Friday, September 18, 2009

International Adoption

This article in the ABC news feed got me thinking about international adoption again. It's a story about international adoptions out of Ethiopia. The article starts with this:
Sit for any time in the foyer of the Hilton Hotel in Ethiopia's capital, Addis Ababa, and you'll see a procession of Americans and Europeans wandering from their rooms across the marble floor to the restaurant or swimming pool with their precious new possessions - babies or infants they've just adopted.
It's actually a pretty balanced article, but it draws a few incorrect conclusions, in my mind. This one would be one of them:
There is overwhelming evidence to prove it is far better for a child to remain with its family or, if that's not possible, with another family in his or her own country than to be shipped off overseas.
Well, ok, there is absolutely no way I am going to argue that the child is not, in most circumstances, better off staying with their own family, but clearly better off being adopted within their own country isn't really backed up with evidence.

I should back up a bit. International adoption is amongst the most complicated issues I have ever given serious attention. At a first pass, it seems nothing short of insanity that children are living and dying in institutions while people in other places would do anything to raise a child.

I reject the notion of parents buying children as possessions as a minority at best (or worst, as the case may be). They may be showing off their newly adopted children in poorly chosen finery, but that does not imply that they have adopted the child as a fashion accessory. At at least some point, just about all parents have done the dress up thing with small kids. They are inherently cute, and it seems silly not to enhance that on occasion - especially if you are just now holding the child you thought you'd never have.

When I went looking for information on international adoption for an essay last year, I discovered a number of things. Firstly, there is bugger all real information about international adoption. What does exist primarily compares children in the country of destination, not of origin. So it compares children adopted from Romania to the US with children adopted within the US, for example. Sweden did an enormous cohort study, but again, it was all about people who grew up in Sweden. Where studies have tried to tease out the effect of being adopted to a different country from all the other possible issues, they have overwhelmingly found that the major predictor of outcome was how long a child lived in an institution before adoption, and the quality of that institution. This effect swamped the effect of cultural differences and racial differences between the child's place of origin and place of adoption.

So, looking at outcome evidence, the most appropriate conclusion is that any child that is in an institution anywhere should be adopted as quickly as possible, irrespective of the location of the adoptive parents (but clearly not irrespective of the merits of those people).

Interestingly, the size of the effect of racial and cultural differences was found to be quite different in different places, suggesting that it has more to do with the destination culture itself than the difference. As well as obvious things like racism in the adoptive culture, there is also the possibility of a self fulfilling quality to predictions that children will suffer by growing up in a different culture than that to which they were born. If you spend a lot of time making a big deal about it, it will be a big deal. I am not suggesting that people should dismiss it, just that perhaps accepting it as one of your family quirks that needs to be discussed openly and sensibly might be a more appropriate approach. This is merely my speculation, I have no further data to support this.

Still, all of this assumes a situation in which children's residence in an institution is independent of the existence of international adoptive parents. Hard experience in Romania, India and Ethiopia (to name the ones I have specifically read about, rather than any sort of exhaustive list) tells us that this is not the case. Donations by adoptive parents or their agents to institutions to support those children not yet adopted become incentive to find more attractive children. Many of the children in institutions have severe health issues, or are too old to be likely to be adopted, and so institutions are known to steal healthy, young children or to deceive parents into giving them up.

There are UN guidelines, mostly borne of the experience of Romania, as to how international adoption should be conducted, however as with all guidelines, they are only useful when fully enforced.

So what to do? Ban international adoption? Make it really, really hard?

I think this is misguided. For children living in institutions, every possible effort should be made to get them adopted. The governments of the adoptive countries have an obligation - not to charge a fortune in order to restrict international adoption to the rich few as in NSW - but to spend whatever they charge adoptive parents on programs to ensure the integrity of the adoption process where the children are. I realise this isn't all that simple, but if we don't even try, we are letting absolutely everyone down. There should also be an active program to encourage families who are in a position to do so, to adopt an older child, or one with health issues who face an awful future where they are.

In NSW it costs $40,000 or so (last time I looked) to adopt a child from another country. There should be no cost to adopt an older child or one with health issues. Clearly normal screening needs to take place, but this price barrier, not to mention the general assumption that adopting a child is a selfish, somewhat questionable choice, stops the world's most needy kids from being looked after.

The other obligation that the adoptive country has is to put the same number of dollars into general welfare, infrastructure and other projects that aim to make international adoption ultimately unnecessary. The one unequivocal statement is that it would be far, far better for these children to never be in the position to need to choose between institutions, local or international adoption.

It is possible, in my opinion, to recognise the dangers of structured international adoption without leaving children in institutions - even well funded ones - and without vilifying adoptive parents as baby buyers. And while I recognise that growing up in a culture different from where you were born is an issue, it's on the list with all the other issues children and teens deal with - needing some appropriate understanding from those around them, but hardly insurmountable. This is not to say that it hasn't been catastrophic when it has been very badly handled, but then teens have been destroyed by personality clashes with their parents and any number of issues.

Ultimately, improving this situation requires strong leadership, clear vision and an iron will to look after the children's interests first on the part of adoptive countries' governments, and I am sadly pessimistic that I will ever see that. And I utterly despair of seeing anything even vaguely like it from the NSW government.

1 comment:

  1. The one unequivocal statement is that it would be far, far better for these children to never be in the position to need to choose between institutions, local or international adoption.

    This. Absolutely this.