The author, Dr. Jane Aronson, is also known as the orphan doctor because of her tremendous contributions about medical issues in adopted children from all over the world. She is Assistant Professor of Pediatrics at the Weill Medical College of Cornell University and the attending pediatrician and consultant in pediatric infectious diseases at The Presbyterian Hospital and Lennox Hill Hospital.
We know a lot more about the health issues of children adopted from China now than we did in the late 1980s and early 1990s. Experience has been a great teacher. The news is great. Kiddies from China have limited long-term medical problems, and these medical issues are generally easily resolved with proper diagnosis and treatment. The important message is that children adopted from China and other countries need to be assessed comprehensively within the first few weeks of their arrival in their new home country. If the medical problems are addressed swiftly, children have the potential for happy, healthy and successful lives. Children need to be followed by their primary care pediatricians or family doctors throughout childhood, and parents need to be aware of adoption-focused and specialized medical, developmental and psychological resources that are now increasingly available in the community at large.
Adoption Medicine as a Specialty
Based on the experience of a number of adoption centers across the country, including my own practice where I have evaluated well over 650 children adopted from abroad, I will review the medical issues that are most common in children adopted from China. It is essential to remember that many of the health issues of children adopted from China are those of children in general in China. With 1.2 billion people and 23 million births each year, China has limited financial resources; there are very common health issues that children face daily whether in or out of an orphanage. Malnutrition, rickets, anemia, lead poisoning, asthma, tuberculosis, hepatitis B, bacterial and parasitic intestinal infections are common medical problems for Chinese children.
Medical problems are obviously compounded in the orphanage, because these kiddies are often abandoned as they begin their lives and orphanages do not have access to modern medical facilities. When a doctor is involved in the medical care of an orphan, it is a non-university trained doctor who attends to the child. It would be uncommon for a university physician to care for a child from an orphanage. Children are rarely taken to modern medical centers because of lack of geographic proximity and economics; it is impossible to spare a childcare worker to take a child a long distance for hospital care; the expense of hospital care is beyond the means of most institutes in China. Daily medical care is left to the common sense of experienced childcare workers who staff the "social welfare institutes" all over China. Many institutes attempt to create in-house clinics and are equipped to give intravenous fluids, antibiotics and other medications right in the orphanage, but without the supervision of trained medical clinicians. Children survive in spite of the limitations of medical care. Their circumstances test their inherent survival capacity. They are truly hardy!