Sincere Smith is 2 years old, but he looks twice his age. That’s because of the steroids prescribed to treat his rashes, which appear on his face and entire body. Sincere, one of three children in a family living in Flint, Mich., had been bathing in water that the city began pumping in from the local river in 2014. That water was later found to be contaminated with lead.

Sincere no longer bathes with Flint River water—his mother, Ariana Hawk, washes him with bottled water—but that doesn’t mean his pain is gone. Each day, Sincere dreads bath time. “This boy actually fears the water,” says Regina H. Boone, the Detroit Free Press photographer who shot this week’s TIME magazine cover. “It’s like Kryptonite to him: he starts screaming. His mother says it’s burning him and when he’s in pain, the whole family is in pain.”

Boone met Sincere and his family after a Detroit Free Press reporter, Elisha Anderson, met Hawk at at one of Flint’s public schools during a blood-test drive for children. Going over to their house the next day helped “put a face to this issue” of lead poisoning, says Boone.

When Boone photographed Sincere, she felt his pain, she says. “He just seems so innocent,” she says, “and so sad at the same time.”

Regina H. Boone is a photographer with the Detroit Free Press.

Myles Little, who edited this photo essay, is a senior photo editor at TIME.

Olivier Laurent is the editor of TIME LightBox. Follow him on Twitter and Instagram @olivierclaurent.

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