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Her name was Serenity.

Her life and her death, though, were anything but serene.

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Alberta’s Child and Youth Advocate, Del Graff, issued a reviewof the case of a four-year-old First Nations girl who died while in a kinship care placement. (The report gave her a pseudonym, Marie.) Graff’s review revealed that the relatives with whom the girl had been placed had been poorly trained and that the home study of their family had been cursory.

The review also found Serenity and her two older half-siblings had been left in the guardianship of this couple, despite complaints and tips about abuse. No workers had checked on the three children in the 11 months before Serenity died.

Graff’s report was disturbing enough, but it omitted medical details even more shocking.

Based on medical records obtained by the Journal, Serenity arrived at a hospital in central Alberta on Sept. 18, 2014, suffering from a suspected head injury, with “blown”or dilated pupils. She was four years and three months old. She weighed just 18 pounds, the weight of a typical nine-month-old baby.