What the Eyes Don’t See

What the Eyes Don’t See

by

Mona Hanna-Attisha

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What the Eyes Don’t See: Chapter 7 Summary & Analysis

Summary
Analysis
Many people who work in the field of public health—whether they’re statisticians, health providers, or humanitarians—are drawn in by the desire to put together puzzles and solve mysteries. She looks back on the story of John Snow, a 19th-century physician and scientist. He became the founding father of public health in 1854, when he did groundbreaking work to locate and contain a cholera outbreak in his London neighborhood of Soho.
Public health is a relatively new field—and since it began, it’s been a misunderstood and embattled one. By invoking the story of a public health figure of a bygone era, Mona is showing her readers just how difficult public health struggles can be to identify and resolve—largely because of people’s doubt in the science behind public health initiatives.
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Snow was one of the rare individuals who doubted the “miasma” theory—the idea that cholera was spread by breathing stagnant air. Instead, he believed that unsanitary drinking water was how the disease spread so quickly. As thousands of his neighbors became sick and died, Snow suggested to local officials that a water pump on Broad Street was the source of the outbreak. He created a map of London’s cholera cases and successfully tied many of them to the Broad Street pump. Snow wasn’t trained in this kind of work, but the problem in his own neighborhood galvanized him to get involved and find a solution.
Just like Mona was galvanized to come up with an innovative way to help her community after realizing that no one else was going to step up and do what needed to be done, John Snow took initiative within his own neighborhood to identify the source of his neighbors’ strife and suffering and remedy it.
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Quotes
Another person who changed their community through persistence and dedication was Paul Shekwana, who was the first bacteriologist to work in the U.S. He was from what is now present-day Iraq and was actually a distant cousin of Mona’s. Shekwana did groundbreaking investigative work surrounding an outbreak of typhoid fever in Iowa and its connection to unpasteurized milk. He also published an important article in the early 1900s advocating for physicians to wash their hands in order to slow the spread of disease and infection. Shekwana died an untimely and mysterious death in 1906 when he either leapt or fell from a railway trestle near Cedar Rapids. 
Paul Shekwana is another of Mona’s public health heroes—but because the two of them are distantly related, he’s also an important part of her family’s long legacy of dedication to pursuing the truth and doing what’s right. Shekwana’s innovative public health discoveries probably saved many lives—and Mona, who grew up hearing his story, learned that there was value in bringing to light uncomfortable truths. 
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Though urban poverty is less lethal today than it was when Shekwana or Snow were alive, the environments of the cities in which people live still dictate what kind of lives they will lead. Environmental injustice is real, and it impacts communities around the world in visible and invisible ways every day.
While science and public health have come a long a way since the eras in which Snow and Shekwana lived, countless communities are still made more vulnerable by environmental injustice. These communities need people who will fight, both in government and in the private sphere, to make their struggles visible and to secure justice on their behalf. 
Themes
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Quotes
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After the meeting concluded, Mona and Elin texted about the health official’s lukewarm response—Mona hoped she wouldn’t face the same indifference from his higher-ups. Mona forwarded the email she wrote to Mark Valacak, the county health director, to Elin. Elin replied with a link to a report that Marc Edwards, the corrosion expert from the D.C. crisis, had posted to his Flint Water Study website. The data revealed that there were extremely high levels of lead in the water—one sample had 1,000 ppb, 65 times the federal action level of 15 ppb. But the MDEQ dismissed Marc’s findings.
Even though Mona was struggling to get the attention of government officials, there were others who were beginning to speak out about what they were discovering in Flint. Mona might have been discouraged by the meeting with the county health official, but learning that others were invested in this fight showed her that she wasn’t going to be alone in rattling cages and pursuing the truth. 
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Looking at the similarities between the D.C. crisis and the burgeoning crisis in Flint, Mona realized that both communities were plagued by inadequate representation: D.C. wasn’t recognized as a state, and Flint was under the direction of an unelected emergency manager. When people are excluded from their local politics, it often results in catastrophic neglect.
This passage directly ties the lack of elected government representation in places like Flint and D.C. to the proliferation of shady, unjust decisions that run counter to the people’s interests. When the agencies and institutions in charge of protecting and looking out for their communities fall down on that duty, it is up to everyday people to uphold community values and fight for their neighbors.
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Quotes
As Mona prepared to see patients that afternoon, she shook off her fear and stress about the water crisis—but as each young patient she saw reported that they were drinking lots of tap water, Mona grew upset. She urged her patients’ parents to switch to bottled water and to try to take their showers and baths at relatives’ homes outside of Flint. She passed out premixed formula to the parents of her newborn patients, urging them to mix powdered formula with bottled water when they ran out.
At this point, Mona had only heard swirling rumors about what was happening with Flint’s water supply—she didn’t know anything for certain, and she didn’t want to scare her patients. But she continued to look out for their best interests even if she couldn’t tell them what was going on just yet.
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After seeing patients all afternoon, Mona asked other physicians in clinic if they were seeing blood-lead screenings, required by certain health insurance companies, coming back elevated—and they were. Mona advised the other physicians and residents to ask every patient about their tap water consumption habits. Mona knew it would be hard to prove that the lead levels were causing problems such as ADHD and rashes in her patients—and the more she thought about the struggle ahead of her, the more furious she became.
Mona’s stress and fury in this passage underscores the unfairness of the situation in Flint. Flint’s government completely abandoned its duty to Flint’s people—and people like Mona were beginning to realize that if they didn’t start taking care of their neighbors and asking crucial questions about their health, nobody would.
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At home, Mona continued researching the fallout of the switch to Flint River water and texting Elin about GM’s (General Motors’s) role in covering up the crisis even after they noticed that the water was corroding metal engine parts in their factory. Even more egregiously, a representative from MDEQ had issued a statement just a month ago urging Flint residents to “relax” about the water situation. Mona began wondering if she should do a study.
The more Mona heard about the crisis, the clearer it became that lots of people in positions of authority in Flint knew that something was wrong—they just weren’t doing anything to address or fix it. This passage is one of the first moments in which Mona comes to the realization that Flint residents were truly going to be on their own—unless people like her started stepping up and speaking out on behalf of their neighbors. 
Themes
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Community Values and Collective Duty Theme Icon