Dear Listmates:

Subject: Inappropriate=20 referrals

Background:

May 21, 2004, Jerri Jenista sent article of the = Chicago=20 Tribune about Russian children who have died and whose adoptive parents = have=20 been charged. The article = said:=20 =93One reason for the high number of deaths among Russians may be = that some=20 parents are unprepared for the problems related to fetal alcohol = syndrome in a=20 country where alcohol abuse is rampant, experts=20 say=94.

September 1, 2004, Erick Downing wrote: = =93In Russia=20 head circumference below the 3^rd centile means FAS until = proven=20 otherwise=94, =93I am seeing a higher percentage of children being = referred who are=20 not appropriate for the adopting family. This over last 3 o 4 months. Am = not=20 sure why.=94

September 2, 2004, Jerri Jenista wrote: "I = agree with=20 Sarah Basham that the rates of reported prenatal drug/HIV/HCV exposure = have=20 soared dramatically since the spring."

Matter:=20 Inappropriate referrals of FAS in = Spain

Adopci=F3n=20 internacional en Rusia: =BFun riesgo a=F1adido?

[International adoption in Rusia. An added=20 risk?]
An Pediatr = (Barc). 2004=20 Oct; 61(4): 344-5.=20

Full=20 text:=20 http://db.doyma.es/cgi-bin/wdbcgi.exe/doyma/mrevista.full= text?pident=3D13066433 (Spanish)

PDF=20 format: http://db2.doyma.es/pdf/37/37v61n04a13066433pdf001.pdf (Spanish)

Medline:=20 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=3DRetri= eve&db=3DPubMed&list_uids=3D15456592&dopt=3DAbstract

Notes:

1. = The=20 manuscript was sent to Anales de Pediatr=EDa for publication in March 8, = 2004.

2. = In=20 agreement with Erick Downing, from Spain I am seeing a higher percentage = of=20 children with FAS being referred who are not appropriate for the = adopting family=20 =A1since October 2003! Why? I am not completely sure. Nevertheless, a = responsible=20 for the international adoptions from Russia, in December 2003, said: = =93I=20 request that the Spanish families who are going to adopt sensitize so = that they=20 adopt to minors with disabilities=94. =20

3. = Regarding=20 infectious diseases, in agreement with Sarah Basham and Jerri Jenista, I = am=20 seeing that the rates of reported prenatal HCV exposure from Russia have = soared=20 in the course of last year. Too, I have observed 3 adopted girls from = China with=20 acute hepatitis B infection (horizontal transmission) whose preadoptive = medical=20 records showed serologic studies for HBV = negatives.

Best regards,

Gonzalo Oliv=E1n-Gonzalvo, = MD

Pediatrics and International Adoption=20 Center

Zaragoza, Spain