About 13 pounds. That’s all they weighed. Two small children, ages two and three years old, were found recently in a home in one of the most poverty-stricken places in the country — the Pine Ridge Indian Reservation on the South Dakota-Nebraska border.

Authorities discovered the girls near death, wearing diapers and living in filthy surroundings, on Nov. 11 — both had multiple signs of abuse and sexual abuse on their emaciated bodies.

Child abuse ranks as one of the top 10 health concerns facing children today, but only 30 percent of all abuse cases are reported.

A witness told FBI agents the adults in the home, who were not the girls’ parents, hid food on high shelves in other rooms so the girls could not reach it. A pediatrician said the children resembled concentration camp survivors from WWII.

Seven people have been arrested on federal charges, three with assault and four with concealing a felony. All pleaded not guilty Nov. 22. At least two other children lived at the home and were later removed. One of the children told FBI agents people saw the girls’ conditions and didn’t like it — but did nothing.

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That appears to be the biggest challenge to stopping abuse and preventing perpetrators from continuing to abuse other children.

When Do You Step In?
“Although most people rationalize that it could not happen in their neighborhood, that is simply untrue,” Alice Baker, a former abuse informant, told LifeZette. Baker (not her real name) anonymously informed on her neighbors in a middle-class community in Kansas six years ago.

The 2015 National Poll on Children’s Health showed that child abuse ranked as one of the top 10 health concerns facing children today, but only 30 percent of all abuse cases are reported, according to Gene Klein, executive director of Project Harmony, which trains nearly 10,000 professionals each year, including educators, on how to protect children from abuse.

[lz_bulleted_list title=”Where to Report Abuse” source=”http://www.childhelp.org/hotline”]1-800-4-A-CHILD|Local police|911|Callers can remain anonymous[/lz_bulleted_list]

Within the cycle of poverty and addiction, which exists on many reservations, people are taught not to “snitch” on relatives; they suffer from misplaced loyalty, according to Pablo Solomon, a former teacher, counselor, and consultant to the Dept. of Education, who has worked on programs to upgrade life on reservations.

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“They unrealistically believe the abuse was just an isolated incident and are reluctant to cooperate with authorities,” he told LifeZette. “In extreme cases, they don’t talk because they’ve committed crimes or [engage in] drug use and afraid that will be exposed.”

“Juvenile laws and formal protections for children are also rather new in the United States — it took until the 1900s for juvenile courts to be established,” Patricia Miljanich, executive director for Court Appointed Special Advocates (CASA) in San Mateo County, California, said. “There are still members of or society who believe that interference with parents’ right to treat the child as they wish is wrong.”

Cases like the one at Pine Ridge may change that attitude.

Bruises, Injuries, Weight Loss … 
Miljanich reminds friends, neighbors, and even casual visitors to be aware of signs of abuse such as bruises, injuries, weight loss, crying, unreasonable fear, or withdrawal.

“Make a call whenever you have even a reasonable suspicion that a child is being abused or neglected. Some people think they have to know for a fact the child is being abused or neglected before they can make that call — that’s not true. The authorities’ job is to investigate and they will.”

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Meanwhile, should parents be screened for competence and mental health at the birth of a child? That’s a radical idea in this country, but Dr. Jack C. Westman, professor emeritus of psychiatry at the University of Wisconsin School of Medicine and Public Health, believes so. Westman researches child abuse, children’s and parents’ rights, and public policy.

“We no longer can presume that everyone is capable of handling the responsibilities of parenthood until they damage a child through abuse and neglect,” he told LifeZette. “We no longer can regard a newborn baby as the personal property of the parents without human rights.”

In the Pine Ridge case, the girls’ mother left them with a grandmother and uncle. Their father is in prison. At this point, the long-term effects of the abuse is unknown.

Pat Barone, MCC, is a professional credentialed coach and author of the Own Every Bite! bodycentric re-education program for mindful and intuitive eating; she helps clients heal food addictions.