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For her son’s seventh birthday, the first one after he witnessed a Norfolk Southern train go up in flames, Ashley McCollum decided to take her family to the water park.

They had been staying in a hotel 10 miles away from their house in East Palestine, Ohio, ever since they were evacuated last February. Going to the water park, however, meant they’d have to leave their two dogs in the empty house.  

When they returned from their trip, less than 24 hours later, the dogs were vomiting and had diarrhea. Their symptoms persisted for three days.  

She wasn’t surprised. The few times she did enter her house after the derailment, McCollum’s teeth would hurt, and she would wake up with debilitating cramps in her legs the next day "to the point where my toes would spread apart, and you could see the tendons in my legs rise up."

Ohio officials announced that it was safe for residents like McCollum to return to East Palestine five days after the Feb. 3, 2023 derailment of a Norfolk Southern train and subsequent release of hazardous chemicals in the town of less than 5,000. But five families who spoke to The Cincinnati Enquirer, part of the USA TODAY Network, just before the one-year anniversary say they're still dealing with health problems.

There are no scientific studies yet that prove long-term health effects of chemical exposure from the derailment. But relocated families are still experiencing symptoms and foot many of their medical bills without help from the railroad or the government. They don't consider their East Palestine homes to be safe, and they're worried that moving back will worsen their symptoms.

McCollum stopped going back to her East Palestine home when her doctor advised against it. Her boyfriend went back for her, sometimes to feed the family’s lizard or to retrieve the mail. Entering the house made his tongue and lips go numb. He said he would get back to the hotel and pass blood.

“Even now, to this day, I feel like we don’t have a home,” she said. “Because when I go there, I get sick.” 

Within eight days, by Feb. 9, Norfolk Southern will end aid for families who relocated to other areas following the derailment. Many of them cannot afford to live outside of East Palestine without financial assistance from the company.

Ashley McCollum's family, along with others, will need to decide what to do in a matter of days.

Families in flux as relocation deadline looms 

Some of the symptoms families say they face are chronic, and others are acute, appearing suddenly after a short period of time spent in one’s home.

Christa Graves, 49, has had migraines before, but they increased in frequency from weekly to daily starting last February. She’s also having trouble remembering things.

While Norfolk Southern offered to relocate people living within a mile of the derailment site, Graves lives 1.2 miles away. The railroad denied her request for relocation assistance, and her family has been unable to move out ever since.

Krissy Ferguson, 49, assistant manager of a gas station, said she's also experiencing brain fog. She used to share her home with her mother in East Palestine.  

In addition, she’s getting tested for a chain of growths that appeared around her groin, under her armpits, and below her breasts. “They’re checking me for heavy metals,” Ferguson said of her doctors, who’ve ruled out the typical reasons that lymph nodes become inflamed. “They’re trying to figure out what is causing that.”  

Candy Kiehl, 62, a retired waitress, moved back to her East Palestine house with her husband in December. Shortly afterwards, she developed severe bronchitis that she’s been fighting ever since. 

Jami Wallace, 46, has been asking herself about the ever-growing list of symptoms she’s heard about from friends and family in East Palestine since last February. "Is it related to the derailment?” she asked. “The problem is we don’t know.”  

Wallace, mother to 4-year-old Kyla Rose and a former human resources manager, has been advocating for residential air and medical testing for East Palestine residents for nearly a year. She’s been frustrated by what she considers a lack of action from the government.

“You can’t even make informed decisions for your family’s health," she said.

Ohio officials tested air, continue to test water

In February 2023, the Environmental Protection Agency measured air quality in more than 600 East Palestine homes and found that none surpassed residential air quality standards.

Anne Vogel, director of the Ohio EPA, said the agency is not planning to offer more residential air testing following those initial results.

“The incident happened a year ago, and the chemicals were dissipated," Vogel said. "There would be no reason to go back.”  

The Ohio EPA has also continued weekly sampling of the municipal water system since February 2023 and reported that no contaminants from the derailment have been detected.

In addition, the Ohio Department of Health conducted an After Chemical Exposure Survey that ran from February to March 2023 and found that 94% of respondents said they had at least one new or worsening symptom following the derailment. The department plans to follow up with the same 528 Ohio residents at the derailment's anniversary to determine symptoms that they are still experiencing.

Residents said there aren't enough health professionals in the area who specialize in chemical contamination.  

Ferguson went to the Cleveland Clinic to get a urine test in April. She tested positive for vinyl chloride, the class A carcinogen released during the vent and burn that followed the derailment. Her doctor immediately advised her to give up her job in East Palestine.  

The East Palestine Clinic was established by the Ohio Health Department to provide permanent care for residents impacted by the derailment, but the free services are limited.

Lauren McIntosh, the facility's nurse practitioner, told Spectrum News that residents can get free screenings that the Ohio Department of Health recommends, but treatment from specialists is not covered.

Temporary relocation aid ending

In December, Norfolk Southern announced it was cutting off relocation aid for families by Feb. 9, 2024. But the families say they can’t afford to continue living outside of East Palestine without Norfolk Southern’s help. 

When reached by email, Bryan Long, a spokesperson for Norfolk Southern, declined to provide an exact number of families relying on its temporary relocation assistance, placing the number at “fewer than 40 households.”

“You know what people are facing right now is going back to homes that have not been tested, that they still don’t feel are safe, that they were having symptoms in before they relocated,” Wallace said.

The families who have tried to get that financial assistance through Norfolk Southern described a complex process that they found exhausting and arbitrary.

On its website, “Making it Right in East Palestine,” Norfolk Southern says impacted families can get money for “lodging, travel, food, clothes, and other related items.” The website directs people to Norfolk Southern’s Family Assistance Center in East Palestine to submit their receipts. Long told The Enquirer that so far, the company has paid $21.1 million in direct support to residents.

Ferguson said she was only able to move her family of six from their hotel to a more spacious rental home after numerous attempts to convince Norfolk Southern’s office to help her do so. “I called them every day for a month crying,” she said. 

McCollum said she got her family’s hotel stays covered since the evacuation, but every other expense – gas, sanitary products, laundry – has been a fight with Norfolk Southern.

Ferguson and McCollum both said they got coverage for certain expenses due to what the railroad called special circumstances, while Kiehl said she was denied. Norfolk Southern was not able to respond to these accounts before publication.

“They say it depends on your circumstances," Kiehl said. "We’re all in the same circumstance. Not just one, we all are.”

Wallace recalled the whole process with frustration. “Norfolk Southern was literally playing God," she said. "Some people were getting food and clothing reimbursed. Some people weren’t. Some people were able to buy new furniture. Some people weren’t.” 

“I fought them every step of the way,” Candy Kiehl remembered. Tired of fighting with Norfolk Southern, she and her husband moved back to their home in December. “Other people did not have to fight them as hard as I did.”    

None of the families The Enquirer talked to sought reimbursements from the company for their medical costs.  

Wallace runs a grassroots advocacy group called the Unity Council that advocates for East Palestine residents in the wake of the derailment. She said she is not aware of any of the members, including 900 people in a Facebook group, seeking reimbursement from Norfolk Southern for medical costs.

Norfolk Southern declined to tell The Enquirer how many people have sought reimbursement for derailment-related medical costs.

Bills accumulate, but some losses remain immeasurable 

In addition to the medical costs for testing and diagnosis, the relocated families described the crushing blow of losing their homes, sometimes passed down for generations.

Wallace’s parents’ house been in the family for six generations, which isn’t uncommon for East Palestine residents. “A lot of people don’t want to move," she said. "They just want to know if it's safe. A lot of our land, our homes are generational, so they mean more than just money to us.” 

Ferguson’s two-story duplex, owned and paid for by her mother since 1970, was ideal for her family’s living situation. The second floor was Ferguson’s and the first floor was for her mom, who has Parkinson's and needs Ferguson's help.

“It was a perfect home for my family," she said. "I had my privacy and she had her independence, which is very important."

Candy Kiehl still feels a strong connection to her East Palestine house, despite feeling unconvinced that it’s free of contamination. “That was my grandparents’ house," she said. "That’s where my mom passed away. That’s where my dad passed away.” Her voice dropped to a hush. “But is it safe? I don’t know.”  

Normally, Kiehl hosts Christmas Eve at her house every year. “I always did a turkey, a ham. Macaroni salad, potato salad, finger foods,” said Kiehl, who worked in hospitality for fifty years before retiring. 

This year, she hosted Christmas Eve at her house, but the tradition was hampered by caution and concern. She limited the event to two hours and cooked the meal in advance, instead of in her own kitchen.  

Kiehl was particularly concerned for her son’s family, who moved out of East Palestine after the derailment.   

“His daughter had severe asthma. After the train derailment, it just ...” she trails off. “He walked away from his house. So he’s paying two mortgages.”     

What the relocated families of East Palestine want 

What the families said they want is simpler than one might think.  

“Just be honest with us," Kiehl asked of government officials and Norfolk Southern. "That’s it."

Ferguson agreed. “I wanted honesty and transparency," she said.

Wallace, who is visiting the White House next week on behalf of the Unity Council, has three demands. She wants the government to provide a disaster declaration, residential testing and health coverage for all affected residents.  

The disaster declaration would help free up federal funding that she hopes will lead to the other two.

The derailment happened a year ago, but one resident said it's as if no time has passed at all.  

“I have been stuck in Feb. 3 for almost a year. Nothing changes," Ferguson said. "It’s the same day, and it has been over and over.”