Less than 24 hours after hanging out with Democratic presidential candidates Bernie Sanders and Hillary Clinton, clean water activist and actor Mark Ruffalo, and CNN host Anderson Cooper – all in Flint, Mich., for CNN’s Democratic Presidential Debate on March 6 – Mona Hanna-Attisha, M.D., M.P.H., F.A.A.P., drove one hour southeast to visit the Wayne State University School of Medicine in Detroit.

“It feels like I’m coming home,” the former faculty member and residency graduate told a packed audience of medical students, residents, fellows, faculty, physicians and administrators in Scott Hall’s Jaffar Lecture Hall on March 7.

In an energetic, fast-paced 30-minute presentation and 30-minute question-and-answer session, the former associate director of the School of Medicine Department of Pediatrics residency program shared in the “Flint Water Crisis Seminar” her eye-opening research into the elevated lead levels in the blood of Flint’s children, how the drinking water became contaminated and what’s needed to repair the broken city of more than 100,000.

“For a population that was already beat down, to get this, it is almost mind-boggling,” she said.

The Flint pediatrician, who practices medicine in a clinic relocated near a bus stop and above a farmer’s market to directly combat the city’s prevalent health disparities, has become one of the strongest voices and most recognized faces in the conversation about the one-time booming industrial city’s ongoing water crisis. She writes prescriptions for produce in a city with no full-service grocery store. A large percentage of her patients miss appointments because they lack transportation. Even before the water issue, a Flint resident’s life expectancy was 20 years less than those living in nearby Flushing, Mich.

“This was the last thing Flint needed,” she said. “Because it happened in a community that already had so much toxic stress, so much adversity, it makes it so much worse.”

After earning a medical degree from the Michigan State University College of Human Medicine based at the Hurley Medical Center in Flint, Dr. Hanna-Attisha completed her Wayne State University residency at the Detroit Medical Center Children’s Hospital of Michigan, serving as chief resident from 2005 to 2006. She returned to Hurley in 2011, and is director of the Hurley Children’s Hospital Public Health Initiative.

Her two-person team’s research released last September showed that elevated blood lead levels in Hurley Medical Center’s youngest patients had doubled from 2.4 percent to 4.9 percent after Flint, in a bid to save money, switched its water supply from the Detroit Water and Sewerage Department (sourced from Lake Huron and the Detroit River) to the Flint River in April 2014. While residents immediately complained about the water’s color, smell and taste, “nobody listened to them for 18 months,” she said.

Lead is a potent, irreversible neurotoxin with lifelong, multigenerational impact, affecting cognition and behavior. It disproportionately impacts low-income and minority children.

Virginia Tech Professor of Civil and Environmental Engineering Marc Edwards, Ph.D., an expert on water treatment and corrosion, came to Flint in September 2015 with several students to test the water. His visit, requested by Flint mom Lee-Anne Walters, supported the concerns of doctors and public health advocates like Dr. Hanna-Attisha.

The three areas, or wards, with the highest lead levels were those with the oldest water age – the time it takes for water to travel from a source to consumers. One home had a water lead level of 13,000 parts per billion. The Environmental Protection Agency considers anything above 15 PPB a problem.

Rates in the hot spots climbed from 4 percent before the change to 10.6 percent. The culprit was the lack of corrosive controls, avoided to save $80 to $100 a day. The decision allowed lead to leech from pipes into the water supply.

“Hurley Children’s Hospital is the only shop in town for pediatrics. We process pretty much all the labs for the county, so we had a really good sample size to do this work. (The increase in elevated lead levels) was contrary to every trend that had been happening (in previous years),” Dr. Hanna-Attisha said.

Recognizing that the results indicated a public health crisis that couldn’t wait for publication, the doctor and her co-researcher held a news conference. “This was a public health crisis. We had a moral and ethical obligation to share our research, and to share it yesterday. When we released our research, we were attacked,” she said.

What followed was “about two hours” of dissent from the state of Michigan. “And then we fought back, and people were fighting back for us,” she said. “We knew we were right. The numbers did not lie.”

Officials switched the water supply back to Detroit last October, and a federal state of emergency was declared in January 2016.

“The water’s still not safe,” she said. “The 18 months of corrosive water that was untreated significantly damaged our infrastructure. The EPA folks say it is like drinking through a lead-painted straw.”

And while her news conference was the catalyst for a national conversation about water quality, the research actually missed the children’s peak lead levels because the blood draws were from children ages 1 to 2 years old. The doctor and a team at Hurley are now trying to identify all children younger than 6 who were living in Flint beginning in April 2014, and are committed to following them for 20 years. They also are reviewing cord blood from children born in the same time frame, in collaboration with the School of Medicine’s Douglas Ruden, Ph.D., a professor of Obstetrics and Gynecology, and director of epigenomics and program leader in the Center for Urban Responses to Environmental Stressors. His October 2015 study, “Multigenerational epigenetic inheritance in humans: DNA methylation changes associated with maternal exposure to lead can be transmitted to grandchildren,” published in Scientific Reports, showed that lead passes through the placenta into a fetus’ developing bones and organs.

“What we do for our youngest as a nation and as a state really predicts what our future will become,” Dr. Hanna-Attisha said at the lecture.

She was invited to speak at WSU by the School of Medicine’s World Health Student Organization in conjunction with the Department of Internal Medicine as a Grand Rounds lecture.

“We think that local health disparities are equally as important as those abroad,” said Chih Chuang, M.D., ’06, WHSO’s faculty advisor and one of Dr. Hanna-Attisha’s residents when she was an attending physician and assistant professor in the Department of Pediatrics’ Division of Ambulatory Pediatrics and Adolescent Medicine.

School of Medicine faculty, staff and fellows waited after Monday’s lecture to say hello to their former colleague. They included Sarah Ramiz, M.D., a first-year fellow in the Division of Hematology and Oncology, who completed her pediatric residency as co-chief at Hurley Medical Center last year.

“She was always able to motivate us as residents,” Dr. Ramiz said. “She advocates for everyone who works for her.”

Academic Services Officer and Pediatrics Residency Program Administrator Kate Sheppard met the doctor in 2003.

“My first, and lasting, impressions were how unfailingly optimistic, energetic, persistent, kind and funny she is,” Sheppard said. “I knew she was going to do great things, but I am amazed at the scale and level of accomplishment at this stage in her life and career, and so impressed with how strong and courageous she has been.”

Assistant Professor of Pediatrics Nadia Tremonti, M.D., has known Dr. Hanna-Attisha for 14 years. They served as co-chief residents at Children’s Hospital of Michigan.

“It's about time I saw Mona's name in the papers. There was no question that one day she was going to change the world. I'm sad it revolves around a crisis like a lead poisoning, but I knew that Mona was destined to mix her strong backgrounds in pediatrics, public health, policy and advocacy into something much bigger than herself. I am fully expecting one day to see Mona at the table with the president of the United States, giving advice on the future of health care for our children,” Dr. Tremonti said.

Vice Dean for Research Bonita Stanton, M.D., was the Department of Pediatrics chair during Dr. Hanna-Attisha’s residency.

“She was a super chief resident for a year after residency, and was fabulous. She was simultaneously a terrific advocate for the residents, patients and community members,” Dr. Stanton said. “She understands the importance of being assertive and persistent but not aggressive or whiny to get the job done.”

The job, now, is fixing the mess, something to which Dr. Hanna-Attisha is firmly committed. She has met privately with Michigan Gov. Rick Snyder, serves on state task forces, and spreads the word to celebrities, politicians and advocates.

“If I don’t keep talking to people and share the story of the Flint, the national eye is going to go away and we’re not going to get the resources we need, because it’s just now,” she said. “I’m going to be the mouthpiece on this, but there are so many other people who are working as hard as I am on this issue, striving to make a better tomorrow for our kids.”

Monetary donations are need to support positive health outcomes for the city’s children through early childhood education, continuous access to a pediatric medical home, nutrition education, healthy food access, integrated social services, research and more.

“We cannot reverse what has happened, but we can throw every single evidence-based child development-promoting intervention at these kids so they do not see the consequences of their lead exposure,” she said. “We feel we can serve as an incredible model for the rest of the nation.”

She stressed that water filters are getting to residents who need them. Bottled water donations are no longer needed. A large surplus is stored at a military base.

“We are asking every philanthropist in the world to give us money,” she said. “If you want to send a check in a water bottle, we’ll take that.”

Visit FlintKids.org to donate to the Flint Child Health and Development Fund and learn more about the Flint water crisis.