INDIANAPOLIS -- Cindy Oetjen asks a class of 19 fourth graders how many of them know someone who has been shot. Thirteen raise their hands.

Oetjen and a partner, Wendy St. John, are spending a Friday afternoon at the Tindley Renaissance Academy on Indianapolis' northeast side. They're part of a joint effort between the Marion County Prosecutor's office, IMPD and Eskenazi Health known as the EKG Program ("Educating Kids about Guns").

Oetjen is a deputy prosecutor with the agency's community prosecution division. St. John, a registered nurse, has 20 years of experiencing working at Wishard and then Eskenazi hospitals. She's currently Eskenazi Health's trauma program manager.

Guns, as Oetjen and St. John will tell you, kill 3,000 kids every year in the United States. They're the fourth leading cause of death for Americans between the ages of 5 and 14.

In Indianapolis, four kids under the age of 18 have already been killed in shootings since the beginning of the year. Oetjen and St. John are prepared to talk bluntly to these kids so that none of them becomes the next victim.

But first, Oetjen has to lay out the problem in a way they can understand.

"If you have 500 people in your school, and 3,000 kids are killed every year, how much of your school is that?" Oetjen asks.

An 11-year-old boy raises his hand: "Everybody."

Getting Through

Fourth and fifth graders aren't any more inclined to sit quietly through a presentation about gun violence than they are about fractions or geography.

The students in Acelynne Upshaw's class rock their desks back and forth, bounce around in their seats and clamor to talk over one another – even when the questions are about relatives who've been shot, or how to deal with gang violence.

They are still kids. But they are old enough to die.

That's what Oetjen and St. John are trying to get through to them. The pictures they see projected on the wall – a 10-year-old shot in the eye, another shot through the skull, fatally – could be them.

It's macabre and blunt and, at times, unsettling. For many of the students, though, it's nothing new.

"When my dad got shot, a bone got replaced in his heart," one boy offers, unprompted. "It was really scary."

Another girl says she knows someone who got shot but never got the bullet removed, because they didn't have enough money to go to the hospital.

The impromptu testimonials are enough to send one young girl into the hallway in tears. The rest of her classmates remain to hear what Oetjen and St. John have to say.

All of that is par for the course in the classrooms St. John visits for the program.

"It's not uncommon that a large number of kids have been exposed to that, and as we know, it has lifetime effects for them, potentially," St. John said. "The thing that can be really difficult for me as a presenter is that these are such young kids and they've been exposed to it. It's helpful for us to have a group that we can rotate through, because those stories can stick with you."

The material in the EKG Program is designed to be shocking in hopes of sticking in kids' minds. But, as St. John said, it's rarely their first introduction to violence.

This presentation is the first time IMPD Officer Vincent Stewart has participated in the EKG Program. As part of his duties in the department's community engagement office, Stewart presents the NRA's "Eddie Eagle" gun safety program to young kids in classrooms around the city.

He says the kids always seem to know more than they should about violence.

"One child specifically said, 'If there's a dead body in the yard, you need to call 911.'"

"The unfortunate thing is, when we talk about why to call 911, a lot of these kids already know such things as, if a robbery takes place, or if someone breaks into your home and holds everyone at gunpoint," he said. "I kind of have to sit back and think, 'How do these kids know this?' It's not just from TV they've seen this. Some of them have experienced it. One child specifically said, 'If there's a dead body in the yard, you need to call 911.'"

Stewart, 34, is an Indianapolis native. He attended North Central High School before graduating from Zionsville High School. Before his assignment in community engagement, he patrolled the city's "hot spot" areas. There, he saw firsthand how kids become accustomed to violence.

"What I used to see on the street, which was always disturbing to me, was that, when we would be on the homicide scene, parents would bring the child to the scene to see the body, to see the gruesome. And I never understood that," Stewart said. "Whether the parent was trying to have a teaching moment of saying, this could be you, I don't think the child receives that. The child receives that as, there's a dead body, it's no big deal, we keep it moving."

More Kids, More Guns

In 2013, IMPD officers encountered 81 kids under the age of 18 in possession of a firearm.

That number has risen every year since, hitting a new high of 138 last year – a 70-percent increase in just four years.

The overall number of guns IMPD encountered during that period was erratic – dropping from 3,044 in 2013 to 2,495 the next year, and then back up to 3,149 by 2016 – but, on the whole, only rose about 3.4 percent.

The department says it doesn't know what's behind the rise in kids with guns. But the effects of it are clear.

Last year, 15-year-old Dewuan Rockingham was killed when a gun accidentally went off at a friend's house. The bullet struck him in the head.

On New Year's Eve, 5-year-old D'Asia Turentine was accidentally shot and killed by her 3-year-old brother.

Since then, three more kids under the age of 18 have been killed in Indianapolis.

"Part of what they do when they goof around, like guys do, is they point their guns at each other. Unfortunately, in a couple cases, the guns went off by accident and they killed their best friend."

On January 30, 14-year-old Anthony Lee Hughes Jr. was killed in a Popeye's parking lot on the west side. Two weeks later, 16-year-old Antonio Frierson Jr. was shot and killed in an apparent accidental shooting in the 3600 block of Glen Arm Road.

In late February, a 17-year-old male was shot and killed on Indy's east side. Police have not yet released the victim's name, but said the death appeared suspicious.

All of those incidents are part of a spike in youth-related firearms cases coming through the Marion County Prosecutor's Office, according to attorney Peter Haughan, who supervises MCPO's juvenile division.

Haughan says he's troubled by the youth firearm statistics – both as a prosecutor and as a citizen of Marion County.

"They're kids. They're going to make mistakes. But when you're armed with a deadly weapon, even if it's a joke, someone's going to get hurt," Haughan said. "Recently, I can think of a couple cases we had with kids who were childhood friends, known each other their whole lives, and they both carry guns. Part of what they do when they goof around like guys do is they point their guns at each other. Unfortunately, in a couple cases, the guns went off by accident and they killed their best friend."

Why These Kids

Back at Tindley, if any of the kids wonder why they're getting a crash course in trauma, they don't let on. Maybe the equation is obvious.

As a charter school, the Tindley Renaissance Academy theoretically pulls students from all over the city. But school officials say a lot of students are still drawn from neighboring areas – like Martindale-Brightwood, just to the south, where 19 people were killed last year. Forest Manor, the neighborhood where the school is located, wasn't that bad – only three homicides in 2016. Directly to the west is the Meadows, which had five.

Add another variable to the equation: Almost 95 percent of the students enrolled at Tindley Renaissance Academy this year are black. All of the students in Upshaw's class are black. That's important, too, in a city where black residents, at 28 percent of the population, made up 74 percent of all murder victims last year.

St. John, who is white, knows someone else – maybe a celebrity or an athlete, she says – might face fewer barriers up front with these kids. But she believes that what she does is important.

"I recognize what I look like and even what my age is. And so, somebody that's older coming in and talking to younger kids at a certain age … our high school age students, they don't necessarily want an older woman coming in and telling them all these stories," she said. "I have small children, and so I like to teach that age and feel like I can at least talk to them in a way that they understand. I think that's kind of important to build a relationship in that manner."

Oetjen and St. John – and other EKG members like Dr. Clark Simons, a trauma surgeon at Eskenazi Health – say they'll talk to anyone who will have them, because their message isn't just important for kids who live in a certain area or who look a certain way.

"We as a country are in love with our guns ... adults, we love them. Why wouldn't they?"

In Indianapolis, a city with more than 92,000 licensed gun owners – and a city where police pulled more than 3,000 illegal guns off the streets last year alone – every child could benefit from a course on what to do if they see a gun, lest natural fascination lead to tragedy.

"We as a country are in love with our guns," Dr. Simons said. "Not to get into the political things about what we should do or so forth, but we are in love with guns. So what do you expect kids to do? Adults, we love them. Why wouldn't they?"

And so Simons, and Oetjen, and St. John and others talk to kids about what decisions they should make if they encounter a gun. They tell them that they shouldn't pick it up; that they should call an adult or 911. And they show them pictures of the very real consequences of guns.

"Yes, these pictures are graphic, and it's sometimes hard for some kids to watch and look at it. But it's better to expose them under our circumstances where it's controlled, where we can help them understand the consequences," Simons said.

They're personally invested in the program, too. St. John says she's talked to her kids about their responsibility if they're ever exposed to a gun. Her coworker, Danielle Gilyan, Eskenazi Health's injury prevention coordinator, says she brought her 5-year-old daughter to see one of St. John's presentations.

"Not that I want to expose her to things like this, but it's the reality. It's what she's going to run into. It's what she's going to hear from her peers. I think it's things she needs to be aware of," Gilyan said.

At 5, Gilyan's daughter would be one of the younger kids to go through the program. But she still took something away from it.

"The child with the eyebrow injury, her response to that was, 'That is a really bad owie.'"

"The child with the eyebrow injury, her response to that was, 'That is a really bad owie.' Her response to the child with the gunshot to the abdomen was, 'Did you give him a really big Band-Aid?'" Gilyan said. "So her comprehension of the depth of the injury was not really there, but she knew the injuries and what caused them, and that's what I wanted her to get."

Should 5-year-olds – or 10-year-olds, for that matter – be exposed to the realities of gun violence? Should they know what a bullet does when it enters the human body, or what a gunshot wound looks like?

"No, I don't think it's fair at all. I don't think it's right. I would love to not do it. But I also know the reality of what goes on in the inner city, and I know what goes on here every day," Gilyan said. "But if they can walk away with the message of, 'If I touch a gun, I'm going to get hurt or someone's going to get hurt,' I will continue to do what I do. Because it's a message I think they need to get."

If you're interested in more information about the EKG Program, you can contact the Marion County Prosecutor's Office at (317) 327-3522 or visit Eskenazi Health's violence prevention page.