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Michael Moore’s Roger and Me introduced people all over the world to Flint, Michigan, the city that lost more than half its population when General Motors moved most of its plants out of town. In the movie, Moore also visits the site of AutoWorld, an amusement park that promoters predicted would draw a million visitors a year and “save” Flint. It quickly went bust. Leaving the theater, moviegoers might have wondered, “What more could happen to Flint?” Two new books recount the next chapter. In 1988, the Michigan Legislature passed an Emergency Financial Manager (EFM) law, enabling the governor to appoint a representative to take over cities and school districts in severe financial trouble and return them to local control only after a city’s fiscal house was deemed in order. Responsible solely to the governor, EFMs were empowered to bypass local elected officials. Two decades later, in 2011, Governor Rick Snyder signed a bill strengthening the law’s provisions and appointed emergency managers (EMs) to rule over deindustrialized cities and school districts — all of which had majority African-American populations. Flint, having lost half of its population to surrounding suburbs, was 57 percent black and had the highest poverty rate in the state. It was to have three emergency managers. The EMs sold public property, slashed public workers’ wages and pensions, and closed community centers. Any semblance of democracy was disregarded. From the beginning residents protested the law, holding meetings, marches, press conferences, and demonstrations. They pointed out that much of the deficit had been caused by cutbacks to revenue-sharing required under the Michigan Constitution, and denounced the racist character of the law’s implementation. In November 2012, Michiganders repealed the emergency manager law in a statewide referendum. Seventy-five of the state’s eighty-three counties voted to dump it. But legislators, in a lame-duck session, passed a nearly identical bill designed to block a future referendum, and Snyder quickly signed the legislation. The mechanism that would help unleash a public health disaster in Flint was now firmly in place.

Poisoned Water, Ignored Warnings The Poisoned City: Flint’s Water and the American Urban Tragedy, by the journalist Anna Clark, tells the story of what happened next — how public officials, in their drive to save money, ended up poisoning not only the one hundred thousand residents of Flint but those who worked there. Genesee County officials proposed moving from the Detroit Water and Sewerage Department’s water system (DWSD) to a newly planned one, the Karegnondi Water Authority (KWA). The new system would pipe raw water from Lake Huron to the plant Flint owned, where the appropriate chemicals would be added and monitored. Flint’s EM, Darnell Earley, claimed the plan would save the area serviced by KWA $200 million a year and give Flint control over a crucial resource. Earley wanted Flint to end its contract with DWSD and use the Flint River as a temporary fix until KWA was built a couple of years down the road. Although Earley didn’t need to ask for a city council vote to proceed, the city council also voted 7-1 in favor. In his eagerness to switch, he even sold the nine-mile pipe connecting the Detroit system to the county for $3.9 million. Meanwhile, all the other municipalities remained with DWSD. The switch to Flint River water was a catastrophe. While even small amounts of lead are dangerous — particularly for pregnant women and children under the age of five — officials disregarded a warning from the city’s utilities manager that Flint’s water treatment plant was not ready. The chlorine room was still under construction, and employees had not been trained. Officials plowed ahead anyways, switching Detroit’s system — which uses water from Lake Huron and treats it — to the Dort Highway plant, using the Flint River. More than a year earlier, staff at the Michigan Department of Environmental Quality (MDEQ) had cautioned that the move was risky. Clark cites an internal email from Stephen Busch, supervisor of their drinking water office, warning that the river would “pose an increased microbial risk to public health.” Yet on April 25, 2014, as officials toasted the switch at the treatment plant, Busch remarked that in drinking the treated river water, “Individuals shouldn’t notice any difference.” Clark, a Detroit-based reporter whose grandfather was participated in the 1936–37 sit-down strike, notes that no other suburb would join KWA in leaving the Detroit system before the new one was up and running. But they also weren’t suffering from debt and under the thumb of an EM. She asks: Why didn’t MDEQ staff make sure that the Flint plant was ready for the switch? Why didn’t they require the treatment plant add and monitor phosphates? Why didn’t officials, MDEQ or health departments at the city or county level, intervene when residents showed up at city council meetings with bottles of orange or brown water, testifying about its foul-tasting smell and questioning the curious rashes on the bodies of their children? Faced with angry residents, officials gave various explanations for the water and counseled patience. Yet less than four months after the switch was made, the city issued the first of three boil-water advisories for E. coli, a fecal coliform bacteria. Soon after plant staff increased the disinfecting chlorine treatment, they discovered TTHM (four chemical compounds that can cause problems to the nervous system), but only reported it to residents nine months later. By October management at the General Motors engine plant concluded that the Flint water was too corrosive for their operation — and petitioned the city to allow them to reconnect with the Detroit water system. Earley was quick to give them the go-ahead, despite the fact that the changeover would mean a $400,000 loss for the city. And as GM reconnected, Clark notes, “Over at the UAW [hall], members were beginning to ask, ‘If it’s too corrosive for an engine, what’s it doing to the inside of a person?’” In April 2015, faced with growing protests, the city council voted to reconnect with Detroit’s water system. But the guy with the power was the new emergency manager, Jerry Ambrose, who called the vote “incomprehensible.” He said such a switch would cost more than $12 million annually. Meanwhile, residents were suffering. LeeAnne Walters — her family of six stricken with rashes, her teenage daughter’s hair falling out, her son diagnosed with a compromised immune system — got a note from a doctor and asked the city to test their water. The federal Lead and Copper Rule sets the mark for federal action at 15 parts per billion parts of water (15 ppb). The results revealed levels seven times higher (104 ppb). Officials scrambled to find a reason why the Walters household registered such an elevated lead level, and even replaced service pipes. When the result was even higher, the city shut off their water. Dependent on bottled water and garden hoses connected to a neighbor’s spigot, LeeAnne Walters was forced to become a whistleblower, and Clark details the process of finding the evidence. Walters called the regional Environmental Protection Agency office and got the attention of their regulation manager, Miguel Del Toral. But his report, “High Lead Levels in Flint, Michigan,” sent on June 24 to seven EPA and MDEQ officials and water experts, was unable to force officials to take another look. MDEQ staff claimed the treatment plant was using corrosion control, manipulated testing mandated under the Lead and Copper rule, and badgered EPA administrators into disciplining Del Toral. By mid-July Brad Wurfel, MDEQ communication director, attempting to squelch media accounts and deflate protests, stated in an interview that “anyone who is concerned about lead in the drinking water in Flint can relax.” The final piece of the puzzle came from Dr Mona Hanna-Attisha, a public health pediatrician at Flint’s Hurley Medical Center and author of What the Eyes Don’t See. When she realized the children whom she and her team were seeing had been exposed to lead, she pulled together figures that demonstrated children’s elevated levels had almost doubled since the water switch. Within two weeks of her press conference, Governor Snyder announced that Flint would be reconnected to Lake Huron water.

Crisis, Resistance, and Hope As Anna Clark recounts the horror of the poisoning and cover-up, she encourages readers to recognize that lead is just one of the country’s toxic legacies. Segregation is another. Woven into her account is the story of Flint’s history of segregated housing. General Motors built housing for white employees only. Redlining by city and federal agencies, along with racially restricted covenants, made Flint the most segregated of all northern cities. This pattern was reinforced with the growth of suburbs after World War II, as housing loans were only available for whites. Could this disaster have happened in another, less segregated city? Certainly it was less likely to occur in metro Detroit’s white, wealthy suburbs — and those cities never experienced an EM. But given the infrastructure of the country, there are other Flints in the waiting. In a sense, deindustrialized and segregated communities are the canary in the mine. In fact, the author examines an earlier struggle over lead in the Washington, DC water system, a struggle in which both Del Toral and water expert Marc Edwards were involved. The Poisoned City names those responsible for the lead poisoning, some of whom are facing trials. State and federal funds have been appropriated to replace all of Flint’s eighteen thousand lead pipes by 2020 and carry out school-based screening. But accountability, if it actually happens, means little without changing the structures that discriminate and without prioritizing transparency. One question that remains unanswered is whether there is a backstory to Flint’s decision to move to KWA, and why it alone decided to go with the temporary fix of using the Flint River. It’s reasonable to suspect not just the neoliberal austerity drive, but also corruption. Dr Mona Hanna-Attisha’s account, What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City, concentrates on the last month of the cover-up. It is a gripping story of how a public health doctor, realizing that children are in danger, finds the data to prove causation. The account reads like a detective story, as this “outsider” — a child of leftist Iraqi immigrants who works but does not live in Flint — uses all of her resources to press for an end to the poisoning. Once she mines enough data to prove the case, she gives the mayor three days to decide if he will support the findings. She is disappointed when he declines. Hanna-Attisha tells her readers that she was deathly afraid of being shamed as she broke the story. Over the course of the book, she explains that she found the courage she needed from digging into her family history, from remembering admirable teachers, and from recalling particular heroes — Genora Dollinger of the Women’s Brigade during the Flint sit-down, Alice Hamilton, a pioneering authority on industrial diseases and lead poisoning, and John Snow, who first traced cholera to people drinking unsanitary water. A director of the pediatric residency program at Hurley Medical Center, Dr Mona (as she is called at work) oversees the Community Pediatric program. Each class begins with a tour of the city, learns about Flint’s history, and records its decline in the number of blighted neighborhoods and boarded-up schools. To learn about medical racism they discuss the Tuskegee syphilis experiment and the story of Henrietta Lacks. They read about the connection between racism and health, meet community leaders and activists, attend court hearings and community events. The goal, she writes, is to have residents understand the lived experience and environment of our kids. They would become familiar with the city’s weaknesses and needs but also feel a sense of solidarity and empathy with the people of Flint — and see the city’s deeper potential.

Uncovering the Cover-Up Once an environmental activist who participated in a successful campaign to shut down an incinerator, Hanna-Attisha was disturbed that even after she showed officials her damning data, they minimized the crisis. Reflecting on the mayor’s reaction, she writes: He was copping out already. Okay, maybe there is lead in the water, he was saying, but it isn’t the city’s, the state’s, or the feds’ responsibility — or mine. It’s the people’s fault. I couldn’t help but think how this echoed the lead industry’s blaming of victims. Then he mentioned the prohibitive cost of switching back to Detroit water. Hanna-Attisha’s September 24, 2015 press conference began with a power point presentation with graphs comparing 1,756 children five or younger in seven Flint zip codes, and demonstrated that the post-switch blood-lead levels were almost twice what they had been before. She also compared Flint children with those still using the Detroit water system in the rest of the county, and ended her presentation by recommending next steps: declaring a health advisory, distributing high-quality water filters, only using bottled water for women and young children, and reconnecting to Lake Huron water. Following the press conference, MDEQ’s Brad Wurfel labeled the conclusions “irresponsible.” The Michigan health department attempted to refute the study, claiming her findings were the result of a “seasonal anomaly.” Deeply insulting to a person who values the scientific method, Hanna-Attisha smarts when a spokesperson in the governor’s office argues the study had been “spliced and diced.” But the campaign against Hanna-Attisha collapsed when the Detroit Free Press concluded that the state data actually confirmed hers. The new superintendent of Flint public schools, bowing to popular pressure, announced the schools would stop using the Flint water system. As the state backtracked and Governor Snyder apologized, ordering the reconnection with Lake Huron, Hanna-Attisha was busy writing a list of next steps to ensure that Flint children received the resources they needed in the coming decades. Ten thousand infants and children under five had been exposed to lead at a crucial stage in their development: She explains: early trauma and toxic stresses leave a mark on the brain and change neural pathways. Children exposed to adversity need to be soothed, loved, and taught how to cope and be resilient; they need to be properly nourished and surrounded by people who value them; they need policies that support them. With all these in place, they can cope and rebound; otherwise they may be living with the impact forever. Already, children in Flint face developmental obstacles. Hanna-Attisha recommends an “ecobiodevelopmental” approach to tackle the residual lead problem — what I’d call reparations. Even if some of the criminals lost their job or faced charges, even if the state was forced to pay for their nickel and diming to reduce Flint’s debt, even if Governor Snyder’s name was always associated with the emergency manager system still on the books — all that’s really beside the point if the most vulnerable people do not receive the care they deserve.