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Health Issues, page 2

There are about 4,000 children in Ohio right now waiting to be adopted. Many of them have clear physical or mental problems that prospective parents know about. Tracking medical history for foreign orphans is not so easy. Family history can be absent and it's too simplistic to say one country has healthier kids than another. The director of adoption services at Rainbow Babies and Children's Hospital in Cleveland, Dr. Anna Mandalakas...

Dr. Mandalakas: With respect to the quality of care, and access to medical care that children get, I've seen the healthiest kids I've seen - and the least healthiest kids I've seen - come from the same country. So that really says to me that within certain countries, the pre-adoptive care varies greatly.

That country was Romania. The hospital's program checks foreign children for infectious diseases such as HIV, tuberculosis, and hepatitis b, and also looks for certain facial features that may indicate fetal alcohol syndrome...

Dr. Mandalakas: They have developmental delays; they have a lower IQ; they may have behavioral problems; and they also have this spectrum of facial features and other physical findings that are part of the syndrome. What we do emphasize to parents is that children may be exposed to alcohol in utero and not develop [those] facial features. Theoretically, the presence of those facial features depends on when the mother drinks during gestation.

Some parents assume children raised in foreign orphanages have been shielded from disease, when actually institutions can allow for an easier spread of infection. Another common malady is malnutrition. Dr. Mandalakas says 42% of the adopted children the adoption service sees show signs of vitamin deficiency and other malnourishment and that can have long term effects...

Dr. Mandalakas: We screen for those things immediately. If we identify those problems we give children oral vitamin supplements and resolve the micro-nutrient deficiencies and vitamin deficiencies. That's easy. Long-term consequences with children from having malnutrition during their first year of life may relate to learning disabilities. So we know children who've experienced malnutrition during the first year of life are at greater risk for learning disabilities that surface when the kids are nine, ten years of age.


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