Newly released epidemic disease data was withheld from community
by Eric T. Campbell
research assistance by Tulani Pryor
republished to riverwisedetroit.org on 2/27/2019 at 10:00am EST
“There exists a positive causal relationship in shut off water and waterborne disease and the proposition is plausible. The case is based on three interrelated facts: 1) Epidemic rates at the time of as many as 80,000 shutoffs, 2) A study that showed that a patient with waterborne disease was 1.48 times more likely to be living on a block with water shut-offs and 3) Without running water to clean and to wash hands the sanitation of a residency is set up for diseases existing and growing. Recommendation: Stop the water shutoffs”
— Summary and conclusion of the report,
Three Waterborne Outbreaks In Detroit,
by George Gaines, MSW, MPH
The summary of George Gaines’s recent report on waterborne disease is direct in its message: Rampant water shutoffs have advanced the spread of water-related diseases in Detroit. Gaines, a former public health official, has compiled data showing a drastic increase in reported waterborne illnesses during 2016-2017. His ongoing work is part of a growing body of community-produced research indicating serious threats to the health in our city. In addition to Gaines’s findings, there exists a recent study by Henry Ford Hospital establishing a connection between rates of reported illnesses and neighborhood water shutoffs, providing evidence that an existing public health crisis continues to grow. City and state health officials, however, are ignoring that evidence.
Retiring from the Detroit Department of Public Health after 19 years of service, Gaines has stayed active in the field by following public health issues and regularly tracking data related to communicable disease. He’s also active with We The People of Detroit, a grassroots organization advocating for a sustainable water future and affordable water services.
Earlier this year, during a routine look at the data compiled by the Michigan Department of Health and Human Services, Gaines noticed a dramatic increase in the number of reported cases for three waterborne diseases: campylobacter, shigellosis, and giardiasis.
He compiled his report based on the data that the City of Detroit is required to submit to the state on communicable diseases. Gaines described the process to Riverwise, saying, “I went into the State computer and got copies of the waterborne diseases in Detroit for 2012-2017. And I took the four years, 2012-2016 and averaged it to get what is known in public health as the endemic rate, or the usual rate. Then I compared that rate to the 2017 data, which is after they had the 90,000 water shutoffs. And that’s where the epidemic showed.”
Gaines has sought peer review of his report from members of the Detroit medical community to improve and advance the study. Thus far, those with whom he has shared his work have been reluctant to support it publically. Students from the Wayne State University MPH (Masters in Public Health) program have attended meetings with We The People’s Water Board, where the report has been discussed, but they have not offered critique or feedback. Henry Ford Hospital health officials failed to attend a 2017 news conference at Wayne State University’s Damon J. Keith Center for Civil Rights to present their ‘preliminary study’, which found that patients who lived on blocks with water shutoffs were more likely to be diagnosed with a waterborne illness.(Experts See Public Health Crisis In Detroit Water Shutoffs, Detroit Free Press, July 26, 2017)
Closely related to Gaines’s findings, the Ford study is the key to understanding the relationship between the shutoffs and waterborne illness. Gaines also looked at the data from the Ford study, which surveyed 37,400 people admitted into Ford hospital for waterborne diseases, and found that people who had their water shut off were 1.5 times more likely to have a waterborne disease.
“We know that the water shutoffs are related, the Ford study showed this, to vulnerable populations, or low-income populations,” Gaines says. “A low-income person has his or her water shut off, they have a water borne disease, they work at a fast-food restaurant— is that why we’re seeing an increase in GI (gastrointestinal) clusters? That’s the reason I mapped the paper. From a public health point of view, not even dealing with the moral point of view, or the practical point of view— the public health point of view is, you’re causing insanitation. Insanitation causes disease.”
City of Detroit officials have all but ignored the recent epidemic numbers arising from newer studies. Gaines told Riverwise that he met former Detroit Health Department Director Abdul Al-Sayed four times and urged him to approach Mayor Duggan with evidence that a public health epidemic was arising and to ask the Water Department director to address the crisis.
“We showed Al-Sayed the data, and he acknowledged that there is a relationship between the water shutoffs and waterborne disease. He couldn’t get to first base with the Mayor, and he quit. That’s one of the reasons he left.”
“We showed [then Detroit Health Department Director Abdul] Al-Sayed the data, and he acknowledged that there is a relationship between the water shutoffs and waterborne disease. He couldn’t get to first base with the Mayor [Mike Duggan], and he quit. That’s one of the reasons he left.”
The fact that water is a human right and a necessity to live has not slowed the city from its shutoff policy. Mayor Duggan dismissed the findings of United Nations rapporteurs who investigated the Detroit shutoff crisis in 2014. The delegation pointed out that the City was violating human rights by denying water to citizens because they cannot pay, and called for immediate restoration of water service where there were shutoffs. Nevertheless, the only relief offered by the City to date is its policy of payment plans— proven to be ineffective among low-income customers.
Gaines and many other water activists are perplexed why the City continues to deny implementing a water affordability plan, which would keep water flowing to needy families, allow for infrastructure maintenance, and provide more income for the city. Philadelphia has provided a working model for such a plan.
“When you factor in all the variables, one major variable is, once you shut off people’s water, you lose that customer,” Gaines says. “So your customer base is shrinking and you’re not getting any income. The question is, wouldn’t it be better to charge them less and have some money coming in rather than shutting it off and having no money come in? So there’s a good rationale for a water affordability plan.”
According to We The People of Detroit, over 100,000 Detroit homes were disconnected from water service between the years 2014-2016. State-appointed emergency manager Kevyn Orr initiated the shutoff campaign supposedly to address outstanding water bills during the city bankruptcy proceedings. Orr was attempting to shed DWSD (Detroit Water and Sewage Department ) liability in the form of unpaid water bills in order to make it financially viable to potential suburban partners.
The risk of waterborne disease only adds to the list of hardships endured by households living without water. Dehydration, poor hygiene, mental health problems, and improper food preparation are known health issues associated with a lack of access to clean water. Elders and children carry the burden of these hardships disproportionately, as they are more likely to be infected by contaminated water. And the health risks are just the beginning for some families. The possibility of being forcibly separated keeps many families from even reporting shutoffs and the health issues they create.
According to Gaines, “When they shut off water now… the city, through Building and Safety, would indicate that the home is uninhabitable, in conjunction with the Health Department. And they would notify DSS (Department of Social Services) that there are children in the home, and there’s no water, and they can take the children. I’ve been expecting this. I’m surprised it’s just started. So people who have their water shut off are not going to be real forthcoming. They could lose their children.”
Gaines’s research has added to the body of evidence coming from various sources working with suffering communities. His recommendation is to turn the water back on wherever there have been shutoffs, and enact a moratorium on water shutoffs entirely. He counsels that we must figure out a way to work collectively, not punitively, to assure that low-income families can live with dignity.
To read the full report produced by George Gaines continue below