A South African pathologist has told the High Court in Christchurch that the sexual assault to which Charlene Makaza, 10, was allegedly subjected would have been extremely painful.
Lorna Martin told the court on Wednesday that the injuries Miss Makaza sustained to her genitals were the result of blunt force trauma indicating a painful sexual assault where the victim would have been close to passing out.
George Gwaze, 60, is on trial for the sexual assault and murder of his adopted niece in January 2007.
The Crown says the girl died after a forceful sexual attack by the accused, but the defence says she died of toxic shock arising from her HIV.
Ms Martin disagreed with Mr Gwaze's lawyer that the injuries could have been caused by HIV or a medical examination.
She said Charlene died from a shortage of oxygen to the brain and not from HIV, as maintained by the defence.
Ms Martin told the court that, though the girl was an HIV carrier, she did not show the sorts of complications expected from someone in the final stages of the virus leading up to her death.
Ms Martin said the girl was well nourished and had not reported symptoms such as diarrhoea.
She said Miss Makaza's death was the result of a lack of oxygen to the brain which occurred in the period between when she was put to bed on 6 January 2007 and when she was discovered struggling to stay alive the next morning.
However, the pathologist was unable to say what caused the girl to suffer a lack of oxygen.
The defence had called evidence from an histologist, Sebastian Lucas, who says the injuries allegedly inflicted as the result of a sexual attack could have been the result of advanced HIV.
But Ms Martin who has done many post mortems on murder victims who were also sexually attacked, asked why so much emphasis had been placed on Professor Lucas's evidence.
She says it is entirely based on what can be seen under the microscope, whereas the work pathologists do is based on an overall assessment of the deceased person.
Evidence has already been given in the trial that Miss Makaza's asphyxiation could have been caused by a hand or pillow being held over her mouth.