Most children adopted from China are abandoned children, which means that after an unsuccessful search for the birth parents, a child is placed in an orphanage under the legal guardianship of the state. 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.
A CCCWA-designated hospital will conduct a general physical exam on your child while in the orphanage. This exam will be forwarded to the CCCWA along with other documents as part of your child’s profile. The physical exam includes a hepatitis B test, complete blood count and HIV test. 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 0.1 percent of our children. 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.)
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.
Adopting a child with a pre-identified medical condition(s) or an older child could be one of the most important and life-changing decisions you will ever make. Therefore, we highly encourage you to do comprehensive research on the special need(s) you are considering and thoroughly contemplate the issues that may be related to adopting an older child. Families should also consult with medical professionals, as well as their social worker, before making their final decision to accept a child in the Waiting Child Program.
Ask yourself:
- Why have you decided to consider a child with a medical condition? If a shortened timeline is your main motivation to consider the Waiting Child Program, this probably isn’t the best program for your family.
- What do you understand about the condition(s) you are open to? What research have you done and with whom have you consulted?
- Have you considered that there may be undiagnosed medical conditions with your Waiting Child that may not be known until after the adoption?
- How have you prepared to adopt an older child who may have spent several months or years of his/her life in an orphanage?
- When considering what age range you desire, have you thought about the ages of children currently in your home? CCAI has no stipulations regarding “virtual twinning” or breaking birth order, but how might this work in your family?
- Do you know what your medical insurance policy will cover for a pre-existing condition? Think about surgery, therapy, co-pays, etc.
- What resources are available in your area? What kind of a support system would you have for this adoption?