Before They Are in Your Arms
The children in China’s orphanage system are there because of a variety of complex issues, such as poverty, poor access to education and health care, government policies and cultural beliefs. An abandoned child is placed under the legal guardianship of the state, which means that after an unsuccessful search for the birth parents, the child is placed in a state-run orphanage.  Because these children are abandoned, information on their birth family is not available.  Most orphanages raise the children in a group-care setting; however, some orphanages place the children in foster care. 

Whether in group care or foster care, CCAI has a positive impression of most orphanages and foster homes and the care that the children receive.  The orphanages and their staff seem to work hard with their limited resources to care for the children.  As China’s economy has grown in recent years, we also see steady improvement in the quality of care orphanage children receive.

Your Child’s Health
A China Center of Adoption Affairs-designated hospital will conduct a general physical exam on your child while in the orphanage.  This exam will be forwarded to the CCAA along with other documents as part of your child’s profile.  The physical exam covers weight, height, condition of limbs, eyes, ears, nose, teeth, heart, liver, spleen, spine, nervous system, genital system, etc…  The child is also given a chest X-ray, hepatitis B test, complete blood count and HIV test.  The CCAA does not match parents with children who have tested positive for HIV.  The US national average of Hepatitis B among adopted Chinese children is 3.5 percent.  Among the children placed through CCAI, 18 have tested positive after returning to the US, representing only 0.2 percent of our children.  CCAI has never placed a child who has tested positive for AIDS after their return to the US. Additionally, tuberculosis can still be found in China.  However, today in China there is a 70 percent case detection rate and an 85 percent treatment rate.  There have been a small percentage of children who tested positive for PPD/TINE when they arrived home and were treated with oral medication monitored by the Health Department.  (Fewer than 10 percent were diagnosed with latent TB, as the BCG vaccine is still given at birth in China, and fewer than one child in 1,000 has confirmed TB.)

While every approved family qualifies for a child with no known medical conditions, children with special needs or correctable medical conditions are also available for adoption, if desired.  Through the Waiting Child Program, CCAI has placed children with cleft lip and palate, heart disease, hepatitis B, limb differences, vision/hearing issues, albinism and other special needs.

Your Child Match
Usually the CCAA mails matches to agencies once a month.  The so called match-packet for a family requesting a child with no known medical condition includes three color pictures of one child matched to you by CCAA and a variety of forms: a complete Physical Examination, the State of Growth, the Developmental Report, the Immunization Record, and a CCAA’s Letter Seeking Confirmation (acceptance or rejection). CCAI confirms and translates the physical exam and sends the whole packet to you.  After the match, we always request updated pictures and physical information on your child.  If you request a child with medical condition, you will receive more medical information.  Different from the non-special need child-match process, you will be matched with a specific child by CCAI’s Waiting Child Department according to your request stated in your Medical Condition Checklist.

When You Meet For the First Time
Abandoned children must be at a certain level of health to be eligible for international adoption.  CCAI wants families to have a realistic expectation of their adoptive child and what their first few weeks together may be like.  It’s important to remember that because an orphanage is not a home, these children may have physical or mental developmental delays, malnutrition, colds, rashes, bug bites, parasites, higher levels of lead, effects of water/air pollution, etc.  For more information on known health risks in China, please visit the World Health Organization’s website at www.who.int.  Despite these issues, most children have had their basic needs met and will flourish once they become part of your family.  We recommend you contact some of our reference parents to discuss their personal experiences.