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Russia Curtails American Adoptions

Working on Overhaul, Russia Halts Adoption Applications

By Lynette Clemetson

Reprinted from The New York Times April 12, 2007

Americans wishing to adopt from Russia may face an indefinite wait. The country has temporarily stopped accepting new applications from American adoption agencies as part of an overhaul of its accreditation process.

Over the last several months, licenses to work in Russia have expired for most of the roughly 50 American adoption agencies with programs there. Licenses for the last two agencies, the Alliance for Children in Wellesley, Mass., and Children of the World Adoption Agency, in Syosset, N.Y., expired yesterday.

Many adoption officials say the expirations represent nothing more than a slow-moving bureaucratic process. The officials added that they expected new licenses to be approved within months.

Last year, according to State Department figures, Americans adopted 3,706 Russian children, making Russia the third most popular destination for overseas adoptions, after China and Guatemala. It is one of several countries revising its international adoption procedures.

China will tighten its requirements in May. Among the many restrictions, it will no longer approve adoptions for applicants older than 50.

Guatemala is revising its procedures to comply with the Hague Convention on Intercountry Adoptions, a treaty to regulate international adoptions that the United States plans to ratify this year.

“What is happening in Russia is part of a fundamental restructuring of international adoption across several countries,” said Adam Pertman, executive director of the Evan B. Donaldson Adoption Institute, an adoption research and advocacy organization. “In most of the countries involved, the changes are part of a widespread change in global practices to protect children, and that is a good thing in the long term.”

Tom DiFilipo, president of the Joint Council on International Children’s Services, a membership organization for international adoption agencies, said people hoping to adopt from Russia should not be alarmed.

“Whenever there is a bureaucratic delay, children suffer, children stay in orphanages longer, and that is where our concern is,” Mr. DiFilipo said. “But families should not panic. This is a delay. This is not a moratorium.”

Tensions within Russia over international adoptions have intensified in recent years after several widely publicized cases of neglect, abuse and death of Russian adoptees by American parents.

Georgia and Tom Aralis, of Mount Prospect, Ill., adopted their 2 year-old son, Demetri, from Russia last June, and they are scheduled to return to Russia this month to adopt another son, Daniel. Ms. Aralis, 36, said that the judge who handled their first adoption raised the abuse cases at their hearing.

“He asked us outright how we were going to treat the child, how we were going to discipline the child, because they knew of abuses of Russian children in the United States,” she said. “But that was a fair question. We got no impression that they did not want Americans to be adopting.”

Putin Signs Decree on Adoption!

Foreigners Face New Hurdles to Adoptions

By Charles Diggs-Staff Writer

Reprinted from the Moscow Times Saturday, April 8, 2000

President-elect Vladimir Putin this week signed a series of decrees aimed at tightening control on adoptions, fanning fears that it may become more difficult for foreigners to adopt Russian children.

The decrees outlaw the use of "middlemen" but do not define whom is considered a middleman. Government officials othen complain that intermediaries facilitate adoptions for foreigners by paying bribes to orphanages and bureaucrats.

The decrees also announced a new year-long accreditation process for foreign adoption agencies. It was unclear whether agencies already registered in Russia would have to register again under the new decree.

Karen Stager, Director of the Maine Adoption Placement Services, which in 1991 became the first agency to ever facilitate the adoption of a Russian child by an American family, said she feared the new policies could lead to harrassment of foreign adoption agencies. "Without a concrete idea of what a middleman is, agencies operating legally in Russia could become targets," she said in a telephone interview.

Adoptions will be overseen by a special government commission headed by Education Minister Vladimir Filippov. But it was unclear who exactly would deal with potential adoptive parents, since officials who work with orphans are specifically banned from acting as "intermediaries."

"Anyone working for an agency could be a 'middleman' in a situation like this," Stager said. Once accredited under the new system, adoption agencies will be responsible for reporting back to the Education Ministry about the welfare of the children they have helped place in homes abroad.

"They are still Russian citizens after all," said one Education Ministry official in a telephone interview, who declined to give his name. While most observers applauded efforts to defend children, many expressed concerns that the decrees were passed out of nationalist sentiments and not out of concern for Russia's more than 620,000 orphans.

"I fear there is an ideological, patriotic tone in these decrees that overshadows any benefits for orphans," said Boris Altshuler, head of the Moscow-based organization Right of the Child. Nikolai Petrov, a political analyst at the Moscow Carnegie Center, agreed that the decrees were part of a general anti-Western mood.

"Our orphans may live in horrible abject poverty, but they are our orphans, and we don't need any help in taking care of them. That is the nationalist message the government wants to send," Petrov said.

Galina Tishnitskaya, head of the Education Ministry department that deals with orphans, bristled at such a suggestion. "Why would we want to deprive a Russian child of a good home abroad?" she snapped. The problem, she said, is that Russian families wanting to adopt children are often passed over because foreigners can afford to pay bribes. But Altshuler said he doubted there were enough Russian families to take the place of foreigners, should they be excluded from adopting Russian children.

"It's admirable that the president wants to bring order to the system, but in the end I don't think it's going to help the children," he said.

What It All Means

A Report by Cynthia Teeters-Eastern European Adoption Coalition, Inc.

I received the following from a trusted source who spoke to the Russian Ministry of Education today. While there is no guarantedd that this information is or will remain valid, I hope that those of you who are in the process will take it as a starting point for speaking with your agency.
  • On May 10, accreditation within Russia of adoption agencies will begin.

  • Referrals which have been accepted but have not been completed will be honored by the Russian government.

  • After accreditation begins those families wishing to adopt from Russia will be required to make two trips (we do not know if this requires only one or both spouses.) The first trip will be used to identify a child. The second trip will be used to complete the adoption. Please understand that there are many unkowns about this two-trip process but we do have region(s) within Russia operating this way.

Accreditation of agencies by Russia may (?) require the following:
  • Proof of 5 years or more working in the field of adoption.

  • Proof of non-profit status with copies of By-laws and tax exempt status.

  • Copy of state license.

  • List of services provided to adoptive parents.

  • Proof of preparation of parents to adopt from Russia.

  • List of agency representatives operating in Russia.

  • Annual report to Ministry of Education.

The accreditation process will be controlled by a committee of the following Russian ministries:
  • Ministry of Education-Head of the Committee
  • Ministry of Health
  • Ministry of Foreign Affairs
  • Mininstry of Justice
  • Ministry of Social Work
  • Accreditation will be good for one year and then would have to be renewed.
  • Please remember that this information comes from a trusted source but that during times of transition it may become difficult to get the "definitive" word.

If you are in the process right now, it is easy to get nervous over this information. As long-time agency personnel can agree, we have previously seen changes in Russian law and process which required families to adjust. These types of time are always tough. My source says there is no talk of a moratorium and that parents who accepted referrals will be allowed to complete the adoption.

New Russian Law

Commentary by Lynn Wetterberg-Executive Director-Uniting Families Foundation

We were told that the new regulations had been posted(published) and that the new regulations were to go into effect on April 20th. The new regulations came as a result of the legislation that was passed two years ago. Now that we finally have the regulations, we know a little more, but the implementation of them leaves all of us, agencies, State Department and families, with more questions than answers. No one knows what will happen in the weeks ahead. The regulations state that once an agency applies for accreditation, the Committee will have three months in which to investigate and rule on the application. At this point, however, there is no office for the Committee and no application forms or procedures in place. When will this be in place? None of us know. We also do not know what will happen with adoptions during the time that agencies are applying for their accreditation. The State Department representative we spoke to felt that adoptions in process would be allowed to be completed. We can hope that he is correct in his assumptions. Some agencies have heard of slow downs, some have heard moratorium and some have heard that two trips will be necessary as families wil have to travel to identify their children personally. There are a lot of RUMORS but no answers for any of us yet. And, as is typical in Russia things will probably vary from region to region.

PLEASE DO NOT PANIC! (emphasis ours). Do not blame your agencies for not answering your questions. We have no answers to give you. I am certain that every agency will do all they can to inform their families as soon as we have some concrete information to give you. Until then please be patient and try not to over react. We will ALL be holding our breath until we know how the regulations will be interpreted and implemented. We should not, however, make projections that are not based on fact. This will drive all of us crazy. Hopefully within the next few weeks we will have a much better handle on the situation. Now we can only hope, and wait, and pray...

The Hope for Children Act

By now most of you have heard of the this act (H.R. 531/S.341), sponsored by Representative Tom Bliley (R-VA) and Senator Larry Craig (R-ID). It increases the adoption tax credit for each adoption to $10,000. Present law provides for a $5,000 tax credit for a child who has special needs. The act is pending before the House Ways and Means Committee. Families or others who support this bill should contact their representatives and ask them if they have signed on as co-sponsors of this important legislation.

The Adopted Orphans Citizenship Act

This bill passed the Senate and went to the House of Representatives last fall. In February, a House Judiciary Subcommittee on Immigration and Claims met and reported that there was major opposition by the State Department and INS(Immigration and Naturalization Service). A modified bill was introduced. If enacted, this bill would simplify the current process by which adopted children of US citizens acquire citizenship. Adopted children are entitled to the same treatment as biological children, under the law and in practice. In this legislation, the requirements which adoptive parents must satisfy in order to pass on US citizenship to their foreign-born children are equivalent to those applicable to a US citizen whose biological child was born overseas. Please join Joint Council in support of this much-needed legislation.

Webmeister's Featured Article

Unfortunately PC Week On-line, now e-Week On-line, will not let us reprint Stan Gibson's interesting article on Russia and Information Technology. If you are interested in reading this article please Click Here.

"...And You Think Putin's Going to Be Interesting?"

According to a recent Washington Post article Vladimir Zhirinovsky, Russian ultra-nationalist and all-around sweetheart sees computer viruses as a useful tool for Russian foreign policy and a way to divert attention away from the ongoing war in Chechnya. "We can bring the entire West to its knees with our Russian computer specialists," the Post quotes Zhirinovsky as saying. "Let us put our viruses into their secret programs like we did recently and they will not be able to do anything."

"Its time to put an end to the news focusing on Chechnya. It must be closed down as a combat spot, and we must track computer viruses more. Thanks to us, the West will soon suffer enormous losses."

Did anybody tell Vlad that the ILoveYou virus came from the Philippines and not St. Petersburg?

More Technology Hype From Russia

Zapersky, a Russian IT developer, uses scare tactics about imaginary viruses to scare public. Read about it at eweek.com.

Justice Enables Oregon To Grant Adoptees Access To Birth Records

From Tribune News Services

Perhaps Geena Stonum's birth parents aren't even alive. Or maybe they'd rather that she stay away from them. But as of Wednesday, state law is no longer keeping this adoptee--and thousands more--from finding out their true parents' identities.

"I have a wonderful family, but there's still that piece that's missing," said the 41-year-old Stonum, a mother of two. "When you see people who maybe look like you, you wonder if they're maybe related to you."

On Tuesday, Supreme Court Justice Sandra Day O'Connor rejected an emergency request to delay Oregon's 1998 adoption records law from going into effect.

That ended two years of court battles started by a group of birth mothers who argued the new law violates the privacy of people like themselves who gave up their children for adoption and started new lives.

The Oregon Health Division on Wednesday will begin processing applications of more than 2,200 adoptees who already have paid $15 to get their original birth certificates. Most are eager to know their parents' identities, and many want to know more about their medical histories. It could take up to six weeks to finish mailing certificates to adoptees, the agency said.

While adoptees eagerly anticipated the chance to learn about their past, Frank Hunsaker, attorney for a group of six anonymous birth mothers who had fought the law, was bitter about the removal of the last legal roadblock.

"My clients are extremely disappointed and scared and even angry that their rights have been ignored by Oregon's voters and Oregon's courts," Hunsaker said.

He said the adoption law, which gives adult adoptees access to their original birth certificates, violates an implied contract the women thought they had that their identities would be protected and that they would never be contacted by the children they relinquished.

There are some birth mothers "who haven't even told spouses or family members" that years ago they gave birth to children they gave up for adoption, Hunsaker said.

The law first was approved by Oregon voters in November 1998 after a campaign in which adoptees said that finding their birth parents could help detect potential health problems and, more important, give them a sense of identity.

Last week, a state appellate court refused to extend an earlier stay blocking the law from taking effect, leaving the U.S. Supreme Court as the only option for opponents.

O'Connor, who fields emergency matters from Oregon for the nation's highest court, rejected the six anonymous birth mothers' request to stay the law.

In 1997, the U.S. Supreme Court refused to review a similar open adoption records law from Tennessee.

Tennessee and just three other states--Alaska, Delaware and Kansas--allow adult adoptees access to original birth certificates, which often have birth parents' names. An adoption records bill in Alabama is awaiting the governor's signature.

Stonum, who's been searching for her birth parents on and off for 20 years, said she was giddy when she learned that O'Connor had cleared the way for Oregon's law to take effect.

"I still might not find her," Stonum said of her birth mother. "There's still so many things here that could be dead ends, but I'm just really excited."

The birth mothers who brought the case have not been identified publicly.

One birth mother, named "Mary," wrote in a letter to The Oregonian earlier this year that she was horrified by the law.

"Soon, for $15, the state may simply hand over your identity to the adult you placed for adoption as an infant 21-plus years ago," she wrote. "In a few days, the very promises we built our lives upon may be up for sale."

Russian Medical Reports: Terminology

By Eric Downing, MD

Frequently prospective adoptive parents (and their advising physicians) are stunned by the arrival of a Russian medical report describing the child that has been referred to them. The information seems to be at odds with what their agency has told them, previous information received about the child, and even the evidence of their own eyes if they have seen videos.

Why Russian Medical Reports Are The Way They Are

It is sometimes said that diagnoses are exaggerated because only unhealthy children may be adopted or to increase the funding available to the orphanage. In my experience this is simply not the case, physicians in Russia believe what they are writing.

The major difficulty with interpreting these reports stems from some particularities of the Russian medical system. Russian physicians practice medicine differently from the physicians with whom you are familiar. Diagnostic categories are different, concepts of pathophysiology are different, methods of assessment are different, the psychology of physicians is different, etc. Even within the same field, the lack of formal standardized certification and postgraduate training makes specialists at times seem to speak different dialects.

An example of differences is pediatric neurology which is a relatively rare specialty in North America. In the west these physicians are quite highly trained and experienced. In Russia, however, it is quite a common specialty. This is a result of a very strong trend to sub-specialization in the Russian system. Russian patients have come to expect to see a series of sub-specialists for their health care.

In pediatric care, Russian parents believe it is necessary for their child to see a pediatric neurologist regularly in the first year of life (not to mention the general pediatrician, pediatric orthopedic physician, pediatric ophthalmologist, and pediatric surgeon, etc.) The pediatric neurologist performs the examination and developmental assessment that in western countries would normally be performed by a Family Physician or Pediatrician. Moreover, the result of this consultation is usually a number of diagnoses rather than detailed history and description of physical findings. The diagnoses of a specialist in Russia is rarely questioned by another physician of a different specialty. (This is a psychological feature of Russian medicine).

The usual training of a pediatric neurologist is about two years after medical school. They perform the assessments mentioned above with some odd twists. Due to years of intellectual isolation, Russian physicians have different concepts of pathophysiology and treatment. Diagnostic terms and therapy are often different from those found in western medicine.

It is very important to obtain good medical reports, but they are very difficult to interpret. Usually there are vague, but rather alarming references to CNS diagnoses such as perinatal encephalopathy, pyramidal insufficiency, etc. Usually there is no associated historical or examination data.

Suggested approach to the Medical Reports:

  1. Gather the facts - information about the pregnancy and delivery, prematurity, numbers and dates (i.e. growth measurements), specific illnesses and diagnoses, specific physical findings, specific lab results and other investigations, developmental milestones.

  2. Weigh the facts - Lab results may be unreliable, cranial sonograms are usually over interpreted. Consultant's reports may consist of little more than a series of unsupported and unusual diagnoses. The amount of reliable information available may not be great, so it is better to determine what is trustworthy and interpret this carefully.

  3. Integrate other sources of information -Videos are important if available, information and observations of the child by a trusted agency representative are important, etc.

  4. Obtain a professional opinion - reports must be interpreted in context, but do not forget that while over diagnosis is common, under diagnosis can be a more serious problem.

  5. Request more information if necessary - If yellow flags are apparent in the medical report, now is the opportunity to follow them up. At the same time, vague requests to agencies for more medical information usually yield only a greater volume of worthless material. Consult with your medical advisor and make any requests for further information focussed and realistic. (I have seen apparent problems evaporate by a simple request for repeat head measurements). Remember also that your agency must advocate for two clients. The child is also a client whether they pay the fees or not. Responsible agencies make all efforts to serve both child and prospective parent. Though nerves can become frayed, it is never the case that a reputable agency will intentionally mislead prospective parents.

  6. Know yourself and your family - Some prospective parents are willing to accept more uncertainty than others. Some have different expectations. Exploration of these issues is an important part of pre-adoption counseling.

Dr. Vsevolod Rybchonok is a Moscow physician who has seen numerous children for adoption examinations in the last five years. He comments that in his experience some common causes of difficulty in obtaining valid medical information are:

  • illegibility of hand-written original Russian medical record or its photocopy
  • frequent errors in translation or acquisition of data
  • errors in converting from metric system
  • lack of such important data as date of report, current anthropometric measurements, and description how is child doing currently in term of his development
  • improper interpretation of the record by translator
  • lack of standard protocols and even terminology within given medical specialties
  • frequent non adequate addressing of minor congenital abnormalities (skin tag around the ear, great toe malposition etc.)
  • unclear current status
  • failure to demonstrate how one or another diagnosis has been confirmed

Perinatal Encephalopathy

These observations about perinatal encephalopathy apply also to pyramidal syndrome, pyramidal insufficiency, vegetative dystonia, spastic tetraparesis, syndrome of motion disorder, perinatal insult of the CNS, natal trauma of the cervical spine, and others neurological diagnoses

  1. The frequency of appearance of these diagnoses is dependent on the facility from which the child is adopted.

  2. In most orphanages the frequency is high enough to make the diagnosis meaningless (95% or so).

  3. Usually the diagnosis is stated without corroborating medical evidence - physical findings are not noted, no laboratory or diagnostic studies mentioned, etc. Most frequently the diagnosis of perinatal encephalopathy is applied in the maternity home or Children's Hospital prior to orphanage admission.

  4. While the diagnosis itself sounds alarming to both medical and non-medical individuals, it does not fit a precise western diagnostic category. Western physicians can easily imagine what it might mean, but they do not know, and without further information the diagnosis will be difficult for them to deal with. Perinatal encephalopathy does not correspond to the western diagnosis of cerebral palsy; Russian physicians are quite aware of CP as a disticnt clinical entity and will communicate concerns about this diagnosis using the specific term.

  5. Most consultants questioned have not been able to give a clear explanation of the term; it can be applied solely on the basis of history (known or suspected problems during the pregnancy). Perinatal encephalopathy might also be diagnosed on the basis of a number of physical findings - such as quivering of the chin and fingers when a child is crying or irritability. (We have found many cases where the origin of the diagnosis could be traced to observations of infant behavior that in the west would be termed fussiness.) The medical theory behind this diagnosis is based on particularities of Russian medical concepts of pathophysiology.

  6. A draft text translation of "Perinatal Hypoxic Neurological Syndromes" is available at this site. This makes for interesting reading. Or try the text relating to neurological examination of the newborn.

  7. One of the more significant questions related to the diagnosis of perinatal encephalopathy and related neurological diagnoses is the question of treatment. Most of these children have been subjected to courses of treatment involving multiple injections of vitamins and "neuro-enhancers". In an institutional setting this clearly increases risks of hepatitis and HIV. At least equally significant is the waste of resources that could have been allocated to food, medicines and increasing caretaker/child ratios.

Hip Dysplasia

This diagnosis is mentioned as it appears reasonably frequently in Russian medical reports. It is an unsatisfactory term and indicates little more than a problem or suspected problem with a hip joint. It potentially includes what would be termed in the west a "congenital hip dislocation" as well as the much more frequent "dislocatable" hip. Usually there is little information indicating the basis of the diagnosis or whether ultrasound or radiological tests have been performed. The diagnosis is regional, you may expect it to occur regularly in certain regions (unless the specialist is on vacation).

Congenital Syphilis

This short paragraph is written because the diagnosis is now frequently seen on adoption medical reports. Syphilis has been on the increase in Russia for the last ten years. Russian obstetricians and pediatricians are very alert to the possability of maternal infection. Mothers are routinely screened in the third trimester of pregnancy and proper treatment given. If maternal history is unknown, the possability of congenital syphilis is actively considered and investigations of the infant obtained. Subsequent treatment and follow up are adequate. Russian specialists as a whole are probably much more experienced with the management of this problem than their western counterparts. In general, if all else is well with a child, I don't become very excited about finding this diagnosis in the past history. Some follow up blood work is necessary to confirm cure, but prognosis is good.

A very nice review of the medical aspects of this problem has been prepared by the Wisconsin Association for Perinatal Care Congenital Syphilis.

Videos

It is clear that once prospective adoptive parents receive a referral, a bond begins to form with the prospective adoptive child. This bond will deepen upon seeing a photograph or a video, and this will occur whether the material is of good or poor quality from the standpoint of a medical professional.

From the standpoint of a young child, this may be for the best. The child has rather simple needs ... a loving and attentive family environment where basic requirements for nutrition and stimulation are provided. (Further opinions on precise requirements can reliably be expected from the child.)

Videos are an important source of information. Parents must balance their own knowledge of themselves and their own common sense against the understandably guarded opinions of their medical advisors. My advice is not to decline a referral on the basis of one video and one medical review. Children being variable from day to day (unlike adults), do not expect a video to be ideal. If all initial information appears worrisome to you, ask for review of child in one to two months and more information. Serious requests of this nature are understandable and acceptable by all reputable agencies.