that grand bargain
29:00that I talked about earlier that Flint
29:02is so famous for so working on that
29:04economic development that participatory
29:07democracy restorative justice and
29:09self-determination for the city so
29:11although our kids were exposed to this
29:13water crisis exposed preventable you
29:17know this man-made crisis that expose an
29:19entire population to a neurotoxin one of
29:22many toxic stresses that we already
29:24we are doing everything that we can to
29:26tip the scale for these kids because we
29:28have to because these kids deserve no
29:30less and that gets to my favorite part
29:33of the story and of the book it is about
29:37how all of us have the power to open our
29:40eyes and to fix things no matter who we
29:43are no matter what we do if we are a
29:46teacher or an accountant or a mom or an
29:49activist or a retired person or a doctor
29:51whatever we are we we have the power to
29:55make a difference and also no matter how
29:58we ended up in this country so I am an
30:01immigrant we came here when I was four
30:04we were fleeing the regime of Saddam
30:05Hussein who remember him brutal dictator
30:07in Iraq we were fleeing fascism and
30:11oppression and we came to this country
30:14for the American dream
30:16and we came for freedom and we came for
30:18opportunity and we came for democracy so
30:21I'm I was that little girl that I when I
30:24see these images this week of those
30:25little that little girl at the border
30:27who's fighting for that same dream I I
30:30see that girl I was that girl in a sense
30:32not exactly but in a sense and we came
30:35here for those opportunities and and and
30:38and I was I every day wake up privileged
30:42and fortunate and grateful to be in this
30:44country
30:44and to be able to serve but also very
30:47much recognizing that in justices are
30:50everywhere and they're happening
30:52everywhere and that we need to be
30:54fighting for all children no matter
30:56where they come from and what they look
30:57like and what their citizenship
31:08so as MLK said whatever ship brought us
31:12here we are in this boat together we can
31:15work together to create a better a safer
31:18world a place where all children develop
31:20without obstacles and barriers we can
31:23come together and each be a piece of the
31:25answer not just for Flint but places
31:27everywhere that are just like Flint
31:29there are kids everywhere growing up in
31:31the same toxic environments as our kids
31:33in Flint where children are bearing the
31:35brunt of life's hardest blows and live
31:38with that poverty that violence that
31:39hopelessness and just as we are in Flint
31:42trying to build resilient children I
31:44think we can work on building resilient
31:47families resilient cities resilient
31:49communities and even a resilient country
31:51so a country like ours can endure trauma
31:55and neglect and once again be a place
31:58where democracy and equality and
32:00opportunity are encouraged in advance
32:03and I think this is absolutely where
32:05healing begins this is my story this is
32:09the Flint story this is the story of the
32:12book it's a story of like I said crisis
32:16resistance and hope thank you guys
32:18[Applause]
32:36today we're enjoying a forum with dr.
32:39Mona on a t-shirt director of the
32:41pediatric residency program at Hurley
32:43Medical Center in Flint Michigan and
32:45author of what the eyes don't see a
32:48story of crisis resistance and hope in
32:52an American city so we're now about to
32:54begin the audience question and answer
32:57phase if you'd like to tweet a question
33:00please tweet it at the City Club and our
33:05staff will try to work it into the
33:07program holding the microphones today
33:10our membership and customer service
33:12manager Cory Esler and youth forum
33:15council chair tio Lu or Sonia so we may
33:20have the first question
33:21please dr. Mona the one of the things
33:27you hear about in national politics
33:28these days is a phenomenon called
33:30science denial yeah you hear about it
33:32especially in context of global warming
33:35and things like that and I wonder how
33:37much of that was part of the story that
33:39you were dealing with up there in Flint
33:41absolutely so Flint is an example where
33:44common-sense science was denied you did
33:47not need evidence of children being
33:49exposed that was too late we had the
33:51evidence in the water we had water level
33:53evidence but like I shared General
33:55Motors stopped using this water because
33:56it was corroding in two parts I mean
33:57like you don't need to be a physician or
33:59a scientist to prove to know that
34:02something was wrong so Flint is very
34:05much a case of what's happening
34:07nationally this trend of science denial
34:09but is also a story where science
34:12ultimately spoke truth to power and we
34:15are very much leaning on science right
34:17now the the amazing signs of brain
34:20development and resilience in our
34:21recovery efforts so I think we have to
34:24all be on guard and what's happening you
34:26mentioned it with with the climate
34:29change denial this is going to threaten
34:31the futures of so many so many of our
34:33children we are going to if we don't
34:35accept the facts we are going to leave a
34:37legacy a catastrophic legacy for our
34:40children we also see it with with
34:42vaccines with a vaccine denial community
34:44but more importantly like I'm
34:46we see it with what's happening with EPA
34:49right now or we're the EPA's through
34:51really being permanently dismantled with
34:54the science of a lot of the regulations
34:55to protect our air and our water quality
34:57our food supply are also being
34:59threatened so I think we have to be on
35:02guard and we have to learn the lessons
35:03of Lynn oh sorry I forgot breaking all
35:08the rules
35:09don't touch the mic and also don't make
35:13statements but I I can't I can't stand
35:16here and not thank you for the amazing
35:18work that you've done and for sharing it
35:25with us through a book thanks I think
35:27that's an incredible way to spread the
35:30message my question we have a crisis of
35:35lead poisoning here in Cleveland what
35:38would you advise us to empower both
35:41individuals to act and also for our
35:44policymakers to act in an effective and
35:46impactful way yeah so there is lead
35:50everywhere not only in our plumbing but
35:54in our paint in our soil because we used
35:58lead and gasoline for so long there's a
36:00almost a full chapter in my book about
36:03the evil history of lead we have known
36:07about the evils of lead for a long time
36:08the Romans put it in their plumbing
36:11actually put it in their food and many
36:12people hypothesize the demise of the
36:14Romans is because I've used so much lead
36:16and everything so it is probably one of
36:18the oldest and most well studied
36:20neurotoxins and it's something unlike so
36:23many of our environment exposures like
36:24it's clear like there's no safe level
36:25like you know there's like oh we have to
36:27have like a certain action levels or
36:28isn't that so so we don't and not only
36:30do we know how bad it is and what we
36:32need to do we need to do something
36:33called primary prevention which in the
36:35public health world is never exposing a
36:37population to this we also actually know
36:40the economic benefit of let elimination
36:42if we eliminated LED exposure we would
36:45save eighty billion dollars a year as a
36:48nation from decreased economic
36:52productivity special education costs
36:54health care cost criminal justice costs
36:56this led economists like this is well
36:58known even the eken
37:00benefit and you'd figure that would like
37:02speak to policymakers but the problem is
37:04the economic benefit is something you do
37:06not see for four decades and it's often
37:09after their term limits or kind of their
37:11shortsightedness
37:13so it requires vigilance and it requires
37:16education and it even requires educating
37:18providers who have often been kind of so
37:22part of the title of my book it's it
37:24gets at a saying that one of my former
37:26mentors in Detroit used to say he used
37:29to say the eyes don't see what the mind
37:32doesn't know so like you know I would I
37:35took care of dozens and dozens of kids
37:37with lead poisoning and I never once to
37:39ask ever about their water because I
37:41their before this crisis like admission
37:43I never knew there was lead and plumbing
37:45and do you guys know that like what the
37:47word lead means it means plumbing so
37:50remember the high school elemental
37:52symbol of lead high school chemistry PB
37:54it comes from the Latin plumbum plumbing
37:56so lead actually always means plumbing
37:58it's meant plumbing I didn't even know
38:01we had lead in our plumbing until this
38:03crisis hit and I was ignorant Lee you
38:07know assuming that their source of
38:09exposure was a bazillion other things so
38:11there's a lot of Education that needs to
38:13happen to educate folks about this and
38:16and it's and it's hard because we are in
38:18this climate of science denial where
38:21industry has the upper hand there are
38:22still folks right now who who are lead
38:24deniers academics pediatricians even
38:27because they are paid by as expert
38:29witnesses on led cases the lead industry
38:32is also this is also my book it's
38:34they've never paid for their harms so
38:36unlike tobacco or asbestos they've never
38:39paid for the evil there's actually a
38:41lawsuit right now on appeal in
38:42California where they're trying to go
38:44after that like Sherwin Williams and the
38:45paint companies for those work so it's
38:47it's a has an evil past we need to we
38:51need to finally not kick the can for our
38:54children we know what it does the
38:56science is there we need to put in the
38:59investments to invest in the
39:01infrastructure work in homes and
39:03underground to no longer have one other
39:05child preventively
39:07exposed the block
39:10and that's one of the great things about
39:11Flint because before Flint like you know
39:14like what took care of lad you know kids
39:16loved levels I've been coming down for
39:18decades we got rid of lead from paint
39:20and gasoline it's okay and one of the
39:22great side effects are ripple effects
39:23the Flint is that people are like oh
39:25yeah you know it was a problem of
39:26yesterday but it's a problem of today
39:28and it's a first or a problem of
39:29tomorrow thank you so much my question
39:34today is how did what evidence did you
39:37take to the public were you measuring
39:38serum lead levels remain in neurologic
39:41or hematologic effects and how much of
39:44an ongoing issue will this be 15 20
39:47years from now great question so it was
39:50the easiest research project I've ever
39:51done in my life so as pediatricians we
39:54we routinely screen children for LED
39:57exposure at the ages of one and two not
40:00all children usually children who are a
40:02high-risk so kids on Medicaid which
40:04serves as a proxy for poverty so we and
40:08you we screen at those ages because
40:10that's when developmentally children are
40:12walking and crawling and they've
40:13hand-to-mouth activity and they're at
40:14risk for a household that exposure like
40:16paint and dust so I just went back and I
40:20looked at children's lead levels that
40:21were done through that routine screening
40:23and I note it and I compared them before
40:25the water switched to after the water
40:28switched and what I saw was contrary to
40:30every trend that was happening at the
40:32state level national level and even our
40:34city level where levels have been coming
40:37down gradually that there was an
40:38increase in the percentage of kids with
40:40elevated lead levels and it directly
40:42correlated with where the water led
40:44levels were the highest that research
40:47from eventually was published and that
40:50that's what was released but it was also
40:53a gross underestimate of exposure
40:55because lead in water impacts a younger
40:58age group that is not picked up by
41:00routine screening lead and water is in a
41:02vehicle made for ingestion we're meant
41:04to drink water we're not meant to eat
41:05chips even paint chips but kids do it
41:07but it impacts especially the unborn and
41:11it also impacts especially those babies
41:14who were drinking formula mixed with us
41:15water and we have terrible breastfeeding
41:17rates the blood in your blood has a
41:19short half-life a short window of
41:21detection so a lot of kids
41:23screen at all or and they weren't screen
41:25to the right ages so that's why we've
41:26treated this as a population right
41:28exposure and everybody is getting the
41:31benefit of all the resources we were
41:33just funded by the CDC to build a flint
41:35registry very much modeled after like
41:37the World Trade Center registry and
41:38other big exposure registries where we
41:41will be able to objectively in a
41:42population level way
41:44epidemiology way answer how our Flint
41:47people doing but more importantly get
41:49them connected to the resources so that
41:51we do not see the consequences we
41:53epically cannot sit back and say this is
41:55the consequences of this crisis we are
41:57proactively improved and you know
41:59preventing trying to make sure that we
42:01don't see those consequences and that's
42:02the data and the neurodevelopmental
42:04assessment work that we hope to share in
42:06the future thank you very much for
42:11coming dr. Mona um I in your educator
42:14hat um there are a lot of young people
42:16here myself included early on in their
42:18careers what advice do you have in terms
42:22of being involved in advocacy and
42:23standing up for what you perceive as
42:26injustice it is your job no matter what
42:29profession you go into it is your job we
42:33so often go about our busy lives as I
42:36was as like punching in punching out
42:38automatons this is my work I'm gonna go
42:40home I'm gonna do this I have Girl
42:42Scouts I have soccer this now and we're
42:44blinded we are we close our eyes to the
42:47injustice is happening all around us and
42:49it's not Flint it's everywhere there are
42:51significant disparities and issues that
42:53need to be addressed open your eyes but
42:56it's not enough to just open your eyes
42:57you need to be involved you need to be
42:58active you need to vote you need you
43:01need to have your voice and your
43:02opinions heard I am so hopeful for the
43:05your guys you this generation you need
43:07to fix our problems and we are seeing
43:10tremendous leadership right now from our
43:12youth we have a Youth Advisory Committee
43:14that informs all of our work children
43:15are telling us what to do look at the
43:17Parkland kids there are up to you guys
43:21to fix the incredible problems that we
43:24have created so we need to listen to our
43:27kids we need to value them and we need
43:30to encourage them to be loud and to be
43:31stubborn and to speak up and also other
43:34bye
43:35that would give us that you're never
43:36alone and all these often in these
43:38fights you think that you're you're
43:39alone this story and what this book also
43:42really shows is that there's a lot of
43:45folks who are in the same fight as you
43:47and I used to think pediatricians had a
43:49monopoly on caring for children like
43:51there's nobody else who cares about kids
43:52as much as pediatricians did but it was
43:54wrong because my team included a water
43:57scientist and a journalist and moms and
43:59activists and other folks who cared as
44:01much as I do so get out of your silos
44:03and work with other folks who care good
44:09afternoon my name is York Husa and I'm
44:11really honored and pleased to represent
44:13the immigration law firm of Markovic &
44:15Associates and to convey her best
44:17regards to you and she know but it's
44:19solid she couldn't be here today and
44:21again to commend you and the great work
44:24you have done and I can't call you as an
44:27immigrant like your neighbor former
44:28naval in Syria on the Iraqi borders to
44:31continue my impression story and I was
44:33inspired by the way I have to say it by
44:35mrs. Wong who was my advisor when I came
44:37to this country 30 years ago at the
44:39school and now I'm working for her and
44:41I'm very pleased and honored to work for
44:43her and to spread the message of as
44:46immigration love and we are voice for
44:48the voiceless and you are a hero for the
44:50children and as we call our boss mrs.
44:52Wong a champion for immigrants so we are
44:54one of them so again make it short now
44:56my question is earlier I'm sorry I can't
45:02help but you know thank you and let's
45:04say of that is thank you in Arabic okay
45:07thank you spin and so you mentioned
45:12earlier that we have crises along the
45:15lines of what you have done the great
45:16three circuit you have done a crisis of
45:19democracy and democracy and then could
45:22you elaborate on that and what crises
45:23especially now immigration issue that's
45:25facing all of us especially immigrants
45:27and even not in good you elaborate on
45:29that and then social injustice that is
45:31absolutely so that's a big question but
45:34in terms of democracy so our very clear
45:37democracy issue in in Flint was we had
45:40no democracy we were literally under
45:42state-appointed emergency management and
45:44at one point in Michigan in 2013 half
45:48our african-american population was
45:50under an emergency manager rule compared
45:52to 2% of the white population so grossly
45:55undemocratic that come in they'd cut
45:58pensions and sever contracts and with no
46:01accountability and unelected officials
46:03usurping democracy but it's it's similar
46:06to what we see in other places so
46:08Michigan is one of the most gerrymander
46:10of states you vote for more Democrats
46:12more Republicans get a left in but that
46:14a clear example of where democracy where
46:17your vote doesn't have clear
46:19representation voter disenfranchisement
46:29Gration issue is it is an even bigger
46:31issue but lots of opportunities for us
46:35to continue to use our voices and
46:37continue to make sure that we have an
46:39inclusive society that is held
46:41accountable all so if if another LED
46:50issue was to occur somewhere word
46:52everywhere I'm sorry sorry but if if it
46:57wants to happen again we're like where
46:59do you think the next place would be
47:00where it occurs yeah so LED is known as
47:04a silent pediatric epidemic it's
47:07happening everywhere and it moat and
47:09just like many environmental health
47:11issues or in my mouth exposures we don't
47:14see it like I wish somebody who had led
47:17exposure had like raised purple spots
47:18then we'd know right away but we don't
47:21see it we don't see it for years if not
47:23decades and when we do see it the the
47:25the consequences are multifactorial like
47:27was the kid the kid got diagnosed with
47:29ADHD was it the lead was he always
47:31supposed to have ADHD was there another
47:32reason so so it's it's the constant you
47:36know it's everywhere but we need to kind
47:38of open our eyes another reference to
47:40title book to see to see these issues
47:43but more importantly we need to be
47:45proactive and preventative we need to
47:47make sure that we are finding it in the
47:49environment before our children are
47:51exposed and like I said it's everywhere
47:53because it was used in paint it was used
47:55in soil it was used in plumbing it's a
47:57heavy metal it persists that's why it
47:59was used so much it was as malleable
48:01so we have to put in that investment to
48:03get to get it out of there in the first
48:04place thank you thank you so much for
48:09illustrating the process of you yourself
48:12stepping out of your bubble something
48:14that we can all hopefully hold on to and
48:16remember that it's our own personal
48:19activism that really does make the
48:20difference and you're stepping out of
48:23that bubble certainly popped a much a
48:26bigger more corrupt bubble and thank you
48:29for that thank what is the nature of the
48:32anti corrosive chemicals that you
48:34mentioned that we're apparently all the
48:36rest of us are drinking as we prevent
48:39this lit exposure
48:40yes I've learned I feel like I've taken
48:42a quick a crash course in like water
48:44treatment and there's some actually some
48:45water people here so they might even be
48:47able to answer that better than I am so
48:49the corrosion control it's a corrosion
48:52inhibitor it's a phosphate so very much
48:54like what's in milk and diet coke or
48:57coke and different things so it is used
48:59to kind of create a protective scale in
49:01our plumbing so that whatever's in the
49:03plumbing doesn't come out of our
49:04plumbing that's one of many things in
49:07water treatment and water treatment also
49:08has disinfectants like we learned from
49:10John Snow to kill bacteria and different
49:12things so water so there's also like
49:16fluoride there's lots of things in our
49:17water treatment it's an art and the art
49:20of it really depends on your source
49:22water and what you need to add to it to
49:24make it comply with regulations and
49:27protect public health good afternoon I'm
49:32Colin Cotter from the Legal Aid Society
49:33of Cleveland and my question for you you
49:35told the story about power not listening
49:38and science really finally getting their
49:41attention do you have any stories of
49:43hope for us in Cleveland of individuals
49:45who had power who became advocates and
49:49really turned this around because it's
49:50you know it's terrific clearly you have
49:53the power of science but you didn't have
49:54the power of being elected official or
49:56lots of money to really change things so
50:00do you have that story from Flint for us
50:01sure so I think a lot of what so
50:05ultimately like I said science really
50:07spoke to through power but it wasn't the
50:08science alone it was also the media so
50:11after my press conference there was like
50:13then these like Google Trends of
50:15the highest peak in Flint water crisis
50:17stories the media finally started to pay
50:19attention so was it because of the media
50:21and the international embarrassment that
50:23we came but the state finally conceded I
50:25think that was part of it too so there's
50:29a lot of you need to make friends in the
50:31media so you even you need to work with
50:33colleagues in journalism the Society for
50:37environmental journalists is actually
50:38holding there in their national
50:39conference now in Flint there's been
50:41many reports about the Flint water
50:42crisis and what was what the bad things
50:45that happen but the good things that
50:46happened and something that was
50:47highlighted was the role of the
50:49investigative journalists so because of
50:51our lack loss of democracy the Ford
50:54Foundation for the very first time
50:55funded our Michigan ACLU to hire an
50:59investigative journalist to report on
51:01the consequences of the loss of
51:03democracy an incredible incredible
51:05reporter and he was highlighted in this
51:07water crisis because he got access to
51:10this leaked memo from the EPA and he dug
51:12and he dug and dug and dug and and tried
51:14to uncover this story and what was
51:16happening it was his articles that that
51:19I first read as well so there's so
51:22journalists have played an incredible
51:25role I also talked in my book about the
51:28role of a physician an amazing physician
51:32in the 1920s her name is Alice Hamilton
51:34and she used to fight the she was a
51:38world expert on lead she was the first
51:40professor that was granted admission to
51:43Harvard female professor at Harvard but
51:45they wouldn't give her football tickets
51:47and she couldn't and she couldn't march
51:48in the graduation ceremonies so she she
51:52fought against Kettering who put lead in
51:56gasoline and and you know called him out
51:58and eventually use the media to her
52:01advantage and to highlight all these you
52:04know toxic cases of flood exposure so I
52:06think that was probably one of the
52:08biggest things is working closely with
52:10media who needs a lot of education to
52:13it's complicated science you know
52:14they're like oh you know there's a
52:15there's a let issue and oh look good
52:17blood levels don't show anything yeah
52:18but the half-life of what is really sure
52:19so you might not see anything it doesn't
52:21matter anyways weather so there's a lot
52:23of education and rapport building
52:24relationships that need to be created
52:28what's your favorite part of being a
52:31pediatrician and what advice do you have
52:33for people who want to be pediatric
52:36nurses and pediatricians oh I saw my
52:38favorite that's a great question my
52:44favorite part about being a pediatrician
52:46is hanging out with kids so it is it is
52:50the best job in the world
52:52pediatricians like there's research done
52:54on different medical professions we are
52:56the happiest profession of all medical
52:59specialties it is the most rewarding
53:01career I get to take care of kids to
53:04make sure like I said they're healthy
53:05today but we protect the potential of
53:08kids to make sure that they have the
53:09brightest future possible it is the kids
53:11that I take care of every day that
53:12inspired me to do this work and I I take
53:15direction from them you guys are
53:17absolutely leading the way so if you
53:20want to be a pediatrician do good in
53:22school do your homework the the tests
53:25never end but it is absolutely the most
53:28rewarding rewarding profession is to to
53:32have a family and trust you with the
53:33care of your child and then to be able
53:35to advocate for those kids at an even
53:36broader level good luck ok we have
53:45actually been lucky enough here in
53:46Cleveland to have great reporting on the
53:48on the crisis as well but we've still
53:50struggled to educate residents and
53:52parents about the danger and empower
53:54them to get involved in the solution
53:55what did it take in Cleveland or in
53:58Flint excuse me to get the residents and
54:00parents aware of the dangers and really
54:02involved yes so it was backwards so the
54:05residents were aware of the issue before
54:07the medical community got aware of the
54:09issue the medical community came late to
54:10the game and the press came late to the
54:13game
54:13it was our residents who are the heroes
54:15of the story because they knew something
54:17was wrong they didn't mean not known it
54:18was led but they knew something was
54:20wrong and they were the ones that were
54:22engaged and loud and activated and then
54:25when they did finally know kind of the
54:27science of what was in the water the the
54:29lead they have been part of all of our
54:32work so all of our work moving forward
54:34has been community informed community
54:36driven and community participatory you
54:38cannot do this work as an
54:40or an institution saying this is what's
54:42best for you it has to be hand-in-hand
54:44with the community and I think that's in
54:46karbala so we formalized that I talked
54:48about this Youth Advisory Council we
54:50have kids advising us we also have a
54:52parent partner group or parents are part
54:55of all of our work and we have residents
54:57and activists that are part of all of
54:59all of our ongoing work so so it has to
55:01be grassroots it has to be peer to peer
55:04or it sits and especially in a climate
55:06like Flint where nobody's trusted where
55:08trust is gone and shattered it needs to
55:11be a close relationship
55:24so today at the city club we have been
55:27listening to dr. mona hanna-attisha
55:30director of the pediatric residency
55:32program at Hurley Medical Center and
55:34author of what the eyes don't see a
55:36story of crisis resistance and hope in
55:39an American city the sale of dr.
55:43hanna-attisha his book what the eyes
55:45don't see a story of crisis resistance
55:48and hope in an American city is provided
55:51by a cultural exchange and that brings
55:55us to the end of today's forum thank you
55:57so much dr. mona hanna-attisha thank you
56:01ladies and gentlemen and this forum is
56:03now a jerk
56:05[Applause]
56:18[Music]
56:22production and distribution of city club
56:25forums on ideastream
56:26are made possible by the generous
56:28support of PNC and the Raskin family
56:32fund with additional funding from Robert
56:35Conrad Cleveland State University the
56:38Chautauqua Institution the Cleveland
56:40Clinic and the United black fund of
56:43Greater Cleveland incorporated

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