Common Medical Issues in Orphans

When you travel to find your child, the referal will come with a "medical statement" about the child. I've heard a lot about the confusion of understanding the medical documents, so start preparing yourself.
I found that in Ukraine there are "frequently seen diagnoses" on the majority of kids' medical records. Understanding what these mean is key in anticipating the health of the child before we accept the referal. Please check these out for yourself. Good websites are www.orphandoctor.com and www.russianadoption.org .

The results are often compromised for several reasons. Lab results are often unreliable, and I have not found a good reason why this is or how true this is. When cranial sonograms are done, the results are often over-interpreted. When physicians evaluate the infants/children, over-diagnosis is common. It has been said that the reason this occurs is so that orphanages can receive additional funding for the care of a special needs child. Yet, in several sites I have read that this is simply not true (any longer). There are several reasons over-diagnosis can happen. Unfortunately, there are sometimes not enough facts, so a diagnosis is made on the likely probabilty. For instance, congenital herpes is sometimes presumed because there is a supposed epidemic of syphilis in EE, though it is actually quite rare for a child to carry it. Therefore, "syphilis exposure" can end up being translated as "congenital syphilis." Inaccurate or poor translation of medical records is another reason diagnoses are sometimes incorrect. Errors in metric conversion also pose problems in how results are interpreted on a medical record. Physicians' determinations may be erring on the side of caution and prospective parents can get assistance in ruling out a diagnosis. But, under-diagnosis is definitely more serious and it is wise for us to be as well-informed as possible. It is absolutely essential to call the orphange director and ask for her personal assessment of the child's development and behavior.
Listed below are the most common medical diagnoses and basic definitions of what they are (based only on my research):

PERINATAL ENCEPHALOPATHY-- also applied to Pyramidal Syndrome, Pyramidal Insufficiency, Vegetative
Dystonia, Spastic Tetraparesis, Motion Disorder, perinatal insult to central nervous system, trauma to spine,
and other neurological diagnoses. **95% of kids are given this diagnosis, but it is most often a meaningless
diagnosis and there is usually no medical evidence to support it. This is usually diagnosed in the maternity home
especially when there is no information on family and prenatal history. Also, "fussy" babies are often given this
diagnosis based on observable things such as a quivering chin when crying. Eastern European treatment for this
"condition" is usually injections of vitamins. The injections themselves pose more of a risk than this supposed
Perinatal Encephalopathy, because the use of needles increases the chances of contracting Hep C and HIV.

HIP DYSPLASIA-- this condition is assigned to a child when there is any reason to suspect a problem with a hip joint.
There is little basis for this diagnosis and usually no tests are administered to confirm. Most often, if there is a
problem, it turns out to be a dislocated hip.

CONGENITAL SYPHILIS-- (or any other number of STDs). If maternal history is unknown, treatment
is with penicillin and follow-up care is adequet. Despite a rumored epidemic of syphilis, children are
rarely, if ever, infected.

MICROCEPHALY-- There is lots of concern about this condition. This diagnosis means the head circumference (OFC)
is small. This is a serious matter because it almost always implies mental retardation. However, children in
orphanages commonly do have smaller heads due to malnutrition. There has been found to be a cause and effect
relationship between small head circumference and being institutionalized. The good news: head growth almost
always increases after adoption!


In reality, our hope for a healthy child cannot be defined by America's standard of what healthy is. A healthy orphan will have a number of problems, but the good news is that they are easily treated or overcome once they are re-nourished. Bringing an orphan home where he will have good emotional and physical care quickly corrects many of the health issues. The following ailments are not at all unusual in an institutionalized child.

MALNUTRITION-- this condition is rampant in orphanages because there is an absence of crucial elements such as
zinc, iron, vitamins. It can cause children to be apathetic, have excessive bouts of crying, and language and
developmental delays. Malnutrition is easily overcome and a child should fully recover.

PARASITES-- in Eastern European countries there is a high risk for the parasites Giardia Lamblia, Dientamoeba
Fragilis, Campylobacter, Shigella and Salmonella. Some physicians in U.S. prefer not to treat parasites in children, but the presence of parasites does interfere with renourishment.

RICKETS-- a very common condition caused by vitamin D and calcium deficiency. It causes low muscle tone, bowing of legs, and a square-shaped head. Usually is resolved quickly, but in some cases, physical therapy may be necessary. The symptoms of Rickets sometimes ends up being misdiagnosed as Cerebral Palsy or other degenerative muscle diseases. (Ask lots of questions if CP is found on the child's medical record; it may only be Rickets.)

SELF-STIMULATORY BEHAVIORS-- when the child is observed, these behaviors can appear to be symptoms of "Attachment Disorder." These self-stimulatory behaviors ( such as head-banging, rocking, etc.) are very common among orphans since their environment is depressing, boring, and lonely.

DEVELOPMENTAL DELAYS-- it is almost a given that orphans will have some forms of delay, either physical, mental, or emotional. Expect it. However, after adoption, recovery is an incredible process that happens right before your eyes! Language delays are the most frequently seen delay, and this problem could continue if no effort is made in bridging the language barrier. If language delay continues and is not treated, the child will "act out" and will have hard to manage behavioral issues.

HEPATITIS B-- some children are carriers of this but you can live normally with it.

We have been advised to take the following health issues under very serious consideration and be sure to be fully satisfied with the reported test results.

TB
HIV
HEPATITIS C (carrier or diagnosed positive?)
FETAL ALCOHOL SYNDROME (FAS)
FETAL ALCOHOL EFFECT (FAE)