The Trouble With International Adoption Is not Trafficking: It's the Global Orphan Crisis

Dr. Jane Aronson

Pediatrician and CEO, Worldwide Orphans Foundation

Posted: 9/20/11 10:06 AM ET

This blog is in response to a September 18 article in the New York Times, by John Leland, on the trafficking of babies in China.

Over the 22 years that I have been an adoption medicine specialist, there have been many historic moments where the legitimacy of the adoption of children from abroad has been questioned and revealed on TV and in print media. Countries have closed at these moments, leaving children stranded in orphanages, parents without their children and accusations of trafficking. Inter-country adoptions have gone from 23,000 in 2005 to about 11,000 in 2010 with fewer and fewer choices available to families looking to adopt from abroad.

A September 18 NY Times article by John Leland sensitively highlights recent trafficking of babies in China. The article includes interviews with American parents of adopted children from China, focusing on how it feels for a parent to think that their child might have been bought and sold. The complex issues about how to speak to one's child about such matters in the future are excruciating, but not impossible to handle. That said, most parents who adopt from abroad rarely know the real facts of that desperate moment when their child was abandoned or relinquished. We have hopefully learned not to glorify birth parents and to respect what we do know and what we don't know in an honest and loving way when we speak with our children. Those conversations change and become more sophisticated as children grow and develop.

Trafficking is rare in international adoption. It is not because of trafficking that international adoption has gone south. I don't dismiss the importance of trafficking and I hope that the Hague Convention on Inter-country Adoption in cooperation with each country will continue to work hard to prevent the violation of the rights of birth mothers and to protect the rights of children. That will never happen however, unless there is a financial and educational investment in the sending country's social welfare infrastructure.
Children are typically abandoned in a public place in China so that they can be found and protected, while in other countries like Ethiopia, they are relinquished to a local orphanage. It is safe to say that the cause for the desperate decision to not parent one's own child in countries all over the world, including the US, is poverty and the resultant isolation and depression that darkens the birth mother's thoughts. There is no hope and no one to talk to and no one to help sort out the possible solutions to the dilemma of shame, no education, no work skills, no dignity, and abject and extreme poverty. 
I ask myself a bigger and more philosophical question about the millions of orphans when I read articles like this. There is a Global Orphan Crisis. When I started out helping parents manage the health issues of children adopted from abroad, I knew very little about the social conditions that dominated the communities of developing countries. For over two decades I have traveled abroad on medical missions and learned about the despair and hopelessness in countries all over the world where there are no social workers or community workers to openly engage in discussions with women who are pregnant and poor. Economic strengthening is limited and women have little access to education and medical care. Why did we create such a marvelous bureaucracy to improve international adoption practices and not pour some of that money into the welfare of mothers in these countries? It seems immoral to me to accredit US adoption agencies and to not empower women from sending countries to make international adoption a well-thought out choice for a birth mother no matter what her economic status. We do this for all domestic adoptions in the US. If we educated women abroad and showed some respect for their process, we might find that some women would still opt for their children to be adopted...even changing some attitudes about domestic adoption in very poor nations.

I review pre-adoption referrals daily in my adoption practice. More and more of the social histories that I read, are about a dead mother or a dead father and 7 children perhaps ranging in age from 15 yrs old to 6 months of age. The one remaining parent may have AIDS and begins to relinquish the youngest children one by one to a local orphanage. The parent signs papers that state that they cannot afford to care for their child. The stories are pitiful and after years of reading them, I am heartbroken. It is these stories that have likely made adoptive parents reading them, realize that there is a moral moment in adoption from abroad. Any decent person who reads a referral that tells the story above, likely lies quietly in the dark of night while waiting for that baby, thinking about the unfairness in life. This is why adoption has gone the way of "boom and bust" resulting in lower numbers and fewer countries. Governments and the global community are not blind to the conflicting issues that arise from poverty, community disintegration, and increasing numbers of children without parental care, whether true orphans or not. It is not about trafficking.

To help orphans have a better life in their own countries, I created a foundation, Worldwide Orphans, 14 years ago. We started in institutions to enrich the lives of orphans and then we grew and realized that orphans were in the community. In our work with HIV-infected orphans and vulnerable children and their families we help to strengthen the local communities to prevent abandonment and relinquishment and also to re-unify families affected by HIV/AIDS.

It would be wonderful if we could address the Global Orphan Crisis now. There are millions of children who are born without pre-natal care, malnourished, low birth weight, and living in extreme poverty; they cannot all be adopted.

Let's set priorities and reach more children in their communities, provide social services for women, lessen abandonment, lessen relinquishment and trafficking will naturally be less of a threat. Let's strengthen the adoption opportunities so there is complete transparency and finally, let's also be community builders. Let's not be afraid to face all the issues honestly and let's not perpetuate the theory that trafficking is the cause of the demise and demonization of international adoption. Nothing is ever that simple.

Follow Dr. Jane Aronson on Twitter: www.twitter.com/wworphans

September 16, 2011

For Adoptive Parents, Questions Without Answers

By JOHN LELAND

IN almost any adoption, the new parents accept that their good fortune arises out of the hardship of the child’s first parents. The equation is usually tempered by the thought that the birth parents either are no longer alive or chose to give the child a better life than they could provide.

On Aug. 5, this newspaper published a front-page article from China that contained chilling news for many adoptive parents: government officials in Hunan Province, in southern China, had seized babies from their parents and sold them into what the article called “a lucrative black market in children.”

The news, the latest in a slow trickle of reports describing child abduction and trafficking in China, swept through the tight communities of families — many of them in the New York area — who have adopted children from China. For some, it raised a nightmarish question: What if my child had been taken forcibly from her parents?

And from that question, inevitably, tumble others: What can or should adoptive parents do? Try to find the birth parents? And if they could, what then?

Scott Mayer, who with his wife adopted a girl from southern China in 2007, said the article’s implications hit him head on. “I couldn’t really think straight,” Mr. Mayer said. His daughter, Keshi, is 5 years old — “I have to tell you, she’s brilliant,” he said proudly — and is a mainstay of his life as a husband and a father.

“What I felt,” he said, “was a wave of heat rush over me.”

Like many adoptive parents, Mr. Mayer can recount the emotionally exhausting process he and his wife went through to get their daughter, and can describe the warm home they have strived to provide. They had been assured that she, like thousands of other Chinese girls, was abandoned in secret by her birth parents, left in a public place with a note stating her date of birth.

But as he started to read about the Hunan cases, he said, doubts flooded in. How much did he — or any adoptive parent — really know about what happened on the other side of the world? Could Keshi have been taken by force, or bought by the orphanage in order to reap the thousands of dollars that American parents like him donate when they get their children?

In his home in Montclair, N.J., Mr. Mayer rushed upstairs to re-examine the adoption documents.

According to the news reports, the children were removed from their families when they were several months old, then taken to the orphanages. “The first thing I did was look in my files,” he said, speaking in deliberative, unsparing sentences. According to his paperwork, his daughter had been found on a specific date, as a newborn.

He paused to weigh the next thought.

“Now, could that have been faked?” he said. “Perhaps. I don’t know. But at least it didn’t say she was 3 months old when she was left at the orphanage.”

According to the State Department, 64,043 Chinese children were adopted in the United States between 1999 and 2010, far more than from any other country. Child abduction and trafficking have plagued other international adoption programs, notably in Vietnam and Romania, and some have shut down to stop the black market trade.

But many parents saw China as the cleanest of international adoption choices. Its population-control policy, which limited many families to one child, drove couples to abandon subsequent children or to give up daughters in hopes of bearing sons to inherit their property and take care of them in old age. China had what adoptive parents in America wanted: a supply of healthy children in need of families.

As Mr. Mayer reasoned, “If anything, the number of children needing an adoptive home was so huge that it outstripped the number of people who could ever come.”

This narrative was first challenged in 2005, when Chinese and foreign news media reported that government officials and employees of an orphanage in Hunan had sold at least 100 children to other orphanages, which provided them to foreign adoptive parents.

Mr. Mayer was not aware of this report or the few others that followed. Though he knew many other adoptive families, and was active in a group called Families With Children From China — Greater New York, no one had ever talked about abduction or baby-selling.

“I didn’t even think that existed in China,” he said.

Again he paused.

“This comes up and you say, holy cow, it’s even more complicated than you thought.”

“ADOPTION is bittersweet,” said Susan Soon-Keum Cox, vice president for public policy and external affairs at Holt International, a Christian adoption agency based in Eugene, Ore., with an extensive program in China. The process connects birth parents, child and adoptive parents in an unequal relationship in which each party has different needs and different leverage. It begins in loss.

Adoptive parents and adoption agencies have powerful incentives not to talk about trafficking or to question whether a child was given up voluntarily, especially given how difficult it is to know for certain. Such talk can unsettle the children or anger the Chinese government, which might limit the families’ future access to the country or add restrictions to future adoptions. And the possible answer is one that no parent wants to hear.

Most parents contacted for this article declined to comment or agreed to speak only on the condition of anonymity. Several said they never discussed trafficking, even with other adoptive parents. To a query from The New York Times posted on a Web forum for adoptive parents, one parent urged silence, writing, “The more we put China child trafficking out there, the more chances your child has to encounter a schoolmate saying, ‘Oh, were you stolen from your bio family?’ ”

Such reticence infuriates people like Karen Moline, a New York writer and a board member of the nonprofit advocacy group Parents for Ethical Adoption Reform, who adopted a boy from Vietnam 10 years ago. “If the government is utterly corrupt, and you have to take an orphanage a donation in hundred-dollar bills, why would you think the program was ethical?” she said. “Ask a typical Chinese adoptive parent that question, and they’ll say, my agency said so. My agency is ethical. People say, the paperwork says X; the paperwork is legitimate. But you have no idea where your money goes.

“Now you have to give $5,000 as an orphanage fee in China. Multiply that by how many thousand adoptions. Tens of millions of dollars have flowed out of this country to get kids, and you have no accounting for it.”

Agencies say that cases of child abduction are few compared with the number of abandoned Chinese babies who found good homes in America. The abductions reported in August were of 16 or more children taken from their parents between 1999 and 2006. According to the investigation, population-control officials threatened towering fines for couples who violated the one-child policy because they were too young to be married or already had a child, or because they had themselves adopted the child without proper paperwork. When the parents could not pay, the officials seized the children and sent them into the lucrative foreign adoption system.

“The incident when it happened was resolved quickly by the Chinese in a way that was drastic and made very clear that the Chinese would not tolerate trafficking,” said Ms. Cox, of Holt International. “I’m not saying there are not any other incidents, but people can be assured that the process in China is a good one.”

A 2010 State Department report said there were “no reliable estimates” of the number of children kidnapped for adoption in China, but cited Chinese news media reports that said the figure might be as high as 20,000 children a year, most of whom are adopted illegally within the country, especially boys.

But it is hard to know, said David Smolin, a professor at the Cumberland School of Law at Samford University in Birmingham, Ala., who has written extensively about international adoption and trafficking. Changes in China in the early 2000s — a rising standard of living, an easing of restrictions on adoption within the country, more sex-selective abortion — meant that fewer families abandoned healthy babies, Professor Smolin said.

“Orphanages had gotten used to getting money for international adoption,” he said, “and all of the sudden they didn’t have healthy baby girls unless they competed with traffickers for them.”

PROFESSOR SMOLIN has two daughters, whom he and his wife adopted from India as teenagers. Within six weeks the girls disclosed that they had been kidnapped from their birth parents. But when Professor Smolin and his wife tried to find the girls’ biological parents, he said, no one wanted to help.

When he started to speak publicly about his experience, he met other parents in the same situation — hundreds of them, he said. “They all said they felt abandoned by adoption agencies and by various governments,” he said. “There’s a sense that other people in the adoption community did not want to hear about these circumstances. People were told that it was not a good thing to talk about. So you’re left alone with these practical and moral dilemmas, and that is overwhelming.” In the end, it took more than six years for the couple to find their daughters’ birth parents, by which time the girls were young adults.

Susan Merkel, 48, who with her husband adopted their daughter, Maia, at 9 months old in August 2007, said that even within their own home, her husband did not like to talk about the possibility.

“My husband really feels like it’s something that we don’t know whether that’s the case and would rather not think about it,” she said at her home in Chesterfield, N.J.

But for Ms. Merkel, who is studying social work at Rutgers University, the uncertainty is haunting. Her daughter’s orphanage, in Hubei Province, which is immediately north of Hunan, is near an area known for strict enforcement of the one-child policy, and Ms. Merkel said she could not shake the possibility that a population-control official had seized her and turned her over to the orphanage.

Ms. Merkel was adopted as a child, and said that meeting her birth mother had helped her understand her past and herself. What, then, was her responsibility as a parent — to find Maia’s birth parents, who might make a valid claim for her return? How could Ms. Merkel, who got so much out of meeting her own birth mother, not want that for her child? “What I do know is that she’s my daughter and I love her,” she said. “We’re giving her the best family and life that we can. And if she has questions someday, we’ll do all we can to help her find the answers.”

Ms. Merkel said that she would support Maia’s meeting her birth parents if it was possible, but that she would not willingly return her to them, even if there was evidence that she had been taken.

“I would feel great empathy for that person,” she said. “I would completely understand the anger and the pain. But I would fight to keep my daughter. Not because she’s mine, but because for all purposes we’re the only family she’s ever known. How terrifying that would be for a child to be taken away from the only family she knows and the life that she knows. That’s not about doing what’s right for the child. That’s doing what’s right for the birth mother.”

BRIAN STUY, an adoptive father of three in Salt Lake City, runs a service called Research-China.org to help adoptive families learn about their children’s origins. When he has managed to contact birth parents, he said, most were content to learn that their children were alive, that they were healthy and in good homes. “Unfortunately, the reaction of most adoptive parents is to go into hiding,” Mr. Stuy said. “When they have suspicions, they don’t want to come forward.”

Many parents simply never have suspicions. Tony X. Tan, an associate professor of educational psychology at the University of South Florida whose research specialty is adoption, surveyed 342 adoptive parents of Chinese children last month. Two-thirds said they “never” suspected that their children might have been abducted, and one in nine said they thought about it “sometimes.” Several said the paperwork from the orphanages was inconsistent or suspicious.

One mother, who adopted two girls from different provinces, wrote, “My Guangxi daughter was adopted with a group of 11 other infants, all roughly the same age, and came home with an extremely detailed description of her first 11 months of life in her orphanage. Yet ‘her’ information was word-for-word the same as the info given the families of the other 11 children adopted at the same time — making it all too specific to be believable.”

Judy Larch, a Macy’s executive who lives in Pelham, N.Y., said she adopted two girls from China, in 2001 and 2007, because she had heard good things about the program, and because she could adopt as a single woman. Though she has read about trafficking, she said, “I’ve never had any doubts or concerns about their adoptions.” She said she had faith in the adoption agency, Holt International.

Such faith is small comfort to a woman named Ms. Chen, who said population-control officials in her hometown, Changle, in Fujian Province, took her daughter in 1999. Ms. Chen, who is in the United States illegally, applied for asylum as a dissident this year, but was denied. She declined to speak to The Times, but gave permission for a reporter to watch a videotaped interview conducted by a Christian group in Flushing, Queens, called All Girls Allowed, which works with women’s rights groups in China and maintains a database of photographs of missing children. Her story could not be corroborated.

In the interview, Ms. Chen said that her first child, born in 1997, was a girl, and that she was under great pressure from her in-laws to produce a son. She became pregnant soon afterward, but this child, too, was a girl. Ms. Chen was in violation of the one-child law, which in her area allowed parents to have a second child after six years. Officials came to her with a choice: give up the second child — then 5 months old — or undergo tubal ligation.

“I was holding my daughter and crying,” she said on the video. The official told her that if she gave up the child, in six years she could try again to have a son, she said. “I was afraid for my marriage,” she said. “Of course I didn’t want to give up the child. But I was afraid that without a boy my marriage wouldn’t last.”

She said, “I handed her over meekly.”

MR. MAYER, in Montclair, who also has an adopted son from Ethiopia, has accepted that he may never know the full truth about his daughter’s beginnings.

After absorbing the revelations about trafficking, he said, he took a step back. “O.K., what does this mean to my life today? And how does it change my life today?” he said he asked himself. “And today it changes absolutely nothing about my life with Keshi. If I want Keshi to be able to question and to come to terms with the issues of why she would have been put up for adoption in the way she was, she’s going to ask these questions. This is just another one of those questions to which I don’t have a concrete answer. That’s my role as a dad.”

In the future, families like his may have better answers. Parents or children may be able to search online databases of children whose birth parents say they were taken. For now, though, is it the parents’ duty to ask those questions? Or is it for children to decide, in time, how much they want to know?

“I can’t change the past or change whatever anybody has done in China,” Mr. Mayer said. “What’s most important to me is there are real significant issues for my daughter coming of age and understanding her birth story. And I’m committed to supporting her in that and making sure that it’s as honest and truthful and supportive as possible. And that’s a scary thing.”