Ordinarily, if you’re a renter, when the pipes are frozen or the elevator breaks, you probably call your landlord to get it fixed. If your landlord is the City of New York, you better have your lawyer on speed dial.

Having to go to court to repair your bathroom isn’t the way it’s supposed to work, but that’s the level of desperation that led the tenants of DeWitt Clinton Houses to sue the city earlier this month. The complaint accuses the New York City Housing Authority (NYCHA) of massive negligence, which has resulted in disrepair that pose a public health risk and represent a systematic indignity against the city’s poorest communities.

The suit, litigated by the Urban Justice Center’s (UJC) (disclosure: where I previously volunteered and interned), details grim conditions at the Lexington Avenue complex: “serious leaks, mold, and disintegrating plaster on walls and ceilings”—along with security hazards such as a broken intercom.

The most vulnerable residents of the DeWitt Clinton Houses are the oldest, the sickest and the youngest. When the elevator breaks, Laudiel Fernandez, a wheelchair-bound tenant on the sixteenth floor, testifies that he sometimes has to wait for hours for the repairs to be made, either in a local park or, when it rains, in the lobby. He worries about being exposed to the streets and to the elements, “because there is a lot of crime in the area and I am vulnerable to any of them.” But it’s not necessarily less safe than being stuck inside with a broken elevator. “There is no way for me to walk down the stairs,” Fernandez says, “or even for someone to carry me down the stairs.”

Araia Moore, who suffers from asthma, first called for a paint job to cover the mold in her bathroom back in April 2010. Four years after she was issued a pending ticket number, the lawsuit notes, the mold remains, alongside peeling paint and broken kitchen cabinets—and it has grown to a point where “paint would not be an adequate method of addressing this condition at this time.”

Meanwhile, dust and mold loom in the bathroom of Patricia Puchades’s apartment, which aggravates her respiratory problems “due to lack of adequate ventilation,” according to the suit. While she awaits repairs, amid a broken smoke detector and exposed electrical outlets, she now requires a homecare aide for housekeeping help, and she is plagued by panic attacks.

The mothers of her grandchildren have complained about the unsafe environment, Puchades testifies, and she has spotted the children eating paint chips. Unable to be the active grandparent she once was, she says, “As the apartment got worse and worse, my grandchildren stopped visiting. They don’t even want to spend the night because of the conditions in my apartment.”

As with many other public-housing residents, a main reason the plaintiffs put up with these conditions is that they can’t afford not to. A product of the postwar “urban renewal” era of city planning, which blasted through traditional old neighborhoods and shunted poor families into dismal cement fortresses, NYCHA’s towering projects were designed to provide durable housing for working-class families. Today these developments remain a bastion of affordable rents for hundreds of thousands of New Yorkers, in a sea of wildly overpriced real estate. But despite an average rent of about $450, NYCHA-owned buildings harbor hidden costs—the social and health burden of chronic neglect and disrepair. Despite years of pressure for reforms to the repair system, an assessment published by Public Advocate (then Bill de Blasio) in mid-2013 showed a monstrous backlog of outstanding repair requests. The wait time for repairing more than 5300 air conditioners, for example, was nearly 200 days, “Smoke detector repairs had been on hold for an average of 236 days, and broken sprinklers had awaited repairs after 224 days.”

NYCHA’s problems are rooted in the city’s deep racial and economic segregation—NYCHA’s projects and related low-income housing programs are embedded in poor communities of color, often carrying a reputation for crime and blight. And adding to the climate of instability is the structural deterioration that is sickening tenants and taxing public health. According to the Natural Resources Defense Council. “asthma prevalence among children living in New York City public housing is nearly two times higher than rates among kids living in other types of housing in the city.”

Superstorm Sandy aggravated the substandard conditions; even now, many households remain scarred by storm damage and broken boilers.

Due to a special exemption for NYCHA apartments, low-income tenants generally lack the same protection under city housing codes that applies to private housing residents. Private landlords typically face cumulative penalties for outstanding building problems. Listing ten of the city’s most overdue lead removal work orders, the Public Advocate’s office calculated, “If NYCHA was subject to the same penalties as traditional landlords,these ten outstanding repairs might have cost the agency more than $1.3 million in penalties.”

Denise Miranda, head of UJC’s Safety Net Project, says that for many tenants, “Repair dates are given, and they come and go, and no one shows up. Or they’re given a date six, seven, eight, nine months from now, when you’re talking about black mold. Black mold is not a “[wait] nine months, and we’ll come by,’ situation.”

As of June 2014, NYCHA reports it is whittling down its backlog, down to around 80,000 from a high of more than 400,000 in early 2013. But the UJC is suing to push the city further toward a comprehensive overhaul, wary that the statistical drop may count cases that were generally addressed, but not necessarily completely fixed. Meanwhile, following a legal settlement with advocacy groups, NYCHA has promised to address backlogs for repairs to hazardous buildings and reduce wait time to about one or two weeks. But for complex work orders, like plastery or carpentry, residents can still expect to wait several weeks or months. And the agency still faces a budget deficit of $77 million to $87 million.

The de Blasio administration recently launched an ambitious plan to expand affordable housing, but Miranda says that in addition to housing more poor and homeless people, the city must prioritize the maintenance of existing apartments for the city’s most precariously housed. All the Clinton tenants are asking for is that the city’s biggest landlord follow its own rules. “New York City has to set the standards [for] the conditions for tenants in apartments,” Miranda says, “and yet, they’re some of the biggest violators.”

With Clinton’s location in the midst of some of the planet’s priciest real estate, she adds that in New York’s housing market, “there are no other places where some of my clients can live and raise a family while they pay $475 in rent.” So they are forced to “stay in homes where their children are sick… or go where? There is no alternative.”

For residents like Patricia Puchades, her broken apartment is forcing her to choose between her being a grandmother and protecting her family’s health, pushing her grandchildren away from the walls rotting around her.