Flint water adviser draws on personal health trauma in helping city cope

This is 1990. She’s a 19-year-old college freshman with a healthy lifestyle. Then, suddenly, she’s in a hospital bed. Liver and kidney failure are among her overall ailments, and doctors can’t figure out why.

She fearfully wonders, “Am I going to die?”

What could be the cause? Think of all those industrial smokestacks on her side of town, growing up on Saginaw’s east side. She can’t be 100 percent sure, but she suspects that poison in the air is part of the reason.

Within months, she recovers her health, just as mysteriously as when she had fallen ill. She rededicates her chemical engineering studies to place stronger emphasis on environmental impacts and on public health.

That’s the background story for Pamela Pugh, Flint’s chief municipal public health adviser. And that’s why she says the impact of the city’s infamous water crisis will linger long after the final replacement pipes are set to be installed late this year.

Pugh, who wears another hat as a state Board of Education member, rarely shares her personal account with the various health professionals, scientists, environmental officers, local clergy and citizen leaders she works with on the Flint water crisis, now in its fifth year. Few realize that her service is inspired by her nightmare episode three decades ago.

Flint Mayor Karen Weaver created the new position and hired Pugh in October 2016 to help lead the recovery and reform efforts that had started 11 months earlier.

Pugh describes her first reaction to her new job description.

“I felt as if I were looking in the mirror,” she says. “Every experience, every twist and turn that had been in my path was reflected in the needs of this role. My life story. This is where I was meant to be.”

No easy answers

Pugh started with the city when Flint’s trauma was well into its second year.

Details now are etched in history. In a money-saving misadventure during the Republican administration of now-former Gov. Rick Snyder, state-appointed emergency managers pushed a temporary switch from Detroit water to the Flint River in 2014.  

Pollution controls were inadequate and complaints from residents soon ensued. Pipes became corroded, causing the water supply to be laced with high levels of lead and iron, with pathogenic microbes such as legionella bacteria. Flint switched back to Detroit water within 18 months, but the damage was done.

Long-term health effects, especially on young children and seniors, may linger into the next decade and even beyond. For example, imagine in 2022 that a 12-year-old adolescent falls ill. Will the poisoned water from the past decade have contributed to the cause?

“These are questions for which we never may find the answers,” says Pugh, who describes the need for a public health officer as “eternal.” In effect, individuals of all ages may encounter health mysteries similar to the episode that landed her in a hospital bed three decades ago.

For now, part of her role remains in immediate citizen education. Residents are encouraged to filter their tap water or use bottled water, even if they already have received new copper pipes to replace their former lead or iron outlets, because poisoning could continue to infect the total system until all the work is finished.

So far, starting in 2015, crews have explored more than 20,000 properties, replacing pipes at about 40 percent of them. Workers are on schedule to finish by the end of 2019.

Meanwhile, more than a dozen state and local water quality administrators and employees have lost their jobs. Criminal proceedings are underway in some cases for alleged malfeasance or coverups. New Michigan Attorney General Dana Nessel recently tapped her solicitor general, Fadwa Hammoud, to head up the Flint water crisis investigations.

Two prominent leaders, Michigan’s former Health and Human Services Department Director Nick Lyon and the state’s former chief medical executive, Eden Wells, have both been charged with involuntary manslaughter in connection to the Legionnaires’ disease outbreak that killed 12 people in 2014 and 2015 and sickened others.

In 2019, primary Flint water headlines will likely stem from the ongoing infrastructure replacement and the court cases. On the more lower-profile and longer-term side, Pugh will continue working on the third main aspect, public health.

Tackling lead paint

After her illness, Pugh continued her studies at Delta College. She later attended Florida A&M University, where she completed her bachelor’s degree in chemical engineering.

That prepared her for a leadership post with the Saginaw County Department of Public Health, where she worked to combat child lead paint poisoning from loose chips in older properties. The effort’s success from 1997 through 2011 has served as a model for similar outreach in communities across the state.

Pugh worked with Lansing legislators to pass lead paint poisoning oversight and prevention provisions when Democrat Jennifer Granholm was governor.

All the while, Pugh was investing her scant free time in off-campus studies through the University of Michigan, where she was awarded her doctorate in public health in 2014.

She also hails from a politically involved family active in the NAACP’s Saginaw and state branches. That inspired her to seek and win a Michigan State Board of Education seat as a Democrat. It was the same year she earned her Dr. Ph, while at the same time serving as state NAACP health chair.

in September 2016, she was visiting Flint city schools in her capacity as a state education board member, when she observed unplugged drinking fountains. Later that day, she encountered Dr. Mona Hanna-Attisha, a pediatrician whose research revealed that the city’s water source switchover had made the product become discolored and foul tasting.

Far worse, the water — even when clear — was poisoned with lead, similar to the old-house paint chips, dust and soil that too many of Saginaw’s young children had ingested while innocently toddling and playing, something of which Pugh knew all too well.

Hanna-Attisha said she was impressed with Pugh, sympathetic with her background story, and encouraged her to apply to become Weaver’s new public health aide.

For her part, Weaver found an unexpected benefit in hiring Pugh, who would go beyond being a science wonk. She possesses experience not only in science and public health, but also in politics and communications.

She had run for state representative as far back as 2006. For years, Pugh has been outspoken as an environmental justice advocate, keynoting at forums and writing newspaper op-ed columns. That includes a recent Detroit Free Press piece in which she praised new Gov. Gretchen Whitmer’s first executive directive aimed at increasing accountability in state departments handling environmental and public health threats like the Flint water crisis.

“With Pam’s background, there could not have been a more perfect person,” Hanna-Attisha says. “She was an ideal fit. She is an expert on the effects of lead, and she has been able to communicate this with the public in layman’s terms, while bringing the scientists and the community to the same table. Standing alongside Mayor Weaver, she serves as our voice of science and our voice of public health.”

Learning from experience

With modest humor, Pugh notes how her background prepared her for the position.

“Now I’m not telling anyone to go out and get an illness,”  she says, “but I encourage that we all soak up everything we can from our own experiences. This has definitely carried me a long way in serving this poisoned, traumatized and distressed community.”

The water crisis has compounded hardship in a Flint community already suffering from nearly a half-century of disinvestment, losing a huge portion of its manufacturing base, along with family-run and other small businesses. The population, once 200,000, has eroded below 100,000.

Pugh already has honored requests to advise other cities, ranging from Detroit and Pittsburgh to East Chicago, Ind.

Whitmer has pledged to make Flint’s water crisis, and statewide public health, a top priority, working closely with both Weaver and U.S. Rep. Dan Kildee (D-Flint). Pugh says solutions will have to go beyond the Band-Aid of bottled water.

Renewal of public confidence will be a main challenge, Pugh says, in a Flint community where some citizens feel so offended and “disposable” that they have vowed never to drink or use tap water ever again, no matter how much their leaders may reassure them.

“If people don’t trust and use the water system, then the water never moves,” she says, with resulting contamination from the stagnant status. “I am not, at all, a long-term advocate of bottled water. Bottled water is not the solution.”

Pugh is also looking ahead to the future.

“Flint has an opportunity. We’re not the only ones who will encounter problems,” she notes. “We want to become the water research leader of the world so that this type of tragedy never happens again.”

Flint residents should continue to make use of filtered water or bottled water, even if they have received new pipes or if their existing pipes have been deemed in no need of replacement. Lead pollution still could seep into the stream until a total overhaul is completed at the close of 2019.

Arrange for their tap water to be tested repeatedly, not simply once. For free-of-charge tests, residents may contact [email protected] or call 810-787-6537.

Allow tap water to run in a cleansing stream, even when filtered; for instance, 30 seconds before drinking a full glass from the faucet.

Take advantage of child lead screenings offered at all Flint schools. Children who were exposed to lead during the Flint water crisis will be screened to determine whether they need health or special education services.

Sign up family members, especially young children and elders, at flintregistry.org

Visit the Flint municipal website, cityofflint.com, and follow local media reports for the latest updates.

As for residents of other communities, Pugh advises that leaders begin by exploring their own water systems. If Flint has 40 percent of homes with lead pipes, it is most likely that similar conditions exist in other older towns.