Monthly Archives: July 2014

Sad Statistics From the State Department

The U.S. State Department just released a report revealing the continuing decrease in the number of international adoptions. Since the peak of 22,884 in 2004, the number of international adoptions has dropped to 7,094 in

China still tops the list of sending countries, followed by Ethiopia and then Ukraine, Haiti and Congo. Russia, once one of the most popular sending countries, is almost off the list completely, with just 250 adoptions taking place before it banned adoption to the US last year.

Chuck Johnson, National Council on Adoption CEO, cited the application of the Hague Convention on Inter-Country Adoption as one of the reasons for the decline in adoptions. As I have pointed out before, this is not a surprise. The rigorous guidelines that come with overregulation make it exceedingly more difficult to adopt today than it was 10 years ago.

The Convention requires countries to meet minimum standards in international adoption; meeting these standards requires establishing new entities and systems within government in order to be compliant.1

But lower income countries like many in Africa don’t have the resources to meet these requirements. Because these countries can’t meet the Convention’s standards, the US State Department refuses to carry out inter-country adoptions with them.

As a result, adoption rates fall, leading to devastating consequences. Children languish in orphanages or on the streets. They contract and even die from diseases that are treatable or preventable in receiving countries. They are abused, trafficked on the black market, or become sex workers to survive.

More important than the drop in international adoption rates is the respective rise in the number of suffering children throughout the world. These sad statistics aren’t surprising, given the regulatory framework that’s in place. The system needs to be de-regulated, and should instead function via public-private partnerships.


1The Intercountry Adoption Act of 2000: The United States’ Ratification of the Hague Convention on the Protection of Children, and its Meager Effect on International Adoption, by O’Keeffe, Kate, in 40 Vand. J. Transnat’l L. 1611 (‘November, 2007) at 1628-1629

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Misdiagnosing Children as Seriously Ill to Bolster International Adoptions

Doctor's Office in Kazakhstan

Doctor's Office in Kazakhstan

It's a basic economic principle that heavy regulation leads to corruption in the form of black markets and cheating. Complying with regulations is expensive, so if you can find a way to get around the rules and skirt regulations, you can increase your gains.

In Kazakhstan, regulation of international adoption has led to the absurd result of doctors purposefully misdiagnosing infants with serious illnesses like cerebral palsy or spastic quadriplegia so that they can be adopted internationally.[1]

The Hague Convention on International Adoption was drafted to ensure that international adoptions are “made in the best interests of the child and with respect for his or her fundamental rights and to prevent the abduction, the sale of, or traffic in children and each State should take, as a matter of priority, appropriate measures to enable the child to remain in the care of his or her family of origin.”

Countries acceding to the convention, like Kazakhstan, implement standards that must be met before children from that country can be adopted internationally. One standard required of the Convention is that placement of a child in the country of origin must be sought before international placement may be considered.

Hence Kazakhstan's deviousness. By informing Kazakhstan citizens that a child is disabled in some way, adoption agencies can report that their citizens passed the child up, and offer it for adoption internationally, getting more money for the placement.

Kazakhstan's behavior is just one of many examples of how rigorous regulation leads to corruption rather than protection in the international adoption process.

People have a human right to parent, and children have a human right to live and thrive. By over-regulating international adoption, we are hurting and often outright denying those rights.


[1] ” International adoption: sick children are healthy?” by Altynai Zhumzhumina, in Tengri News, available at

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Educate, Don't Regulate.

Yesterday's article, “Want to adopt from Syria? Adoption agencies urge people to 'slow down'” is a great read if you're wondering about possibly adopting from war-torn Syria to help children who have lost their families. There are many causes of orphanhood, including the devastations of natural disaster and war. In 2010 the earthquake in Haiti orphaned tens of thousands of children.1 Today the civil war in Syria has affected over 5 million children. Millions have had to leave school or flee to other countries, and more than 10,000 children have died as a direct result of the conflict.

NOUR KELZE / Reuters. A Syrian refugee child stands outside a tent in the southeastern city of Kilis, near the Syrian-Turkish border, on March 2.

NOUR KELZE / Reuters. A Syrian refugee child stands outside a tent in the southeastern city of Kilis, near the Syrian-Turkish border, on March 2.

Images of children during times like these are heartbreaking. As Lisa Belkin described during the aftermath of the Haitian earthquake, “they reminded me so much of my own 10-mont-old, except these orphans don't have food and water. … They sleep in the same position, play in the same way and cry in the same way as my baby, but I've been hearing stories of severe dehydration, lack of formula and

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other basic supplies. … I can just drive to the nearest supermarket to provide for my baby, we have food in abundance, but the orphans in Haiti don't have even the accessibility to basic needs. It makes me want to adopt – something I never, ever thought would remotely enter my mind.”2


During times like these, international adoption is particularly vulnerable to corruption. Many children become separated from parents or relatives who are still alive and would not consent to an adoption. But amid the chaos of conflict, systems that might be in place during times of peace won't function to effectively ensure that a child is truly adoptable; that there is no family willing to raise her. Adoption “middle men” may see monetary opportunity in playing on Americans' sense of wanting to help through adoption.

One (undesirable) way to address this problem is through ultra-strict regulation, like the current system in Syria. Syria does not allow international adoption of Muslim children, effectively making it impossible to adopt from Syria. No adoption means no corrupt adoptions (ignoring for the moment the black market adoptions that surface as a result of a total ban on adoption at the state level). But it also means orphans who suffer as a result of hunger, violence, fear – needlessly dying from preventable and treatable diseases.

A better way to address the problem is by educating people who see heart-wrenching images of children and want to help. People need to understand that the most important thing these children need is not necessarily a new family; they may already have one that is prepared to care for them if they can only be reunited. People also need to know that adopting in the midst of a crisis runs the risk of an adoption being corrupt.

Ideally, one day there will be watchdog organizations to ensure that children who are adopted no longer have any family to go to in their countries of origin. But until then, people who are confronted with journalistic images of solitary children shouldn't assume that adoption is the best way to help.

1Haiti's Children and the Adoption Question, New York Times (Nov. 25 2007)

2Adopting a Child from Haiti, by Lisa Belkin, New York Times Blog (Jan 25 2010)

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Russia's Latest Attempt to Restrict International Adoptions

Russian orphanages which remain little changed from Soviet times. Photograph: Gideon Mendel/Corbis

Russian orphanages which remain little changed from Soviet times. Photograph: Gideon Mendel/Corbis

Russia has hardly been the poster child of international adoption advocacy lately. It ceased adopting children out to the United States in early 2013, after having adopted out more than 50,000 children to American families since 1991.1 More recently than that, it banned adoption by same-sex couples.2

Pursuant to its latest bizarre policy stance, Russian officials are proposing banning adoptions to countries where it is legal to administer life-terminating treatment to children with terminal illness. As of February, Belgium is the first country in the world to allow this practice – the law states that the terminally ill child would have to face “unbearable physical suffering,” and make repeated requests to die, a decision that must be agreed upon by parents, doctors and psychiatrists.3

Russia should not be restricting its adoption program any more than it already has. In 2011, Michael Schwirtz reported that due to post-collapse social upheaval in Russia, there were more orphans in Russia than at the end of World War II. He noted that these children “languish in Russian orphanages,” where, with few Russian families willing to adopt, large government subsidies keep the orphanage system entrenched. In 2013, a video was released showing staff at an Amur orphanage torturing the children.

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(The video has since been taken down).

It is incumbent upon countries to seize every opportunity to create a system where their children can thrive. In many cases this means creating a functional international adoption system so that children may grow up in a family rather than an institution or on the streets. The more bans countries put in place on international adoption, the more we allow children to suffer abuse, malnourishment, and sickness.

Millions more children will die this year because of the brutal reality of orphanhood than due to legalized euthanasia.4 I can only hope Russia’s proposal doesn’t become law.

1 “Pact on Adoptions Ends a US-Russian Dispute,” by Michael Schwirtz, New York Times July 13, 2011
3 “Belgium’s Parliament Votes Through Child Euthanasia,” BBC News Europe, February 13, 2014, available at

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4 I have estimated previously that approximately four million orphans die in the developing world every year. In 2012, there were 1,432 Belgium citizens who elected to receive life-terminating treatment.

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US Doctors' Practices Focus on International Adoptees

Medical services geared towards adoptees are an important means of advancing international adoption. For one thing, children from low income countries often lack access to comprehensive medical evaluations and healthcare, making them underimmunized and highly vulnerable to illness or disease. What’s more, children from abroad may be exposed to conditions that are not common in the US, such as tuberculosis, measles, or hepatitis. It’s critical that doctors screening and treating these children are aware of their special needs in these regards.

While Dr. Jane Aronson has been screening and treating international adoptees for years in her New York practice, this specialized kind of service has now hit the west coast as well.

UCLA is now home to the new International Adoption and Travel Clinic, which provides medical services to adopting families and their children, from the pre-adoption stage all the way through to the completed adoption. Clinicians Dr. Yvonne Bryson and Dr. Nava Yeganeh, pediatric infectious disease specialists, will screen potential adoptees for physical, mental and behavioral development. During the weeks or months in which a family is in its child’s country of origin, when the family has close contact with their child, the clinic fields questions via email. Finally, when the child arrives in the US, the clinic physicians know to be on the lookout for afflictions that are endemic to the child’s country of origin.

The fact that these services exist is heartening. It shows that society is accepting international adoption as a legitimate means of family formation. In addition, doctors who specialize in international adoptees are a great resource for parents who are thinking about adoption but might otherwise not begin the process out of fear that it would be hindered by medical issues.

Dr. Jane Aronson

Dr. Jane Aronson “The orphan doctor” specializes in practicing medicine for international adoptees

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