Port-au-Prince, Haiti (CNN) -- For more than a week, Sende Sencil had gone without bathing, until two young American doctors at the hospital where she was being treated took the 9-year-old girl for a short walk outside to a shower to wash off the filth and grime.
Beaming, and in clean clothes for the first time since the earthquake, Sende, who was thought to be an orphan, returned to the hospital's tents with the doctors.
As they walked, a man approached them on the street and reached out to grab Sende.
"I'm looking for her. She's my family," the doctors remember the man saying in broken English. "I'm taking her home."
Pediatricians Tina Rezaiyan and Liz Hines, had been looking forward to the day when Sende's parents might come to claim her, but this was not what they'd anticipated.
"She was trembling and hiding behind us. She was so scared of him," said Hines, a second-year pediatric resident at Johns Hopkins University in Baltimore, Maryland.
"She was terrified. She'd been holding Liz's hand, and she clung to it and wouldn't let go," said Rezaiyan, also a second-year pediatric resident at Hopkins. "He kept trying to grab her, and I had to put myself between him and Sende."
The two doctors whisked Sende back to the hospital tent, where the doctors found an interpreter.
The man they'd met on the street wasn't her father, she told the interpreter, but he wasn't a stranger, either. She called him her "godfather," and she lived with him and his wife in Port-au-Prince. Her parents, who live in Gonaives, a rural area several hours north of the capital city, had sent her to live with them.
Video: Child trafficking in Haiti
Sende, they found out, is a restavec. Derived from the French "reste avec," the word in Creole literally means "to stay with." It's a not uncommon arrangement where parents send their child -- usually a daughter -- to live with another family. Sometimes the parents send a child away because they can't afford to take care of her. Other times they send her away because there's no school where they live. Sometimes the child is sold for money, other times no money changes hands.
The United Nations condemns restavec as a "modern form of slavery" where children are forced to serve the families they've been sent to by doing domestic work.
The Jean Cadet Restavek Foundation estimates there are some 300,000 restavec children in Haiti.
According to the foundation, restavec children are usually responsible for preparing the household meals, fetching water from the local well, cleaning inside and outside the house, doing laundry and emptying bedpans. They usually sleep on the floor separate from members of the family they serve, and are up at dawn before anyone else to do household work. Sometimes they're physically and sexually abused.
Sende's story
When the earthquake hit, Sende says she was in a car, and became separated from the adults who were with her, ending up at a makeshift hospital run by the University of Miami on the grounds of a United Nations compound.
Sende had been there for about a week when on Wednesday, January 20, her godfather found her as she walked back with the Hopkins doctors after taking a shower.
As the two pediatric residents, Rezaiyan and Hines, asked her questions through a Creole interpreter, they learned the man wasn't just her godfather, he was her uncle, the husband of her mother's sister.
A more senior physician, Dr. Karen Schneider, an assistant professor of pediatric emergency medicine at Hopkins who'd been appointed the head of pediatrics at the tent hospital, joined them to talk to Sende.
"We asked if she'd been physically abused at her godparents' house, and she said no," Schneider remembers. "I asked if she'd been sexually abused, if she'd ever had to take her clothes off or if he'd touched her in certain places, and she said no. I believe her, because she seemed confused by what I was asking -- she had no idea what I was talking about."
The pediatricians tried to piece together details of Sende's life with her godparents. She was undernourished; with no scales at the hospital, the pediatricians estimated she weighed about 45 pounds, which is underweight for a child her age. They noticed she hoarded the food she was given at the hospital. When they took her to the toilet, she didn't know what it was or how to use it.
The doctors said they learned Sende did laundry, ironing, dishes, and other work around her godparents' house in exchange for going to school. Her godmother did her hair before and after school and sometimes gave her Coke and ice cream.
"After talking to her, it was clear that she hates and despises this family," Schneider said.
While the pediatricians were talking to Sende, her godfather came into the tent. The doctors asked him to leave.
The next day, Thursday, a worker from UNICEF came to talk to Sende and other children at the hospital who were without parents. After they left, the godfather came back again.
"Sende kept saying that the people with the letters across their shirts told her she wasn't allowed to leave the tent, that they would come back for her," Rezaiyan remembers. "We didn't know what she was talking about, and then we realized she meant the UNICEF workers, who wore T-shirts that say 'UNICEF' across them in big letters."
"We told her not to go with her godfather if she didn't feel comfortable," says Nadine Perrault, UNICEF's regional adviser for childhood protection for Latin America and the Caribbean.
The next day, Friday, the godfather came back with Sende's father.
"The father said the mother was at home, wounded from the earthquake, and that's why she didn't come, too," Perrault said. "He was happy to find out Sende was alive."
Concerned the father would return Sende to the godfather, Rezaiyan asked the girl a question: "If you could be anywhere in the world, where would you be?"
"America," she said, according to Rezaiyan. "I asked her, 'If you can't go to the United States, then where would you want to be? She said, 'In this hospital.' I asked her for her third choice, and she said with her mother."
A difficult decision
Sende acknowledged the man her godfather brought was indeed her father. After more interviews with Sende, UNICEF decided to let her go with her father, who promised to bring her to her mother and not send her back to the godparents.
Perrault, the UNICEF worker, said decisions about where to place children are difficult, but that it was clear Sende should go with her father.
"She was eager to see her mom. She thought she was dead," said Perrault, the UNICEF worker. "There's no way we could say no when she was willing to go with her father."
She said she doesn't think the parents will give her away again to the godparents, but that even if they did, they sent her to school and her godmother did her hair every day.
"I don't consider her a restavec -- restavecs don't go to school," Perrault says.
But Joan Conn, executive director of the Restavek Foundation, disagrees.
"We have restavec children who go to school and are raped at home by an uncle," she said. "If you ask a child for her first, second and third choices of where to go and not one of those choices is to stay with the godparents, that should tell you something. If she was fearful when her godfather walked up to her, something's going on, even if her hair was combed and she was in a school uniform."
Still even with her concerns, Conn said she's "sure UNICEF is making the best decisions they know to make at this point."
On Monday, Perrault said UNICEF would not check on Sende themselves, and instead would work with groups that she said would be visiting the family, such as the Haitian government and non-government organizations.
However, on Thursday she sent an email saying a UNICEF worker, Gislet Bordes, had visited Sende with journalists and that that girl and her mother "are fine." Bordes did not respond to repeated calls and emails from CNN.
Even if Sende is doing okay now, some doubt whether anyone in Haiti -- a poor country with few services to protect children even before the earthquake -- will keep track of her to make sure she hadn't been sent again to the man who terrified her.
"The agencies will fail in looking after her," said Dr. Art Fournier, associate dean for community health at the University of Miami, who met Sende at the hospital. "I would have kept her at the hospital until they brought the mother forward and they could get a detailed history of Sende's circumstances."
Fournier, who's been doing medical missions in Haiti for 15 years and is author of "The Zombie Curse," a book about the country, said he worries the parents will give her away again.
"The parents aren't bad parents. These are the survival choices they have to make, and desperate times make for desperate survival choices," he said. "Hopefully Sende can make an impassioned plea not to be sent back to the godparents. At worst, she was being sexually abused by the godfather, and at best she was being treated like a slave."
Schneider, the senior Hopkins pediatrician who interviewed Sende, said she thinks it's likely the parents will give her away again. "Within a year, that kid will be gone," said Schneider, a nun and pediatrician who's made dozens of medical missions to Haiti. "They already gave her away once."
The young doctors who witnessed Sende's initial reaction to her godfather fear for the worst.
"I asked her if she would ever want to go back to live with her godparents, and she said, 'No, I wouldn't do that unless my parents told me I had to,' " Rezaiyan said.
"I wanted to take her home with me so badly," she said through her tears. "I'm probably going to think about her every day for the rest of my life."
