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Michigan health officials scramble to help lead-poisoned Flint

Robin Erb
Detroit Free Press
DeMario Stewart, 27, of Flint said feeds his son Damonei Stewart during his two month check-up at Hurley Children's Center at the Flint Farmers' Market in Flint on Thursday, Oct. 22, 2015.

FLINT, Mich. -- To the panicked parents in Flint: Help is on the way.

That's the message from doctors, university researchers and public health officials mobilizing to move an embattled city beyond shock and anger over its toxic water to a brighter next chapter — one that involves wrapping services around Flint's children to protect them from the worst effects of the lead that streamed through the city's water lines.

"This is somewhat of an unprecedented situation. Usually when we talk about elevated blood-lead levels, it's about an individual child or an individual family situation. Here you have a large, communal source of lead," said Dr. Dean Sienko, associate dean for public health at Michigan State University's College of Human Medicine, which is helping lead the effort.

Michigan House OKs $9.35M to help fix Flint water crisis

While lead poisoning cannot be reversed, experts say that the right kind of nutrition, parenting and community services can mitigate the worst damage: learning disabilities, speech deficits and severe behavior problems in the coming years.

With guidance, in part, from a group known as the Flint Lead INnovation Team, the Michigan Department of Health and Human Services is expected to send letters this week to families recommending they talk to their child's doctor about immediate lead testing and long-term monitoring for developmental problems, as well as focusing on nutrition, since certain foods can reduce the absorption of lead.

Among other steps under discussion:

--Move local nutritionists and dietitians to pediatric offices and health clinics.

--Develop a phone app for Flint residents that would remind them of the importance of screening and even promote healthy recipes.

--Boost enrollment in federal programs such as Women, Infants, and Children (WIC) and Double Up Food Bucks, which give low-income families access to fresh produce.

--Increase aggressive screening to monitor kids for developmental delays, launch school-based stress-reduction programs and boost enrollment in Early Head Start and Head Start programs to give kids who may struggle with learning disabilities an academic boost before they start school.

--Expand home visiting programs in which health care and social workers meet with families, in part, to monitor children for developing learning disabilities or mental health issues.

The crisis came about as a result of Flint officials ending the city's water contract with Detroit in 2014, saying costs were too high and opting instead to join the Karegnondi Water Authority, which is building a system to supply Genesee County with water from Lake Huron. But with that system not coming on line until next year, Flint decided in the interim to pull water from the Flint River and treat it at its own facility. Complaints began almost immediately; last month, research by Dr. Mona Hanna-Attisha, a Hurley Children's Center pediatrician, showed a dangerous spike in children's blood-lead levels, corroborating water testing results earlier this year by a Virginia Tech researcher.

Dr. Mona Hanna-Attisha

Amid accusations of a failure to properly treat the water and a cover-up, Flint reconnected to the Detroit water system a week ago. But it may take a few weeks to completely flush the system.

"We need to give parents hope, and we can do that," said  Hanna-Attisha, who is now also helping lead a team of doctors and researchers. "We need to help them build resilience for their kids."

Just down the hallway from Hanna-Attisha's office in the new, colorfully bright Hurley clinic in downtown, Janika Owens and Demario Stewart last week carried in their 2-month-old son, Damonei, for a routine checkup. He was measured and weighed. Medical staff checked to make sure bones and organs are developing normally, even though lead poisoning's effects won't show up this early.

That leaves Damonei's parents wondering.

Although they've used bottled water for his formula, Owens at times had cooked with Flint water while she was pregnant. She'd brushed her teeth with it.

Lead can pass across the placenta to a fetus, studies have shown.

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"I never thought I'd have to deal with this — ever," Demario Stewart said, trying to soothe his increasingly wriggly infant. "Ill never trust my water again."

Hanna-Attisha says she has seen parents streaming in almost every day in recent weeks  — parents who wonder how much lead their children have ingested. And about whether their child has irreparable brain damage.  And whether it will one day trigger the kind of learning or behavior problems that can set a life permanently off course.

"They wonder: 'Did I protect my baby?' 'Did I trust too much?' " she said.

It's a grinding, toxic stress that finds access points in everyday inconveniences. Is the restaurant coffee made from Flint River water? Are the filters on the public drinking fountains adequate? Will the babysitter be as vigilant in getting bottled water? Is this a passing headache, or something more permanent?

Last week, Kaden Kyger's tiny fingers and face were slathered in strawberry yogurt as the toddler chased the family cats around the living room of their  home. His mother believes he has been spared from lead poisoning because she used bottled water for his formula and she cooked using filtered tap water.

But then again...

The filter is getting old, June Kyger, 25, notes. When should she get a new one?  She has heard there are free filters, but who has the best ones?

And what about lead testing for 16-month old Kaden? Who does that testing?

June Kyger, 25, of Flint holds her 16-month son, Kaden Kyger, while talking about their concerns about using Flint's water at her home in the south side Flint on Thursday, Oct. 22, 2015.

He seems fine — but then again...

The worries "every single day" are compounded by a sense of helplessness, said Kyger, who moved back to Flint earlier this year after several years away: "I don't really know my way around (city services) like I used to."

And some parents still aren't aware of the problem at all. Or they don't know help is available.

For every two clients served in the WIC program, it's estimated there is another eligible client who is not enrolled, said Mark Valacak, Genesee County's health officer.

"We have some very hard-to-reach populations," he said.

'Very, very unusual'

There's a symbiosis in this kind of public health initiative, too.

As researchers and doctors help residents navigate the years ahead, they will gather information from medical exams, cord blood testing of newborns, a review of low-weight births and miscarriages, results of water testing and geo-mapping of the hardest-hit areas. And that, in turn, will guide future public health efforts.

"What has happened in Flint is very, very unusual. They have essentially conducted an uncontrolled experiment, in that they corroded the heck out of these ... lead pipes," said Wayne State University lead expert Shawn McElmurry, who last weekend was in Flint testing water in homes just 48 hours after the city switched back to Detroit water.

Secondary to helping Flint's residents, Flint's crisis can offer important lessons to other cities relying on aging infrastructure, he said.

Testing over the coming years will offer insight into how well "the infrastructure recovers."

All of this, though, will take work to shift the conversation from finger-pointing to something more productive, said Jeffrey Dwyer, a senior associate dean at MSU's College of Human Medicine, which already was positioned in Flint to work with the community. Funded by a $9-million grant from the Charles Stewart Mott Foundation, its researchers are focused on the public health problems that Flint residents identified as their most pressing: chronic disease, behavioral health and healthy behaviors.

Let others call for the investigations when it comes to the water issues, Dwyer said — for public health, the most immediate task is buffering Flint's families from the worst effects of lead.

"We can all do the finger-pointing, but at the end of the day, there are people who need our help, and we have an obligation to figure out how to provide that," he said.

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