With that assault began a series of events that led to an international debate over abortion. And one of the organizations at the center of the discussion was Ipas, a Chapel Hill-based organization dedicated to promoting women's reproductive rights around the world.
The girl, who came to be called Rosa, though that's not her real name, did not inform her parents of the attack. Soon after, she began vomiting and feeling weary. Her mother took her to the hospital, and after three visits the doctors finally established she was about five weeks pregnant. The doctors told Rosa's mother about her daughter's condition.
Rosa remained in a San Jose hospital for 25 days while undergoing tests. Doctors and social workers encouraged her to have the baby, not telling her that there were risks because of her age. Her parents wanted to return to their native Nicaragua, and get help having an abortion.
Enter Ipas, which has worked for 30 years to reduce the deaths and injuries of women from unsafe abortion. The organization's goal was to ensure Rosa's safety and well-being and carry out the family's wishes to terminate the pregnancy.
Marta Maria Blandn, director of Ipas Central America and a psychologist in reproductive health, was in Chapel Hill this month and discussed Rosa's case. She found out about Rosa's story from the intense media coverage it was receiving in Central America, and stepped in to help Rosa and her family.
Blandn and Ipas mobilized allies, such as the women's movement and human rights organizations.
According to Blandn, Rosa's parents were "very sad, angry, confused, and uninformed." The parents wanted to go home to Nicaragua to make the important decision. After a string of legal obstacles with the governments of Costa Rica and Nicaragua, Rosa and her parents returned to Nicaragua in February.
Ipas helped in several ways. It put together medical data that covered the serious risk of complications in pregnancy for a by-then-9-year-old, given her physical immaturity, and the safety of medical abortion when performed by qualified personnel in hygienic conditions. A leading, prominent Brazilian obstetrician/gynecologist, known throughout Latin America and a colleague of Ipas, wrote a letter to the obstetrician/gynecologist society of Nicaragua making these points and supporting, from a medical standpoint, the family's wish to end the pregnancy. In addition, Ipas Mexico collected information justifying the termination of pregnancy in this case in light of international agreements on human rights. Other women's rights groups pitched in to help.
On the other side were the Catholic Church, which has lobbied extensively in recent years to toughen Central American abortion laws, and top Nicaraguan public health officials, who argued that abortion is a crime.
The case of la nina Rosa consumed the public consciousness in Nicaragua and across Central America. It was all over radio and TV. Pro-choice and anti-abortion organizers staged demonstrations and passed petitions. Priests made it the subject of homilies.
For six weeks, Ipas covered the family's legal expenses, food, lodging, transportation, and communications.
In Nicaragua, the law requires agreement by three doctors that the woman's life is in danger before an abortion can be performed. The doctors concluded that her life was at risk either way--having the child or having an abortion. Rosa's supporters took that as a ruling that aborting the fetus was legal, and three anonymous doctors in a private clinic performed a medical abortion, which is carried out by taking a regimen of pills, inducing a miscarriage. There were no complications.
Blandn credited a network of allies at the national, regional, and international level for supporting Rosa's case, particularly historic allies of Ipas and allies within the medical sector.
"We're very happy to save this child's life -- to give back her childhood to an extent," said Blandn. "[Rosa] has gone through therapy, gone back to school, wants to be a psychologist or lawyer, and has many hopes and dreams."
But the debate is not over. As a result of the case, pressure is building to restrict abortion further in Nicaragua.
"We realize we do have to keep working with our allies," Blandn said, "so we can pull our resources, efforts, and ideas to make it possible that rights can be a reality."