Kutum (Sudan), Apr 18: Khadija Adam is not sure how old she is, but the hospital nurse guesses between nine and 11. Khadija does know she was gang raped by Arab militiamen. Older girls usually manage to escape the marauders but the younger ones are caught, says Hawa, head nurse at the only hospital in the West Sudan town of Kutum, which has been taking in between one and four victims of gang rape a week since July.
The admissions are probably the tip of an iceberg in a vast region where few people ever visit a hospital and where a sense of shame deters families from bringing in their daughters.
Kutum lies in the Darfur region, where war broke out last year between government forces and rebels reacting to the ravages of Arab militiamen allegedly backed by Khartoum.

The mounted militiamen, known as janjaweed, have been driving African farmers and their families out of their villages in the region in what international organisations have called ethnic cleansing and even attempted genocide. The Khartoum government says they are outlaws.
A common pattern is that the janjaweed ride into a village, kill men of fighting age, rape the girls, loot any property they find, then burn down the grass huts in which the villagers live.
Hundreds of thousands of people have been displaced and more than 100,000 have fled across the border into neighbouring Chad.
Nurse Hawa, who did not give her full name, says the number of rapes has been increasing in recent months.
"Since last July we have seen between one and four rape cases a week... Most are gang rape -- three to four men raping at once. Most of the cases we see are between 11 and 14 (years of age)," she added.
The militiamen dump the victims by roadsides or in open country where passers-by find them and bring them to hospital.
Khadija's 13-year-old sister, Arasa, is also in the hospital, to treat a leg broken during a failed rape attempt.
"They (the fighters) said they were going to make me into a woman. When I didn’t come with them they broke my leg," she said from the ward where she has been in for nearly two months.
Human rights group Amnesty International says it has reports of systematic rape in Darfur, but adds that the full extent of the problem is unknown because victims risk being shunned in the region's traditional society.
Hawa says it is difficult to tell which side is responsible. "Those who rape you wear fatigues and those who protect you wear fatigues. We don’t know any more who to run from and who to run to," she said.
The government military and the rebels wear military fatigues. Janjaweed wear less formal military-style clothing.
One aid worker said it remained difficult to get a full picture of the problem.
"We won’t know the magnitude of this until we have complete access (for aid organisations)," she said. Related problems include the spread of sexually transmitted diseases and the long-term effects on the victims and the area's social fabric.
Doctors and nurses try to lessen the trauma despite meagre resources. If the rape occurred within 72 hours of admission to hospital, doctors give the girls high doses of contraceptives to reduce the chances of pregnancy.
"As long as they don’t get pregnant we tell them that they still have a future. We try to tell them that nothing has changed," says Hawa.