Dr. Mona Hanna-Attisha, author of the new book “What the Eyes Don’t See,” tells SEEN why she decided to share her story of exposing the Flint water crisis.
Title: Founder and director of the Michigan State University and Hurley Children’s Hospital Pediatric Public Health Initiative
Hometown: Royal Oak
Current city: West Bloomfield
By Stephanie Steinberg
Featured photo by Jenna Belevender
1. Our women’s issue is focused on women innovators, and you’re an example of a physician who’s implemented innovative practices at Hurley and throughout the Flint water crisis. Can you share an innovative accomplishment you’re most proud of?
I think it’s the model that we put into place in terms of a recovery. So this pediatric public health initiative was built as a model public health program to mitigate the impact of this crisis, and it’s all about improving children’s health and it’s all about doing things outside of the box and working in partnership with kids and parents and community to turn the story around for Flint kids.
But what we are doing is so cool and innovative because it’s not just for Flint. And that’s what I hope what this book shows is that the story of Flint is not isolated. It is about crises that are happening all over this country, be it from democracy or environmental injustice or loss of health care or assault on children. It is about things that translate everywhere. Kids in Flint, but kids in Detroit and kids all over this nation wake up in the same situations as Flint kids. The same nightmares which make your ZIP code at birth more powerful than your genetic code. Kids in Flint will actually live 15 years less than kids in an adjacent neighboring ZIP code, but that’s not unique to Flint. That is all over this country.
So what we’ve been trying to do is disseminate what we’re doing here to other communities. And it’s already happening. For example, in my capacity of the Michigan chapter of pediatricians for the new administration and the governor and Legislature, we created this blueprint for Michigan children. This is, based on science, what all kids need. All kids in Michigan need families that have living wages and paid family leave and healthy nutrition and safe neighborhoods and safe water. But the neat thing is that this is built on what we’re already doing in Flint. So we’re using this model that we built, and we’re expanding it to the state.
Our work is divided into many teams, many efforts, and one of our big projects is nutrition. There’s a lack of nutrition and grocery stores. Our nutrition prescription program is robustly evaluated by academics, and we’ve shown great success. Senator (Debbie) Stabenow, another amazing woman role model very much part of the Flint story, is aware of our clinic and our nutrition prescription program. So she actually put a prescription program in the U.S. farm bill. And just a couple months ago it passed, and it was signed by the president. And it was inspired by our clinic. So here is another example of how our innovations here, in terms of doing what kids need and building a healthy future, is being spread all over this nation.
2. What does the nutrition prescription program entail?
Every single kid who comes to our clinic, be it for an ear infection or a well baby checkup, printed on our electronic medical record, just like amoxicillin, just like any medication, they get this $15 prescription for healthy living. They fill it downstairs at the farmers market. They take it to a vendor, and they get $15 worth of fruits and veggies. And sometimes they save it. We’ve done a lot of different analysis and some moms are like, “My kid has never had a blueberry before. We’ve never been able to afford this.”
Think of the demographics of farmers markets. They’re rich white people. I used to tell my patients, you should eat avocados and kale, and they would just stare at me like, “Where the heck am I going to get avocados and kale? I can’t afford that, and we have no grocery stores. It’s much easier for me to go to like a party store or fast food.”
So we’re really changing the demographics of who goes to our farmers market. And now, this is becoming a national program as part of the U.S. farm bill, and it’s going to be administered by the U.S. Department of Agriculture, which is really exciting!
3. You’ve also helped bring mobile grocery stores, breastfeeding services, two free year-round preschools and literacy programs to Flint kids. Tell us more about that.
One of my favorite things we’ve been able to put in place is the expansion of early literacy. Reading is important, especially little kids reading. But in places like Flint, there’s about one book for every 300 children. So think about that. By the time kids in these kind of communities have reached the age of 3, research shows that they’ve heard about 30 million less words. By 18 months, there’s an achievement gap that’s already visible. By kindergarten, it’s almost impossible to bridge. So in response to the crisis, we have massively invested in early literacy. I got a small grant from the Aspen Institute in 2016 which launched Flint Kids Read. It’s this umbrella organization of all of our literacy work.
Now in Flint, every single kid gets a book delivered in the mail from ages 0 to 5. It’s part of Imagination Library which is part of the Dolly Parton Foundation which is amazing. So every kid 0 to 5 gets a book mailed to them at home. I think over 40,000 books have been mailed. Currently there’s over 5,000 kids in that program.
4. And you’ve had your hand in all of these programs?
Absolutely! It’s amazing. I have gone from taking care of one child at a time — like literally holding the hand of one kid at a time — to be able to hold the hand of a population of children. But the neat thing is that it’s exceeded the boundaries of the city, it’s exceeded the boundaries of the state and we’ve been able to make an impact at a much, much bigger and broader level.
5. And now you’re reaching millions?
I hope. It’s been such a privilege being able to write this book and expanding the story and the messages. The neat thing about the book is that it’s been picked up by colleges and universities as first-year reads. Bowling Green University just emailed me, “This is going to be our freshman read for all the new students.” Two days ago it was selected as Maryland’s state read. Like the one read for the whole state of Maryland — that’s amazing! And it’s currently Rhode Island’s read because it’s not an isolated story. Because it is a story about people and places and problems everywhere that we choose not to see. And it’s about how we have that power to open our eyes, to make a difference and change to the trajectory of especially children.
6. Throughout the book, you repeatedly use the phrase “what the eyes don’t see the mind doesn’t know.” For people who haven’t read the book yet, can you explain what this means?
It means a lot of different things. I first heard that phrase when I was a pediatric resident in Detroit at the Children’s Hospital, and a faculty member pediatrician would always say — especially if we were stumped on a case, like we’re at the bedside, it’s a sick kid, we couldn’t figure out what was going on and we exhausted this list of possible options — and he would say to us, “The eyes don’t see what the mind doesn’t know.” Which pretty much said, “You need to read more, you need to learn about any other possible things that could be causing the situation, just expand your horizons and maybe you’ll find out what’s going on.”
“What the eyes don’t see” also refers to the very literal, like lead in water, we don’t see it. It’s invisible, it’s odorless, it’s tasteless. We also don’t see the effects of lead. It’s well known as a silent pediatric epidemic. Kids don’t present with purple spots when they’re exposed to lead. It’s something you see decades later, and it’s very difficult to attribute it to the past, which is similar to all environmental health issues.
But the biggest reason why the title is “What the Eyes Don’t See,” is because it speaks to our blindness to certain things. Oh that’s Flint. It’s over there. It’s not going to happen here. It’s those people. And how we do that all the time, but how it’s not supposed to be that way. This book is this rallying cry for us to literally open our eyes.
7. What motivated you to write the book?
I went into medicine never expecting to write a book. It’s not what I set out to do. And then after the crisis, everybody and their brother was telling me to write a book, do a movie, all these things. I was like, “Go away. I’m so busy. I have so much work to do.” Because from the moment we realized what was happening, our focus became building this model innovative program. But then I realized that it was almost a dare. Like I needed to share the story because people needed to realize what was happening on American soil. Like how could this be in the 21st century in America, in the richest country in the world that for a year and a half, brown water was coming out of people’s taps and nobody did anything?
There’s been many books on Flint. There will continue to be many books on Flint. But this is a firsthand, fast-paced account of what happened through my eyes. And another reason I wrote this book is it’s not just about Flint. It’s very much about me and how I got to be in Flint and how I came here, and I think that became an even more important part of the story because that’s the perspective of how I see the world. This is the lens that I see and how I was raised and that immigrant story I think got even more elevated, especially with our current political climate. I came to this country for what all immigrants come — for freedom, for democracy, for opportunity, for the American Dream. And I wake up absolutely lucky every single day to be in this country, but also acutely aware of what injustice can be and what people in power can do to vulnerable populations. So it was that kind of milieu of my childhood that made me go into medicine, that made me be in Flint, that made me serve my community no matter where it can be.
And I think it’s an important story to share because right now there’s kids who look just like me, that literally have the same color skin as me, who want to come here for the exact same reasons as me, but literally Lady Liberty’s arms are not open as wide as they used to be. So it’s almost as if that American Dream has corroded. We’ve taken that away from people who would be here.
8. To boil it down, you were one woman facing the government who said the water was safe to drink. But you also had support from your friend Elin who worked at the EPA and your colleague Jenny who helped devise your study. The CEO of Hurley is a woman who backed you up and told you she wanted the hospital to be part of the solution. Male physicians and colleagues supported you, but in many ways, it seems like it was women who really went into action to expose the crisis?
The most important women are the moms. The Flint moms, the activists are amazing. And it’s always moms in these stories: Erin Brockovich, Lois Gibbs. It’s moms who fight for their kids and the entire city’s kids. The mayor is a woman.
9. So really the crisis was exposed by women?
Uh huh. And it was created by men. Which is common in many crises and many community issues, especially environmental issues. It’s often led by women.
10. Who are the women you admire and look up to?
This book is also a tribute to giants who have walked before me. And all of us stand on the shoulders of incredible giants who made us who we are — be it from our mothers or our grandmothers, professors and colleagues and other women who have paved the way. I have two shoutouts in there about two Michigan women who paved the way for me.
One is Alice Hamilton, a U of M Medical School alum from 1893, who was a lead expert in the 1920s. She was fighting General Motors and lead in gasoline in the 1920s. The very first woman professor at Harvard, (Dr. Mona starts reading from her book), “but she couldn’t go to the faculty club, she couldn’t go to football games. She wasn’t allowed to march in commencement and called hysterical many times — the code word for ‘stupid woman overreacting,’ yet used science, used stubbornness, used persistence, used advocacy to fight for kids. She went on to work for Jane Adams in Chicago at the Hall House providing wrap-around services to kids, health care,” exactly what we’re doing here. An amazing, amazing woman who I absolutely stand on her shoulders. It was her and folks like her who got us to where we are today.
My other favorite woman I call out here is Genora Johnson Dollinger. Both of these women were also inducted into the Michigan Women’s Hall of Fame. She was a Flint activist in the 1930s. So often when we hear about the Flint sit-down strikes, we hear about the autoworker men, but the women were a big part of it. (Dr. Mona starts reading) “She was a serious socialist who also became a critical strategist during the sit-down strike and fundamental to its success. She organized the women’s emergency brigade, so not just to give their husbands coffee and donuts, but they were literally part of the strikes. They were physically dragged and beaten. She became the Joan of Arc of Labor. She then went on to Detroit, where she was a victim of a lead pipe attack, worked with the Michigan ACLU, was a long-standing activist for a peace movement.” She was in Flint in the 1930s. That’s what Flint is all about. They create these badass women that fight. This book is a tribute to them.
11. I was going to ask who’s been a mentor in your career, but that kind of answered the role model question.
Absolutely. It’s women who’ve walked before me and it’s women who’ve walked with me. And I have been blessed by so many women. When I was a high school kid organizing against this incinerator in Madison Heights that we helped close down, our high school environmental group leader was this amazing woman, this New York transplant. And the woman who was organizing in the community was a single mom nurse — another woman. So very similar to the moms here. I’ve been very fortunate to have been mentored and guided by these women and many, many more.
12. Do you have any advice for medical students who are training to be pediatricians?
Yes, I have advice for any students. When I wrote this book, in my head it was for students. I tell students who often feel that they’re alone, or it’s very difficult to raise concerns, I tell them of the value of creating teams. One of the reasons I didn’t want to write this book is it’s not about me. It’s about a team of unexpected rag tag folks who came together, and part of that team was journalists, but it was also moms and activists and pastors and water scientists.
I think that’s an important lesson, especially for students because as we progress in our careers, we get so siloed in our disciplines and our professions, and it really speaks to the value of getting out of your box and making diverse friends and building networks. Like, thank God my high school best friend was a drinking water expert! But there’s a need to build teams around you.
Also, you cannot underestimate the role of journalists in the story. A lot of reports on the Flint water crisis have called out the exceptional role of investigative journalists like Curt Guyette, Lindsey Smith, Rochelle Riley, Nancy Kaffer, Ron Fonger, so many folks who were very, very, vocal. A lot of reports have reiterated that in this era of decreased investigative reporters and print journalists, this is a place where they shined because they dug and they dug and they dug, especially Curt Guyette who was randomly funded by the Ford Foundation — the very first time they funded an investigative journalist via the ACLU.
People often say that science spoke truth to power and got the state to concede, but really it was the media. After I shared that science, it was finally when a lot of national media started to pay attention.
13. I’m asking all the women I’m interviewing for our May issue, “what’s been the biggest challenge of your career?” Is it safe to assume the Flint water crisis tops the list?
Yeah, I think it’s been the biggest challenge, but I think it’s been the biggest opportunity. I wake up everyday absolutely blessed and privileged, and I pinch myself that I am able to do this work. So I am going to hold on to this microphone as long as I have to be able to touch as many children as I can through this work.
And I get all these heartwarming emails everyday. Like some random person just emailed me this morning, “I just finished reading your book. I couldn’t sleep. I’m in India. Thank you.” And then they decide to donate to the Flint Kids Fund. That’s one of the reasons I wrote this book too because part of the proceeds go back to the Flint Kids Fund so that we can do this long-term recovery work. A lot of my speaking fees go right to that work too. We’ve raised about $20 million in the Flint Kids Fund, but we’ve given out about $7 million, and that’s what’s gone to fund the home delivery of books and the breastfeeding education, home visiting programs.
14. How did you find the time to write this book between your work and family?
Layers of support at home and work. But yeah, the book was a two-year process. I’m Type A OCD, especially as a doctor, most doctors are. The hardest part about writing this book was letting go, because I could keep editing forever! You know as an editor, I’m like, I can make it better, I can make it better!
Also, there are so many intersessions into history in this book. Genora Johnson Dollinger who’s in there for a paragraph, I read two books about her. Alice Hamilton, I think I read three books about her. I talk about my great uncle who fought in the Spanish Civil War with the Americans as part of the Abraham Lincoln Brigade. I got his full file from the Spanish Civil War. That was digging and digging and digging in research. All the rabbit holes took a long time, but the history is so important to put in there because we literally walk through history every day. We walk through complicated systems. We sit here in Flint, but how did Flint come to be? That’s important. That’s important to know the history of red lining and blockbusting and racism and what made this city what it is.
So often people are like, “I don’t want to hear the history because it’s too dark and it’s too complicated,” but you have to. That’s why the public health history and the lead history and the Flint history and the personal history is in there — to give it more substance.
15. You’ve been named one of Time’s most influential people and have received a slew of local and national awards. What’s that feel like?
So many of these accolades are so awkward. I’m like, I’m just doing my job. But then my husband is like, “It’s not about you.” He’s like, “You go accept that award because it’s about the girls.” Not my girls, but girls. And it is. If I can inspire one girl, especially a girl of color, to go into science, to use your brain, to be an advocate, to fight. It’s all worth it.
On to your style…
16. You can’t leave home without…? My glasses.
17. You’re never fully dressed without…? My white coat.
Your Local Love List…
18. Favorite coffee shop? Flint Crepe Company and Foster Coffee Company.
19. On the weekends, where can we find you hanging out? Home in sweatpants.
20. Favorite quote or words to live by? “Unless someone like you cares a whole awful lot, nothing is going to get better, it’s not.”
Bonus: What’s something people don’t know about you? I love puzzles.