When the World Runs Dry

Case Study: Flint, Michigan—Ground Zero of America's Water Infrastructure Crisis

The effects of lead is [sic] insidious, But I don't want you to pity us, Or to get rid of us by poisoning us. But to use your might to do what's right, Equal protection of the law is a civil right, Redistribution of resources will change our plight.

—From “The Menace of Lead” by Bunyan Bryant, Ph.D., professor emeritus, University of Michigan, and an environmental justice scholar and researcher

At first glance, Flint looks like many other small cities in the United States. Its downtown has shops, restaurants, and a historic theater for plays, concerts, and movies. Cars park along the main street and people hurry to and from appointments. The city boasts the second-largest art museum in the state and a robust state university campus community.

But beyond downtown, in the nine wards where people should be living, it's clear that Flint has scars. The first were inflicted when the largest manufacturer and employer, General Motors (GM), and other manufacturing businesses began leaving the city in the 1980s and caused sweeping unemployment—and more recent ones followed with the water crisis.

Once called Vehicle City because half its population worked at the GM plants, many streets in Flint are now filled with skeletons of scorched, empty homes with weed-choked gardens and vacant lots where houses once stood. By 2018, only one or two homes were still occupied on some ward streets. Stores were shuttered. The frustration of residents was signaled by the empty water bottles littering the lawn of city hall near the bronze statue of an assembly line autoworker. The statue symbolized the perseverance of Flint's past generations who had fought for labor rights and helped create the middle class in the United States.

What went wrong in Flint? Like so many cities, Flint had an aging water infrastructure. When the city's water source was switched in April 2014, lead from the improperly treated pipes leached into everyone's water supply. Residents were not notified until after the lead was in their bodies.

The Flint River

“So later this spring, we will all be drinking Pure Flint Michigan Natural Mineral Water,” Flint mayor Dayne Walling said in his State of the City address in March 2014. “The new water will be properly treated, lightly fluoridated, and will taste slightly different than the water from Lake Huron that came through Detroit. Pure Flint Michigan Natural Mineral Water.”

Flint's finances were in dire shape after the loss of manufacturing by GM and others. The tax base was dwindling, and the cost of supplying water to residents was rising. To save money, city officials decided to switch water companies from Detroit Water and Sewage to the Karegnondi Water Authority. Before the new connection to Karegnondi could be built, the city turned to the Flint River as a temporary water source.

In his address to Flint residents, Walling put a great spin on the cost-saving measure. But the truth was, using Flint River water was risky. All river water is exposed to unwanted particles, microorganisms, and organic matter that can enter the water easily. Flint River also had a history of pollution from the abundance of local manufacturing facilities, and it has long been naturally high in corrosive chloride that can eat away at lead water pipes—which was especially bad for Flint. Although lead pipes were banned from use in US plumbing systems in 1986, Flint was one of the many cities with older water infrastructures that incorporated them.

Still, the plan went ahead. An engineering firm was hired to prepare the Flint Water Treatment Plant for Flint River water, and Flint Emergency Manager Darnell Earley stated in a March 2014 letter: “We expect that the Flint Water Treatment Plant will be fully operational and capable of treating Flint River water before the date of termination [with Detroit Water and Sewage].”

When the switch occurred, residents complained about the taste, the color, and the rotten-egg smell. But they didn't know it lacked appropriate treatment of the corrosive river water to ensure drinking-water safety, despite Earley's assurance. To save money, phosphoric acid—a chemical that inhibits iron pipe corrosion and prevents lead from leaching—was not added.

So what happened when Flint River water began flowing through the pipes? The chloride corroded the pipes, and toxic lead leached into the water. The people of Flint drank, and also bathed or cooked with, lead-contaminated water. The corrosive water damaged dishwashers, washing machines, and plumbing throughout the city. More seriously, lead entered the bloodstream of everyone who drank the water.

Remember—if lead concentration exceeds 15 ppb in more than 10 percent of taps sampled, the US EPA requires public notification and service lines replaced. Lead levels in Flint exceeded this by twenty times for some homes tested in 2015, with several testing over 100 ppb and one water sample exceeding 1000 ppb. Lee Anne Walters's Flint home was reported to have a lead content of 104 ppb. The testing of 252 out of 300 samples were shipped to Virginia Tech for analysis. Their conclusion found such high lead quantities that Flint water should have failed to meet the EPA Lead and Copper rule. And yet it would take state officials more than a year to inform the public about the high lead levels.

All the while, Flint residents continued drinking contaminated water and also using it for bathing and cooking.

The Discovery

While local and state officials kept silent, Dr. Mona Hanna-Attisha, a pediatrician at Hurley Medical Center in Flint, revealed the disaster in early autumn of 2015. She was first alerted to a potential problem by a former EPA employee who told her that water engineer and college professor Marc Edwards and his Virginia Tech team had studied the water and found high levels of lead in the homes of Flint residents. Until that chance conversation Dr. Hanna-Attisha had had no idea of the potentially dire situation. After all, it wasn't unusual for kids growing up in older homes with lead paint to experience some exposure. Even when her patients had shown signs of lead exposure, she hadn't connected the problem to Flint's drinking water. But she soon discovered that some cases she was seeing in her general practice were different: They were originating in the city's drinking water.

Many Flint babies had their blood tested when they were one and two years old as a regular practice. When Dr. Hanna-Attisha investigated the health records of babies born before, during, and after the water switch to the Flint River to discover any abnormalities in their lead levels, she found a spike that the health department had not reported to the public.

Once she made the connection, Dr. Hanna-Attisha couldn't keep silent. She urged everyone to stop drinking Flint water at a press conference in September 2015.

Testing began throughout the city, revealing a water crisis of epic proportions that had an impact on everyone in Flint, young and old. Governor Rick Snyder released a plan in October to provide free filters and water testing for Flint residents.

Putting Fire to the Kettle

The water in Flint resident Tia Ivory's bathroom faucet measured 376 ppb of lead and 1150 ppb of copper in 2016. Both elements were dangerous to her health. Her kitchen results were significantly lower, at 27 ppb of lead and 170 ppb of copper, but they were still far above the EPA's approved percentages. Ivory's lead levels were so high that US Surgeon General Vice Admiral Vivek H. Murthy visited her home in February 2016. It turned out that her 48507 Flint zip code had one of the highest lead levels in the city.

How do you stay clean and healthy when you can't use your water to drink, bathe, or cook for days, weeks, months, or years? Tia Ivory and her neighbors—many of whom were already suffering from lead poisoning—had to figure that out.

In February 2016, the city hired contractors to begin replacing the pipes. Water bottles were distributed to residents to be used for all their water needs in the meantime. It was difficult, however, to shower, wash their hands, or cook with bottles of water. To keep her teenage son healthy, Ivory sent him away from Flint to live with his dad.

Two years after Murthy's visit, Ivory's water was still not clean. Although the city was working on replacing the pipes under Flint streets, the plumbing in local homes was also in need of replacement. The damage was far-reaching and expensive. Meanwhile, Ivory was still relying on bottled water. She had rashes on her skin and was driving many miles to shower at a local gym.

Ivory's grandparents, like so many others, had come to Flint in the 1940s to work for General Motors. Their house had passed to Ivory, but now—with high city water bills, taxes, and the added expense of purchasing clean water to get through the crisis—she was struggling to keep it. And she wasn't the only one. In May 2017, more than eight thousand Flint residents were at risk of losing their homes if they did not pay the money owed on their water bills. That's right: Through all this, residents were still receiving bills for the toxic water flowing through their pipes. In addition to buying bottled water, they were expected to pay for the water they were using only to flush their toilets. The water crisis became a housing crisis as residents struggled to maintain their properties and their property values.

Ivory spoke out about the crisis at her community center. She knew that the more people who were aware of what her city was going through, the better. Flint residents needed answers and support.

“If we put enough fires to the kettle, it will burn,” she said.

Legionnaires' Disease Outbreak

While some Flint residents were speaking out, the city's water crisis was taking a deadly new turn. In addition to the lead in the water, there was also bacteria—including the Legionella pneumophila bacterium, which can cause a dangerous type of pneumonia called Legionnaires' disease, or simply Legionnaires'. The bacteria, which grows in water, can enter someone's lungs when it's inhaled from a shower or sprinkler system, or if someone chokes on a gulp of contaminated water.

How did this happen in Flint? When chlorine was added to Flint's water supply during treatment in 2014, a chemical reaction occurred in the damaged pipes. The chlorine caused iron to leach from the pipes in addition to lead. Iron promotes the growth of bacteria, including Legionella pneumophila. Bacteria levels spiked. More chlorine was added to combat the problem; although it reduced some of the bacteria, it also led to the growth of others. Stagnant water in the lines caused the growth to proliferate even further.

As a result, Flint residents suffered from the third-­largest Legionnaires' outbreak in the history of the United States. At least ninety people were infected in 2014 and 2015, and at least thirteen died.

Of the seventy-eight people who survived the initial infection, twenty died over the next two years—and there may have been others. Not everyone who passed away in Flint during that time was tested for Legionella. Plus, since the disease mostly targeted people with increased health risks like cancer, heart disease, or diabetes, Legionella deaths may have been attributed to other preexisting conditions. The health department claimed that 84 percent of the Legionella cases during the outbreak affected residents who had a compromising health condition. Jassmine McBride was one of those residents.

Jassmine McBride

On a sunny October day in 2018, Jassmine McBride sat on the porch of her home in Flint, Michigan. Tubing from her nose connected her to an oxygen tank that helped her breathe. When she spoke, her voice was weak.

In August 2014, the then-twenty-four-year-old had visited the local McLaren Flint hospital for a routine appointment to get an iron supplement to treat diabetes. But, unlike with her other appointments, Jassmine didn't return home after this treatment. Instead, her mom received horrific news: The hospital called to ask for permission to resuscitate her daughter. Shocked, Jassmine's mother answered, “Of course,” and she rushed to her daughter's bedside.

The scene at the hospital was a nightmare. Jassmine was in intensive care, alive but in a coma and unresponsive. Legionnaires' disease had attacked her lungs. The young woman who had sung with such a bright, loud voice in her high school choir now had barely enough oxygen to live.

Her mother prayed and waited by her daughter's bedside. Days passed, then weeks. Jassmine remained in intensive care for two months as doctors worked to save her life. When she woke up from the coma in October 2014, she had to relearn everything—from how to eat to how to walk. “She's my miracle,” said her mother.

Jassmine returned home that December, but the effects of the disease continued to ravage her body, causing kidney failure, heart failure, and respiratory failure. She passed away just four months after she'd sat on her porch and shared her story on that sunny day in October 2018. In February 2019, she became the thirteenth official victim of Flint's legionella crisis as well as the youngest.

Seeking Answers

Did the switch to the Flint River water cause this outbreak of Legionnaires'? Ask a Flint resident, and they'll likely answer with a quick yes, but the state wanted to investigate. Two studies conducted by Wayne State University's Flint Area Community Health and Environment Partnership found that there was an increased risk of developing Legionnaires' disease throughout Flint. They determined that the change in Flint's drinking water had caused seventy-two of the ninety reported cases of the disease. They also found that there were cases that had gone undetected. Some cases were misdiagnosed as the flu or another respiratory illness in people who were fortunate to recover. These cases didn't require reporting or additional treatment.

The state health department, the same government agency that didn't report the spike of higher lead levels in Flint's children, called the scientists' findings “inaccurate” and “incomplete.” The state conducted its own study and blamed McLaren Flint hospital's water distribution system for the outbreak.

The Aftermath

In 2018, years after lead had initially leached from the city's pipes, the scars from Flint's water crisis ran deep in the community. Residents faced ongoing rashes on their legs and arms, vacant homes lined entire streets, many of Flint's schools were shut down, and the signs on water fountains still signaled either clean or unsafe drinking water. Less obvious were the heartache and anxiety left in the wake of the crisis and the impact of developmental issues that compromised the city's children.

Early-childhood education centers and other programs serving kids from two months to five years old sprang up throughout the city to address learning disabilities caused by the high lead levels. Many people moved even though their homes had lost all their value because the houses couldn't be resold without clean, potable water.

But some Flint residents, like sixty-two-year-old retiree Sandra Ballard, found moving during the crisis impossible. “You've got to put first and last month's rent down. Believe me; I wish I could get out of here,” she told the New York Times in 2016. Sandra died in 2018 without ever leaving Flint.

As for replacing the pipes, the work is ongoing. In October 2018, a marquee in downtown Flint read: mayor weaver's fast start initiative has excavated 15,031 pipes at flint homes to date!

But much more work needs to be done to replace the estimated twenty thousand pipes running under Flint streets. Once all those are replaced, the pipes in individual homes will have to be changed. And the dishwashers, washing machines, and other appliances destroyed by the toxic water also require replacement.

It has become clear that at the time of the switch, the city's water treatment plant did not have the necessary upgrades in place to treat the Flint River water; in addition, the Michigan Department of Environmental Quality did not require corrosion control. Investigations continued into how the crisis developed and who was responsible. In January 2021, nine officials—including Governor Rick Snyder, Michigan Department of Health and Human Services director Nick Lyon, state-­appointed emergency managers Gerald Ambrose and Darnell Earley (also Flint finance manager), Flint Director of Public Works Howard Croft, and Michigan Department of Health and Human Services official Nancy Peeler—were arrested for their participation in this crisis. Their charges ranged from misdemeanors for neglect of duties to felony charges of involuntary manslaughter. All the accused are presumed innocent, pending the outcome of their trials.

Building a Village

The Flint crisis was unprecedented, and according to Dr. Hanna-Attisha, it changed our country.

“Because of Flint, there has been an incredible ripple effect,” she said in 2018. “People are now testing. They're questioning the safety of their water. They are finding contaminants, whether lead or PFAS [chemicals]. They are no longer believing that our water is safe. That is amazing. That is incredible. People need to be engaged.”

Dr. Hanna-Attisha claims that one of the proven lessons of Flint is that it is a “necessity to build a village of folks that are united in whatever cause that you are working toward.” She also spoke to the importance of banding together to vote in politicians who advocate for the needs of the community, emphasizing that every voice counts.

Case Study: Newark, New Jersey— The Politics of Denial

“Water has not contributed in any significant way to the elevated lead levels in our children's blood. Lead-based paint and dust has done that in the city of Newark, and, I would suspect, in many cities across America,” said Ras Baraka, mayor of Newark, New Jersey, when he addressed the spike of high lead levels across his city with Anna Werner on CBS This Morning in November 2018.

Why would the mayor of Newark resist the idea of lead exposure coming from the city's aging water infrastructure, especially after the highly publicized Flint disaster? The answer is: politics