[sak9645]

A couple of thoughts.

1. MS is a serious illness, and although it's well controlled, there are a lot of countries that won't accept a person with this disease, because the authorities there will not feel confident that your husband will have a normal lifespan and be equal to the challenges of parenting an adopted child. China won't, for example, and neither will Korea. Talk to a lot of agencies and ask specifically if they've ever placed a child from overseas with a person who has the condition, and if there are some countries that they recommend. Frankly, I think it's going to limit your choices greatly.

2. Each country sets its own standards, with regard to what children can be referred and to whom. As an example, China tends to look at children as belonging to one of three groups -- relatively healthy infants and toddlers, children of any age with significant special needs, and relatively healthy school aged children. The rules for healthy infants and toddlers tend to be the most strict; as an example, both parents must be under 50. Healthy preschoolers are pretty much grouped in with infants and toddlers. There is a small amount of flexibility with regard to age and other matters, if you are willing to adopt a relatively healthy school aged child (6+) or a child with a significant special need, such as cleft palate. However, the health rules for parents are not relaxed.

If you find some countries that will accept a person with your husband's medical condition, you will have to see what children you qualify for in that country. It is possible that you will qualify for a relatively healthy toddler or preschooler, but you may be told that you can adopt only a child with special needs or a school age child.

At this time, for example, Ukraine is NOT accepting dossiers from ANY people seeking healthy children or children with minor special needs, who are under age six. (You can read about this on the website of the U.S. State Department.) Unfortunately for you, it seems to be increasingly common for countries to be most flexible with requirements, if a person is willing to accept a school-aged child (6+) or a child with significant health issues. These are the kids who most need families, and who have the hardest time finding them.

3. Remember that most countries, including the U.S., view adoption as finding parents who can meet a child's needs, rather than as finding a child who meets a parent's expectations. As a result, you are rarely going to be allowed to go around and "inspect" children, in order to select one. Even with Ukraine, you are not shown all the children in an orphanage. While you are in the National Adoption Center, you review brief reports on children and decide on a small number of children you want to visit. If you get to a region and find that you don't feel comfortable with those children, you may have to go home without a child. At this time, Ukraine is NOT showing books of healthy children under age 6.

In most countries, you will receive a referral of a child, with a photo and brief medical report. If you request additional information, it may or may not be forthcoming. And don't always assume that the information is completely accurate, since many countries simply don't have a Western medical model AND since the children may be rushed through an exam by busy practitioners who are expected to see a whole orphanage of kids in a couple of hours.

Once in a while, an agency will be able to arrange for you to bring a doctor with you. However, don't count on having him/herdo any sort of serious exam before you commit to a child. In some ways, this is an insult to the medical professionals in the country, as if you are saying, "We don't trust you." Now, if you are referred a child who is said to be healthy, but you get to the country and see very clear signs of something fairly significant, such as cerebral palsy, your agency will usually be able to arrange for the child to be seen by a local doctor, who can confirm or dispute your assessment.

Do remember that a "doctor in the family" is not necessarily familiar with adoption medicine. There are lots of things that may scare the bejabbers out of a Western doctor with no experience with internationally adopted kids -- intestinal parasites (VERY common), really weird diagnoses spelled out in the medical records (Russia has some customs regarding medical records that can make a perfectly healthy child sound as if he/she is at death's door -- like "perinatal encephalopathy", sometimes used to indicate that the birthmother was young or had no prenatal care!), developmental delays (very common), and so on.

In addition, when you first meet your child, he/she is likely to be terrified, angry, and emotionally overwhelmed. Many children will seem, to the doctor who hasn't experienced international adoption, to be mentally ill, or even autistic. My daughter was so shut down by shock and grief that she didn't cry, didn't smile, and acted like a robot; it would have been easy to conclude that she was "damaged", and not the amazingly huggy/kissy/smiley child that she turned out to be, three days later.

You simply cannot judge an institutionalized child by Western standards. Adoption professionals will tell you that many kids who have small head circumference, low weight, parasites galore, lots of delays, strange diagnoses in the medical record, and so on turn into amazingly bright and on-target kids when they get some love, nutritious food, and good medical care. Adoption medicine professionals have done a good deal of research, and are in a much better position to tell you if a child seems likely to have a good outcome.

4. Remember that, in any given country, there is bound to be a wide variation among orphanages and foster homes. Some will have adequate food. Some will have enough staff to provide some personal attention. Some will use Western concepts of child socialization. However, others will not. And even in the "better" facilities, there is often no way of knowing whether someone has been molesting or beating children.

Korea has an incredible reputation for good care, and truly makes an effort to put children with foster parents who are screened, trained, and supervised. However, even there, occasional bad things have been discovered.

Most countries are not nearly as prosperous as Korea, and you will find that foster parents and orphanage staff are rarely screened, trained, and supervised the way you would wish, and that there may be simply too few staff and too little money to provide a good experience for kids. However, the kids in these facilities still need loving homes in order to reach their potential. The question is whether a particular parent is up to the challenge.

5. Most countries and most agencies will try to match you with a child whom you can parent. They are not trying to pull the wool over your eyes. But you have to remember that "healthy" is a relative term, when it comes to international adoption. You have to be prepared for many minor issues, ranging from delays to attachment problems to undiagnosed asthma, in a child listed as healthy. And there could even be a major issue, undetected because of limited health resources.

You also have to remember that the older a child is at the time of adoption, the more likely it is that he/she will have been exposed to bad things, either in the home of his/her birthparents, or in foster care or orphanage settings. These could be things like physical, sexual, or emotional abuse; a parent with alcohol or drug problems resulting in neglect of the child; extreme poverty and hunger; death of a parent from violence or a medical issue; and much more.

As a result, you need to expect that an 8 year old could have more issues than a four year old, and that a four year old could have more issues than a one year old. No, there are no guarantees. There are two year olds, even in this country, who have been sexually abused and have long lasting emotional problems as a result, and there are ten year olds who come to adoptive homes and turn out to be amazingly healthy and loving.

The bottom line is that international adoption involves a big leap of faith. It is not easy to make that leap. If you do a lot of reading about international adoption, you'll see some of the risks. However, if you go to adoptive family gatherings, you'll also see some of the rewards! I would really suggest that you do both, so that you truly understand the range of possible experiences.


Sharon