AMY GOODMAN: A new report by PBS Frontline has found the death toll from the water crisis in Flint may be higher than Michigan officials have acknowledged. The state has admitted 12 people died following an outbreak of Legionnaires’ disease after Flint switched its water supply to the Flint River in an attempt to save money. But according to PBS Frontline, the city also saw a spike in pneumonia deaths during the water crisis. Some of these deaths may have actually been caused by Legionnaires’. Between April 2014 through October 2015, 119 people died of pneumonia in Flint—a jump of 46 percent from that same time period a year earlier.

More than a dozen state and city officials are facing criminal charges, in part for failing to alert the public to the risk of Legionnaires’ disease during the Flint water crisis. On Wednesday, Nick Lyon, the former head of the Michigan Department of Health and Human Services, was in court for a hearing to determine whether he’ll stand trial on manslaughter charges.

Well, we spend the rest of the hour with Dr. Mona Hanna-Attisha, the Flint pediatrician who helped expose the dangerous levels of lead in Flint, Michigan’s drinking water, after she tested blood lead levels in children. In 2016, Time magazine named Dr. Mona one of the hundred most influential people in the world. Her new book is titled What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City. She recently came to our studios. We sat down for an interview, and I asked her to describe the situation in Flint today.

DR. MONA HANNA-ATTISHA: Our water quality is definitely improving. It is absolutely getting better. Shortly after we released our findings that children’s lead levels were elevated, we switched back to treated Great Lakes water. However, the 18 months that we were on that corrosive water ate up our pipes. It ate up our lead pipes. And they’re being replaced. And replacing pipes doesn’t happen overnight. We’ve replaced about 6,000. We have about 9,000 to go. And until those pipes are all replaced, people still need to be on filtered water or bottled water.

AMY GOODMAN: So, let’s go back to the beginning. Some people have heard about Flint water. Maybe others haven’t. But tell us the story of what actually took place.

DR. MONA HANNA-ATTISHA: Yeah, so, Michigan has a crazy law, that if you are in a near-bankruptcy state, the state can swoop in and usurp democracy. Flint has been in crisis, really, for decades—financial crisis, with disinvestment, unemployment, racism, poverty. And in 2011, the governor appointed a state-appointed emergency manager to come in with one purpose. And that purpose was austerity. It was save money, save money, save money, really no matter what the cost.

And they decided that the water that we had been getting from Detroit, which was fresh Great Lakes water, for half a century, was too expensive for this poor minority city that was near bankruptcy, and that instead we would start drawing water from the local Flint River, until a new pipeline to the Great Lakes was to be built. But the critical error came where the water from the Flint River was not treated properly. The Flint River water may have been OK, but it was not treated with the necessary corrosion control. And without that medicine, I think of it, that you put in the water treatment—it prevents the lead that is in all of our plumbing to come out of the plumbing and go into our drinking water.

AMY GOODMAN: So, this corrosive water supply leached out the lead in the pipes.

DR. MONA HANNA-ATTISHA: Absolutely. So we were stubbornly slow as a nation to listen to science and to restrict lead in our plumbing. The lead industry was and continues to be absolutely evil. We still had regulations in place that could allow lead service lines until 1986, but not until 2014 did we restrict lead from our brass fixtures. So we have lead in all of our infrastructure. New York City actually has the most lead lines in the country. But if it’s properly treated, it minimizes the lead released—doesn’t prevent it, but minimizes it. So the corrosive water really just ate up the scale that was in those pipes, and then released the lead that was already in that plumbing into the drinking water.

AMY GOODMAN: Now, it’s not as if people weren’t aware. I mean, we went to Flint. We met with the people who were marching in the streets, who said the water smelled funny—

DR. MONA HANNA-ATTISHA: Absolutely.

AMY GOODMAN: —it looked funny. Describe the water and what it took, and especially what you did.

DR. MONA HANNA-ATTISHA: Yeah, so, the heroes of the story are the people of Flint. They were heroic and brave and loud. Incredible activism and resistance. Right when the water switched, they said, “Hey, you know, the water looks gross. It tastes gross. It’s brown. It smells like sewage. My kids are getting rashes.” We had bacteria in the water. Then they dumped a lot of chlorine in the water to kill the bacteria. People felt that they were, you know, drinking a swimming pool. That excess chlorine caused high levels of chlorine byproducts, which are carcinogens. They cause cancer. And then, just a few months into this water switch, General Motors, which was born in Flint, stopped using this water because it was corroding their engine parts. So, a full year before my research, they—

AMY GOODMAN: I mean, this is an amazing story. We went to the house of one of the union workers in Flint, who worked at the engine plant.

DR. MONA HANNA-ATTISHA: Yeah, yeah.

AMY GOODMAN: And they got a waiver—

DR. MONA HANNA-ATTISHA: Yes.

AMY GOODMAN: —because they were getting corrosion on their engine parts and saying, “We can’t sell these engines.” So, clearly the city and the state knew there was something wrong with the water. And here were the Flint workers at the plant saying, “Wait, if it’s corroding our engines, what’s happening to our bodies?”

DR. MONA HANNA-ATTISHA: It is mind-boggling. And the state repeatedly just told people to relax. They literally said, “If you have any concerns about lead in the water, you can relax.” So, I heard about the bacteria. I heard about the high levels of chlorine. But the state was reassuring everybody. And, I mean, who doesn’t believe that the water that comes out of your tap in the 21st century is OK? And Michigan is literally—we are the Mitten State. We are literally in the middle of the Great Lakes. Here’s Flint, right there. We are middle of the largest source of freshwater in the world, 20 percent of the freshwater in the world.

AMY GOODMAN: You’re holding up your hand.

DR. MONA HANNA-ATTISHA: This is the—

AMY GOODMAN: And you’re showing Flint is right below your pointer finger—

DR. MONA HANNA-ATTISHA: Yeah, Flint is right here.

AMY GOODMAN: —next to your thumb, right in the middle.

DR. MONA HANNA-ATTISHA: Here’s Detroit. Here’s Ann Arbor. Here’s Grand Rapids. And here’s Flint, literally in the middle of the largest source of freshwater in the world. Like who would believe that in the 21st century, in the middle the Great Lakes, that when you turn on your tap, that your water is not fine?

AMY GOODMAN: So, Dr. Mona, talk about where you were working at the time.

DR. MONA HANNA-ATTISHA: Sure. So, I’m a pediatrician and a medical educator at our public Children’s Hospital. And families would come in and see me, and they would be worried about the water. And I was reassuring families, telling them, “It’s OK. Don’t waste your money on bottled water. The state says everything is OK.” And I wasn’t tipped off until a high school girlfriend came over who happens to be a water expert. So, at my home, not at work, with a glass of wine in my hand, and this high school girlfriend tells me, “Hey, Mona, the water’s not being treated properly.” I’m like, “What are you talking about? Everybody says it’s OK. How could the water not be OK?” And she’s like, “Well, there’s no corrosion control. And if you’re missing that ingredient, there is going to be lead in the water.”

AMY GOODMAN: Was she from Flint?

DR. MONA HANNA-ATTISHA: She’s not from Flint. Drinking water expert, formerly with the EPA, in metro Detroit. And that was the very first time, with a glass of wine in my hand, that I heard the possibility of lead in the water. And when a pediatrician hears the word “lead,” it’s a call to action. We know what lead does. It’s probably the most well-studied neurotoxins known to man. It impacts cognition and behavior and alters a child’s entire life course trajectory. It’s already a form of environmental racism. Our kids in Flint already had higher lead levels, just like kids in Detroit, in Chicago, in Philadelphia. It impacts them forever. So, when I heard that there was potentially lead in the water, that really started kind of my quest to see if that lead in the water was getting into the bodies of our children.

AMY GOODMAN: So, talk about what you did.

DR. MONA HANNA-ATTISHA: I tried to get the data from both the county and the state. So, lead is something that there are surveillance programs for. All the blood lead levels done at anywhere in Michigan go to a surveillance system, just like we have surveillance for flu and HIV. I tried to get that surveillance data but was blocked in every direction, so then decided to do my own research in our hospital, which sees really the most Flint kids, pulled up those labs as quickly as possible and compared children’s lead levels before the water switch to after the water switch, and noticed that, contrary to really every trend that was happening at the national level, the state level and even our city level, where lead levels had been going down for years because we got lead out of paint and gasoline, there was an increase. Even if it had stayed the same, it would have been alarming. And this was all a massive underestimation of exposure.

AMY GOODMAN: So, then talk about what happened, as you gathered the information. I mean, you had people—their hair was falling out. They had rashes.

DR. MONA HANNA-ATTISHA: People’s—rashes. Hair was falling out. Worried about their children. All kinds of nondescript symptoms. The hard thing with environmental health exposures, especially lead, is you can’t really pinpoint it. It doesn’t have one symptom. Like I wish it had like purple spots and like, “Oh, that means you’re exposed to lead.” But it’s known as a silent pediatric epidemic. You don’t see the consequences of lead exposure for, really, years after exposure, and then, often, it’s too late.

So when we knew that we had this data, when we knew that we saw this increase in children’s lead levels, and it was in the same geographic areas where the water lead levels were the highest, we tried to alert local officials. They were not interested in listening. So, I held a press conference. And this is definitely not something doctors do. It’s actually kind of a form of academic disobedience. You are supposed to release your research in journals and publications. It’s supposed to go through a peer review process, which takes time. And our kids in Flint had no time.

AMY GOODMAN: Describe to us what happened when you got your numbers back, before the news conference.

DR. MONA HANNA-ATTISHA: Yeah.

AMY GOODMAN: What did you see?

DR. MONA HANNA-ATTISHA: Yeah, so—

AMY GOODMAN: Where were you?

DR. MONA HANNA-ATTISHA: Yeah, so, I was in my office at the hospital with one of my co-researchers, another young woman, a young mom. And we got the data back that showed this increase in blood lead levels. And I tried every which way to prove that I was wrong. I was trying to be a statistical devil’s advocate. I did not want to be right, because to be right, to have seen an increase in lead levels, was dire for our children. That’s not what these Flint kids need, who are already struggling with every adversity to their development, every obstacle to their success.

AMY GOODMAN: And so, then you decided to hold this news conference.

DR. MONA HANNA-ATTISHA: Right, decided to hold a news conference, so, literally, like walked out of the clinic and into this conference room, a press conference, to share this data.

AMY GOODMAN: I want to go to a clip of that news conference.

DR. MONA HANNA-ATTISHA: The percentage of children with elevated blood lead levels has increased. The most striking increase is in the ZIP codes with the highest water lead level.

AMY GOODMAN: So that’s Dr. Mona Hanna-Attisha at a news conference announcing the results of the studies she had done based on the kids of Flint. Dr. Mona Hanna-Attisha is a pediatrician in Flint, Michigan. Talk about the response to this news conference.

DR. MONA HANNA-ATTISHA: Yeah, so, I shouldn’t have been surprised, because everybody in this story who had raised the flag had been attacked—the incredible moms, the activists, the pastors, the journalists, the water scientists. Everybody was dismissed, denied and attacked. So when I shared this evidence, these facts, this proof that there was an alarming increase in children’s blood lead levels, I was also attacked. I was called an “unfortunate researcher,” that I was causing near hysteria—which is one of my favorites because it was also blatantly sexist–and that I was splicing and dicing numbers, and that the state’s data was not consistent with my data.

So, when the state attacks you, you feel like crap. And I doubted myself. I second-guessed myself: Maybe I was wrong. But I quickly realized that every single kid in my data, every number, every statistic was a child, a child that I had probably cared for within that last year or so. And they gave me the strength to fight back, because this was not about numbers, this was about kids. And this was about the future of those kids.

AMY GOODMAN: So, talk about your data versus the state’s data.

DR. MONA HANNA-ATTISHA: Right.

AMY GOODMAN: So, if you weren’t wrong, they were wrong.

DR. MONA HANNA-ATTISHA: Yeah. So, they were wrong. So they said that, “We know our numbers don’t show this. It’s not consistent with what your findings are.” And there was about a week, two weeks, of this back and forth, you know, comparing data, fighting in the media. And then, finally, the state’s chief medical doctor called me, and she’s like, “Tell me how you did your research. Like, let’s have a physician-to-physician conversation,” which means, “Let’s kind of cut the crap.” “What did you do? Share your research.” And that really forced the state to go back and look at their data. And when they did go back and look at their data, they saw the same thing that I had seen.

AMY GOODMAN: So, you had the Governor’s Office, the governor of Michigan, Rick Snyder, attacking you. And then, the next thing we see is a news conference of Governor Snyder, and you’re standing at his side. Let’s go to that news conference.

GOV. RICK SNYDER: Our most recent data indicates that 43 of 2,182 adults and children tested had elevated blood lead levels since October 1st. This includes 23 children under the age of 6, seven children age 6 to 17, and 13 adults. As part of this, once a child has an elevated blood level result, the Michigan Department of Health and Human Services is funded and is working with the Genesee County Health Department to provide follow-up case management.

AMY GOODMAN: Describe what happened then.

DR. MONA HANNA-ATTISHA: Yeah. So, I will work with anybody who is willing to work for children. That is the constituency that I respond to. So the governor asked—it was his first visit in Flint, with the new mayor, who had just been elected, and they were, you know, discussing the situation and what needed to be done.

AMY GOODMAN: That was Dr. Karen Weaver, the psychologist—

DR. MONA HANNA-ATTISHA: Right, yes.

AMY GOODMAN: —who sort of almost ran on a single plank.

DR. MONA HANNA-ATTISHA: The water.

AMY GOODMAN: “I’m going to deal with the water of Flint.”

DR. MONA HANNA-ATTISHA: Absolutely. She’s a pediatric psychologist, so is well aware of the consequences of a water crisis and a lead crisis. So I was standing at this press conference with the new mayor, with the governor, with many of his Cabinet members, and they, at that point, had acknowledged the crisis but were continuing to downplay the crisis. And although I was standing there and asked to be there with them, I couldn’t agree with what they were saying. They were saying that only a few children were exposed. They were saying that it was by and large, you know, the schools’ fault that there was high levels in the schools. It wasn’t that it was the corrosive, untreated water’s fault. So I very visibly shook my head. I’m like, “This is is not right,” and in opposition to what they were saying.

AMY GOODMAN: So, they cherry-picked their data. It’s just not a matter of, oh, they happened to have different conclusions than you, and then they call you up, and they say, “Oh, we should do it another way.” This had been developing for a few years. People had been raising many concerns. So, what did they leave out, that you found?

DR. MONA HANNA-ATTISHA: Yeah, so, actually, in all these FOIAd emails that eventually came out, the state Health Department had actually looked at children’s blood lead levels that previous summer. So, in the summer of 2015, they had actually analyzed blood lead levels from the summer of 2014 and actually saw a spike in children’s blood lead levels, but didn’t share that information. So that was another missed opportunity where this crisis could have been averted.

AMY GOODMAN: So, explain what happened next. Governor Rick Snyder is still the governor of Michigan, but a number of his top aides have been indicted.

DR. MONA HANNA-ATTISHA: Yeah. There’s been over 15 criminal charges. In addition to a lead crisis, we also had one of the largest outbreaks of Legionnaires’ disease, which causes pneumonia and fatalities. People died. At least 12 people died from Legionnaires’ disease, which was also due to this untreated water. There was an overall uptick in pneumonia. So, there is some homicide charges because of that. There has been charges against the water quality, water treatment folks, people at the Health Department, the emergency managers, city officials. So there’s been many, many investigations and ongoing efforts at the accountability.

AMY GOODMAN: Talk about the role of the EPA—

DR. MONA HANNA-ATTISHA: Yeah, so—

AMY GOODMAN: —the Environmental Protection Agency, which is, to say the least, extremely relevant today in the Trump administration, the rollback of regulations. But this was not during the Trump administration.

DR. MONA HANNA-ATTISHA: No, this was during the Obama administration. The head of the EPA Region 5, which is where Michigan is, Susan Hedman, resigned because of this crisis. The EPA actually did their own internal report with their inspector general and noted that they should have acted seven months sooner. There were heroic and brave, defiant folks at the EPA who were raising the alarm bells on what was happening in Flint, but they were also silenced. So there’s a role of the EPA at fault. And it’s concerning now, because, you know, the EPA is further being emasculated with—you know, almost being permanently dismantled, with cuts in regulations and cuts in senior staff. So it’s even more concerning that we will see many more Flints to come.

AMY GOODMAN: There was an EPA whistleblower.

DR. MONA HANNA-ATTISHA: Absolutely.

AMY GOODMAN: You have the head of the EPA stepping down.

DR. MONA HANNA-ATTISHA: Yes.

AMY GOODMAN: But there was someone who was willing to share his data with residents of Flint, so alarmed by what he saw.

DR. MONA HANNA-ATTISHA: Yes. There was a heroic EPA whistleblower. His name is Miguel Del Toral. And he came up to Flint after an amazing mom called him. LeeAnne Walters called him and said, “Hey, I think there’s something wrong with my water.” He drove up to Flint. He offered to use his own money to do testing in Flint. He inspected her whole house. And he wrote a damning report, a memo, in July of 2015, really early on, with alarm bells everywhere, saying, “Hey, there is lead in Flint’s water. We need to look into this.” And he was silenced. The state called him a rogue employee. Susan Hedman apologized for his behavior, that he kind of stepped out of line. So, there were folks at the EPA who were trying to do good.

AMY GOODMAN: And the Michigan Department of Health and Human Services director, Nick Lyon, is facing manslaughter charges.

DR. MONA HANNA-ATTISHA: Yes. This because of the Legionnaires’ outbreak.

AMY GOODMAN: What should they have done at the time, aside from not having switched the water supply?

DR. MONA HANNA-ATTISHA: Yeah, obviously. I wish I could press rewind and never have switched to this water supply, because it was all preventable. This was all man-made. But when we knew of the early signs of elevated lead levels, when we we saw a few cases of Legionnaires’ disease, people should have been alerted. Providers should have been alerted. A health advisory should have gone into effect. When we knew this was corroding engine parts, that should have been a red flag. So there were so many missed opportunities, that for 18 months people remained on this water source and suffered the consequences.

AMY GOODMAN: You had the unelected city managers, as you talked about, like Darnell Earley. They also were indicted.

DR. MONA HANNA-ATTISHA: Yes, yes. Yep, the emergency manager was indicted.

AMY GOODMAN: You had the City Council of Flint voting overwhelmingly—

DR. MONA HANNA-ATTISHA: Yes.

AMY GOODMAN: —to return to the original water supply, and the unelected manager saying, “How dare you do this!”

DR. MONA HANNA-ATTISHA: Right, because we can’t afford it, because poor people evidently are not good enough for clean water. Is this how our society is supposed to be? Shouldn’t public welfare benefit all, no matter your privilege?

AMY GOODMAN: So, you have the crisis of Flint water, and then you have the state of Michigan now approving a controversial permit to allow Nestlé, the largest water bottling company in the world, to expand its operations in Michigan. Michigan’s Department of Environmental Quality has given the OK to Nestlé to withdraw 400 gallons a minute from the state’s groundwater table, despite receiving over 80,000 public comments against the project. Nestlé is not required to pay anything to extract this water, besides a small permitting fee to the state and the cost of leases to private landowners. According to one count, Nestlé’s bottled water is 7,000 times more expensive than what Nestlé is actually paying for it. Critics say Nestlé shouldn’t be allowed to profit from the state’s natural resources at a time when Michigan’s cities, like Flint, are still facing a crisis over contaminated water.

When we went to Flint to talk about the poisoning of an American city, we also went to the source of Nestlé’s water, because when we were in Flint, we were being handed bottled water everywhere. Companies were giving truckloads of bottled water to people, which was also great advertising for them. But, more importantly, where was this water coming from? The issue of this bottled water, talk about it.

DR. MONA HANNA-ATTISHA: Amy, this is unreal. So, the same week that the state granted Nestlé this permit for $200 a year for unlimited access, essentially, to the Great Lakes was the same week that they cut bottled water for Flint. There are people in Flint who still cannot afford water. They are, to this day, getting shutoffs because they cannot pay their bills for water, that they still need to use a filter to drink from. And we grant a corporation unlimited access to the Great Lakes water. It is mind-boggling. It is tone-deaf. It is unreal for this to happen.

AMY GOODMAN: Flint, Michigan, pediatrician Dr. Mona Hanna-Attisha. Her new book, What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City. If you’d like to go back to the documentary we did in Flint, when we were there during the height of the crisis, you can go to democracynow.org and put into search “Thirsty for Democracy, the Poisoning of an American City.”

That does it for our show. Democracy Now! has a job opening for a broadcast engineer. Check our website at democracynow.org.