by Erin Fitzgerald

Darwin had a colostomy and desperately needed surgery so he could attend school.

Two angry red bulges appear. The blue skin surrounding the raw intestine appears sore and infected. Visitors are often so repulsed that they are forced to look away.

Born with a rare anorectal malformation, Darwin underwent an emergency colostomy as an infant just so he could survive. Since then, his life has been filled with the agony that comes with overwhelming health problems. And now he waits for surgery to complete his digestive tract and close the colostomy.

Darwin lives outside San Pedro Sula, Honduras, with his grandmother, Ángela, who also cares for six other grandchildren. The family shares an adobe house. A kitchen and bed occupy one part, more beds and a couch fill the other. Electrical wires are strung precariously overhead, and a photo of one of the grandchildren’s sponsors hangs on an exposed wall.

Outside, the home is surrounded by a large yard devoid of grass, but the children play in the dirt, mercifully shaded by a variety of fruit-bearing trees. Discarded items litter the area, and chickens and dogs wander freely, scratching at the packed dirt for scraps of food.

Barefoot, Darwin wanders as freely as the chickens. With his exposed intestine and the unsanitary living conditions, it’s hard to imagine that parasites or a fatal infection haven’t consumed his body.

The family can’t afford basic sanitary supplies necessary for Darwin to attend school, let alone the costs associated with complicated surgery. Instead of proper colostomy bags, he uses grocery bags or whatever else is available. Ángela helps him clean the openings with rainwater that falls in a large trough, thanks to a strategically placed rusted sheet of metal that catches the water from the roof.

Just Surviving

As Darwin waits for surgery, his mental and physical health suffers. He’s not really living, just surviving. About once a week, his body is consumed with pain. He becomes depressed and often experiences diarrhea. Other children have shunned him since he often smells of feces.

He’s terrified among crowds – undoubtedly because of the teasing he’s endured in public. Home is Darwin’s sanctuary; he’s only comfortable with his family and nearby neighbors and ventures no farther than his own yard.

“He doesn’t want to go to school because he’s embarrassed,” Ángela said as her eyes filled with tears.

Darwin can survive without the operation, but psychologically it would be cruel and inhumane to leave him in his current state, said Mariela Castillo Pires, Darwin’s doctor who works at a Children International clinic. She worries that Darwin’s care will become so burdensome that eventually his own family will reject him, leaving him to fend for himself. His condition could even lead to suicide, she said.

“It’s a real shame,” Castillo Pires said. “It’s been very psychologically traumatizing. He doesn’t talk. He walks with his head down.”

Hope for a Better Life

To help raise money for Darwin’s care, his mother recently left to seek better job opportunities. The family hasn’t heard from her and don’t know when – or if – they will see her again.

In her absence, Ángela is trying her hardest to keep the family together. She is Darwin’s rock, the only one he has for support. And she survives on income she receives from three of her children. But that isn’t enough, and she often goes without food so her grandchildren can eat. “I’m not really hungry,” she said, her angular features and hollow cheeks empty of emotion. “I’ve gotten used to not eating.”

Somehow she manages, and devotes herself to Darwin and his overwhelming physical and emotional needs. Ángela regularly turns to her faith for support. Each morning and night, she lights a candle and clasps her leathery hands together in desperation, asking God to help Darwin. It’s easy to see that her pleading eyes are filled with doubt that help will ever come.

At 65, she looks much older, and she suffers from high blood pressure and heart palpitations. She’s worried that her health will fail before her grandchildren are grown. “I hope they might be able to study and have a career so that the day I die they can all fend for themselves,” Ángela said.

Thanks to sponsorship and future donations, Ángela’s prayers for Darwin will likely be answered before her frail body gives out. And one day, Darwin might even realize his dreams of becoming a doctor so he can help other children.

Update: After undergoing two surgeries, Darwin no longer has the colostomy. Today, he leads a normal life, attending school and playing with other children his age, thanks in part to support from Children International. Our organization covered the cost of medical consultations, medicine, psychological support, food for the family and other essentials. Field staff in Honduras continue to monitor Darwin's situation and help ensure he has the follow-up care he needs.

Photo by Andrea Waters.