The fate of a pregnant 10-year-old has not only become a national debate in Paraguay but has underscored what activists say is a problem with child rape in this poor South American nation and led other victims to speak out.

Cristina Britez de Mendoza is the director of a shelter for troubled youth in Ciudad del Este, a gritty and bustling town of 350,000 that sits across the border from Brazil and Argentina. She said many of the children she works with have been sexually abused, such as a 12-year-old girl who gave birth last month. The girl lives at the shelter with the baby.

"When the other children play, this girl wants to play, too," said Britez de Mendoza, who attended a rally to demand stiffer penalties for sex abusers. "She is still a child."

Monday's rally in Ciudad del Este drew 200 people under the banner of "No More Abuse!" and participants said it was unprecedented in this city with little culture of social protest. Another protest was held in the capital on Asuncion.

The rallies came amid a fierce debate over what is best for a 10-year-old rape victim who is being denied an abortion. In Paraguay, the procedure is banned in all cases — even rape — except when the mother's life is in danger.

The decision to not give the girl an abortion has sparked international and local condemnation, with United Nations human rights experts on Monday blasting Paraguay for failing to protect her.

"The Paraguayan authorities' decision results in grave violations of the rights to life, to health, and to the physical and mental integrity of the girl as well as her right to education, jeopardizing her economic and social opportunities," the four experts said in a statement.

Looking on at Monday's protest in Ciudad del Este, a 17-year-old told The Associated Press who said she had been repeatedly raped by her stepfather from the time she was 9 until she was 14, when she told her mom about the abuse.

"If I had seen protests like this before, maybe I would have spoken up sooner, or maybe it wouldn't have happened to me," said the girl, who is not being identified in line with The Associated Press policy of not naming the victims of sexual abuse.

She said her mother confronted her stepfather, who denied the abuse and still lives in the house. The girl said she is now physically strong enough to fend off his advances, but for a few years she was afraid of men and ate heavily — at one point she weighed 89 kilograms (196 pounds) — to make herself less attractive.

"I try not to be at home so I don't have to see him," she said through tears. "He makes me sick."

About 600 girls 14 or under become pregnant each year in this country of 6.8 million people. Studies by the U.S. Centers for Disease Control say thousands of children in the United States also give birth each year.

In Paraguay "these cases are very common. What's needed is the political will to get us out of this hole," said Britez de Mendoza, who runs the shelter in Ciudad del Este.

In the case of the 10-year-old, the girl's stepfather, who is accused of raping her, was arrested over the weekend and placed in isolation to prevent other inmates from attacking him. The girl's mother is being held at a female prison for neglecting to take care of her daughter.

In response to the calls for a therapeutic abortion for the girl, Paraguayan Health Minister Antonio Barrios has responded that the girl is in good health at a Red Cross hospital and that the pregnancy, at five months, is too advanced.

The president of the country's Episcopal Conference, Msgr. Claudio Gimenez, decried the possibility of a therapeutic abortion, saying Paraguay is already split over the case.

"Some want to legalize abortion, the killing of an innocent who still is in a period of gestation," he said. "And for the other side, those who oppose that idea."

Some protesters said they think the case of the 10-year-old is the tip of the iceberg.

"How many thousands of other girls are raped and we just don't hear about it because they don't have the baby or don't report it?" said Sebastian Martinez, 34.

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Associated Press reporter Pedro Servin contributed to this report from Asuncion, Paraguay.