Sanaa Cunningham’s death: Tough love or lethal intent in Phoenix?

Australian citizen Lisa Cunningham could face a death sentence in the US over her stepdaughter’s death.

Sanaa Cunningham, who died in February 2017 aged seven.

Sanaa Cunningham was just seven years old when she died, with an open wound on her foot and marks on her wrists from zip ties used to restrain her in a deckchair.

But was the little girl murdered? Or were her parents — her Australian stepmother, Lisa Cunningham, 43, and her biological ­father, Germayne Cunningham, 38 — doing all they could to keep the mentally ill child alive?

These are the questions at the heart of one of the most perplexing and potentially sensational child murder cases to have come before a US court.

The trial of Adelaide-born Lisa Cunningham, a suburban mother of four, has the potential to strain the close relationship between the US and Australia, which opposes the death penalty for its citizens.

Cunningham had been leading a relatively affluent life with her US-born husband Germayne in Phoenix before both of them were charged last December with the first-degree murder of the little girl.

“We thought it would be OK because they never would hurt Sanaa,” Lisa Cunningham’s eldest daughter, Cierra Anderson, 20, tells Inquirer. “But then last week they took them into custody and now the state wants to kill them. I am in shock.”

The Cunninghams vehemently deny the charges, saying Sanaa suffered from a dizzying array of serious mental health problems, including pica (where a person will eat dirt and, in Sanaa’s case, her doll’s hair) and schizophrenia, the diagnosis of which is extremely rare in children.

They say they took their daughter to see psychiatrists, nutri­tionists, psychologists and behavioural therapists as they tried desperately to stop her from hurting herself and others.

Sanaa was being treated with a powerful anti-psychotic medication in the weeks before her death.

“We think the medication could have poisoned her. It’s been horrible, what’s happened to my family,” Anderson says.

“We need the Australian government to help us because we are getting no help here.”

Cunningham would appear to be eligible for financial assistance under the so-called serious overseas criminal matters scheme, which provides funding for the legal defence of Australians overseas facing the death penalty.

Sanaa Cunningham’s stepmother Lisa Cunningham, who is an Australian citizen.

Sanaa Cunningham’s father Germayne Cunningham.

The scheme previously has provided legal assistance for convicted pedophile Peter Scully; accused drug trafficker Cassie Sainsbury; convicted drug trafficker Schapelle Corby; former Guantanamo Bay inmate David Hicks; and two of the so-called Bali Nine, Andrew Chan and Myuran Sukumaran, both of whom ultimately were executed.

Anderson says her mother is Australian, and records show that Lisa Marie Cunningham, nee Topsfield, was born in Adelaide in 1974 before moving to Queensland in the late 1980s.

There, she met US serviceman Russell Anderson. They got married before moving to Japan, where Cierra was born. Two years later, Cierra’s brother arrived, before the family returned to the US. The marriage broke down and Lisa later married Phoenix police detective Germayne Cunningham, who also had two children: Sanaa, and one other whose identity is protected by the courts.

Lisa Cunningham’s eldest child, Cierra Anderson.

The Cunninghams then went on to have two more children ­together, whose identity is likewise protected.

“Sanaa was seven, so she was sort of in the middle,” says Anderson. “I called her my sister because I have known her since she was real­ly little. We’ve always had custody of her.”

Anderson says Sanaa was “completely normal until she turned six. That was when the ­decline started, and we all had to watch it. She would become catatonic, or else she’d throw things, try to hurt us. She’d scream, and my parents would sit up and cry all night with her.”

Anderson says her mother went to “so many doctors, trying to find out what was going wrong. At first she was diagnosed with ADHD, and the answer was: change her diet. But our family eats a predominantly plant-based diet. So then came autism spectrum disorder, and Mum is like, ‘OK, I want a second opinion.’ Then came all the other disorders: pica (eating dirt and hair) and oppositional defiance disorder, depression, bipolar, the whole range of mental illnesses. She tried to kill our dog once with a river rock.

“But the worst part was, she would try to hurt herself.”

The fact Sanaa had significant health challenges is not disputed by the prosecution in the case. An autopsy report produced eight months after Sanaa’s death devotes five pages to her “complicated” medical history.

“She had to wear goggles so she didn’t scratch at her own eyes,” Anderson says. “It was really scary.”

She says her parents also had to restrain Sanaa, “like, Dad would put her in a bear hug like you see on autism YouTube channels, where you hold her until she calms down. And Mum found a restraint shirt, you know with long sleeves you can tie up, also from looking at autism websites online, where they show what might help you.”

Anderson confirms that Sanaa slept in a downstairs laundry, away from the rest of the family, “because we had to do that because she’d get up and we’d find her looking over one of the babies’ beds.

“But everything they were doing, they were doing to try to help her,” she insists.

Anderson says the family was struggling along as normal on the night of Saturday, February 11 last year.

“My dad was at work” — Germayne was at that time a senior detective with the Phoenix police; his career ended after Sanaa’s death — “and Mum was being the mother hen.

“Sanaa had the sniffles, but my mum made sure she was warm, but later that night, around 1am, Mum was up checking on her and she thought something wasn’t right, it was like Sanaa was sighing. She would take a deep breath, and let it out, like a sigh.

“Mum called my dad, and I stayed upstairs with the babies because my brother, he was still on breast milk then, they couldn’t be left alone. Mum and Dad took Sanaa to the (Phoenix Children’s) hospital. And we lived 3½ minutes from the hospital, so when they say my parents didn’t get care for my sister, we were there in less than five minutes.

“And the next day she died there. And from what I heard, my dad was walking up and down the hospital corridors saying ‘I’m going to sue you people’, because my parents were saying it was the medication the state put Sanaa on that maybe killed her.”

The record shows that Sanaa’s parents were given a prescription for the powerful anti-psychotic drug Risperdal for Sanaa about a month before the little girl’s death.

Risperdal is not commonly prescribed for children except in severe cases of autism. Side effects can include mood swings and drowsiness.

“My mum says she should never have been on it,” says Anderson.

Police did not immediately lay charges over Sanaa’s death, in part perhaps because the autopsy — conducted by the Maricopa County Office of the Medical Examiner on October 12 last year, eight months after Sanaa died — listed the cause of death not as homicide but as “complications of sepsis in the setting of acute bronchitis, with bronchiolitis and early bronchopneumonia”.

The manner of death was “undetermined”.

However, it’s now apparent that detectives in Goodyear, a suburb of Phoenix, had quietly begun what would become an 18-month investigation into circumstances surrounding Sanaa’s death, and they paint a vastly more disturbing story.

Among other things, they uncovered an anonymous report of neglect of Sanaa, lodged with the Arizona Department of Child Safety on March 4, 2016. An investigator was sent to the Cunninghams’ home but the children, including Sanaa, “denied any abuse or neglect” and the case was subsequently closed.

On October 27, the department received a second complaint and dispatched a second investigator. Sanaa again denied that she was being abused, and Germayne Cunningham again explained that the child had serious mental health and behavioural problems, for which they were seeking ­treatment.

On December 21, 2016, the department received a third complaint. This investigation was “still in progress” when Sanaa died in February last year.

The suggestion that welfare officers turned a blind eye to the reality of Sanaa’s care in the Cunninghams’ middle-class home because her father was a police officer and her mother a former prison officer has been strongly denied.

In any case, police presented their evidence before a Maricopa County grand jury last December, after which both the Cunninghams were indicted on 10 charges of child abuse and one of first-degree murder.

They were released on bail, with ankle bracelets and a curfew, still protesting their innocence.

Anderson says her parents were confident of being cleared “because it’s obvious how many doctors they went to, how much help they were trying to get for Sanaa.

“But maybe the problem was my dad was shouting about a lawsuit, he wanted to sue the department for what they did to my sister. Then the state charged them with murder.”

The case took its most dramatic turn last week when prosecutors announced their intention to seek what’s known as a “death note”. Essentially, this means they believe they have enough evidence to justify the execution of the Cunninghams if they are found guilty.

After a two-day hearing, Maricopa County Superior Court judge Michael Kemp agreed: this was a capital case.

The Cunninghams subsequently were taken into custody.

Some of the evidence against the Cunninghams remains sealed, but prosecutors say they will tell the jury that Sanaa was “spread­eagled” and restrained with zip ties (known as RIPP ties), attached to a large water tank in the garage outside the Cunninghams’ home, and made to wear a shirt with oversized sleeves tied behind her back, like a straitjacket.

Phoenix police detective Noah Yeo told Kemp that he had collected statements from neighbours who said they saw Sanaa, dressed only in a nappy, being forced to rake rocks or pick up dog faeces with her bare hands as punishment for her wild behaviour.

Police also have a home video, date-stamped December 14, 2016, that captured a “festering, uncovered and untreated wound” on Sanaa’s foot that authorities say the Cunninghams failed to treat. Germayne Cunningham has told police he wrapped the wound and applied antiseptic.

A second home movie, dated February 7 last year, is said to show Sanaa “catatonic, constantly shaking, drooling, and unable to eat or drink normally”. The Cunninghams say they wanted to show authorities the effect the anti-psychotic drugs were having on her.

Sanaa’s biological mother, Sylvia Norwood, who did not have custody of either of her children, has told local papers: “Pneumonia, sepsis, she just living in distress, tied up. No child should ever have to go through anything like that in life. Ever.”

Sanaa’s biological mother Sylvia Norwood, right. Picture: Sean Holstege/Phoenix New Times

The Arizona Department of Child Safety in a statement ­acknowledged the difficulty of proving a case against the Cunninghams while also saying it “mourned the death of Sanaa”. “The facts surrounding this case were clearly complex,” the statement says.

The case will be complicated further by the fact Australia and the US are the closest of allies, a relationship that is likely to be tested by a trial in which an Australian citizen faces the death penalty. Arizona has executed 37 inmates, none of them women, since the death penalty was reinstated in 1976. However, the death penalty has not been applied since the ­botched execution of a double-murderer in 2014.

Anderson says her mother is an Australian citizen “but we can’t get anyone from Australia to help us”. The Department of Foreign Affairs and Trade has been approached for comment but was not able to respond to queries before deadline last night.

While Cunningham’s Australian passport is thought to have expired, her Australian citizenship was raised by the prosecution as a reason to refuse her bail.

“She’s tried and tried and tried to get help, and we don’t know, are we going to the wrong people?” Anderson asks. “Because we need help.”