In February I travelled to Liberia to provide medical care in orphanages and facilitate international adoptions. The trip there involved five flights, touching down in five countries, with an overnight stop in Senegal. But in reality, the trip was much longer and started twenty-seven years ago. On that day, a social worker arrived unannounced to my office with a three-inch binder of information on the medical issues facing adopted children coming from foreign lands. She said, “You may want to read this because I am making you my international adoption pediatrician.” Since she was involved with a large number of the placements in Nashville at the time, her threat carried weight. Soon I found myself helping families with pre-adoption assessments and weekly arrivals of new patients from China and Russia. Over the years, children from Guatemala, Korea, Oceania, and Ethiopia joined them. Working with these special families provides one of the most satisfying and challenging aspects of my practice.
The international adoption process starts with a referral. A history of the child’s situation and medical records along with a photo or two comes to the prospective family. Frequently there are complex medical issues that contributed to the child’s need for a new family. While helping families understand these issues, I frequently mused that if I could examine the kids myself, I could offer a much better appraisal of their health. A few years ago, a colleague in town told me of an agency that was looking for a pediatrician to travel with them to China to evaluate children eligible for adoption. “Sign me up!” This was exactly what I hoped for: on-the-ground history gathering, complete examination, and the ability to discuss my findings directly with prospective families on my return. During that trip and one other, I reported on about one hundred children, many of whom have found forever families in the United States and around the world. Unfortunately, new laws in China now prevent foreign NGOs from continuing this kind of work.
Enter Liberia. My trips overseas have been at the invitation of the Small World Adoption agency (http://smallworldadoption.com) which has its home in Mt. Juliet. They carry full Hague Accreditation. This signifies that they have the highest standards of vetting families before adoption, as well as ethical adoption practices within the country of origin. They are one of a just a few agencies qualified to work within Liberia. On this recent trip, I assessed children ready for adoption and visited a number of other private and government orphanages to offer supportive care. As a whole, they enjoyed good health and careful attention in their facilities despite limited resources. Liberia is a country still reeling from civil war in the 90s and the more recent Ebola epidemic. Few families have escaped tragedy and death. The economy and infrastructure have suffered severe setbacks. As such, many children face dire futures. While it is ideal to place orphaned children in families of native culture and language, there currently are not the necessary resources within the country.
So that is why I travelled to Liberia.