Energetic children tumbled around inside their Milwaukee home as their mother, Laura Manriquez, rounded them up for a check-up at the doctor’s office. She loaded her young sons into the car and zoomed off to the clinic with the chatting and laughter of her boys as background music. Manriquez, a nurse, made a point to schedule regular check-ups for her children, and get them there on time.

When Manriquez arrived at the clinic, she braced herself for tears and cries from her sons; icy stethoscopes, sharp needles and bright lights can add up to a painful experience for children. Manriquez prepared her sons for the trip to the doctor’s office, but she was not prepared for the follow-up letter that arrived about a week after the appointment. She felt panic as she opened the letter, marked “urgent,” and discovered that her children’s lead levels had tested dangerously high. The letter stated that they needed to return to the clinic as soon as possible for more testing.

“I was thrown off,” Manriquez said.

Manriquez frantically tried to determine where the lead could have come from; before her children were born, the paint in her house was fresh and the windows were new. Manriquez considered what the lead could do to children: behavior issues, learning disabilities and low test scores—all troubles that could start in school but last much longer.

Especially after the water crisis in Flint, Michigan that dominated national news, many people felt concern for their children’s health. Despite the media attention, however, Milwaukee actually topped Flint in 2015 with 11.5 percent of children under age six testing for five micrograms of lead per deciliter of blood over 6.4 percent of children from the same age range in Flint according to each city’s respective health department. Lead poisoning is not limited to the rust belt, though—it’s a national problem. According to the Centers for Disease Control and Prevention, an estimated five hundred thousand children aged five and under have high levels of lead in their blood in the United States.

A rainbow of gray

It helps to view lead poisoning as a spectrum rather than a binary illness; the CDC deems five micrograms of lead per deciliter of blood unsafe for children under the age of six, which is the most vulnerable age group for lead poisoning. Long-term effects of lead poisoning include impulsive and sometimes violent behavior, as well as slowed learning and low IQs, which can lead to problems both in and out of school. Extremely high levels of lead in young children can cause seizures and death. However, Dr. Geoffrey Swain, medical director and chief medical officer of Milwaukee’s health department said that no level of lead is a safe level for young children.

“The reason that it’s such a big deal for kids, compared to adults, is that their brains are still in this important developmental stage,” Swain said. “Also, their bodies are small, so relatively speaking, it doesn’t take much lead to cause a significantly increased level of lead in the blood and then cause these problems.”

Because of the seriousness of lead poisoning, the city has pumped $50 million into childhood lead poisoning prevention over the past decade, with an added $11 million in the 2017 budget to target the sources of lead. Funding and services by the city have helped bring down the number of cases of lead poisoning in Milwaukee, resulting in a 90 percent decrease in children testing above five micrograms since according to the Milwaukee Health Department. However, advocates still wish to see the number of cases decrease to zero.

Swain attributed the toll of lead poisoning to “the sheer loss of productivity in human potential” in society, since the illness does not allow children to grow and learn normally. Many of the nation’s lead-poisoned children live in one of the CDC’s estimated four million homes with lead hazards in the nation. Lead hazards lurk in a few different parts of the home, but one facet starts at the faucet: lead water pipes and fixtures can erode, causing particles of lead to get into the water. Old lead water service lines in several big cities across the country deliver water into people’s homes; lead service lines deliver water to more than seventy thousand homes in Milwaukee. Some groups and individuals in the city wanted to step up to combat this invisible phenomenon to help more kids reach their potential and enrich the community at large by starting with the lead pipes.

Something in the water…

Milwaukee’s roughly 70 thousand service lines contain lead; service lines connect water from the main to individual households and buildings. One half of each service line is publically owned, running from the water main to the curb stop, which is underneath the sidewalk, and the other half is privately owned, picking up at the curb stop and delivering water to the house. It is important to note that the source water from Lake Michigan goes not contain lead, nor do the water mains, but the service lines and lead fixtures in homes may be at risk. The city treats the water with orthophosphates and other chemicals to prevent corrosion of the lead pipes, but this treatment isn’t one hundred percent effective. Lead particles can still make it through the faucet, especially in areas under road construction or where there are partial water pipe repairs, like when a pipe has a leak. While this nuance may seem insignificant, temporary spikes in lead in the water can alter the lives of young children who drink it. So Spanish Journal editor and UW-Milwaukee alum Robert Miranda joined forces with Laura Manriquez and other citizens to co-found the Freshwater for Life Action Coalition, or FLAC, to fight to get the city to replace lead pipes and pay for it too.

“What struck me is a comment [Bevan Baker, commissioner of the Department of Health in Milwaukee] made, which I found very odd and disturbing, when he said that there is no lead coming through our tap water,” Miranda said, “and when he made that comment, I said whoa, there’s something not right here.”

Miranda observed the Rules and Steering Committee meeting in January 2016, where they learned that the City was doing “end-of-line” testing to calculate the tap water’s lead levels. According to Miranda, this technique does not yield accurate results for how much lead is in the water. So Miranda made it FLAC’s mission to push the City to acknowledge the presence of lead in the pipes, and possible lead in the water, to further push the City to replace the pipes and pay the bill. According to Miranda’s research, the City mandated that residents purchase and install lead service lines, on both the public and the private sides, in 1872.

“If government back then told you to lay the pipes, government today should fix the problem and remove these things, and that’s the root of our issue here,” Miranda said.

The Milwaukee Common Council tabled the last city budget meeting in late November in order to take more time to consider the issue of who is responsible for paying for lead pipe replacement. The city proposed paying for two thirds of the total replacement on both the public and private side of the service lines, but FLAC argued that the city should pay for replacing all of it (not including lead fixtures within homes, however; Miranda believes that responsibly falls on property owners). Miranda, Manriquez and FLAC continued their battle against the City with more research, identifying where the City’s funding comes from to bring options to the table at the next meeting.

“We basically tell them, hey, we know where the money’s at,” Manriquez said. “We know where it comes from.”

The organization hopes that offering concrete suggestions on how to finance replacing the pipes will make it harder for city officials to say no. FLAC believes Milwaukee owes it to its residents to cover the cost of the replacement. Miranda said that many people living in the affected homes live below the poverty level, and cannot afford to pay for even a third of the service line replacement in smaller monthly installments added to their property tax.

“If folks add more money to their property tax, then what happens when they can’t pay their property tax with that extra money?” Miranda asked. “Then the city winds up with their house!”

As the City takes time to debate over the funding, however, many residents hope for some help in the meantime.

Filter the water, stall for time

As organizations and citizens started to raise awareness of lead water pipes in the city and push to get them replaced, more people got involved. The United Way of Greater Milwaukee and Waukesha County wanted to do something to help in the meantime as the city sorted out a plan to replace the pipes, so they started with their own donation of $15,000, which led to Aurora, Ascension, Froedtert and Children’s healthcare systems matching that donation. Then the United Way partnered with the Health Department to identify households affected and in need to begin the distribution process.

Hundreds of residents and children wrapped around a cold cement building on the South Side of Milwaukee in November’s early twilight. In the middle of the growing line stood a woman in a puffy black parka, arms crossed, making small talk with two other women beside her. The doors of the building they stood by had only been open for half an hour when the woman, Lynn Jones, turned around to see the line of people stretched beyond the parking lot and way down the street. Jones, along with everyone else around her, was waiting in line to receive a free water filter, donated by the United Way and the city’s various healthcare systems, at the Sixteenth Street WIC-Clinic on Cesar Chavez Drive.

The free filter distribution took place months after Milwaukee Mayor Tom Barrett’s call to action at a Marquette University symposium on lead pipes, telling city residents to purchase water filters certified to remove lead. While lead pipes have existed in Milwaukee for decades, along with lead poisoning, many citizens felt a sense of urgency. An initial distribution gave priority to individuals and households at higher risks, like families with children under age six and pregnant women, but the event in December was open to anyone living at a home connected to lead water service lines. The United Way of Greater Milwaukee and Waukesha County, along with the other organizations in the area raised over $90,000 so far to provide filters to and filter replacements, but they did not have enough filters for all of the more than 500 people at the event.

Families with children six and under and families with pregnant women took priority in an initial distribution. The vice president of the United Way of Greater Milwaukee and Waukesha County, Nicole Angresano, said she knows that water filters are not a permanent solution.

“United Way’s priorities are making sure that we have a thriving community, and a community can’t thrive in the absence of basic needs being met,” Angresano said. “And there’s perhaps no more critical need than clean drinking water.”

While organizations may plan to raise more money to provide a filter and some replacements to every home in Milwaukee, the cost of filter replacements add up over time and some families cannot afford them while waiting on free filters and pipe replacements. However, people can reduce the risk of lead leaching into their water by running water from the tap until it gets really cold to flush out particles of lead that could be present. Swain and the health department recommend doing this for all drinking and cooking water to minimize the threat. While this technique may also not be an ideal fix, Swain said other lead hazards in the home pose a trickier threat: paint.

…but there’s also lead in the walls?

Although lead pipes and lead-contaminated water do pose a threat to young children in Milwaukee, Dr. Swain said the majority of cases of childhood lead poisoning diagnosed in Milwaukee can be traced to lead paint hazards. According to Swain, the health department assesses homes where children test for high levels of lead to determine the source, and he said without exhaustive searching, they can usually spot lead paint chips and dust quickly. About 130 thousand homes in Milwaukee contain lead paint, which is the leading cause of lead poisoning in children in not only Milwaukee, but around the country, according to the Health Department.

Lead paint poses a threat to children when it starts to deteriorate on the walls; lead chips and dust can get in the air and on the floor, where young children crawl around and get it on their hands, which they often end up sticking in their mouths. Lead dust and lead paint chips exist outside too, when exterior lead paint begins to crack and flake and end up in the soil where children roll around and can pick the particles up too.

Swain said lead paint poses a more imminent threat than lead in the water because it has no simple solutions. While water filters may not be a permanent solution, they do prevent most of the lead from getting through in the water. Lead paint, on the other hand, has no temporary fix. When a home has been identified for poisoning a child with lead via paint, a certified contractor must strip the home of all the original woodwork. This process requires training and equipment to prevent the contractor from getting lead poisoning when working on the house and creating lead dust.

“The thing is, it’s basically invisible,” Rocky Everly, president of the Milwaukee Lead and Asbestos Abatement Information Center said. “It’s not like you spill gasoline or something, you can smell it and see discoloration or whatever or oil or something like that. It’s so subtle, you just think it’s a little dusty in here.”

Ingesting lead paint dust is the most common cause of lead poisoning among children, but inhaling lead dust is the most common cause of lead poisoning in adults according to Everly. Most adults are not at risk of lead poisoning, but certain occupations can put an adult at higher risk, especially those that work in construction.

Even though mostly young children and developing fetuses have the highest risk of lead poisoning, lead alters the DNA, which means the effects and damage of lead poisoning can get passed down from generation to generation, which creates a greater problem for society.

“There’s a correlation [between lead poisoning and crime] also, a societal cost, of not addressing this issue because we end up with more people in prison,” Everly said.

It’s worth noting that there is a lot of overlap between the 130 thousand homes with lead paint and the 70 thousand homes with lead pipes; lead builds up in bloodstream, so ingesting it by water and by dust can increase levels of lead in the blood. Whatever the source of lead, however, everyone everywhere should understand the impact of lead poisoning on society.

Lead is everywhere, really

Nearly two decades after Laura Manriquez got that call from Israel’s teacher, she answered the phone again. This time it was Israel, calling from jail. Israel told his mother that he got into a car accident. The police discovered that Israel was driving a car that he purchased with a loan—a violation of his probation from a previous run-in with the law. Although Israel wasn’t supposed to buy his own car under his probation restrictions, he needed a car to get to his job at Culver’s, and while he could have legally driven his mother’s car (and she allowed him to do so), Israel wanted independence.

“He’s had lifelong struggles as a result of [lead],” Manriquez said. “Being very impulsive, he always would end up somewhere he’s not supposed to be.”

Israel was on probation after being convicted of robbery with a gun. According to Manriquez, Israel stole marijuana from an elderly woman in the community, and when he refused to give it back, she called the police and told them that he robbed her of one thousand dollars.

“When the police stopped Israel, he had no gun on him, he had no money on him…but he was high as a doorknob,” Manriquez said. “And that’s a part of that ADHD self-medicating.”

Israel served 10 years in prison, where he sat locked in a small, concrete cell for 23 hours each day. Manriquez felt happy when he was released, but her heart dropped when his probation violation landed him back. During Israel’s years in prison, he didn’t get to attend his brother’s funeral after he got hit in an accident. Manriquez reflected on her son’s lost time.

“He could have had his PhD by then,” Manriquez said.

Impulsive behavior can lead to trouble in the criminal justice system. Various studies show a link between childhood lead poisoning and crime. One study from the University of Michigan found that many of the prisoners they studied reported having lead poisoning as children. While correlation does not always equal causation, Dr. Swain said that there seems to be enough collective evidence to suggest a real link between the two.

“Childhood lead exposure is not a small thing that’s just making a few more kids have attention deficit disorder, or a few more kids maybe score more poorly on their third grade reading scores,” Swain said.

Research has found that lead poisoning in young children, which causes poor academic performance, can lead to suspensions in school, which can serve as a precursor to trouble the with criminal justice system. Still, Swain emphasized that not all children with lead poisoning grow up to be criminals, but simply that the more children in a community with elevated levels of lead, the more crime that community will likely experience as these children grow up. Lead alone is not the cause of crime, but simply another factor that contributes to it.

“I don’t believe that a child just woke up overnight and said hey, I think I’m going to hang out with these guys, and let’s go start stealing cars!” Manriquez said. “When you talk about a population of individuals that are living below poverty, and there’s no types of grants or waivers, that means young people are left up to their own devices to run the streets and make the rules themselves as they go along.”

With crime on the rise in the past two years in Milwaukee, and lead remaining in the water and walls despite the decrease in cases of lead poisoning, many citizens want some things to change.

“How is it that my kids are struggling when they’ve been given so many tools?” Manriquez asked. “They were being poisoned.”