The city of Ostrava is famous throughout the Czech Republic for its residents’ respiratory problems, with some scientists contending that Ostrava’s children suffer from the world’s highest rates of asthma. Activists blame Ostrava’s steelworks, whose management, in turn, suggests that local residents should do more to improve their own health. This chapter examines how childhood asthma gets cast as a citizenship issue, inspiring national debate over whether the state is the ultimate guarantor of citizens’ rights. I argue that by drawing on prevalent tropes about working-class labor and the need to protect vulnerable children, popular representations of Ostrava’s woes portray a struggle between citizens who are suffering and a state not living up to its obligations. Evoking social contract ideals, such calls upon the state engage in a politics of last resort, translating personal responsibility into civic engagement and endeavoring to reclaim the state as the ultimate moral agent.