Growing up along the shores of Lake Michigan, my friends and I had standing jokes about how if you swam in the lake, you would likely grow a third eye, tentacles, emerge a fishman, or any other more bizarre mutations that we could conjure. There was an unspoken understanding to never swim in its waters. The perception of the lake as dirty and disgusting was something known but rarely examined. At the time, these seemed like typical observations and musings rather than some dark mental coping mechanism for the desecration of one of the most precious natural resources on Earth. 

Eventually, I had the sad realization as to why the lake was universally understood to be defiled. It was about terrible as anyone could expect—Milwaukee dumps literal sewage into the lake—something even the teenage version of myself could understand not being good for anyone, whether you are a human, bird, fish, or fishman.

As recently as August 2021, 380 million gallons of untreated water were diverted into Lake Michigan and other local waterways due to heavy rains overwhelming the city’s combined sewer system. To prevent sewage backups during heavy rains, the Milwaukee Metropolitan Sewerage District can divert untreated water—which may contain sewage—into waterways. I found a gem of a quote from a 2011 Chicago Tribune article referencing Chicago’s similar practice of dumping sewage into the lake: “Lake Michigan, long considered the sewage outlet of last resort.” In layman’s terms, to prevent sewage from rocketing up through your toilet, we rocket it into the fourth-largest freshwater lake in the world.

Crimes Against Nature are Crimes Against Ourselves

Yet, this story is nothing new. Milwaukee’s sewage dumping habits reached a peculiar climax with the Cryptosporidiosis outbreak of 1993. Cryptosporidium, often referred to as crypto (not the techbro kind of crypto), is a microscopic parasite that causes diarrheal disease for up to 30 days. I’m not sure about you, but 30 days of clutching to a toilet begging for forgiveness sounds like literal hell.

It is estimated that 403,000 people had watery diarrhea attributable to this outbreak during a two-week period—the largest waterborne disease outbreak in the history of the United States. The cause of the outbreak was initially a mystery. I wonder what type of water cooler talk occurred as a quarter of the population was suffering from acute diarrhea. Has it happened to you? What pagan god is exacting its revenge upon us? Is this a sign of the end times?

This also reminded me of the climactic scene in Batman Begins when Scarecrow and his goons pump “fear toxins” into the water supply, causing mass hysteria. Except instead of inducing mass hysteria, a strange toxin was causing people to mysteriously vacate their bowels at an alarming rate—I can only imagine that this could also induce mass hysteria. I also hate to say it, but this seems like some bizarre karmic revenge from nature for pumping shit into it.

Eventually, epidemiologists and public health officials identified that the cause of the mass illness was Cryptosporidiosis induced by a Cryptosporidium-infected water supply. As a result, residents were eventually instructed by Mayor John Norquist to boil their drinking water.

Rest Your Fear, Panicked Masses. The Beer is Safe!

My favorite tidbit about the Crypto outbreak is from an article from the September 2007 editions of Infectious Disease News, in which William R. Mac Kenzie, an epidemiologist who was part of the team researching the outbreak, was quoted, “The good news was that Miller Brewing Company cold filters its products and their filters were small enough to remove all Cryptosporidium.” I’m not sure if you can find a much more Milwaukee quote than: we’re all violently ill, but thank god; the beer is safe!

This also is a bizarre reflection of the myth in which people drank more beer than water in the Middle Ages of Europe to avoid water contamination. If you’re being compared to the Dark Ages of Europe, you’re probably not doing too well. Previously, I had believed that this myth was a reality. In actuality, water in the Middle Ages was generally free and clean. So I guess we have used human ingenuity to achieve worse and more expensive water than the Dark Ages of Europe… womp womp.

The Outbreak Was a Predictable Consequence of Contaminating Our Waterways

Though the exact cause of the Cryptosporidium outbreak is challenging to prove, researchers have a pretty solid hypothesis of what caused the sordid event.

The short version goes something like this. Heavy rains caused a sewage overflow. The sewage overflow caused human waste sewage to contaminate local waterways. Currents in Lake Michigan caused contaminated water to enter the Howard Avenue Water Treatment Plant. Inadequate filtration at the plant led to the contaminated water entering the city’s water supply. The theory is pretty strong—especially given that genotyping proved the source of contamination was human. So any way you slice it, we probably caused a massive disease outbreak by pumping shit into our waterways. As mentioned earlier in the article—this is something that we STILL DO.

As an aside, I marvel that a lot of the finger-pointing in my research for this reflection was centered around the inadequate filtration at the purification plant. While this certainly was a severe problem, it’s not like infecting our waterways with contaminated sewage is okay as long as we don’t drink it later. You know, ecosystems and such are also important.

The Human Toll

As childishly funny as a lot of this story is to me, the tragedy and human suffering wrought by this public health disaster cannot be left unsaid. As we saw with the ongoing COVID-19 pandemic, the social groups who are othered by broader society are disproportionately impacted by public health disasters. At least 69 people died from the outbreak—most of whom were people with AIDS.  Additionally, researchers found an uptick in deaths among people with HIV in the six months following the outbreak.

Beyond deaths, the public burden of the outbreak was enormous. Of the 403,000 residents of the five-county area who experienced symptoms, 44,000 were treated as outpatients, and 4,400 people were hospitalized. Analysis by the CDC estimated that the average cost of illness per person ranged from $116 for mild cases and $7,808 for severe cases.

All in all, the estimated total cost of outbreak-associated illness was $96.2 million. Adjusting for inflation, that would be closer to $200 million in today’s dollars—money that a lot of good could have been done with. While there is scant information on the social distribution of costs, it does not take a logical leap to conclude that, once again, otherized social groups bore the brunt of impacts.

Health Inequities Follow Similar Patterns During Public Health Disasters, and That’s Not a Coincidence

Low-income individuals and families have less financial bandwidth to withstand unexpected medical expenses and lost wages leading to long-term economic and health consequences due to the cumulative health impacts of poverty and debt. Our society chose to directly ensure that black and brown people would be poorer and live in areas with fewer resources. The intersection of race, place, and poverty likely exacerbated the impacts of the crypto outbreak on historically oppressed populations. In relation, Becker et al. (2015) concluded that low-income and non-white people in the United States have a significantly higher risk of Cryptosporidium.

While the outbreak was an unmitigated disaster, some good came from the debacle. As our country loves to wait to fix things until after they have blown up and inflicted a massive amount of unneeded human suffering. Our process of short-term obsession leading to long-term disaster reminds me of when in high school and college, I’d proudly exclaim that “homework is tomorrow me’s problem—and fuck that guy.” It wasn’t exactly a recipe for success.

The Clouds of This Shitstorm had a Silver Lining

In the three decades since the outbreak, the jurisdictions of Milwaukee, Milwaukee County, the Milwaukee Metropolitan Sewerage District, and others have invested over $5 billion in cleaning Milwaukee’s waterways. Milwaukee has even been deemed the water technology capital of the world. The University of Wisconsin School of Freshwater Sciences is the only graduate school of its kind in the county and only one of three in the world. A $400 million cleanup project is currently underway to clean up and restore Milwaukee’s waterways.

Milwaukee’s green stormwater management infrastructure, such as rain gardens, trees, and other aspects of urban greening, did keep at least 38 million gallons of water out of the sewer system in the storm surge of August 2021. I’ll make the bold claim that we should endeavor to pump exactly zero shit into our waterways.

That’s Not Enough, and What We Need to do

Storm-caused sewage overflows contaminating our waterways are a graphic reminder of the ongoing need for green stormwater management in Milwaukee and the country as a whole. Green infrastructure must be expanded to capture stormwater not only to prevent human waste from entering our waterways but also to keep a myriad of other pollutants from industry and other sources out of our waterways.

The Crypto Outbreak of 1993 wasn’t just a wakeup for the need to cherish our waterways and lakes as the precious resources that they are. It also was a test case for the holy hell that global warming could cause in Milwaukee and beyond. Flooding (read more storm surges causing more sewage in our drinking water) and extreme heat are expected to become more common in Southeastern Wisconsin.

Green infrastructure must be used to protect Milwaukee’s residents from climate change, improve water and air quality, increase public access to green and open spaces, and expand safe active commuting and transportation in our city. Unsurprisingly, the health benefits of nature and the protections from climate change it provides are not equal in the most segregated city in America.

Affluent communities have more access to higher quality green spaces and parks than low-income, non-white communities. Black and poor communities in Milwaukee are having their health harmed the most by industrial pollution of air, land, and water.

Sometimes constructing a Ben Shapiro proof argument about why having an equal society and resources for all groups no matter social, racial, or sexual orientation can take a backseat to having the moral courage to stand for basic human rights such as affordable, clean water.

The challenge is not whether we can do this; the challenge is will we choose to.

Featured photo credited to Jeffrey Phelps / Milwaukee Journal Sentinel