Easing the Transition from Orphanhood

Photo from haitiorphansproject.org

Photo from haitiorphansproject.org

One of the unfathomably tragic numbers to come from last week’s earthquake in Haiti last week is the estimate about the number of orphans the disaster created. As many as tens of thousands of children may have been orphaned by the earthquake, according to United Nations estimates, a total that becomes even more shocking when it’s added to the approximately 380,000 orphaned children in the country before last week’s disaster. Some efforts have sprung up quickly to try and find homes for these children, but so far it’s only a trickle, restricted both by logistical difficulties from the earthquake and pre-existing legal obstacles to international adoption.

That real-time crisis lingered over a timely event held Saturday at Comer Children’s Hospital on the University of Chicago Medical Center campus. Organized by the hospital’s International Adoption Clinic as an informational and networking session for about a dozen families who have adopted or are on the verge of adoption, presentations and conversations kept veering back to the topic of Haiti.

“It’s hard today not to talk about international adoption and at the same time keep those images of Haiti out of your head,” clinic founder Larry Gray, assistant professor of pediatrics, told the room at the start of the event. “It’s sort of overwhelming at times.”

The International Adoption Clinic, which started in 2002, was set up to help children from countries such as the Ukraine, Ethiopia and China medically and developmentally transition to a new life with a new family. Gray and nurse practitioner Linda Walsh screen newly adopted children for a wide range of diseases and conditions that can be brought on by living in poverty or an overcrowded orphanage, directing them toward the treatment they need to recover. Many of the children are literally shrunken by the stressful environment they endured, charting as significantly shorter (stunting) or less heavy (wasting) than other children their age. In extreme cases, the child’s brain will even shrink from malnourishment, a condition called microencephaly.

Finding and addressing the causes of these medical issues requires extensive screening, Gray said.

“We think that to pull out a successful adoption transition, it needs to be a very multi-focused effort,” Gray said. “When a family arrives in the United States, it’s just the beginning of a network of processes that come into play.”

Gray, a developmental pediatrician, can assess how far the child has developed both physically and mentally relative to their age – though as he pointed out, every developmental curve is different, even for non-adopted children. Walsh, who has vast experience treating patients with HIV, is familiar with the sometimes unusual conditions that children can carry with them thousands of miles from their original home. The clinic has become a favorite of the hospital’s laboratory, she said, because of the rare parasites and diseases they test for with newly adopted children. After the initial screen, University of Chicago doctors can continue caring for any chronic diseases (such as HIV) that the children carry, or direct them to clinics familiar with such conditions closer to their adoptive home.

The legal and medical hurdles surrounding adopting children with HIV were also a common topic of discussion at the event. Carolyn Twietmeyer, whose family has adopted four children from Ethiopia, launched her organization Project Hopeful after learning of the tremendous obstacles to bringing an HIV-infected child into the United States. Though her organization’s efforts have made it considerably easier to adopt HIV-infected children (8 such adoptions in 2007 bloomed to 150 in 2009), medical and social issues surrounding children with the disease remain, a subject addressed by Walsh and associate professor of psychiatry and pediatrics Scott Hunter.

But amid all of the immediate and far-away concerns, there was an optimistic thread – research and the anecdotal evidence of those in the room both indicate that even children rescued from unspeakably tragic conditions can rebound once placed in a new, healthier environment. Gray showed pictures of an Ethiopian infant, abnormally small for his age and clenching his fist in the tightly-wound gesture revealing a stress no child that young should feel. But two years after his adoption, the child was back within the normal range of height and weight for his age, and was pictured smiling and care-free on the back of his adoptive father. No special therapies are required for this remarkably recovery, Gray said; the “ordinary miracles” of living a normal life in a loving environment can sometimes be enough.

“I was watching those pictures of Haiti, and grappling with that horrible tragedy and thinking about resiliency,” Gray said. “Some kids who are exposed to an enormous amount of adversity turn out just fine…some kids can weather the storm very well.”

About Rob Mitchum (526 Articles)
Rob Mitchum is communications manager at the Computation Institute, a joint initiative between The University of Chicago and Argonne National Laboratory.
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