Nursing Book Club

What the Eyes Do Not See: A Story of Crisis, Resistance and Hope in an American City by MONA HANNA-ATTISHA, M.D., MPH, FAAP

A pediatrician exposes the water crisis in Flint

Like electricity, public health is something we all benefit from, but which we often take for granted until it breaks down. The great advances public health has achieved in increasing our average lifespans and improving our quality of life remain fragile, depending on factors like vaccination, sanitation and clean water. Take any of those away and the consequences can be catastrophic.

Mona Hanna-Attisha, M.D., MPH, FAAP, a pediatrician at a public hospital in Flint, Mich., has seen firsthand what happens when one of the pillars of public health collapses. In her new book, What the Eyes Don’t See, Hanna-Attisha describes the crisis in Flint and the role she played in identifying the looming menace in Flint’s water.

Flint is a majority-black industrial city near Detroit, originally founded to house the families of General Motors workers and for many years the home of GM’s Buick Division. Flint is a majority-black industrial city near Detroit, originally founded to house the families of General Motors workers and for many years the home of GM’s Buick Division.

In 2014, Flint’s unelected emergency manager decided to save money by changing the source of the impoverished city’s water supply from Lake Huron to the polluted Flint River. Officials also decided to forgo corrosion control measures to save another $100 a day.

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When the river water began flowing through the city’s century-old pipes, the result was significant lead contamination. Once used in everything from pipes to paint, lead is an extremely dangerous neurotoxin that has a particularly devastating impact on babies (especially those drinking powdered formula) and toddlers. The water also suffered bacterial contamination that caused rashes and skin irritation.

Official Apathy and Public Resistance

After a close friend of the author’s who had worked for the EPA warned Hanna-Attisha that the city was not using corrosion control, the pediatrician began discovering more and more children with elevated blood lead levels, especially among Medicaid beneficiaries.

An activist since high school, Hanna-Attisha quickly sounded the alarm, only to meet with apathy, derision and resistance from local, state and even federal government. The community had to struggle mightily to bring public attention to the problem and convince public officials to take any action. This terrible situation took a huge toll on work, friendships and families.

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I found Hanna-Attisha’s story riveting. She intersperses her narrative with chapters about her family leaving Iran to settle in America, life-threatening physical trauma and the history of public health in this country.  She also discusses the history of Flint, which in the past two decades has struggled with twice the poverty rate of the rest of the state, leaving the city on the brink of bankruptcy and putting residents at the mercy of state-appointed emergency managers.

The story still isn’t over. Flint is now in the process of replacing the pipes, but many residents still can’t safely drink from the taps in their homes. The former emergency manager and 14 other city and state officials now face criminal charges for their role in the crisis, but the state recently stopped supplying bottled water, leaving churches and charities to try to fill the gap.

What the Eyes Don’t See is fascinating reading. It pushes all of us to stand up for our beliefs and serves as a reminder to take our commitment to advocacy seriously. Sometimes, it’s a matter not only of health, but also of justice.

What the Eyes Don’t See: A Story of Crisis, Resistance and Hope in an American City by Mona Hanna-Attisha, M.D., MPH, FAAP (One World/Penguin Random House, 2018)


Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.


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