Detroit water shutoffs and a crisis of public health

On a gray, chilly February morning, Reverend Roslyn Bouier opens the doors to the Brightmoor Connection Food Pantry in northwest Detroit. The pantry entrance is tucked into the back of a church building, just across the parking lot from a low-income senior apartment complex. Volunteers restock canned goods and organize clothing donations. In the corner, several cases of water—enough for two families for a week—are on hand. They likely won’t be enough to meet the needs of the day’s visitors. Nor will the clothing. “Half these clothes are going to be gone today because you can’t afford to wash clothes without water,” she says. “You always need clean clothes.”

The pantry is on the front lines of Detroit’s water shutoff crisis. For six years, Bouier and volunteers have been distributing donated water in plastic bottles to families whose municipal water has been shut off by the Detroit Water and Sewerage Department (DWSD)—more than a hundred and forty thousand since 2014. Earlier today, the City of Detroit announced it would begin restoring water to affected homes in preparation for a potential coronavirus (COVID-19) outbreak. (According to a statement, the State of Michigan will cover the first thirty days of costs, after which residents can pay to have their service extended for $25 per month.) But activists have been fighting for years to get the city to recognize water shutoffs as a matter of public health.

The water crisis in Detroit began in earnest in 2014, during the city’s bankruptcy proceedings, when the DWSD abruptly shut off water service to tens of thousands of Detroit residents for nonpayment. The department had been notoriously sloppy in its billing procedures for years, so the sudden change in policy caught many by surprise. An activist coalition of residents and civil rights attorneys garnered the attention of the United Nations and filed a lawsuit filed asking for a moratorium and an affordability plan for water utilities. That suit was dismissed by bankruptcy judge Stephen Rhodes, who argued such a moratorium was outside of the court’s authority. That dismissal was upheld on appeal in 2016.

In November, the Michigan ACLU renewed a petition to Michigan Governor Gretchen Whitmer, asking her to end the shutoffs, and Detroit City Council President Pro Tem Mary Sheffield announced that she would be directing the city’s legal department to ask the governor to declare a water emergency. In late February, Whitmer’s attorney, Mark Totten, responded to the ACLU, citing “insufficient data” to support declaring a health emergency.

Since the start, Bouier and other water activists have been fighting a narrative that assigns blame primarily to those impacted by the shutoffs. Early on, officials perpetuated the idea that residents were simply lazy and irresponsible. One official suggested that Detroiters should go down to the Detroit River with a bucket to fetch water. Then-emergency manager Kevyn Orr suggested that customers would rather pay for “luxuries” like cell phones than water.

Detroit’s water activists have worked across several fronts to shift the story from one that assigns responsibility to individuals in an isolated community to one that recognizes the role of systemic inequity and poses a public health threat. “For a lot of people, what they default to is ‘why don’t they just pay their bills?’, says Detroit Free Press columnist Nancy Kaffer. “Which is frustrating, because of course, if it were that simple, they would have just paid their bills. And there are obviously reasons why folks are not able to do that.”

Those reasons, according to Monica Lewis-Patrick, co-founder of water shutoff advocacy group We the People of Detroit, have everything to do with people living in “abject poverty.” But Lewis-Patrick and her partners realized that simply telling individual stories of people affected by shutoffs, however heart-wrenching, would not be enough to shift the narrative. They needed to show that the shutoffs were a systemic problem. And to do that, they needed research.

In 2014, We the People of Detroit helped convene the Detroit Community Research Collective, a group of local stakeholders, activists, and academics, to research and publish reports documenting the inequity and public health impacts of the water shutoffs. The community research collective model is based on the premise that social research should not exist in an ivory tower, separate from the community, but should instead be done by and for the people it impacts.

In 2016, the collective published a highly visual report, Mapping the Water Crisis, that offered deep context and attempted to re-frame the narrative. The report began by tracing the roots of the crisis to before the bankruptcy, documenting decades of city-suburban infighting, which led to the burden of cost of the regional system being placed largely on the city. It also drew links between race, water shutoffs, and foreclosures.

Getting data to complete the study was a challenge because the city would not share water shutoff data, citing privacy concerns. After two years of effort, including multiple Freedom of Information Act (FOIA) requests, the collective was able to access incomplete data, according to report designer Emily Kutil. “The data was probably about half the shut offs that happened that year, and so it was still not a full representation,” Kutil told me. “But at least we could see the pattern and which parts of the city were the hardest hit.”

Around the same time, researchers from a major hospital in the city, the Henry Ford Health System, conducted a study to attempt to document the public health impacts of the shutoffs. Alex Plum was working as a program coordinator of the Global Health Initiative at Henry Ford. Plum also served as a deacon in the United Methodist Church, bringing him into contact with social justice advocates in the city, including water activists. “I think basically people said, ‘Hey, Alex works for Henry Ford, and he’s got a public health degree, and he’s someone that we trust. Maybe he’s someone we could sit down and have a conversation with,’” Plum said.

Plum began working with the infectious disease department at the hospital, assessing the correlations between waterborne illness diagnoses and geography—namely, living on a block that had experienced a water shutoff. He and his co-authors published results in 2017 that showed patients with a waterborne illness were 1.42 times more likely to have lived on a block that had experienced a shutoff, and patients who lived on blocks that experienced a shutoff were 1.55 times more likely to have been diagnosed with a waterborne illness. We the People of Detroit placed the findings into a handout to communicate with the community.

The study was never designed to show causation, Plum points out, but merely to show a plausible association that demanded more research. Almost immediately, one of the study’s other authors accused activists of mischaracterizing the findings and using the study for “political purposes,” and the health system closely restricted comment. City health officials rejected claims of any public health impacts. Michigan Radio reporter Sarah Cwiek remembers trying to follow up on the story. “I know me and at least one other colleague tried to reach out to some of the researchers. They weren’t talking. Henry Ford sort of backed away from the findings,” she said.

“We have no scientific evidence on face value right now to demonstrate a causal relationship between shutoffs and health impacts,” said Plum, who has since been promoted to a director of the hospital’s Global Health Initiative but wanted to make clear he was speaking in his capacity as a deacon. “We do have evidence that suggests there’s an association and that evidence demands better data collection and better research…There’s clearly evidence that something is happening here. We need to continue to study it.” (The Henry Ford Health System has not, to date, followed up on the study.)

A third research project was conducted in 2017, by Dr. Nadia Gaber, a researcher at the University of California, San Francisco, in cooperation with We the People. They trained more than forty community volunteers to implement a study of psychosocial distress related to water insecurity across the city and in the Brightmoor neighborhood. The study was based on protocol developed by the Centers for Disease control for rapid assessment in disaster areas with limited resources. Preliminary results, published in March, showed that “Not only does having your water shut off significantly impact your mental health and your level of distress, but [so does] even the fear of having your water shut off,” Gaber said. (The statistically significant findings held true when controlled for gender, class, race and other demographic variables.)

Finally, in January 2019, the Haas institute at the University of California, Berkeley published an in-depth report that described the systemic causes and effects of the Detroit water shutoffs and made specific policy recommendations. While that research was not strictly approached as community-based research, contributor Wendy Ake told me the project relied heavily on the existing body of work already created by the Detroit research collective. “We were huge beneficiaries of the fact that there has already been so much [community-based research] in Detroit. “So when we tapped into a few networks, they were like “okay, here’s the thing that already exists, there’s an entire network of people you need to speak to.”

When families’ water is shut off, they employ all manner of survival tactics, including relying on neighbors and organizations like We the People for daily rations. Limited help is offered through a Water Residential Assistance Program (WRAP) that can help defray costs of water bills for qualifying families. But many parents live in fear that their children will be taken from them, and might be reluctant to reach out for official government help. “When we lose access to water…we are in imminent danger of losing our children,” says Monica Lewis-Patrick. “And we know as Black women…we never get our children back.”

Linda Campbell leads the Detroit People’s Platform, a social justice activist group and partner of We the People and the Detroit People’s Water Board Coalition. Campbell, who has a background in public health, says her organization’s contribution has been to help frame the issue as a broader public health crisis. “My first response was ‘how the hell do you do that…just shut off the water in the homes of thousands of people? That’s a public health issue,’” Campbell said. “And so our contribution to the work on the Detroit People’s Platform was to add to and expand the narrative to say this was a public health issue and we need to start looking at the impact of water shutoffs through the lens of public health.”

Campbell’s first step was to approach the city’s public health department, which she notes had been “largely dismantled” in the wake of the bankruptcy. She began meeting with then-Detroit Health Department Director Abdul El-Sayed. El-Sayed left the department in 2017, in part, he told me, because of how the city administration was handling water shutoffs. “It was my first job in government, and naively I thought that the city would be focused on real solutions,” El-Sayed recalled. “But when it came to issues like lead or water shutoffs, it was clear that [city administration officials] were more focused on owning their narrative and being able to control that narrative.”

In spite of that, El-Sayed believes the activists have made a difference in how the narrative is framed. “I think it’s a credit to the water rights activists who have been on the ground organizing…providing constituent services that the city ought to have been providing,” says El Sayed. “There are not very many models like it—scraping together a coalition of people to do a really thoughtful analysis of the scope of the problem that’s affecting far more people than I think the city wanted to say.”

According to Lewis-Patrick, the collective research model’s combination of grassroots knowledge and academic rigor made funders and policymakers take notice. “Being able to take advantage of our allies and friends in the world of academia to bring about the scientific rigor in the framing of these questions—that brings about more credibility when you’re talking to funders and decision makers.” Kutil agrees. “There is definitely much more literacy among funders and large environmental organizations, who now have a much clearer understanding of the shutoffs and why they need to take responsibility for working with community groups,” she says.

Another significant outcome of the research, according to Kutil, is that it empowered community groups to better understand an arcane, complicated, and confusing topic. “We used the maps every time we talked about the shutoffs to a new audience,” Kutil said. “It’s a complicated thing to explain. And I think just having something that visualizes it really helps people kind of wrap their heads around it.”

But Gaber told me getting community-based research about public health crises funded, published, and acknowledged remains a huge challenge. “There are…scientific hurdles of having a huge sample and doing all of this representative work when you’re a community group with no money,” she explained. “And there’s also the political hurdle of putting out results that demonstrate the problem without stepping on anyone’s toes or placing political blame.”

Now, in the face of COVID-19, the city of Detroit is officially treating water shutoffs as a public health crisis worthy of intervention. Coronavirus may have been what pushed the city over the edge, but local organizers have been working for years to change the narrative. The activists and media professionals interviewed for this piece say they’ve seen a shift in how people talk about the issue—including in the media. Some of that may be due to raised consciousness about the links between race, inequality, water infrastructure, and public health wrought by the highly-publicized Flint water crisis. But many believe it’s due, at least in part, to the research and noise coming from Detroit’s water activists.

In February, We the People convened water activists from across the globe for a water summit that brought together organizers from Detroit, Africa and Central America to share knowledge about access, affordability, and public health. “Detroit has moved the narrative and has reshaped the way people talked about water shutoff in this city,” Linda Campbell said. “It’s gone from the fault of an individual to recognizing that water availability and water access is an issue not only in Detroit, but across the world. It’s a global problem.”

As of early March, activists had renewed their calls to the governor to enact a moratorium, linking poor sanitation to an increased risk of Coronavirus. â€œMichigan residents have particular reason to fear the spread of coronavirus because the ongoing deprivation of tens of thousands of people from basic access to water and sanitation puts everyone at risk,” the group’s statement reads. “Residents deprived of water in their homes have been sharing or borrowing water at an alarming rate—80% in one study—creating a transmission path for coronavirus, as well as hepatitis A, shigellosis, campylobacter, and giardia, all of which have been plausibly linked to the shutoffs by health officials.”

Beyond today’s announcement, city leaders have rejected calls for a sliding-scale affordability program for water (like the one adopted by Philadelphia, or those being considered in Chicago and California) — a broad and systemic solution activists say actually gets at the root of the problem: that Detroit’s water rates are unaffordable for low-income households. Such a solution in Michigan may also be hampered by state legislation that restricts how utilities can charge customers.

During the press conference announcing the city’s plan to end shutoffs during the coronavirus threat, Duggan made it clear that he is still opposed to a moratorium. Once the coronavirus threat has passed, he said the city will redouble its focus on individual assistance programs. like WRAP. Those with higher incomes will be routed into an incremental payment program. It remains to be seen whether the city will continue to use water shutoffs for what Detroit Water and Sewer Department Director Gary Brown described in a recent editorial as a “tool of last resort”  for collecting unpaid water bills.

Ultimately, for Reverend Bouier, broadening the public’s understanding of the systemic conditions that led to the dire straits of folks she helps at the Brightmoor Connection Food Pantry is critical to ending the crisis she sees unfold around her every day. For Bouier and other organizers, a lack of access to water is not only an issue for coronavirus mitigation, but rather it reflects and perpetuates broader issues of equity, affordability, and public health in the city. “Because if people understood, then we could stop ‘othering’ each other,” Bouier told me. “Instead of saying ‘well I’m not like those people over there because I pay my water bill.’” 

This piece is the second in a 3-part series about solutions to Michigan’s water challenges funded by the Solutions Journalism Network in partnership with Belt Magazine.