[amyfk]

Hi to the List,

I am starting to research China. My husband and I were in the Russia program and we're bailing because all of the referrals we got with our agency had either VD or Hep on them. We are not comfortable with that.

What kinds of health issues can we expect in a Chinese adopted child? How do the agencies work-is there a track for waiting children with special needs and non special needs kids-and you choose the track you want to go down? Does one fill out a list on signing on with an agency about what medical conditions that one is willing to accept?

Thanks in advance,
Amy K NJ

[Teekay74]

Hi Amy- You do basically choose which path to go down. But I think it's important to remember that any child may have some sn down the road. The nsn children in China seem to pretty healthy which is one of the many reasons we chose China. The mothers tend to take good care of themselves. Many of these children are living in orphanages. So they may have some delays, infections, and malnutrtion problems. All of these things should improve quickly once placed with a family. All the children are tested for HEP B, but I've been told it can show up later. If you choose the SN program, w/ my agency you submit a medical checklist and they match when a referal comes in that matches your request. Bottom line- in NSN program- you will be referd a child w/ no KNOWN medical conditions. Hope this helps some.

[amyfk]

Dear Tina

Thanks very much. I appreciate your feedback. I really dont know what to expect with the China program.

Amy K, NJ

[SofiasMom]

for more info on the China program, go to the Families with Children from China website www.fwcc.org

[amyfk]

thanks sofia's mom
Amy K, NJ

[lovemybulldog]

Amy,


I just sent you a PM with some info before I saw your post here. I would like to add that my experience with my agency is this:

We asked to enter the program asking for a boy 18-36 months at time of referral (we've since changed it to 18 months to 4 years based on a personal choice..not agency suggestion), but asked if we can actively watch the SN lists and switch if that's something we want to pursue later, during the process. That was no problem with them. 99% of the paperwork is the same, so changing to SN later shouldn't be an issue. If it is for your agency, ask why. They should be flexible with your needs and requirements.

[amyfk]

Dear Steph

Thanks very much for getting back to me. I appreciate it.

Amy K NJ

[sak9645]

Amy,

You can pursue China adoption in one of three ways.

First, you can go the usual route. You can make sure that your homestudy approves you for an infant or toddler who has no known special needs, other than normal orphanage delays and medical issues. You can also mention that you want an infant or toddler with no known special needs in the letter to China that is included in your dossier. Once you have your completed dossier, your agency will send it to China. When your group comes up for matching, you will be assigned a child who is considered NSN and who is in the 6 mo. to 2 yr. age range. You should have the referral reviewed by a pediatrician and/or an adoption medicine specialist to make sure that nothing in the medical report suggests that China made a mistake and referred you a child with a special need, such as Hep. B chronic carrier status. If there is a mistake, China will refer you a different child, but this is a pretty rare situation.

Second, you can decide that there are certain special needs you will accept -- for example, a child with an extra finger or toe, a child with a club foot, a child with a prominent birthmark, a child with a cleft palate, etc. You can have your homestudy approve you for these conditions. You can also mention these conditions in your letter to China. When your dossier is completed, it will be sent to China, just as it would be for the NSN people. China will then match you with a child that meets your requirements, if one is available. It such a child isn't available, you may be matched with a child with no special need. As always, you should have the referral reviewed by doctors, and you may reject it if the problems clearly go beyond the special needs you requested. But some families find that, by going this route, they actually get a child who is as healthy as or healthier than any NSN child, and whose needs are very mild.

Third, you can go through the Waiting Child program. China has designated some children as hard to place. These children may be infants and toddlers with special needs, or they may be older children (up to 13) with no medical issues at all (though there may be some significant issues involved with a long stay in an orphanage). When the children have special needs, they may be very minor or clearly significant.

With the Waiting Child program, China gives lists of children to agencies chosen to participate. Each agency gets a different list. The agency is then given three months or so to find suitable families for the children. If they find a suitable family, they first ask the CCAA to indicate preapproval. Then, if preapproval is given, they have the family submit a dossier, which gets expedited review. If all is well, the family waits for travel approval and goes to get the child. The process can be considerably shorter than either of the previous two routes to China adoption.

If you want to participate in the Waiting Child program, you should get a list of the agencies that participate -- I think there's one on APC -- and request their latest Waiting Child lists. You can then look at the information on each child, which will include a photo, some medical facts, and some other information, to see if there are any children you think you can parent.

If you find a child on a list, whom you think you could parent, you should let the agency representing him/her know. If there are several families interested in the child, which is likely in the case of infants and toddlers with fairly minor needs, the agency will select the one it deems best equipped to parent the child.

If you are selected, the agency will request preapproval from China, based on some general information. If you get preapproved, you will submit a dossier. If there are no new facts in the dossier, which cause the CCAA to view you more negatively, you will officially be referred the child. You will then wait for travel approval, and then travel to adopt the child.

Many people really love the Waiting Child program, because they feel more in control of the process. They can actually select a child. Many people also like the program because some of the Waiting Children have surprisingly minor needs, such as a large birthmark that can be lightened with a laser, or an already corrected heart problem.

I hope this helps.


Sharon

[amyfk]

Dear Sharon

Thanks for all of your help. Your knowledge is really appreciated around here.

Sincerely,
Amy K, NJ

[sak9645]

Amy, you have explored many countries by now. I think, by now, that you have learned one thing, which is that international adoption takes a leap of faith.

Yes, giving birth involves a leap of faith, too. But adoption in general, and international adoption in particular, must be considered as having more risks.

Health risks are, in particular, an issue for all internationally adopted children. And when the birthparents are unknown, as they are with most Chinese children, the risks are increased.

With China, you will not know whether there are any diseases in the birthparents' family, which could manifest themselves in your child, sooner or later. For example, you won't know if there is a history of schizophrenia, ovarian cancer, or stroke. Your child could appear to be perfectly healthy now, but could have trouble anywhere from several years from now to when she is older.

With China, you will not know under what conditions your child was born. You will not know whether her birthmother had decent nutrition during pregnancy, drank during pregnancy, got prenatal care, or delivered in a hospital. You will not know the Apgar score. In most cases, problems will be noticeable before referral, and a child with such problems will be listed as having special needs, but as you know from Russia, there are conditions like FAS/FAE that may not show up until a child is of school age.

You will not know, with China, if the child spent any significant period of time with his/her birthparents, whether they were loving or abusive. My daughter was apparently with her birth family for the first 9.5 months of her life, and having observed her over the past nine YEARS, I am convinced that she got her huggy/kissy/smiley nature both genetically and from their loving example during that period. But some families have come to suspect an abusive or neglectful situation.

With China, you will not know, for sure, what conditions in the orphanage or foster family were like. Orphanages and foster care are no substitutes for a permanent family, but some are simply better than others. Orphanages overseas often can't afford to hire the best caregivers, and child abuse is not unknown; foster parents, too, can be abusive or neglectful or only in it for the money. And even when there is no neglect or abuse, a lack of resources and training can mean that children are underfed, given little opportunity for physical activity and socialization, and given little love and intellectual stimulation. Fortunately, children tend to be resilient, but some children WILL come home with problems that need fairly significant therapy, even if they are technically considered healthy.

You will not know, for sure, how well the staff who write up a child's file know that child. Chinese referral documents, these days, are full of statements like, "Loves to eat" and "Loves music." Occasionally, they seem to be pulled from a list, rather than being based on careful observation, although many are very on-target.

And, with China, you will not know for sure if a staffer, acting in what he/she believes to be the best interest of a child, "fudges" his/her health status a bit to get him/her into a good family. The medicals won't be fudged, but a staffer could simply fail to indicate his/her concerns about a child's speech delays or inability to use her left arm well, and a busy doctor may fail to pick up on the problem without such input. There HAVE been occasional children, who were listed as healthy, but who had conditions that should have been clear to the staff and doctors, such as autism.

What I'm trying to say is that you have spent a long time analyzing country after country, without bringing home a child. I know that some of the reasons relate to changes in the countries, and to problems with agencies. But I wonder if you have really searched your heart and come to terms with the leap of faith required for international adoption.

It's a big leap. No one would blame you for having trouble with making it. Many families have turned away from international adoption, and gone to domestic adoption, assisted reproduction, surrogacy, and even child-free living, because they concluded that the risks were too great.

I also wonder if you feel that some countries are simply all-around "better" than others, and if you are searching for an ideal country. If so, I must tell you that there is no ideal country. Risks, not just medical, but also those involved with the process, exist with every country. What matters is choosing among the risks that you will accept.

China is currently stable, but it seems to be moving in the direction of more strict requirements for families, because it is clear that the country can attract married, healthy, young couples to parent its abandoned children. It is also about to implement the Hague Convention, which could cause some process changes.

No one expects the changes to be huge or systemic. But nobody expected huge and systemic changes back in 1996, either, just four years after China passed its adoption law and set up its international adoption process. Yet one month after my dossier went to China, the country announced a huge reorganization of its adoption system! The Ministry of Justice was removed from the process of receiving and reviewing dossiers, and making matches.

I had met the head of the adoption unit at Justice when she visited the U.S., and my dossier was in Justice when the change was announced. A process that was supposed to have been clear cut, and to have resulted in referrals in 2-3 months was totally changed. My adoption actually happened 13 months after my DTC date.

So there are leaps of faith to be made, even on non-medical issues. During my long wait, one couple in my group "jumped ship" and opted for Korea. I was counseled repeatedly to look at Vietnam and other countries. But I had already made the leap of faith that I could deal with the unknowns of abandonment and China's rather sketchy medicals. And I decided that I could deal with the unknown time frame, and with the uncertainties about the way the new CCAA would look at me, an older, single woman.

For me, the risks and the leaps of faith were worth the reward. I have the child of my dreams. But no one can promise you the same happy ending, so you will have to decide for yourself whether you can relinquish control, shut your eyes, and jump -- whether to China, Russia, Armenia, or someplace else.

I continue to wish you the best of luck in finding the child of your dreams.

Sharon

[SofiasMom]

Amy, as stated above you pick the track you want to go down. That being said, children who are listed as NSN sometimes do have issues that might not be known about right away. From my travel group and friends who adopted, their children have been diagnosed with Cerebral Palsy (my daughter), deafness, TB, attachment issues, learning disabilities etc.