It’s Memorial Day weekend. I’m sitting on the front porch of a potentially pretty front gabled house on one of East Liverpool’s many hillsides overlooking the river and what’s left of downtown. The house belongs to Amanda Wilson-Kiger, a lifelong East Liverpool resident and, as of the last year or so, an organizer with a coalition of community, labor and faith-based groups called the Ohio Organizing Collaborative. She and her husband just bought the house less than a year ago and, while it’s easy enough to see it’s Victorian charm, there’s still a lot of work that needs to be done to it and they were understandably self-conscious about having a random guest over—so much so that Amanda’s husband Mike, who’s a house painter by trade, went so far as to paint their bathroom that morning before I got there. Say what you want about the Midwest, but I don’t know of too many other places in America where someone will paint their bathroom for somebody they’ve never met before.

Amanda had just given me the grand tour of East Liverpool in all its dilapidated splendor, taking me through their half-vacant historic Diamond District, where remnants of the wealth and prosperity that were found in this town a century ago when it was “the pottery capital of the world” still stood and down route 39 to the now isolated East End, which has born the brunt of region’s misery over the past quarter century. The East End, where the vast majority of East Liverpool’s black population lives, was the area chosen by developers to situate the massive hazardous waste incinerator for reasons far more cynical than practical.

The first thing that strikes most visitors to East Liverpool’s East End—after the abysmal quality of the roads, which have suffered the neglect that comes with being in a low income neighborhood in a town with virtually no tax base—is how close the Heritage Thermal incinerator is to a residential area. When it was constructed, the incinerator was only 300 feet from neighborhood homes and 1,100 feet from an elementary school and, after more than two decades of pollution and community activism, the only thing that has changed is that many of the East End’s homes now sit vacant and the elementary school has been shut down—casualties of a toxic enterprise that only could have happened in a place like East Liverpool.

Theoretically, the best place to build a facility like the Heritage Thermal Services hazardous waste incinerator would be a remote area that’s more or less devoid of people, wildlife or any sources of potable water. That way, when (not if) something went wrong and operator error resulted in the expulsion of excessive levels of dangerous toxins and heavy metals into the air—as happened 195 times in a 4 year period according to a recent EPA report—it would have as minimal an impact as possible on the surrounding communities and ecosystems. However, not only was the Heritage Thermal incinerator built within PGA Tour driving distance from an elementary school, it was also built right on the banks of the Ohio River, near a public water supply and atop a floodplain. If you’re asking yourself why anyone would think that siting a hazardous waste incinerator here was a good idea, the answers lie in a document called the Cerrell Report.

Published in the mid-eighties by the California Waste Management Board, the Cerrell Report was essentially a how-to manual on how to go about siting “waste-to-energy” facilities in difficult political climates. In the report, the authors describe with alarming frankness what they have found to be the ideal location for siting hazardous waste incinerators based on “personality profiles” and a broad cross-section of socioeconomic and regional variables. According to the report, the best places to build an incinerator with the least resistance are in predominantly working class towns in the South or Midwest that already have a significant amount of industrialization, “conform to some kind of economic need criteria”, and have population composed of, “older people, people with a high school education or less, and those who adhere to a free market orientation.” It is not a coincidence that the demographic profile they laid out fits East Liverpool to a T—it’s that way by design.

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After driving around the East End a little more, Amanda took me back to her house to sit in on a meeting with some locals who have joined in the fight against the Heritage Thermal incinerator. There is a very seasoned and well respected group of advocates who have been fighting the incinerator from the beginning and who can regale you with stories about getting arrested for trespassing with Martin Sheen, but many of them are now in their 70s and 80s and couldn’t jump a fence if they wanted to. Their opposition and knowledge regarding the history of incinerator and all the political intrigue attendant to it is invaluable, but I suspect that even they recognize that it’s time for a passing of the activist torch.

At the house, I met with Jen and Danny, who are two members of the new generation of homegrown activists. Jen and Danny are young (21 & 23, respectively), in love and pissed off. Both of them were born and raised in the area and haven’t known a day when the Heritage Thermal Services/WTI hazardous waste incinerator wasn’t pumping pollutants into their air. At first glance, there didn’t seem to be anything about these two that would distinguish them from the majority of young twenty-somethings currently fumbling their way into adulthood across middle America. But, the more I talked to them, the more extraordinary they appeared. Maybe I am guilty of stereotyping, but I certainly wasn’t expecting a couple of young adults who grew up in urban appalachia to be heavily invested in the #blacklivesmatter movement or to be allies for the LGBT community, which both Jen and Danny were.

Like pretty much everyone I talked to in East Liverpool under the age of 30, Jen and Danny suffered from asthma and chronic bronchitis, but they had gotten off relatively lightly when compared with some of their friends and relatives—especially those who had tried to conceive:

“Miscarriages…spontaneous abortions…that sort of thing’s just a part of everyday life around here,” Jen told me as she lit one of her off-brand cigarettes. “One of my friends, she had three miscarriages before her first kid. Another one of my friends had four of ’em before she had hers. Both of them were my age and the doctors checked and said there was nothing wrong with their uteruses. There was a woman in town who gave birth to a kid whose heart was upside-down and on the other side of its body.”

“Upside-down and on the other side of his body?” I asked, dumbstruck.

“Yep, upside-down and on the other side of its body. But at least that kid’s got a chance. I knew another woman who gave birth to baby without working intestines and died. That’s just the sort of stuff that goes on here.”

Just the sort of stuff that goes on here. In a report on the Heritage Thermal incinerator that was released earlier this year, the EPA outlined the cornucopia of carcinogenic and otherwise toxic substances being spewed in illegally large quantities over the citizens of East Liverpool and the effects that they have on developing fetuses and young children—to say nothing of the rest of the population—are profoundly disturbing. Perinatal and early childhood exposure to organic hazardous air pollutants (HAPs) like the polychlorinated biphenyls (PCBs) being leaked by the incinerator have been linked with increases in childhood leukemia, cognitive deficits, low birth weight and a wide range of endocrine disorders, while other HAPs like quinoline, styrene and benzene are associated with increased risk of developing autism spectrum disorders and neural tube defects like Spina Bifida. The dioxins & furans released by the incinerator, in addition to containing “known human carcinogens”, has been shown to lead to marked increases in spontaneous abortions, preterm delivery, induced abortions and pregnancy loss. This is what an entire generation of East Liverpool residents—Jen and Danny’s generation—has grown up with.

Danny & Jen Protesting the Heritage Thermal Services hazardous waste incinerator at the Ohio EPA last year

“Tell him about your sister.” Danny said.

“Yeah, so when my younger sister was a teenager, all of her hair just started falling out.”

“What do you mean it just started falling out?” I asked.

“I mean, all of the sudden big clumps of her hair started coming out of her head.” Jen said. “She couldn’t take a shower without clogging the damn drain up with hair. They said she had Alopecia areata—luckily it went away when she got older, but she had an awful time when she was teenager.”

I didn’t know it then and Jen’s sister might not know it now, but one of the the hazardous emissions released by the Heritage Thermal incinerator is Selenium, a PM metal that has been linked to, among other things, “loss of hair.”

Sitting there next to those two, I wanted to tell them to get the hell out of Dodge while they still could—before their immune and endocrine systems had been thrown completely out off whack and some bizarre cancer started metastasizing in their bodies, but I couldn’t. I couldn’t because I knew that, if our places were reversed and they were the ones driving down to Cincinnati to ask me why I was living in a bubble of carcinogens and bizarre maladies, I wouldn’t leave either.

“I’d feel like an asshole if I left”, Danny told me when I asked why he stuck around when so many others had left or died from not leaving. “I know it sounds pretty corny, but maybe one person can make a difference, you know?”

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That night, I found myself with Amanda and her husband at a bar in downtown East Liverpool called, well, The Bar. As we walked up to the small cluster of smokers standing outside of the bar, which amounted to the entirety of everyone that was there that night, bartender included, Amanda got into a heated argument with a man over the hazardous waste incinerator—an argument they had probably had half a dozen times by now and one which Amanda had initiated more out of stubbornness of will than any genuine expectation of changing his opinion. The argument progressed along lines familiar to anyone who has visited communities where the interests of industry and fossil fuels butt heads with issues of public health. One side argues that a man’s gotta take whatever job he can get to feed his family. The other side argues that the job the man’s chosen is killing the family he’s trying to feed. Both are right, and every second they spend fighting one another instead of fighting the powers that be that control Heritage Thermal Services and the federal, state and local governments that regulate industry is a second they all get a little bit sicker.

A little later on, after we’d gotten settled into our bar stools and (almost) everyone had taken to nursing the drinks in front of them, the owner of the bar stumbled in and began, in as innocuous a manner possible, harassing the young woman who was tending bar that night. Apparently, the owner had brought a very intoxicated, on the border of unconscious, woman that he may or may not have been friendly with into the bar after closing the week before and asked her to take care of her while he went outside to make a phone call. Whether or not he made that phone call is uncertain. What is not uncertain is the fact that the owner didn’t step foot back in his bar that night and left his young bartender to deal with a mewling, incoherent vomit factory while she was trying to close up.

Over and over again in his ribbing of the bartender, the owner prefaced his statements by saying that everything was 100% his fault and that he was owning up to it, but…if the bartender had closed up a little quicker that night like she was supposed to, she would have been on her way home when he showed up and never would have had to deal with the drunk mystery woman in the first place. The owner repeated this line of booze-fueled reasoning over and over again for about a half an hour, riling the bartender up more and more and more until she finally couldn’t take it, told him to get bent and stormed out of the bar. The owner followed her out the door in quick, albeit serpentine, pursuit and all of the sudden, I found myself in bar without a bartender.

As we were all waiting to see whether or not the bartender would come back (spoiler alert: she did), a woman in who had been sitting on the other side of the bar closest to what may have been a kitchen walked over and started making small talk with Amanda in the way you do when you’re talking to someone you only run into every now and again. Amanda told her all about the protest action she was planning outside of city hall for next week and the town hall meeting that was going to take place the week after and the woman spoke lovingly to Amanda about her grandson. Apparently, they had just thrown a party for his second birthday and she went on and on with grandmotherly affection about the boy and how much fun he and all his friends had.

However, the birthday was bittersweet as her grandson had some sort of cancer in or around his brain and had to get into surgery soon to have his skull cut open so they could place these little inflatable bags in between the bone and the brain to give it room to swell. There was no tremor in her lips when she talked about this, nor was there fear or despair sitting in her eyes. There was simply exhaustion—the type of exhaustion that comes from seeing tragedy and misfortune seep into almost every single corner of your life. Hers was the exhaustion of the beaten and the bruised because in East Liverpool, telling your friends about pediatric cancer or spontaneous abortions or rare blood and bone cancers is what counts for small talk these days.