Flint water crisis is an issue that took place in Flint, Michigan that started in April 2014 and involved contamination of drinking water. The origin of the crisis can be traced back to the decision by Flint to change its water source to the Flint River from treated Detroit Water and Sewerage Department. During this change, relevant officials failed to utilize corrosion inhibitors, which contributed to a series of issues that ended up in lead contamination. The lead contamination of the drinking water created a serious health danger and water crisis. This paper examines the issue or problem of drinking water contamination in Flint following the change of water source. Based on disaster management theory, the author examines the public health danger and concerns arising from the crisis and its implication to nursing. The author provides recommendations for enhance nursing practice, management, and administration in the future. Background of the Problem

Flint water crisis is an example of an emergency or disaster with considerable public health concerns and dangers that have significant implications to nursing. The significance of this problem is that it helps highlight important aspects that can be used to enhance the practice of nursing, nursing management, and nursing administration in the future. As previously mentioned, the origin of the crisis can be traced back to April 2014 when it started following the decision by Flint officials to change the region's water source. The situation has been described as a scenario of unpreparedness, environmental injustice, government failure, inaction, intransigence, and delay (Flint Water Advisory Task Force, 2016).

Flint water crisis is a by-product of ineffective disaster management approaches that generated nursing and health problems. While the City's officials decided to change the water source after a series of events, they did not adopt suitable measures to ensure that the new water source was healthy. For instance, the Michigan Department of Environmental Quality (MDEQ) incorrectly determined that corrosion control, a crucial component of water treatment, was not needed immediately. Consequently, when water distribution commenced, city residents started to complain of its taste, odor, and appearance. This was followed by several water quality problems and operational difficulties that led to violations in water quality, especially E coli contamination and disinfection by-products (Flint Water Advisory Task Force, 2016). In addition the corrosiveness enhanced the possibility of contamination with Legionella through leached lead from water pipes and plumbing fixtures.

The lead contamination and other challenges in Flint water supply created serious public health concerns and danger. Since it was the primary source of water for the City's residents, a significant portion of the population was exposed to serious health issues and problems. For instance, the water crisis exposed approximately 12,000 children in Flint to high levels of lead, which is associated with numerous health problems. The severity of the crisis was also witnessed in the outbreak of Legionnaires' disease that affected nearly 100 residents and killed 10 of them. Consequently, the water crisis brought by poor disaster or emergency management approach resulted in a huge public health problem with significant implication to nursing.

The poor disaster management and health concern that characterized Flint water crisis is evident in the failure by the Michigan Department of Health and Human Services (MDHHS) to sufficiently and promptly act to protect public health (Flint Water Advisory Task Force, 2016). Together with MDEQ, MDHHS stubbornly dismissed and discredited claims of lead contamination, outbreak of Legionnaires disease, and lead contamination. The disaster was prolonged by these actions as well as the rush by the City's water department to fully utilize Flint Water Treatment Plant despite being unprepared. Moreover, the U.S. EPA delayed enforcement of Lead and Copper Rule and Safe Drinking Water Act. The other event that exacerbated the disaster and enhanced its health risks is the failure by the Governor or his office to undertake measures to reverse the wrong decisions by state-appointed emergency managers and MDEQ. These failures contributed to severe public health impacts such as increased lead contamination and exposure, outbreak of Legionnaires disease, and other health effects.

Review of Literature

Flint Water Crisis is an issue that has attracted considerable attention and evaluation from various quarters. Actually, the crisis has attracted significant attention by public health officials and emergency management officials. Based on existing literature, the crisis is regarded as a disaster of poor management rather than a natural disaster because the decision to change water source was fueled by the ideology of cost-cutting through all measures (Cohen, 2016). While the county has been involved in a constant stream of water quality issues since April 2014, cost-saving measures have been the core of determining Flint's water...

According to Cohen (2016), the consideration of this water crisis as a disaster of poor management is because the problem emerged when the water department was operated by a state-appointed emergency manager. Moreover, the environmental agency of Michigan insisted the water was safe even with growing concerns about its appearance, taste, and odor.
The Flint Water Advisory Task Force (2016) seemingly concurred with Cohen (2016) by arguing that the crisis was a case of poor emergency management by Michigan Department of Environmental Quality, which ignored corrosion control, an important aspect of water treatment. The department ignored this important component despite existing requirements by Environmental Protection Agency's Lead and Copper Rule (LCR). Cohen (2016) argues that the federal Environmental Protection Agency and President Obama should be blamed for this crisis since it's the federal government that establishes standards for drinking water across the United States. While evaluation and administration of drinking water standards is delegated to states, the federal Environmental Protection Agency failed to effectively exercise its responsibility and authority to intervene.

Milbank (2016) agrees with this position by stating that even though Environmental Protection Agency had no role in decisions that led to Flint Water Crisis, it deserves blame for its failure to issue public and stern warnings. Moreover, this agency is at fault for being deferential to state authorities since it was aware of high levels of lead affecting children in Flint sometime last year. Therefore, the disaster was not only a fault of Michigan Department of Environmental Quality but also exacerbated by the federal Environmental Protection Agency. This implies that the agencies and relevant authorities did not follow the disaster management cycle in preventing and/or responding to this human-caused emergency. The prevention and/or response measures undertaken to mitigate the crisis' impact on Flint's residents, especially children were largely ineffective and worsened the situation.

Apart from literature on disaster management relating to Flint Water Crisis, public health has also attracted significant attention because of the health implications of this crisis. Heavey (2016) contends that Flint Water Crisis exposed several public health issues, particularly health disparities. She states that this problem highlights the great risks that poorer communities experience with regards to devastating health implications or impacts since it would never occurred in the wealthier, leafy suburbs of Detroit (Heavey, 2016). Moreover, response by relevant authorities would have been different if the water crisis took place in an affluent or wealthy community.

According to the Flint Water Advisory Task Force (2016), the water crisis brought a public health concerns because of the health effects of consuming contaminated drinking water by Flint residents, especially children. The outbreak of Legionnaires disease that killed 10 and affected approximately 100 other people is an indication of the health impacts of the crisis. Therefore, the major implication of Flint Water Crisis to nursing is the occurrence of disease outbreak following a disaster. In this case, the nursing field is faced with several challenges including disease outbreaks in the aftermath of a disaster regardless of whether it's natural or caused by human factors. These challenges emerge from the fact that nurses are some of emergency responders who help in mitigating the health impacts of a disaster through providing necessary care.

Frist & DeSalvo (2016) contend that the implication of this crisis to nursing is the fact that it highlights the need for collaborative model and process in responding to emergencies or disasters in order to enhance community health. Despite medical innovations and technological advances in the recent past, these investments do not adequately generate desired results. Therefore, nursing professionals and practitioners need to work collaboratively with other public health professionals and other relevant professionals to enhance community health, especially in the aftermath of a disaster. In essence, building healthy communities entails caring for individual patients through collaborative efforts by public health professionals including nurses and other relevant authorities.

Recommendations

In the aftermath of Flint Water Crisis, several initiatives have been undertaken to help address its impacts across all sectors. This process has entailed public health initiatives including conducting blood tests to determine the number of residents affected by lead. Residents with lead-positive blood tests are then given appropriate care and support to help in recovery and lessening the health impacts of the crisis. In addition, various agencies including the Department of Pediatrics & Human Development and community organizations have established programs to combat lead exposure among residents and children who consumed contaminated drinking water. While these efforts…