Medical care could have saved his brother’s life. His parents prayed instead.

As Willie Hughes walked around the weathered plots and mounds of dirt at Peaceful Valley Cemetery, he remembered family that died too young and his brother Steven, who was born with spina bifida.

Steven never saw a doctor, a physical therapist or used a wheelchair. He crawled around on his forearms and died of pneumonia at age 3.

“I remember his was the first body that I saw and touched. It was traumatic for a 4  1/2 -year-old to see his little brother in a coffin. I can’t tell you how many dead bodies I’ve seen,” said Hughes, a Boise truck driver who grew up in the Followers of Christ church.

Nearly one-third of the roughly 600 gravesites in Peaceful Valley Cemetery belongs to a child, advocates say. Spotty records make it difficult to identify how and why the children died before burial at the graveyard used by the Followers of Christ, a splinter sect that practices faith healing and believes that death and illness are the will of God. But coroner and autopsy reports gathered by advocates, and former church members’ childhood memories, tell a story about children needlessly dying from a lack of medical care.

Child advocates estimate that nearly 183 Idaho children died because of withheld medical treatment since states across the nation enacted faith-healing exemptions in the early 1970s. They say many of those victims are buried at Peaceful Valley.

“We assume that a lot of deaths can be prevented,” said Bruce Wingate, founder of Protect Idaho Kids Foundation.

Wingate estimates three to four children will die this year in Idaho alone if lawmakers fail to lift the state’s faith-healing exemptions.

“Because this happens over time, people don’t get shocked. But 183 kids is outrageous,” Wingate said. To make his point, he built 183 pint-size coffins. On Monday, dozens of children’s advocates carried the pine boxes through the streets of Downtown Boise to the Idaho Statehouse in a rally that unfolded in part protest and part funeral procession.

Marchers remembered the victims and carried signs urging state lawmakers to repeal Idaho’s faith-healing exemptions so parents could no longer deny their children medical care under the shield of religious freedom.

“No child should die as a result of neglect of any kind,” said Roger Sherman, executive director of the Idaho Children’s Trust Fund.

“Idaho policymakers have chosen to ignore this aspect of medical neglect. The most vulnerable members of society needed the protection of adults in society,” Sherman said amid a crowd of marchers carrying the coffins.

More children die of faith-based medical neglect in Idaho than any other state, according to Children’s Healthcare Is a Legal Duty, a nonprofit organization that tracks medical neglect and lobbies to repeal religious medical-care exemptions. The organization’s retired president, Rita Swan, points to the gravesites at Peaceful Valley as evidence. More than 200 of those sites belong to children, and many of their deaths could have been prevented, she said, citing data from gravestones, coroner reports, obituaries and statements from family members.

Many of the gravesites at Peaceful Valley remain unmarked, however, concealing information about the lives and deaths of those buried there.

Linda Martin, a former church member and retired Lane County barber, said Followers of Christ members eschew birth control, normally give birth at home and frequently forgo prenatal care. They often home-school children and go without birth certificates, making efforts to track faith-healing deaths difficult, she said. The culture and rituals of the church compound the problem, said Canyon County Sherriff Kieran Donahue. He said Followers have not always alerted authorities after a death. When deputies are called, they often find bodies moved, washed and redressed and dozens of church members milling about the house of the deceased, he said.

“You can start to imagine how difficult it is for law enforcement,” Donahue said.

The Washington Post contacted several members of the church for comment. None responded.

“My biggest concern is that this law creates an exemption for a very small segment of the population, which is discriminatory.”

In Idaho and more than half the other states, some kind of religious exemption allows parents to withhold medical treatment from a child. Sixteen states have no religious exemption, according to a 2016 Pew report.

Efforts to repeal faith-exemption laws across the nation pitted parental rights and religious freedom against children’s welfare. After decades of lobbying state lawmakers across the country, child advocates succeeded in overturning only a handful of exemptions in states including Hawaii, Massachusetts, Maryland, Oregon and Tennessee, Swan said.

“Many of these changes don’t happen without a ghastly death,” she said.

Martin said that after Oregon removed spiritual healing as a defense in 2011, some Followers of Christ church members moved to Idaho to escape scrutiny of their religious practices.

That same year, Oregon prosecutors charged and convicted one couple of first-degree criminal mistreatment after failing to provide medical care for their son. In 2011, another couple received a six-year prison sentence for manslaughter after not getting medical care for their premature son. And last year, an Oregon couple faced charges after prosecutors alleged that the parents failed to seek care for their infant daughter who stopped breathing and died hours after birth.

A 2015 Idaho governor’s task force report pointed to at least two preventable deaths because of faith healing in 2012. One child died of gastrointestinal illness, another from diabetes. The panel recommended a review of the law.

But child advocates said those recommendations fell on deaf ears.

Advocates asked Idaho lawmakers during the past five legislative sessions to strike faith-healing exemptions from its books. Last year, the Idaho Legislature considered a bill that outlined how judges could intervene in faith-healing cases.

Idaho state Sen. Dan Foreman, R-Moscow, said that legislation, which died in committee after some opponents said it didn’t go far enough to protect Idaho children, was basically a clarification bill.

“I saw grown men and women agonizing over this almost to the point of tears because they’re good people and they were looking for a solution that would take care of everyone and there is no solution and that’s frustrating,” he said.

Foreman said he hasn’t heard any talk about a faith-healing bill resurfacing, and advocates doubt that the Republican-majority Legislature would reconsider the issue anytime soon.

Jim Jones, a former Idaho Supreme Court chief justice turned child advocate, said the GOP reluctance to legislate on religious issues stalls efforts to push a repeal of the law forward.

“Some people look at the Bible as applicable law,” Jones said of state lawmakers. Plus, he said, it’s an election year.

The deep religious veins that run through Idaho and Utah make it especially difficult to lobby the state’s lawmakers to drop religious exemptions, Swan said.

“And it’s also the independence of the Western culture. They don’t like government telling them what to do,” she said. “There’s this feeling that parental rights are absolute and religious freedom rights are absolute.”

Following the 1974 passage of the Federal Child Abuse Prevention and Treatment Act, the Department of Health and Human Services interpreted that act to mean that states must implement faith-healing exclusions, said Shaakirrah Sanders, an associate professor at the University of Idaho College of Law who studies faith-healing laws.

“From that point on, the majority of the states passed faith-healing exemptions to get federal funding,” Sanders said.

She said the department later rescinded that interpretation but by then it was too late.

Plenty of case law upholds the rights of children and cases affirm religious freedom, but nothing addresses the role of faith healing in children’s medical care, Sanders said.

“There is a little bit of a gap in the case law that allows these exemptions to exist.”

A court challenge could fill the gap but that raises other questions.

“The question is getting it into court and challenging it. The question is, who’s going to bring it to court? I don’t know,” Jones said.

Hughes rarely spoke of his brother Steven to people outside of the church.

“We were taught that we were not to speak of the church outside of our family,” said Martin, the former church member. Death became a regular part of childhood, he said.

“My friends would be at church one day and the next week, they would be gone,” she said.