by Erica Llewellyn, DOHMH Local 768, Shop Steward

I feel pressure on my back. I open my eyes and hear a familiar “Meow.” It is Minnie, my small and fuzzy roommate, here to wake me from my slumber because it’s her breakfast time. I drag myself out of bed and begin my morning routine. I shower and put on my uniform: a golf shirt marked with the letters “NYC Health,” nylon palazzo pants, and a pair of platform Ugg’s. I highlight my brows and apply a shiny pink lip gloss; “Cute,” I mouth as I admire myself before leaving for my commute to work in my tiny Chevy Sonic hatchback. Traffic is dull and boring as usual.

I arrive at what appears to be a hotel; strange but not unheard of. As I enter through the extravagant but worn-down hotel doors, a woman motions me to come forward. She says, “How can help you?” I explain, “I’m here from the Department of Health for an inspection in room 5A.” She asks for identification, and I produce a shiny gold badge akin to that of the NYPD but instead written across the top is “Health Inspector.” I realize this a shelter and not a hotel. I take in all the luxurious fabric decorating the windows and the thick wallpaper peeling off the walls. “There’s no lead here,” I think. Many of our unit’s lead exposure cases are sourced from the paint in old, pre-war buildings. Legislation was passed in 1972 prohibiting the use of lead in paint after it was found to be toxic by the EPA.

I knock on the door and hear a soft “Who is it?” I yell back, “Department of Health.” I hear a lot of shuffling and muttering. No one answers the door for quite some time. I yell again, “DEPARTMENT OF HEALTH!”

As a New York City health Inspector and licensed EPA risk assessor we are required to do a risk assessment to evaluate a child's environment. It is a short questionnaire that helps us identify where the lead is coming from. Now you might ask yourself how do we, the government, know about the lead in a child’s blood, Erica? How did it end up there? Well, when a child goes to the doctor, a lead test is performed as part of a panel of tests up until a certain age. Adults can request a lead test as part of their panel if they feel they have been exposed. When the level in the blood is above a 3.5, we intervene. NYC law requires the doctor refer the case to the DOHMH Lead poison prevention unit. At times we have received cases with extreme levels of 30 or 60, so a level of 3.5 is nothing to stress about. It is, however, a proper point for preventative measures to be enforced. Children are often exposed through ingestion from hand to mouth activity amid lead positive or contaminated surfaces. It is important to note that if a child is exposed for a prolonged period whether the BLL (blood lead level) is high or low the damage can be seen in delayed speech, hyperactive disorders, and possibly autism. We reach out to prevent these issues. After the questionnaire we conduct an environmental inspection. This is where we use an XRF or x-ray fluorescence machine (basically an X-Ray gun) to test any peeling or chipping painted surfaces (occasionally toys or furniture) in the home. We report our findings using systems that will eventually generate a Commissioner’s Order or a letter to the landlord that enforces the law requiring them to replace the lead positive surfaces.

Much of this information is relayed to the client prior to the inspection. The department reaches out by phone to schedule voluntary appointment for inspections after fully explaining the purpose of our potential visit to maintain efficiency, privacy, and consent.

I knew she was expecting me as we had spoken on the phone two weeks ago and made an appointment for today as per unit protocol. I hear footsteps heading towards the door. A young woman with tan skin and a kind smile opens the door, she greets me and gestures for me to come in. I notice an accent which I can’t place and take note of a headscarf which indicates to me to be conscious of Islamic culture and practices when doing my assessment. As I enter her small room, one of many on this labyrinth like floor, I ask her, “Is it okay if I wear my shoes?” She nods and says, “of course but thank you for asking.” I introduce myself and explain the purpose of my visit; “Hi, I’m Inspector Llewellyn and I’m here because your child tested positive for lead during her last visit to the doctor.” She responds, “Yes, I spoke to the nurse a few weeks ago, she gave me some information before.” “Good, I’m glad” I say, “now let’s start with our questionnaire to look at her surroundings and then we’ll do the physical inspection where I test any peeling or chipping paint using my equipment. The assessment should only take 15-20 minutes, and the testing may take up to an hour, but I don’t think there’s any lead present in this room because a lot of it is covered in wallpaper.”

I ask her a series of questions related to the child’s environment such as: Where was the child born? What work do they do? Has there been any renovation or repair work in the home or room within the last year? Does their child attend a daycare or school? We’re required to do Department of Education classroom inspections just in case the lead is coming from their school. The schools are very old and likely have underlying layers of lead paint within the walls. It is rare that the source is the school or daycare, but it adds an extra layer of protection.

I ask about any recent travel, she says “Actually we have recently come from Afghanistan, we were running from the Taliban.”

I’m shocked. Even though we encounter various stories of arrival on the job, this one is different.

“What was that like? How were you able to leave? Oh my god that is so intense, are you alright?”

She goes on, “We are fine, no need to worry. Here we are safe. My husband worked for the government, so we were able to use his status to leave.” She comments about the differences between her country and New York. She explains she has been having difficulty navigating the subway while taking her children to school. I ask her to expand on that. I’m sure I can help being a long-time, born and raised resident. She says, “I just don’t understand it, when I take the train, it takes me 3 hours to get there, I don’t understand the subway.” I ask her what is confusing she explains, “I have no knowledge of the subway or smart phones or much of the modern world. My husband and I recently escaped from the Taliban in Afghanistan where women have little to no rights. I could do nothing in my country. I was able to get some education but since the United States has withdrawn, the Taliban has punished us, and I can’t do anything. All they let me do is sit in a room! I have all this knowledge and no opportunity.

That’s why me and my husband left. Being a government official allowed us to use our connections to leave before things got any worse.” She goes on, “I want opportunity for me and my children. I want to see my girls grow. I want to be able to be free and my husband wants that for me. I’ve never even had a bank account. I just don’t understand a lot of this, and I am learning”

 My eyes light up, an opportunity.

I open my phone. I search banks in the area and show her my screen. I point out all the banks in her area.

I excitedly explain the steps to opening a bank account like I was told when I was 15. I say, “There’s a difference between checking and savings. A checking account is where your money is deposited or submitted and readily available. Savings accounts are used in scarcity and accumulate interest to make money.” I list popular banks, what to say upon arriving, and the difference between a credit and debit. I show her how to find local banks on her own phone and the perks of map apps when picking up her children.

She is grateful and my heart is full.

I finish up my inspection and pack up my things. As predicted, there was no lead, so I reinforce education about other sources of lead like food or spices, cosmetics, crayons, and painted toys from unregulated vendors.

Before I leave, we share a small hug of acknowledgement and appreciation. She looks at me warmly and says, “Thank you. Hopefully we’ll see each other in life again and I can thank you properly.” I say, “of course, it’s what I’m here for and if you need any advice on how to navigate here, please don’t hesitate to call.”

I head back down to my car. Another job well done. Another story told. I finish my two follow-up inspections and head home. Traffic is swift, and my mind is blank during the drive home but there is hint of accomplishment underneath the surface. I arrive to my old and bulky building. I walk into the door of my apartment and hear a familiar, “MEOW.” Its dinner time.