While visiting a friend in Uganda, East Africa, Lauren Costabile held 6-month-old Elizabeth in her arms. The child had Down syndrome. She was small for her age and her breathing was labored — a likely sign that she was among the 50% of babies with Down syndrome born with a hole in their heart. With surgery, they can live long, healthy lives, but without it, they die very young. Looking into the baby’s face, Costabile heard God’s voice: “Help her.”

“I was convicted, but I didn’t know what that meant,” Costabile shared with the Register.

Through prayer and trust in God, it ultimately meant becoming the founder and executive director of Hearts of Joy International. It began in 2019 to give children with Down syndrome access to heart surgery in developing countries. Since its inception, 100 children have received the lifesaving surgery in five countries: India, Uganda, the Philippines, Mexico and the United States.

At that time in 2017, however, Costabile could not have imagined such an ambitious goal. All she knew was that children with Down syndrome held a special place in her heart. It began when she was a 17-year-old volunteer at a camp for young adults with special needs ages 15-25. “I was nervous not knowing what to do,” she admitted. “I was standing to the side in a big gym.”

Looking across the gym, her eyes met a boy with Down syndrome. “I smiled, and he ran across the gym and gave me a big hug,” Costabile recounted. “He thought, ‘I think that girl needs a hug.’ That camp was eye-opening for me. I was drawn to these individuals. Their hearts are fashioned to see the way that God sees; they see hearts.”

Costabile earned a degree in recreational therapy from St. Thomas Aquinas College and began working with adults with disabilities at a day program. In 2015, she went on a mission trip to Nicaragua with the Mustard Seed Communities, which have homes for children with special needs in impoverished countries.

“It was the first time I saw people with special needs and poverty in the same breath,”

Costabile explained. “That’s where God planted the seed in my heart for mission, to go to countries where people don’t have resources to help care for these children. I surrendered it to God, however, he wanted it to go.”

Her next overseas trip was in 2017, to visit a friend in Uganda who founded Imprint Hope, which works to provide rehabilitative services to children with disabilities. “I had visited about 10 children with Down syndrome in their homes and was shocked,” Costabile said. “They were hidden in their homes. There was a great stigma and shame associated with Down syndrome. And not only were these children misunderstood, but they were dying, because they were not getting the necessary medical care that they need. My favorite people in the world were being hidden and not embraced.” The last child she met was Elizabeth.

Costabile returned home uncertain as to what she could possibility do to help the precious baby. “But I couldn’t get her out of my head and heart,” she said. “I arranged with my friend to have her heart checked. She had multiple holes that needed to be corrected.”

Turning to prayer and to Go Fund Me, Costabile raised $5,000 in just a couple of days: enough for surgery and all the expenses to cover a trip for the mother and child to travel to India, where a cardiac team had been identified as a good fit. But then a translator who Costabile had met while in Uganda reached out to tell her of a 2-year-old who also needed surgery. So Costabile raised more money to include the second child.

She returned to Uganda in 2018 to escort the girls and their mothers to India. The younger baby turned 1 in the hospital, celebrating with a birthday cake and song the day before surgery. Sadly, the other child, who was almost 3 by then, was inoperable. Doctors deemed she had too much lung damage for the surgery to be successful. “In that moment of grief and disappointment, I knew I needed to start something to help save other children,” Costabile said. “Parents need to be educated, and these children deserve to be loved and cared for.”

By 2019, Costabile began Hearts of Joy International as a charity to provide heart surgery exclusively for children with Down syndrome. The program also offers education and counseling. Social workers, translators and nurses participate in accompanying families through the surgery process, which takes between four and six weeks. The cost for one child to receive complete cardiac treatment, including surgery, medications and travel expenses is $10,000. 

The work they do has been transforming for families and communities, according to Costabile. A mother of a boy named Emmanuel has referred a handful of children to the program in the last five years. The mother’s touching story is shared in this video. “It comes from the belief ‘My son has value, and I don’t need to be afraid to share him,’” Costabile explained. “We’ve empowered mothers to know that God chose them for this child, and we help them to become advocates.”

 

Cardiac Nurse

Christiana Molnar is a cardiac nurse who met Costabile in 2015 when they were both volunteering at a Missions of Charity soup kitchen in New Jersey. Knowing Molnar’s health-care experience and that she had lived in Kolkata, India, for six months serving alongside Mother Teresa’s sisters, Costabile invited her to come along on the first trip. She is now part of the travel team and acts as a liaison between the hospital medical staff and families. Seeing how the doctors advocate for the patients helps break the stigma and promotes acceptance and inclusion within global health systems. 

Molnar has also participated in educational seminars. “We want  families to understand the signs and symptoms of the heart defect and to advocate for their children who we believe deserve respect and the best health care possible.” Forming support groups, according to her, has also created mentorships where younger moms are encouraged to see how their child can live a life full of purpose and meaning.

“It’s been a blessing to see all the love these mothers have for their children,” Molnar said. “I’ve been able to see children years after surgery and how much they have grown and the beautiful relationships they’ve developed with their families.”

Mia Del Rosario has been on the Hearts of Joy Advisory Board for two years and has a 36-year-old brother, Joseph Tupas, who has Down syndrome.

“My brother is an altar server at our parish, Holy Trinity Church, in Atwater Village,

California,” she said. “One day, Lauren walked into church and started talking with him. She invited our family to their Hearts of Joy Gala in 2021. I was blown away when she talked about her mission and so drawn to her cause, not just because of my brother, but I have a son born with a congenital heart defect too.” Another blessed connection for her is that she is a speech therapist, and some of the children she works with have Down syndrome.

 

Breaking the Stigma

Del Rosario was born in the Philippines, one of the places served by Hearts of Joy. “I was struck watching the videos to see that some of the families were from the same province my family is from, an hour south of Manila,” she said. “In the Philippines, my mom had a friend with a daughter with Down syndrome, and she was hidden away. My grandmother did the complete opposite: She moved here from the Philippines to help take care of my brother. She would tell him, ‘You can do anything anyone else can.’ She was nurturing and encouraged him.”

“My brother was so adorable and affectionate and happy as a child,” Del Rosario recalled. “We are always trying to be present, but my brother always is.” If anyone in the family should start to bicker, she said Joe will remind them: “God said to love one another.”

As a speech therapist, Del Rosaria works with many children with Down syndrome. “I don’t see myself doing anything else,” she said. “It can sound exhausting, but it strengthens me.” Between her brother, son and her own field of work, she has become a big supporter of Hearts of Joy.

“I can’t image how it must feel for a parent not to have the resources they need for their child. That is gut-wrenching to me. If I can be a part of something to help another mom who doesn’t have access to what I have access to, it brings me joy to give a child a chance to have a life. They just need that chance.”