Medical Consultation on International Adoption Referrals

Coming to the decision to adopt internationally starts an unforgettable journey. For many families, adopting internationally will be the biggest event of their lives leading to the fulfillment of having a child and completing their dreams of a family. While this process can lead to your success it is not always easy and has risks associated with it. One of the risks of international adoption is to understand why children become available for adoption. The number one reason for availability is poverty. With poverty comes health risk. I do not mean to say that all children are unhealthy, but mean to identify that a primary issue to plan for in your international adoption is how to assess and screen for health issues. While educating yourself is the first step in health assessment, selecting an internationally experienced physician for consultation is the most important step.

Since health risk is the most significant risk factor for any international adoption, being able to obtain medical information on the child and having this information accurately interpreted is essential. Using a typical Russian adoption as our model for discussion, a family would either receive a medical excerpt prior to traveling or would be allowed to review the referral child’s medical records during the first trip to meet the child. The medicals are written in Russian and require translation. Translation of medical records can be complicated and can possibly contain errors that an inexperienced person may not recognize. Additionally, the Russian medical system is not the same as the United States system. One example is in diagnosing. Anyone familiar with Russian medicals knows that the Russian physicians are often more harsh and critical medically and they offer diagnoses that sometimes have no substantiation. In contrast, a US physician will usually only diagnose when there is substantiating evidence to support the diagnosis.

Early in our adoption experience at Adoption Options, Inc. we would bring older children to the US through our Cherry Orchard program as a host program. These children were from 5 years of age to 12 years of age. They would stay with host families and be afforded the opportunity to meet potential adoptive parents. As part of this program we would arrange for the children to be medically evaluated. During one particular program, we arranged with the director of pediatrics of a university teaching hospital to evaluate the children using his residents. He had extensive international experience. The evaluations consisted of reviewing the medical excerpts provided by the Russian authorities and doing a cursory physical exam of each of the children. At the end of the evaluations this physician invited us to attend a teaching conference with the evaluating residents where he had each resident present their findings. The striking outcome was that after each presentation he informed each of the residents as to the errors of their conclusions based upon his international experience. The lesson to learn was that families not only needed a medical evaluation but one done by a physician that had international experience.

Fortunately for adoptive families there are a number of physicians and clinics throughout the US that are competent and offer helpful evaluations. You can locate these services by asking your local adoption agency, your placement agency, your local country specific support group, or by an internet search. The services offered vary greatly, so talking with families that have already used these services can be very helpful. Depending upon the country that you are doing your international adoption through you may be able to arrange for an independent adoption doctor to evaluate on site during your first trip.

Screening for health issues is absolutely essential with international adoptions. There are costs associated with the evaluations but this is not something anyone should ever try to shortcut. Adopting children internationally is a viable way to complete your family but it does require being prepared.

Brent E Yoder, LCSW
Executive Director