Today Dr. Mona Hanna-Attisha spoke at the School of Public Health on the Flint water crisis. I walked in thinking that I may leave feeling more discouraged than uplifted, given the gravity of the situation in Flint and the many children and families that have been harmed by the toxic levels of lead in the water. However, I left feeling inspired and propelled forward to act by the words of this physician and public health advocate.
Dr. Hanna-Attisha emphasized that her role as a pediatrician is to be an advocate, going so far as to say, “Everything about pediatrics is public health.” I had never thought about it in quite those terms, but I realized that she is right – pediatricians counsel daily on the importance of nutrition, safety, and contraception, among other topics. These lessons serve not only the children they see in clinic but the broader communities around them. Children can’t advocate for themselves on tougher gun control or environmental safety, but they need us to speak for them.
In the talk, she helped us become familiar with different tenets of public health, such as primary vs. secondary prevention. In Flint, it is too late for primary prevention – children have already been exposed to lead. However, secondary prevention is all the more critical, and Dr. Hana-Attisha’s strategy relies on the principles of assessing, monitoring, and intervening. By tracking children’s neurodevelopmental development and intervening as early as possible, she hopes that the community can buffer the effects of the lead poisoning.
As she told us about her research team and how they had used their data to bring the crisis to the attention of the state, I was struck by the immediate importance research can have. Like she said, some research is more suited for an immediate press conference than waiting several months to publish in a peer-reviewed journal!
“Pay attention in your bio-stats class. Data can help you move mountains.” –Dr. Mona Hana-Attisha
Furthermore, I was inspired by the ways in which her pediatric clinic interacts with the community at large. It is located on the second floor of a farmer’s market in Flint, and she is able to give families “prescriptions” and coupons for proper nutrition! I learned that nutrition plays a key role in buffering the negative effects of lead. I was so surprised to hear of this location. The previous week, my classmates and I attended a design workshop, “Doctor as Designer” lead by Dr. Joyce Lee. In that workshop, we designed our ideal clinic workflow. One of my classmates, Aisling Zhao, had the idea of placing doctor’s offices in prominent community locations, such as grocery stores and public libraries, so that patients could integrate their health monitoring into their daily lives. I was so excited to hear that this vision is already a reality in Flint!
Finally, I was struck by her comment that what the Flint community needs now is not more water, but an investment in tomorrow. Each child needs the opportunity to have a medical home in which a physician can follow their neurodevelopmental progress and refer them to appropriate resources if needed.
As a leader of our AMA chapter at the University of Michigan, I’ve been working on a project to bring a Pediatric Advocacy Workshop to students next week. By partnering with faculty and residents, we hope to shed light on what students can do now to advocate for pediatric patients in clinic and the legislature. I’m so thankful to Dr. Hanna-Attisha for showing us what an impact we can make for children in our communities. Stay tuned for an update!
Nonie Arora is a 4th year MD/MBA candidate at the University of Michigan. She is passionate about improving the delivery of healthcare and health policy. She can be followed on Twitter @nonie_arora.