The world goes not well

First, if you are reading this as a kid less than 16, skip this post.

We know the world goes not well, but usually it is a background irritant to the illusion of success.  Today, however, the "not well" is like a punch in the gut.  On my ward, a 6 year old girl, who was raped.  A very normal looking sweet thin little girl in a red polka dot dress,  watching us all, accompanied by her pregnant mother and harried father.  Seems she and her two siblings were in the family's gardens alone (not so shocking, mom was tired, told them to go play after lunch) when an old man, a former UPDF soldier, grabbed her, told the other kids not to scream or he would find them and shoot them . . . and then proceeded to hold the little 6 year old girl down and rape her.  The siblings ran home crying, having recognized the man as an uncle of their neighbors, and the family brought the little girl bleeding profusely to the hospital.  This happened over the weekend, but even today the evidence of the trauma is quite clear on exam.  

How do I as a pediatrician react to this?  Shock and horror and outrage and anger.  Then some action, paltry probably.  Most importantly to let the little girl tell me her story, again, figuring that another adult taking it seriously and letter her vent is a good thing.  She spilled it out rapidly, concretely, matter-of-fact, not emotional.  Then to tell her in very clear terms this is not her fault, she did nothing wrong, she did not deserve this, she has nothing to hide or be ashamed of.  And to promise that we and her parents will make every effort to protect her.  Then to get her started on HIV-post-exposure prophylaxis (which thanks to our trip to EGPAF two weeks ago, I actually HAD in the medicine store, thank God).  The soldier connection is worrisome, and there is a belief that sex with a virgin can cure AIDS, so it could have been part of the motivation for the attack.  And treatment for syphilis.  And calling the child welfare officer attached to the town council.  And filling out the blank police report form.  And then, at last, marching to the police station myself with Heidi and the nurse and the father, to discuss the plan to apprehend the perpetrator.  It is actually unimaginable to me that no one has taken any action yet.  Fear?  Reluctance to get involved?  Hope for a cash settlement?  Apathy?  Or just lack of transport?  In this country the police sort of wait in their office for the family to do the real work of finding the criminal.  I put down a good chunk of money to try and spur on some action.

Last week our worker Saulo's family went into a frenzy of panic when their little girl, Nightie (?age 4ish) was missing from her nap.  They searched and found her a few minutes from home, left lying by the river, with a story that a man speaking Luganda had entered the house and picked her up while she slept, then threatened her not to scream . . not clear why he set her down, but he did, and she was unharmed.  There is a lot of press right now about child sacrifice, about unscrupulous and greedy people taking children to witch doctors for sacrifice to ensure success in business.  It is always attributed to "outsiders", someone from another tribe.  There is also an idea that only an un-scarred child will be used, so a circumcised boy, or a girl with pierced ears is safer.  This is driving earlier and earlier circumcision, the culture is abandoning the historical traditions of near-adolescent group-enculturation and ceremonial circumcision, in favor of protecting their toddlers.  And the day after this scare, Nightie and her sisters had their ears pierced.

When children are used by adults as sacrifices for their success, healing, or need for power . . . we know that the world goes not well.  We have a visiting pastor, Craig, from the Mariner's Church in Annapolis which supports the Pierces.  He read us the Lazarus story last night and spoke on the verse "Jesus wept".  This, he said, is God's continual posture towards the broken world.  He weeps.  Even knowing that resurrection is imminent, knowing that the Kingdom comes, does not erase the pain of wounded love for His children.  He is not indifferent, and He is actively reclaiming the territory of grief, with tears that become springs in the desert, that transform suffering into blessing.  Hard to see that today, but we hold onto the truth and pray for the Kingdom.