The African orphan crisis and international adoption.

Roby, Jini L. ; Shaw, Stacey A.

The orphan crisis in sub-Saharan Africa has reached desperate proportions. In a region racked with civil war, poverty, and diseases, 12.3 million children have lost one or both parents to AIDS, and orphan numbers are projected to rise to 18.4 million by 2010 (UNAIDS, UNICEF, & USAID, 2004). With 25 million people in the region living with AIDS, overall infection rates are more than 20 percent in seven countries and reach 38 percent in some areas (UNAIDS, 2004a). Although adult prevalence rates in the region appear to have stabilized (UNAIDS, 2004b), AIDS claimed 2.2 million lives, and 3 million people became infected in 2003 (UNAIDS, 2004a). The full impact of the AIDS pandemic hits the hardest in the lives of young children. Although only 10 percent of the world's population live in sub-Saharan Africa, nearly 80 percent of the world's AIDS orphans come from this area (UNICEF, 2003). Each orphaned child has a story and a life.

Although the orphan crisis has been building for more than a decade, the global response has been slow and unorganized. In 2001 Carol Bellamy (2001), executive director of UNICEF, labeled the world's collective response as "the conspiracy of silence." In late 2003 Stephen Lewis (2003), the UN Secretary-General's special envoy for HIV/ AIDS in Africa, expressed grave concerns about the lack of a comprehensive plan for orphans. Fortunately, there are emerging signs that the global community is mobilizing. As a significant step, in 2001 the UN General Assembly Special Session made specific commitments to address the orphan issue, leading to the identification of a model for orphan care: strengthening the capacity of families, mobilizing and strengthening community-based responses, ensuring access to essential services, strengthening government's role in protecting the children, and raising awareness. These core points, first articulated by the widely accepted document Children on the Brink, are to guide the development of national and international orphan care policies and programs (UNAIDS, UNICEF, & USAID, 2002).

Most recently there has emerged a dialogue on possible solutions for African orphans (see Bhargava & Bigombe, 2003; Foster, 2002; Nyambedha, Wandibba, & Aagaard-Hansen, 2003; Williamson, 2003). This article examines some of these beginning efforts and provides a close examination of international adoption as one small but plausible option. It must be clearly understood that adoption is not being discussed as the only or even a priority option; indeed, it must be a last resort for children whose needs cannot be met otherwise.

FAMILY, COMMUNITY, AND GOVERNMENT EFFORTS

The suffering of African orphans is relentless and huge in magnitude. Orphans are more deprived than their national peers of education, socialization, and nutrition (UNICEF, 2003). They face isolation, prejudice, crime, abuse, neglect, child labor, prostitution, exploitation, and HIV infection (UNICEF, 2003). Psychological effects include depression, guilt, fear, and possible long-term mental health problems (Foster, 2002). Orphans living in child-headed household are even more at risk (Foster, Makufa, Drew, & Kralovec, 1997; Roby & Cochran, in press).

In traditional African culture, there were "no orphans," as parentless children were cared for within kin systems (Foster, 2002). Throughout sub-Saharan Africa today, extended families are caring for more than 90 percent of orphaned children (UNICEF, 2003). However, with the death of so many adults, few can afford to support extra children (Bhargava & Bigombe, 2003), and those who take in orphans face worse poverty and challenges in meeting even basic needs (UNICEF, 2003). The once seemingly limitless network of extended family--that expanded through geographic areas and generations--is depleting because of migration, Westernization, demographic changes, and AIDS (Foster, 2000). Many families who take in orphans are headed by grandparents, siblings, or other relatives (UNICEF, 2003). In some cases grandmothers are caring for multiple orphans. One widowed grandmother in Kenya lamented:

 In the past, people used to care for the orphans
 and loved them, but these days, they are so many,
 and many people died who could have assisted
 them, and therefore orphanhood is a common
 phenomenon, not strange. The few who are alive
 cannot support them. (Nyambedha et al., 2003,
 p. 306)

With the added strains, families are less willing or able to take orphans, and some even take advantage of them (Crawley, 2001; Wax, 2003). In some cultures, unequal treatment of kin children is tolerated because of traditional lines of inheritance and socially accepted family roles (Rutayuga, 1992). UNICEF in Kenya found that some orphans were treated poorly, abused, forced to work, and discriminated against (Crawley). These unfortunate developments underscore the need to provide more support to kin and protection for children in kin care rather than dismissing their central importance.

Although strengthening the family remains the primary goal, community efforts have coalesced to provide support for orphans and other vulnerable children and families. Thousands of local organizations and informal groups help through small business efforts, rotating credit and loan groups, grain-loan programs, and self-help groups (Foster, 2002; Menting, 2000; UNAIDS et al., 2004). They also help by paying school fees, giving psychological support, food, and clothing (Foster, 2002); distributing donations; raising community crops to pay for school fees; and visiting vulnerable orphans (UNICEF, 2003). Often from faith-based or women's groups, these community-based organizations (CBOs) care for orphans with cultural sensitivity and relevancy, but little funding (Foster, 2002). Such was the efforts of a group of community activists we observed, organized under the pastor of their church to assist terminally ill mothers in rural Mozambique. Because the CBO had no funding, their assistance was limited to visiting and comforting the women, cleaning their huts and surrounding areas, washing the families' clothes, and caring for the children. Their plea to the government and international community was to assist them with the means to provide urgently needed food and medical care for the families and children (personal communication with Pastor J. Antonio, July 24, 2004, Maputo, Mozambique). Financially supporting and working alongside CBOs is essential, as it leads to community empowerment, program acceptance, access to caregivers, and better support of children (Foster, 2002; Sayson & Meya, 2001).

At national levels, some countries have hastened to establish national plans for orphan care. Malawi was the first to form a multisectoral policy on orphans, the "National Task Force on Orphans" (Smart, 2003), and Uganda's "Hope Never Runs Dry" provides guidance, resource allocation, and a framework for implementing programs at all levels of society (UNAIDS et al., 2004). Unfortunately, factors, including financial strains, the stigma of HIV/AIDS, and lack of orphan visibility, have slowed the policy development in other countries. At the end of 2003, six--only 15 percent of sub-Saharan African countries--had developed a national orphan care policy, and eight nations were actively formulating such plans (UNICEF, 2003). To best serve orphans, policies need to be integrated with health, education, and development programs, and must seek to protect children as well as offer essential services (UNAIDS et al., 2002). Besides cooperation within each country, collaboration is essential with other nations, nongovernment organizations (NGOs), and private, community, and donor groups to develop and deliver services for orphans (Smart; UNAIDS et al., 2002).

Multinational organizations, international agencies, and NGOs have also been involved in raising awareness and providing support. Publications and conferences conducted through the United Nations on orphans and AIDS issues raise awareness and encourage nations to act. Globally, $5 billion (US dollars) was raised for AIDS-related spending in 2003, although an estimated US$20 billion will be needed by 2007 for care and prevention (UNAIDS, 2004c). Continued and increased international support is critical, in the forms of financial and material resources, commitment, and awareness (UNICEF, 2003).

Ideally, CBOs should be assisted at the grassroots level (Bhargava & Bigombe, 2003; Sayson & Meya, 2001), by NGOs with specific child welfare missions. An example of such a CBO initiative for orphan care is found in the Action for Children (AFC) program in Uganda. Sponsored by Holt International, a U.S.-based child welfare agency, and implemented by Action for Children, a CBO in Kampala, Uganda, it provides family preservation services to more than 300 families and 1,500 children. The objectives of the program include housing, education for children, securing an income source, health and nutrition, participation in community life, psychosocial well-being, and opportunity for peer mentoring. AFC uses supportive family care, community child care counseling, grandparent action support, children's clubs, and micro-credit (Action for Children, 2003; personal communication, with J. Nyeko, president, Action for Children, Kampala, Uganda, and B. Dahl, African program director, Hok International Children's Services, Eugene, Oregon, November 6, 2004).

Some children in Uganda are less fortunate, as we found in 2002 that children were picked up from the streets of Kampala and housed in delinquency facilities until a more permanent solution could be found with the assistance of NGOs. Some governments are faced with the difficult decision to care for children in temporary makeshift or institutional settings. In Kenya, where 650,000 children have been orphaned by AIDS (UNAIDS et al., 2004), hundreds of orphans were rounded up from the streets and put into "social halls," underground spaces in which children could be fed and housed overnight. Government officials regretted that this was nothing more than warehousing the children, but even this effort had strained their resources (personal communication, with B. M. Gachuhi, K. Johnson, and L. Kunga, officials at Ministry of Education, Ministry of Housing and Community Development, Nairobi, Kenya, September 23, 2003). These temporary measures are obviously not in the children's best interests; but neither are long-term institutions.

Experience has demonstrated the negative effects of institutionalizing children, including posttraumatic stress (Hoksbergen et al., 2003), mental health problems, developmental delays (Judge, 2003; Weitzman, 2003), and insufficient preparation for healthy adulthood (UNAIDS et al., 2004). Even devout advocates for keeping African children in Africa have acknowledged that adoption is preferable to institutionalization (Melone, 1976). John Williamson (2003), senior technical advisor for USAID'S Displaced Children and Orphans Fund, underscored the capacity of families and communities, and advocates, against caring for children in institutions. In addition, in a statement released on January 15, 2004, UNICEF declared:

 For children who cannot be raised by their own
 families, an appropriate alternative family environment
 should be sought in preference to institutional
 care, which should be used only as a
 last resort and as a temporary measure.

In-country adoptions may be seen as a promising option for these orphans. Kin adoptions have been the tradition in many regions of the world, such as in the Pacific (Roby & Matsumura, 2002), although more recent research (Roby & Payne, 2005) indicates that in-country, nonkin adoption is not likely to increase. In-country adoptions increased at an impressive rate in South Korea during the 1970s (Chun, 1989) through the efforts of the government and Holt International, but the rates have dropped off more recently (Lankov, 2003). On a worrisome note, adoption by nonkin has never been widely practiced in Africa because of strong cultural barriers. In some African cultures the adoption of a child is believed to introduce alien spirits into the family, and in-country adoption is most likely not going to provide a significant solution to the orphan crisis (Child Protection Society of Zimbabwe, 1999; personal communication with S. Muchanga, chair, child welfare section, Mozambican national legal reform UTREL committee, June 28, 2005). Williamson (as cited in Meriting, 2000), believes that in-country formal adoption may have a role in the crisis but that it would be inadequate to meet the need. Although we have yet to research this subject in depth, we have observed cultural beliefs against adoption in several African countries. Rather than adoption, family-based orphan care, similar to foster care, is more widely accepted and provides an encouraging option to orphans (Child Protection Society of Zimbabwe, 1999; personal interview with J. Otieno, family-based care director, Reach the Children, Nairobi, Kenya, September 18, 2003). One drawback to this solution, however, is that it does not provide a legally recognized and permanent family for the child. This concern raises the need to push for changes in the image of adoption as well as the need to provide long-term solutions for sustainability of families.

CURRENT ISSUES CONCERNING INTERNATIONAL ADOPTION

Determining the desirability of international adoption--particularly adoption of African children by Americans--is not simple. There are justifiable fears and worries at the threshold of such a discussion, on both sides. These concerns is raised, but not necessarily resolved, in this section.

Lingering Effects of American Slavery

The American slavery that began in the early 1500s and lasted through the Emancipation Proclamation in 1865 has been called one of the most tragic episodes in the history of humankind (Clarke, 1998). The century following emancipation saw rampant social discrimination against African Americans, in many ways embedded in the American social structure. The Civil Rights movement has led to significant improvements in government and private sector policies, but studies show that discrimination lingers in subtle ways in health care, higher education, employment, residence, and social status (Anderson & Massey, 2001; Cokley, Dreher, & Stockdale, 2004; Swim, Hyers, Cohen, Fitzgerald, & Brylsma, 2003).

In contrast, there are hopeful signs that racial relationships are improving over time. After a review of policies and attitudes between 1940 and 1978, Dovidio and Gaertner (1986) suggested that the United States had become more liberal and egalitarian by the late 1970s, noting that changes in mass-media stereotyping had increased race awareness. This positive trend continued into the late 1990s, when Bobo and Kluegel (1997) documented a decline in racial prejudice during the preceding three decades, although government policies intending to bring equality were met with mixed emotions. Other researchers confirmed that attitudes have continuously improved regarding principles of equal treatment, although views regarding government implementation of equal treatment policies and complete integration of neighborhoods and schools are improving at a slower rate (Schuman, Steeh, Bobo, & Krysan, 1997).

Modern-Day Slavery and Child Trafficking

Slavery was officially banned in Africa in the 1880s, but children there continue to be sold into domestic, agricultural, and sex industries today (International Organization for Migration [IOM], 2003). An incident in 2001 involving a ship carrying 250 children from Benin and Togo destined for slave labor in Cameroon highlighted this reality in Africa (CNN, 2001). Rumors that some children may be taken for adoption (Africans in America, 2003) heightened fears, although there are no documented cases of adoption trafficking into the United States from Africa. Isolated cases of ethical and legal problems in the adoption of children into the United States (Ethica, 2003; Kesich, 2004; Roby & Matsumura, 2002) raise the need for tightened regulations and enforcement of existing federal and state regulations--which are delineated in a later section.

Children's Identity and Well-Being

Many (Freundlich, 2000; Kim, 1978; Melone, 1976; Serbin, 1997) have commented on the importance of racial and cultural identity for children in their adoption experience. Thus, transracial adoptions have been opposed by some child advocates in the United States. In the early 1970s, the National Association of Black Social Workers (NABSW) strongly opposed placing African American children in white homes, and transracial adoption subsequently declined (Carter-Black, 2002; Hollingsworth, 1997). The NABSW has since accepted transracial adoption as an alternative, but in-race adoptions are still viewed as preferable (Carter-Black; McRoy, 2003). On this point, the National Association of Social Workers (NASW) has emphasized the need to keep race as an important factor in the adoption matching. The summary of NASW's policy statement on adoption and foster care states, "the placement of choice should be within the child's family. If no relatives are available, every effort should be made to place a child in a home with foster parents of a similar racial and ethnic background to the child's family" (NASW, 2003)

International conventions also recognize the need for cultural continuity. The United Nations Convention on the Rights of the Child (CRC) (1989) stressed international adoption as an alternative, "if the child cannot be placed in foster or an adoptive family in the child's country of origin" [Art. 21 (b)]. In addition, the Hague Convention on the Protection of Children and Co-operation in Respect of Intercountry Adoption (1993, hereinafter "the Hague Convention") requires member nations to give priority to in-country placement (para. 2) before considering international adoption (para. 3). Specific to this article, the question is to what degree African children adopted into the United States would be fostered in their cultural identity, receive acceptance, and enjoy a sense of belonging in their families. Owing to the recency of adopting African children, we were unable to find research data on African adoptees. Hence, we present the next most relevant research: transracial adoption within the United States, specifically white parents adopting African American children, which affords a large body of research data.

Some studies show that transracial adoptions may result in negative self-esteem and adjustment outcomes. DeBerry and colleagues (1996) found that as older children, African American adoptees displayed competence in a Eurocentric orientation, with 40 percent to 60 percent showing maladjustment despite their academic competence. Hollingsworth (2002) analyzed 93 media reports of interviews with transracial adoptees age 20 and older and found that 82 percent have had difficulty with ethnic identity development, and 97 percent have encountered racism. Other researchers point to racial identity confusion (McRoy & Grape, 1999) and advocate for policies that encourage same-race placements (McRoy, Oglesby, & Grape, 1997).

Others have reported that transracial adoptees overall are comfortable with their racial identity (Simon & Alstein, 1996), and that their parents want them to be proud of their racial background (Simon & Alstein, 2000). Vroegh (1997) found that 88 percent of transracially adopted children consider themselves as black or mixed race. Researchers also found that transracial adoptees have secure ethnoracial identities (Brooks & Barth, 1999), satisfying adoption experiences, and normal self-esteem levels (Hoopes, Alexander, Silver, Ober, & Kirby, 1997). Their adjustment is comparable to other adopted children (Feigelman & Silverman, 1984), with 70 percent of placements having satisfactory outcomes (Rushton & Minnis, 1997). Most people in the United States seem to approve of transracial adoption (Hollingsworth, 2000), but the need to educate families about the importance of child's racial identity continues (Vonk, 2001).

Children in the U.S. Foster Care System

One of the most sensitive aspects of discussing adoption of African children is the number of children in the U.S. child welfare system, especially the disproportionate numbers of African American children (Casey Family Programs, 2004; McRoy, 2003; McRoy et al., 1997). In September 2001 there were 542,000 children in the U.S. foster care system (Adoption and Foster Care Analysis and Reporting System [AFCARS], 2003). Of these, 126,000 children (23 percent) were awaiting adoption (their parents' rights had already been terminated or their permanency goals were set as adoption by state child welfare workers). Of the "waiting" children, 45 percent (56,306) were non-Hispanic African American children (AFCARS). During that year, 50,000 children of all races were adopted from the public welfare system (AFCARS), assisted by incentives given to states (Fostering Families, 2001) and tax credits to adoptive parents (Bush, 2003), and one-third (17,606, 35 percent) of them were African American (AFCARS). Besides the incentives for adoptive parents, transracial adoptions have also increased as a result of other federal efforts, including the Multiethnic Placement Act, passed in 1994 (U.S. Code, 2002a), and the Removal of Barriers to Interethnic Adoption Act (U.S. Department of Health and Human Services, 2002), which prohibit race from being a primary factor in public adoptions. Furthermore, the Adoption and Safe Families Act of 1997 (U.S. Code, 2002b) and the Adoption Promotion Act of 2003 (P.L. 108-145) have increased incentives to adopt more children out of foster care. Still, it is daunting that 126,000 children are waiting for permanent families, and 55,000 to 60,000 of those are African American children (AFCARS).

The number of waiting U.S. children may seem ironic juxtaposed to the increasing number of children being adopted from foreign countries. In 2005 more than 22,000 children were adopted from outside the United States, with the top five countries of origin being Mainland China (7,906), Russia (4,639), Guatemala (3,783), South Korea (1,630), and Ukraine (821) (U.S. Department of State, 2006). These numbers represent a steady rise over the past 10 years (Table 1). Why, then, should we discuss adopting African orphans? Arguably, adoption efforts should be focused solely on U.S. waiting children and on culturally appropriate practices for African American children, such as preventive strategies and screening more same-race adoptive families "in" rather than "out" (McRoy, 2003; McRoy et al., 1997).

However, there may still be some plausible justifications for considering adoption of African children. First, the numbers of children adopted from U.S. public child welfare system and from foreign countries are both on the rise. A five-year (1997 to 2002) comparison of domestic public adoption and international adoptions shows that although international adoptions increased 58 percent, domestic adoptions of children in foster care rose by 64 percent during the same period (see Figure 1 and Table 1). During the 2002-2004 period, the domestic rate decreased slightly (3.7 percent) while international adoptions increased by 13 percent. The 2002-2004 figures may indicate a new trend, but could also be a slight variation on the overall pattern.

[FIGURE 1 OMITTED]

Although domestic adoption seems to have reached a plateau in 2002 and has since declined slightly while international adoptions have continued to rise, the new federal laws encouraging adoptions should produce another spurt in the rate of adopting U.S. waiting children. It may therefore be fair to speculate that an increase in international adoptions does not necessarily decrease domestic public adoptions. However, this topic needs to be researched more extensively.

Some Americans may adopt internationally for reasons different from those adopting from the U.S. public system. Some parents may adopt internationally because they are more open to working with private (rather than public) agencies. They may feel apprehension about children who become available for adoption as a result of abuse, neglect, or substance abuse by birth parents. The adoptive families may perceive that international adoptions offer advantages over domestic adoptions, such as ease of approval. In addition, although it is not our intent to promote a practice or policy of "locking out" birth families, some adoptive families may prefer to avoid the now-common practice of open adoptions (Pertman, 2000). Most adoptive parents prefer to adopt children of the same race (Freundlich, 2000), but some parents seem to take pride in building a culturally diverse family (Roby, Wyatt, & Pettys, 2005). Finally, and perhaps most significantly, Americans may view the African situation as an international humanitarian crisis. As in the wake of the Korean conflict (Wilkinson, 1995), the fall of Saigon (Zigler, 1976), and the demise of communism in Eastern Europe (Bartholet, 1993), U.S. families may be drawn to rescue children from an extreme crisis compared with children in the U.S. foster care system, who at least have minimal guarantees of health care, nutrition, and protection. Already, there seems to be a growing interest in adopting these children from Africa (Americans for African Adoptions, 2004; Carter-Shorts, 2003; personal communication with S. Tompkins, director, Journeys of the Heart Adoption Services, Hilsborough, Oregon, December 9, 2003).

AFRICAN RESPONSE

The African response to international adoptions has not been adequately explored. It is generally perceived that most African countries do not wish to participate in international adoptions (personal communication with M. Fruendlich, policy director, Child Rights, Inc., January 1, 2004, New York; Nemapare, as cited in Menting, 2000). As previously discussed, in some countries adoption is met with resistance because of cultural beliefs and traditions (Child Protection Society of Zimbabwe, 1999; Menting, 2000). Only a handful of African countries are participating in international adoptions into the United States. The highest number of African children were adopted in 2005 from Ethiopia (441, up from 105 in 2002), where the government has approved four U.S. agencies to conduct adoptions (U.S. Department of State, 2006). South Africa, Kenya, and Liberia have allowed a few more children to be adopted, but most African nations remain closed to international adoption. Many African countries have lengthy processes that make it difficult to adopt, and some do not allow adoption at all. For example, membership in the Moslem faith is required to adopt in Morocco, complicated laws differ in many states of Nigeria, and adoption is considered only after 18 months of fostering a child in Malawi.

However, international adoption is a legitimate option in the wider context of the orphan crisis (personal communication, with S. Hunter, independent consultant, UNICEF, Nairobi, Kenya, September 19, 2003). In addition, the African response cannot be generalized, as it appears to vary widely even within one country. On the first author's 2003 trip to Africa, many government and private-sector leaders expressed an interest in exploring the option of international adoptions. Some asked extensive questions about the adjustment of African American children in the United States, the legal and procedural safeguards in the international process, and the rights extended to adopted children. A Kenyan social worker and teacher who operates a day center for more than 120 orphans wrote:

 We are hit by so much poverty, HIV/AIDS,
 and sometimes ignorance which we can't fight,
 and drought which makes it so difficult for our
 lives are cut short by lack of enough food and
 lack of human rights for especially women and
 orphaned children and widows, I will work with
 all my friends in the world to open more doors
 and create hope for all children. If adoption
 will be officially accepted [by my country], and
 get the right information and caring families
 who love life, I will be willing to help to make
 children orphaned and desperate have a family
 and get education and freedom to choose their
 rights. (personal communication with D.
 Nzomo, September 25,2003, emphasis in original).

In contrast, a difference between the national and provincial levels was noted in a 2004 visit to Mozambique, where there are 1.5 million orphans (UNAIDS et al., 2004) and, according to the UNICEF office in Maputo (personal communication with O. Perrais, chief consultant, July 23, 2004), at least 280,000 of them are "double" orphans (both parents lost). Officials at one province had voiced support for international adoption, along with frustration with the inadequate resources to meet the medical, nutritional, and psychological needs of the orphans. However, national officials reported that orphans were being adequately cared for by kin and substitute families or in institutions and that adoption was not needed (personal communication with F. Lucas, deputy director, Ministry of Social Action, July 23, 2004, Maputo, Mozambique).

PROTECTION OF CHILDREN IN THE ADOPTION PROCESS

In the dialogue about international adoption, it is essential to address adequate legal and procedural protection of children and families as a threshold matter, which must be available and enforced with vigilance in the sending, transit, and receiving countries. The lack of such regulations and enforcement have given rise to grey and black market practices in the Marshall Islands (Roby & Matsumura, 2002), Guatemala (Ethica, 2003), and Cambodia (Joint Council on International Children's Services, 2004), to name a few. Most questionable cases of international adoption into the United States can be traced back to such a lack of regulations or their enforcement in the sending and transit countries, as well as actions motivated by potential profit (UNICEF, 2004).

Legal and Procedural Safeguards

The United States has a legal structure for regulating international adoption, using a combination of federal and state regulations, albeit imperfect in design and administration. Federal regulations require immigration visas for all children coming into the United States for adoption purposes. This process includes a background check for criminal or child abuse history, and a homestudy--an evaluation of the prospective family by a licensed adoption agency. This homestudy examines the applicants' motives for adopting, physical and psychological health, financial resources to raise the child, and verification of suitability by third parties. Then, before the child can leave the sending country for entrance into the United States, proof that the child is an orphan or was either abandoned or properly relinquished (Code of Federal Regulations, 2004) is required before the orphan visa is granted. On finalization of adoption by U.S. citizens, the child automatically becomes a U.S. citizen under the Child Citizenship Act of 2000 (U.S. Code, 2003), and a Certificate of Citizenship is issued (U.S. Department of Homeland Security, 2003). The United States has tried to shore up its monitoring efforts as stated in a press release:

 The Departments of State and Homeland Security
 strongly support transparent, consistently
 applied adoption processes that provide strong
 safeguards for the welfare and interests of children,
 birth parents and adoptive parents. We
 work actively to eliminate illegal activities ... and
 facilitate the appropriate, legal international
 movement of adopted children (U.S. Departments
 of State and Homeland Security,
 2003).

However, such assurances do not always mean a fail-proof protection against misuse, misrepresentation, or fraud. In a recent case (United States Department of Justice v. Lauryn Galindo), the director of a Seattle-based adoption agency was found guilty on charges of conspiracy to commit visa fraud, money structuring, and money laundering. She was sentenced to a prison term, ordered forfeitures of funds obtained illegally, and ordered to pay restitution. As a result, Cambodia has declared a moratorium on the adoption of children by U.S. adoptive applicants (Joint Council on International Children's Services, 2004). This case represents the first major federal prosecution of adoption-related violations, and hopefully will raise the bar on ethical practices by all agencies.

At an international level, in 2000 the United States ratified the Hague Convention, which is designed to provide many procedural protections with an emphasis on preventing the abduction and sale of, or traffic in children (Hague Convention, para 4). It is anticipated that in 2006 the provisions of the Hague Convention will take effect. Under the convention, the basic federal protections and procedures already in place would be maintained, but all international adoptions between the United States and other Hague countries would feature heightened protection for children. Hence dialogue concerning international adoption should include the ratification of the Hague Convention and implementation legislation in the sending country.

At the state level, government officials license and monitor the adoption agencies that are responsible for conducting home evaluations, facilitating the necessary paper work, and providing post-placement supervision. If the adoption is not finalized in the sending country, courts can approve the finalization of international adoptions only upon finding that proper legal steps have been taken. Caution must be stated, however, that in some states the licensing protocols are not as stringently monitored as they should be and ethical violations are difficult to prosecute, especially if there is no state law that requires adherence to foreign country's and U.S. federal laws (Roby, 2004). Private adoptions--that is, those that are not facilitated by licensed adoption agencies but typically by attorneys--can also pose problems in that professional oversight is not always required or available. On the positive side, states laws require that adopted children be treated in every aspect as children born into the family, including the rights of support and inheritance. The states are also required to investigate and intervene if there are any reports of suspected or actual child abuse or neglect of any children, without regard to adoption status.

CONCLUSION AND IMPLICATIONS

Certainly, the primary solution to the African orphan crisis is to build sustainable, community-based programs to care for the children. Many examples are beginning to spring up, and although the efficacy of such programs in terms of providing for the physical and emotional needs of children should be evaluated, the programs provide culturally appropriate options for children. In-country adoptions should be fostered through education and support. In this larger context, international adoption is not a panacea for African orphans. On the contrary, it is a relatively short-term, small solution to a huge problem calling for efforts on a heroic scale. Only when kinship and community efforts fail to provide a safe and loving family for the child should adoption be considered, starting with in-country options if they are appropriate in the cultural context. In the meantime, the global community should consider the option of international adoption. Adoption must be approached with careful planning and safeguards in place. The numbers of children thus served will be relatively few, but the positive effect on each child may outweigh the potential downsides of international adoption. If carried out with respect to the history and culture of the child's African origins and with meticulous attention to the ethical and legal details, it is possible to offer the gift of a family, safety, and love to a small number of children. In January 2004, UNICEF released an important position statement:

 Inter-country adoption is one of a range of care
 options which may be open to children, and
 for individual children who cannot be placed
 in a permanent family setting in their countries
 of origin, it may indeed be the best solution [italics
 added].

UNICEF (2004) cautioned that the best interests of the child must always be the guiding principle in international adoptions and that the process must provide secure regulations to avoid the risks involved. Although all of the concerns regarding international adoptions cannot be eliminated, there are substantial legal and procedural protections in the United States, and reciprocal protections can be developed bilaterally on the basis of best practice concepts provided in the CRC and the Hague Convention. Toward this end, dialogue should occur between governments, practitioners, and advocates in both sending and receiving countries.

Adoption can be a compatible part of the five-point action framework for orphans, provided that it is seen as only a small and temporary part of the overall plan. The option to place children for adoption may, at least temporarily, strengthen the capacity of families and communities to care for orphans. Pre-adoption education and efforts for same-race placements, as well as postadoption services, should be well defined and substantial. To assist in the retention and promotion of cultural identity and ease the trauma of adoption, open adoption arrangements could be considered. NGOs and international agencies engaged in adoption activities should provide other child welfare programs in the sending countries, such as supporting temporary foster care arrangements while families shore up their resources and increasing access to medical services, education, and nutrition. Such child welfare activities should concentrate on programs and practices that build long-term capacity; for example, hiring local leadership and using community networks for orphan care. Continuing collaboration among governments and child welfare leaders should be facilitated with ongoing reviews of adoption policies and practices. Research should focus on the cultural implications of adoption practices and outcomes of African international adoptions. Exchanges with African colleagues, joint conferences, and student internships would also provide channels for enhanced dialogue on this topic.

Original manuscript received January 27, 2004 Final revision received May 9, 2005 Accepted August 15, 2005

REFERENCES

Action for Children. (2003). Annual report 2003. (Available from the first author.) Additional information available at http://www.actionforchildren.org

Adoption and Foster Care Analysis and Reporting System. (2003). Retrieved September 6, 2004, from http://www.acf.dhhs.gov/programs/cb/publications/afcars/report8.htm

Adoption Promotion Act of 2003, P.L. 108-145. Retrieved September 6, 2004, from http://thomas.loc.gov/cgi-bin/query/D?c108:4:./temp/~c108NpBc8P.

Africans in America, Inc. (2003). Slavery trade in the past. Retrieved September 6, 2004, from http://www.africanslavery.org/aia_new/assets/pages/undef01.html

Americans for African Adoptions, Inc. (2004). Retrieved September 20, 2004, from http://www.africanadoptions.org

Anderson, E., & Massey, D. S. (2001). Problem of the century: Racial stratification in the United States. New York: Russell Sage Foundation.

Bartholet, E. (1993). International adoption: Current status and future prospects. Future of Children, 3(1), 89-104.

Bellamy, C. (2001, April 26). To the Organization of African Unity Summit on HIV/AIDS, TB and other infectious diseases [Speech]. Retrieved September 6, 2004, from http://www.unicef.org/media/media_10724.html

Bhargava, A., & Bigombe, B. (2003). Public policies and the orphans of AIDS in Africa. British Medical Journal, 362, 1387-1389.

Bobo, L., & Kluegel, J. R. (1997). Status, ideology, and dimensions of whites' racial beliefs and attitudes: Progress and stagnation. In S. A. Tuch & J. K. Martin (Eds.), Racial attitudes in the 1990s: Continuity and change (pp. 93-120). Westport, CT: Praeger.

Brooks, D., & Barth, R. P. (1999). Adult transracial and inracial adoptees: Effects of race, gender, adoptive family structure, and placement history on adjustment outcomes. American Journal of Orthopsychiatry, 69, 87-99.

Bush, G. W. (2003). National Adoption Month, 2003. By the President of the United States of America: A Proclamation. Retrieved September 6, 2004, from www.whitehouse.gov/news/releases/2003/11/20031107-12.html

Carter-Black, J. (2002). Transracial adoption and foster care placement: Worker perception and attitude. Child Welfare, 81, 337-370.

Carter-Shotts, C. (2003, September 19). Adoption for African children. Presentation at International Orphan Care Conference, Nairobi, Kenya.

Casey Family Programs. (2004). Disproportionality: How can we promote parity for children of color in the child welfare system? Retrieved September 6, 2004, from http://www.casey.org/OurWork/Disproportionality/

Child Protection Society of Zimbabwe. (1999). How can we help? Approaches to community-based care: A guide for groups and organisations wishing to assist orphans and other children in distress. Retrieved September 17, 2004, from http://www.kubatana.net/cps/

Chun, B. H. (1989). Adoption and Korea. Child Welfare, 68, 255-260.

Clarke, D. (1998). Slaves and slavery. London: PRC Publishing.

CNN. (2001, April 15). Fears grow for children on slave ship. Retrieved September 6, 2004, from http://edition. cnn.com/2001/WORLD/africa/04/16/benin. children/index.html

Cokley, K., Dreher, G. F., & Stockdale, M. S. (2004). Toward inclusiveness and career success of African Americans in the workplace. In M. S. Stockdale & F. J. Crosby (Eds.), The psychology and management of workplace diversity (pp. 168-190). Malden, MA: Blackwell.

Code of Federal Regulations. (2004),Title 8 CFR, Section 204.3-Orphans. Retrieved September 22, 2004, from http://uscis.gov/graphics/services/appen.htm

Crawley, M. (2001). Cribs and hugs for Africa's AIDS orphans. Christian Science Monitor, 93(173), 1.

DeBerry, K. M., Scarr, S., & Weinberg, R. (1996). Family racial socialization and ecological competence: Longitudinal assessments of African-American transracial adoptees. Child Development, 67, 2375-2399.

Dovidio, J. F., & Gaertner, S. L. (1986). Prejudice, discrimination, and racism: Historical trends and contemporary approaches. In J. F. Dovidio & S. L. Gaertner (Eds.), Prejudice, discrimination, and racism (pp. 1-5). Orlando, FL: Academic Press.

Ethica. (2003). [Position paper on Guatemala]. Retrieved September 6, 2004, from http://www.ethicanet.org/item.php?recordid=guatemalappaper

Feigelman, W., & Silverman, A. R. (1984). The long-term effects of transracial adoption. Social Science Review, 58, 588-602.

Foster, G. (2000). The capacity of the extended family safety net for orphans in Africa. Psychology, Health & Medicine, 5(1), 55-62.

Foster, G. (2002). Supporting community efforts to assist orphans in Africa [Electronic version]. New England Journal of Medicine, 346, 1907-1911.

Foster, G., Makufa, C., Drew, R., & Kralovec, E. (1997). Factors leading to the establishment of child-headed households: The case of Zimbabwe [Electronic version]. Health Transition Review, 7(2), 155-168.

Fostering Families Magazine. (2001). Hope for children bill adoption tax credit 2001. Retrieved September 6, 2004, from http://library.adoption.com/LawsLegal-Issues/ Hope-for-Children-Bill-Adoption-Tax-Credit-2001/article/240/1.html

Freundlich, M. (2000). Adoption and ethics: The role of race, culture, and national origin in adoption. Washington, DC: Child Welfare League of America.

Hague Convention on the Protection of Children and Co-operation in Respect of Intercountry Adoption. (1993, May 29). Retrieved September 6, 2004, from http://hcch.e-vision.nl/index_en.php?act=conventions.text&cid=69

Hoksbergen, R. A. C., ter Laak, J., van Dijkum, C., Rijk, S., Rijk, K., & Stoutjesdijk, F. (2003). Posttraumatic stress disorder in adopted children from Romania. American Journal of Orthopsychiatry, 73, 255-265.

Hollingsworth, L. D. (1997). Effect of transracial/ transethnic adoption on children's racial and ethnic identity and self-esteem: A meta-analytic review. Marriage and Family Review, 25(1/2), 99-130.

Hollingsworth, L. D. (2000). Sociodemographic influences in the prediction of attitudes toward transracial adoption. Families in Society, 81, 92-100.

Hollingsworth, L. D. (2002). Transracial adoptees in the media: 1986-1996. American Journal of Orthopsychiatry, 72, 289-293.

Hoopes, J. L., Alexander, L. B., Silver, P., Ober, G., & Kirby, N. (1997). Formal adoption of the developmentally vulnerable Africa-American child: Ten-year outcomes. Marriage and Family Review, 25(3/4), 131-144.

International Organization for Migration. (2003, March 24). The trafficking of women and children in Southern African region. Pretoria, South Africa: Author.

Joint Council on International Children's Services. (2004). Cambodia continues to remain closed to intercountry adoptions with the United States. Retrieved September 7, 2004, from http://www.jcics.org/Cambodia.htm

Judge, S. (2003). Developmental recovery and deficit in children adopted from Eastern European orphanages. Child Psychiatry and Human Development, 34(1), 49-62.

Kesich, G. D. (2004, September 2). Adoption investigation involves Maine agency. Press Herald. Retrieved September 21, 2004, from http://pressherald.mainetoday.com/news/state/040902maps.shtml

Kim, D. S. (1978). Issues in transracial and transcultural adoption. Social Casework, 5, 477-486.

Lankov, A. (2003, September 3). Adoption, abuse of children? Korea Times. Retrieved March 5, 2004, from http://times.hankooki.com/Ipage

Lewis, S. (2003, September 21). Speech at the XIIIth International Conference on AIDS and STIs in Africa. Nairobi, Kenya.

McRoy, R. (2003). Value dilemmas: Another look at placement issues for African American children. Adoption Quarterly, 6(4), 1-6.

McRoy, R. G., & Grape, H. (1999). Skin color in transracial and inracial adoptive placements: Implications for special needs adoptions. Child Welfare, 78, 673-692.

McRoy, R. G., Oglesby, Z., & Grape, H. (1997). Achieving same-race adoptive placements for African American children: Culturally sensitive practice approaches. Child Welfare, 76, 85-104.

Melone, T. (1976). Adoption and the crisis in the third world: Thoughts on the future. Chronicle, 28, 20-25.

Menting, A. (2000). The village and the children. Children and AIDS. Harvard AIDS Review. Retrieved September 10, 2004, from http://www.aids.harvard.edu/news_publications/har/ spring_2000/spring00-5.html

National Association of Social Workers. (2003). Foster care and adoption [Abstract], retrieved May 4, 2005, from http://www.naswdc.org/resources/abstracts/abstracts/foster.asp

Nyambedha, E. O., Wandibba, S., & Aagaard-Hansen, J. (2003). Changing patterns of orphan care due to the HIV epidemic in western Kenya. Social Science and Medicine, 57, 301-311.

Pertman, A. (2000). Adoption nation: How the adoption revolution is transforming America. New York: Basic Books.

Roby, J. (2004). Understanding sending country's traditions and policies: Avoiding legal and cultural pitfalls. Journal of Law and Family Studies, 6, 303-322.

Roby, J., & Cochran, G. (in press). Child-headed households in Mozambique: Developing a needs-based policy. Social Development Issues.

Roby, J., & Matsumura, S. (2002). If I give you my child, aren't we family? A study of birthmothers who participated in Marshall Islands--U.S. adoptions. Adoption Quarterly, 5(4), 7-31.

Roby, J., & Payne, K. (2005). The feasibility of intra-family and in-country adoptions in the Marshall Islands. Families in Society, 86, 547-557.

Roby, J., Wyatt, J., & Pettys, G. (2005). Openness in international adoptions: A study of U.S. families who adopted from the Marshall Islands. Adoption Quarterly, 8(3), 47-71.

Rushton, A., & Minnis, H. (1997). Annotation: Transracial family placements. Journal of Child Psychology and Psychiatry, 38, 147-159.

Rutayuga, J.B.K. (1992). Assistance to AIDS orphans within the family/kinship system and local institutions: A program for East Africa. AIDS Education and Prevention, 4(Suppl.), 57-68.

Sayson, R., & Meya, A. F. (2001). Strengthening the roles of existing structures by breaking down barriers and building up bridges: Intensifying HIV/AIDS awareness, outreach, and intervention in Uganda. Child Welfare, 80, 541-550.

Serbin, L.A. (1997). Research on international adoption: Implications for developmental theory and social policy. International Journal of Behavioral Development, 20, 83-92.

Schuman, H., Steeh, C., Bobo, L., & Krysan, M. (1997). Racial attitudes in America: Trends and interpretations. Cambridge, MA: Harvard University Press.

Simon, R. J., & Alstein, H. (1996). The case for transracial adoption. Children and Youth Services Review, 18(1/2), 5-22.

Simon, R. J., & Altstein, H. (2000). Adoption across borders: Serving the children in transracial and intercountry adoptions. Lanham, MD: Rowman & Littlefield.

Smart, R. (2003). Policies for orphans and vulnerable children: A framework for moving ahead. Retrieved September 14, 2004, from http://www.policyproject.com/pubs/generalreport/OVC_Policies.pdf

Swim, J. K., Hyers, L. L., Cohen, L. L., Fitzgerald, D. C., & Brylsma, W. H. (2003). African American college students' experiences with everyday racism: Characteristics of and responses to these incidents. Journal of Black Pyschology, 29(1), 38-67.

United Nations Convention on the Rights of the Child. (1989). Retrieved September 6, 2004, from http://www.unhchr.ch/html/menu3/b/k2crc.htm

UNAIDS. (2004a). Fact Sheet: AIDS epidemic in sub-Saharan Africa. Retrieved September 6, 2004, from http://www.unaids.org/bangkok2004/factsheets.html

UNAIDS. (2004b). Understanding the latest estimates of the global AIDS epidemic--July 2004. Retrieved September 10, 2004, from http://www.unaids.org/bangkok2004/docs/QA_Epi_en.doc

UNAIDS. (2004c). Executive summary: 2004 report on the global AIDS epidemic. Retrieved September 21, 2004, from http://www.unaids.org/bangkok2004/GAR2004_html/ ExecSummary_en/Execsumm_en.pdf

UNAIDS, UNICEF, & USAID. (2002). Children on the brink 2002: A joint report on orphan estimates and program strategies. Retrieved September 6, 2004, from http://www.unicef.org/publications/index_4378.html

UNAIDS, UNICEF, & USAID. (2004). Children on the brink 2004: A joint report of new orphan estimates and a framework for action. Retrieved September 6, 2004, from http://www.unicef.org/publications/cob_layout6-013.pdf

UNICEF. (2003). Africa's orphaned generations. Retrieved September 6, 2004, from http://www.unicef.org/publications/africas_orphans.pdf

UNICEF. (2004). UNICEF's position on inter-country adoption. Retrieved September 6, 2004, from http:// www.unicef.org/media/media_15011.html

United States Department of Justice v. Lauryn Galindo. Retrieved May 4, 2005, from http://www.jcics.org/Cambodia.htm

U.S. Code, 42 U.S.C. [section] 5115. (2002a). Adoption and Safe Families Act. Retrieved September 22, 2004, from http://uscode.house.gov/uscode-cgi/fastweb.exe?search

U.S. Code, 42 U.S.C. [section] 671. (2002b). Multiethnic Placement Act. Retrieved September 22, 2004, from http://uscode.house.gov/uscode-cgi/fastweb.exe?search

U.S. Code, 8 U.S.C. [section] 1431. (2003). Child Citizenship Act. Retrieved September 22, 2004, from http://uscode.house.gov/uscode-cgi/fastweb.exe?search

U.S. Department of Health and Human Services, Administration for Children and Families. (2002). A guide to the Multiethnic Placement Act of 1994 as amended by the Interethnic Adoption Provisions of 1996. Retrieved January 19, 2004, from http://naic.acf.hhs.gov/profess/mepa.cfm

U.S. Department of Health and Human Services, Administration for Children and Families. (2005). Adoptions of children with public child welfare agency involvement by state. Retrieved March 21, 2006, from http://www.acf.hhs.gov/programs/cb/stats_research/afcars/tar/report10.htm

U.S. Department of Homeland Security. (2003). USCIS announces program to streamline process for child citizenship certificates. Retrieved September 7, 2004, from http://uscis.gov/graphics/publicaffairs/newsrels/CCA_Release.pdf

U.S. Department of State. (2006). Immigrant visas issued to orphans coming to the U.S. Retrieved March 21, 2006, from http://travel.state.gov/family/adoption_resources_02.html (See http://travel.state.gov/family/adoption_country.html for information on specific countries)

U.S. Departments of State and Homeland Security. (2003, November 17). Department of State and Department of Homeland Security work towards implementation of the Hague Convention on Intercountry Adoptions. Retrieved September 6, 2004, from http://www.state.gov/r/pa/prs/ps/2003/26281.htm

Vonk, M. E. (2001). Cultural competence for transracial adoptive parents. Social Work, 46, 246-255.

Vroegh, K. S. (1997). Transracial adoptees: Developmental status after 17 years. American Journal of Orthopsychiatry, 67, 568-575.

Wax, E. (2003, August 8). A generation orphaned by AIDS, Kenyan children struggle to survive as relatives shun them or take advantage. Washington Post, p. A1.

Weitzman, C. C. (2003). Developmental assessment of the internationally adopted child: Challenges and rewards. Clinical Child Psychology and Psychiatry, 8, 303-313.

Williamson, J. (2003). Distorted image of AIDS and orphaning in Africa. Retrieved September 17, 2004, from http://www.comminit.com/strategicthinking/ st2003/thinking-145.html

Wilkinson, H. S. (1995). Psycholegal process and issues in international adoption. American Journal of Family Therapy, 23(2), 173-183.

Zigler, E. (1976). A developmental psychologist's view of operation babylift. American Psychologist, 31, 329-340.

Jini L. Roby, JD, MSW, MS, is associate professor, School of Social Work, Brigham Young University, 2166 JFSB, Provo, UT 84602; e-mail: [email protected]. Stacey A. Shaw, MSW, is currently conducting research on orphan care in Africa.

Table 1: Domestic and
International U.S. Adoptions.

 U.S. Adoption International
 of Children Adoptions
 from the Public into the
 Welfare United
 System (a) States (b)

1997 31,030 12,743
1998 37,059 15,774
1999 46,750 16,363
2000 51,000 17,718
2001 51,000 19,237
2002 53,000 20,099
2003 50,000 21,616
2004 51,000 22,884
2005 -- 22,728

Note: -- = not available.

(a) Source: U.S. Department of Health and Human Services.
Trends in foster care and adoption--FY2000-FY2004. Retrieved
March 23, 2006, from http://www.acf.hhs.gov/programs/cb/
stats_research/afcars/trends.htm

(b) Source: U.S. Department of State. Immigrant visas issued
to orphans coming to the U.S. Retrieved March 23, 2006, from
http://travel.state.gov/family/adoption/stats/stats451.html