Most parents will agree that the journey to becoming a family is a complex mosaic of uncertainties and possibilities. For those who build families through international adoption, the road to parenthood is a maze of passageways paved with risks. But the prospect of creating a family propels them forward — even when some of the risks make headline news. The outbreak of Severe Acute Respiratory Syndrome (SARS) has emerged as a very visible health risk to parents finalizing international adoptions from Asia, particularly China, where experts now believe the outbreak originated last November, not in mid-February as previously thought. Families adopting from China have found themselves in the heart of the scare — literally — because the U.S. Consulate office that processes all Chinese adoptions is located in Guangzhou, the city in Guangdong province originally identified as the origin of the outbreak. As of April 8, 43 of China’s 52 reported SARS deaths occurred in Guangdong province. But despite the health risks, and the difficult choices they present, most families in the final stages of adoption are making the trip, says Pam Thomas, China program director at Brightside for Families and Children, an adoption agency authorized by the China Centre of Adoption Affairs. Based in West Springfield, Mass., Brightside places children from China with qualified families in all 50 states, as well as with U.S. citizens living abroad. Health risks have always been a part of international adoption, says Dr. Jane Aronson, D.O., a Manhattan pediatrician and pioneer in the field of international adoption medicine, whose practice, International Pediatric Health Services, offers comprehensive primary pediatric care as well as pediatric infectious disease consultations. “The vast majority of children are delayed from being in an institution, and often require early intervention services,” says Dr. Aronson, who has personally seen over 2,000 children, adopted from abroad, during the past 11 years. “But over time, as they get the services they need, they become indistinguishable from other children.” “Families make choices all the time when they travel to adopt,” Thomas says, “not just when there’s a threat of an illness. But overwhelmingly, in adoption, as in nature, things go right. And the good news is there are options. There are always alternatives.”
For example, families with young children, who might normally have brought their child with them on the trip, may choose to leave that child at home with one spouse. When a married couple is adopting, one spouse can travel to adopt in China, taking power-of-attorney for the other spouse, Thomas. While additional paperwork must be completed, both pre- and post-adoption, before the child is entitled to U.S. citizenship, Thomas says, “There are situations where only one spouse can travel, and this is an option for them.” “Limiting the family members who travel, limits the exposure,” Dr. Aronson explains, “but allows you to continue with the adoption. And what we want to do is limit the risk.” Elderly people and very young children are both at greater risk for contracting infectious diseases, so if the risk is present, it’s prudent for those individuals to not make the trip, Dr. Aronson says. And the family members who do travel must take extra precautions. Frequent hand-washing and wearing face masks while on airplanes and in crowds are two key recommendations of the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), both of which have made the latest health and travel advisory information available on their websites, (http://www.cdc.gov/ncidod/sars/) and (http://www.who.int/csr/sars/en/). While families currently preparing for the trip have valid concerns, “they’re keeping themselves informed and not panicking,” Thomas says. “Quite honestly, these families are a rather intrepid group by and large, and they’re not making cavalier decisions. They have questions, certainly, but overwhelmingly they are deciding to travel for their babies. They consider it essential travel.” One such couple is Dorothy and Mark Congiusta of Yonkers, N.Y., who returned from China at the end of February with their new daughter Aelex Ling Zhi. “We waited such a long time for this precious little person in our life. There was nothing going to stop us from going,” Dorothy Congiusta says. But since returning home, she adds, “Some people are a little afraid of being around us and the baby, even though we have had no symptoms, and the incubation time is over.” While the alarm is understandable, it’s important to put things into perspective, experts say. According to the latest information, Dr. Aronson says, SARS is mostly likely a coronavirus from the family of viruses that contain the cold and flu viruses. “It’s not as if we haven’t seen this virus before,” Dr. Aronson says. “And we’re pretty clear that the transmission of it is through droplets. It’s not anything like environmental issues, or toxins. It’s none of that. It’s simply the straightforward droplets transmission.” According to the CDC, SARS begins with a fever higher than 100.4 degrees, possibly accompanied by headache, body ache or an overall feeling of discomfort. Mild respiratory discomfort can also be an early symptom. Within two to seven days, infected individuals may have trouble breathing and/or develop a dry cough. Protecting yourself and your family from being infected requires the same level of common sense you would use when dealing with any other flu-like strain, Dr. Aronson says, suggesting concerned individuals refer to the CDC or WHO websites, which are updated daily. Clearly, people faced with international travel must consider the factors and weigh their options. Parents considering international adoption “need to have a certain inherent kind of flexibility, determination and commitment,” Thomas says. “International adoption has provided a tremendously important resource for children who otherwise would not have parents, and for parents who seek children to parent. It’s a win-win situation. There is always risk involved in becoming a parent, whether through biology or adoption.” “Going to get my daughter was the most exciting thing that has ever happened to me in my life and SARS or any other illness would not have kept us from going,” Dorothy Congiusta says. “It’s just like you’re pregnant. When you’re carrying a baby, the baby’s coming in nine months whether you’re ready or not. In our case, our baby was ready to come into our arms, and whether we were ready or not, we were going to go get her.”
Resources for prospective parents: —Centers for Disease Control SARS update: http://www.cdc.gov/ncidod/sars/
—World Health Organization SARS update: http://www.who.int/csr/sars/en/
—International Pediatric Health Services: http://www.orphandoctor.com/
—Brightside for Families and Children: http://www.brightsideadoption.org/china/index.html http://hometown.aol.com/brightinfo/myhomepage/club.html
—Families with Children from China: http://www.fwcc.org/welcome.html
—International SOS in China: http://www.internationalsos.com/countries/China/
— Adoptions From the Heart http://www.adoptionsfromtheheart.org
