Standing in front of a room of community members in southeast Cleveland, Robin Brown recalled the day more than 15 years ago that she received a call from the family doctor. She was told to bring her daughter to the hospital immediately - the doctor's office had just received her child's test results.
"I could look at my daughter and see no illness. But at any second, she could have gone into that coma, she could've gone into seizures, or she could've dropped dead at any second," Brown says.
She would later find out that her daughter had dangerous levels of lead in her blood, an amount Brown refers to as an "emergency state".
Over the coming months, she came to understand that her four-year-old daughter had ingested chipped paint in their rental home - something common among young children. That old paint was filled with lead and absorbed into her daughter's blood.
Brown is an African-American Cleveland native and until that day, she had no idea what lead could do to the body of a child. Her child.
"I felt really, really responsible. I felt I failed," Brown says.
|More than 15 years ago, Robin Brown's four-year-old daughter had to be hospitalised because she had dangerous levels of lead in her blood [Josh Rushing/Al Jazeera]
Cleveland's lead epidemic
The Flint water crisis that unfolded in 2015 outraged the public as well as federal officials. But at that time, Cleveland had almost three times the amount of children suffering from lead poisoning.
Across the country, the main source of lead poisoning is lead paint in older homes. When the paint starts peeling and chipping away, it can put lead dust into the air and soil. Cleveland, like many older US cities, has tens of thousands of homes that are potential lead hazards.
Starting in the autumn of 2015, the city's local paper, The Cleveland Plain Dealer, published an investigative series on the devastating effects lead has had on Cleveland's children and the failure of the city to prevent children from getting poisoned.
Public records showed years of mismanagement and chronic understaffing. The series pointed out that at least 10,000 children had suffered lead poisoning in the past five years. African-American and Latino-majority neighbourhoods were hardest hit.
WATCH: Poison in Our Walls
Brown has organised a gathering of residents at a local community centre and anyone in the room can see and hear the urgency in her voice when she talks about the issue.
Since her child was diagnosed, Brown has been trying to bring attention to the dangers of lead poisoning. She says many people - especially in low-income neighbourhoods where older, lead-painted homes are prevalent - know little about the issue.
Joshua's story: 'The kids pay for it'
|Ebony Holmes and her husband could not see the lead inside their son's blood, but they saw Joshua's behaviour change dramatically [Al Jazeera]
Ebony Holmes and her husband moved into a rental home in the city just a few years ago. They had no warning about potential lead hazards and, within a year, they said they couldn't recognise their son - he had become aggressive and uncontrollable. An inspection carried out later by the city would show that a number of areas in the house and yard had high levels of lead.
You have parents who don't have an idea about lead poisoning. They move in these neighbourhoods where they can afford their budgets and they're not thinking about their kid's health. They're just trying to get a roof over their heads. And the sad
part about is, the kids pay for it.
At two years old, their son, Joshua, had to be treated in hospital for high levels of lead in his blood. Holmes' voice is heavy when she speaks about that time.
"I cried a lot. That’s the only thing I could say, I cried a lot," she says. "My emotions were going all over the place. Actually, I was discouraged as a mother."
Holmes described what so many families, especially lower-income, go through. "You have parents who don’t have an idea about lead poisoning. They move in these neighbourhoods where they can afford their budgets and they're not thinking about their kid's health. They're just trying to get a roof over their heads. And the sad part about is, the kids pay for it."
The Holmes family had to move immediately and Joshua's lead levels have come down since. But they are not sure what effects Joshua might face later in his life because of the lead in his system.
Studies have shown that lead, especially at higher levels, can cause irreversible brain damage in children. Children who have been exposed to lead poisoning are more likely to have lower IQs, long-term health problems, be diagnosed with ADHD - attention deficit hyperactivity disorder - and exhibit aggressive behaviour.
Children are the most susceptible to lead poisoning because their bodies absorb the toxic metal at higher rates than adults. The Centers for Disease Control and Prevention, or CDC, estimates that more than half a million children aged under five in the United States suffer from lead poisoning.
The consequences are not only tragic, but costly. Billions of dollars are used to educate and treat lead poisoning in children. The Washington DC-based think-tank, the Economic Policy Institute, found that for every dollar spent to control lead hazards, between $17 and $221 could be saved.
In cities such as Cleveland, a child can still be affected by lead poisoning every day. And it is wholly preventable.
The Plain Dealer investigation found that more than 50 percent of homes where children are affected by lead poisoning had not been investigated by the city, a requirement under state law. Rachel Dissell and Brie Zeltner, the reporters behind the series, obtained a list of about 200 homes where multiple children had been poisoned over several years.
"[The city's] basic responsibility was to respond to these cases, do an investigation, and follow the law to make sure that the owner of the home complied with the law, which was to get rid of the lead hazard, or take them to court so that nobody else could live there," Dissell told Fault Lines. "And that was not being done".
READ More - Flint: The US city where people drank poisoned water
Kim Foreman, the director of a local non-profit Environmental Health Watch, says that the burden of lead poisoning prevention cannot fall on parents, whom many policymakers have been quick to blame in the past.
"Sixty percent of our residents rent. They are not responsible for fixing that structure, they are not responsible for dealing with the paint," she says.
Foreman adds that there is an added complication with tenants - they may fear eviction from landlords if they report the problem or they might simply move without the house ever getting fixed. Landlords themselves may not have the funds or the knowledge to deal with the lead.
Her organisation has been advocating putting more energy and funds towards testing houses across the city to prevent any exposure to lead and "not just chasing sick children around."
Cleveland has relied almost exclusively on federal funding for lead-hazard control but missed out on some of those dollars for several years due to mismanagement. Overall, federal funds towards lead-poisoning prevention across the country have been cut drastically since 2012.
In this time, Cleveland has fallen severely behind in addressing the issue: there was a backlog of more than 2,000 cases as of July. There is also no requirement to disclose lead in homes before a sale, nor does the city offer any public list of lead-free homes.
|Robin Brown wants to raise awareness and fight for lead poisoning prevention [Josh Rushing/Al Jazeera]
'It's time to make it a loud epidemic'
After the newspaper's investigation, the city administration started to talk about taking action and has appointed a new health department director. However, advocates worry that the city is not taking sufficient action. Staffing and funding levels for lead-hazard control remain low.
[Lead poisoning] is a silent epidemic and it's time to make it a loud epidemic.
In mid-August, Toledo, another city in the state of Ohio, passed a new "lead-safe ordinance". It will require inspections in rental units where children can be most at-risk for lead exposure.
Cleveland has yet to pass any such ordinance, despite having more lead poisoning cases than any other city in Ohio.
"I know that we have been dealing with this issue since 1990 and so we see it as a major issue, and a major problem," Foreman says. "We know, we have seen, we have researched, what are we doing differently? What are we going to do about it?"
Brown has spent many years pushing for city action because she knows her grassroots work alone can't reach some of the most at-risk families. Even the community gathering won't reach all the parents who are in the neighbourhood.
Down the hall, the city's one case manager has set up a makeshift clinic to do preliminary lead screenings of young children. The free screening was publicised along with the gathering but, in the end, only two young children had come for the test.
"[Lead poisoning] is a silent epidemic and it's time to make it a loud epidemic," Brown says.
For her, the equation is pretty simple. If cities really do care about the future of their children, then this issue must take priority.
"Changes do have to occur and it can't be minimum. And it can't just be 'I'm doing my job' or 'I’m fulfilling the grant.' It has to have the passion and compassion that this is why we're doing this".
Source: Al Jazeera