Foreign adoptees are
screened for disease

By Susan Kreifels
Star-Bulletin

Most adopted children coming into Hawaii from foreign countries come through government programs and are screened for diseases before they arrive, a local adoption agency official said yesterday.

Daniel Leung, administrator for Child & Family Service, said his agency adopts only from countries that have formal government adoption programs. Those programs require health screening for diseases endemic to particular countries. The U.S. State Department does not issue visas for the children until they have been screened, he said.

Leung was reacting to reports about a Marshallese boy who moved to North Dakota to live with unrelated legal guardians. The boy spread tuberculosis to 56 people there.

Leung said nations in Micronesia do not have government adoption programs and most children would come through private connections. More risk is involved, he said, when going through private agencies that work in countries without government adoption programs.

Kasio Mida, consul general here for the Federated States of Micronesia, said his government plays no role in international adoption and requires no medical screening. Mida said most adoptions in his country would be among relatives.

Micronesians are able to freely emigrate to the United States, and Hawaii is a main destination for them. A federal census in 1998 showed at least 6,000 lived here, but officials say numbers could be twice as high.

Leung said his agency has helped couples in Hawaii adopt thousands of children from countries around the world that have government programs. He wasn't aware of any children bringing communicable diseases to the islands.

Although the Marshallese boy's tuberculosis was not drug-resistant, the outbreak points out problems that could occur when children are adopted from countries where drug-resistant TB is becoming epidemic, said Dr. Laurie Miller, an adoption medicine specialist at New England Medical Center's children's hospital in Boston.

"I think we will see much more clinical disease, and the disease will be much more difficult to treat in the future," she said in an interview with The Associated Press.

In an editorial in the New England Journal of Medicine, Miller said children brought into the country for adoption should be tested for conditions such as TB and syphilis.

U.S. families have adopted more than 125,000 children from other countries since 1986. Although children must get check-ups before they get a visa to travel to the United States, that is not enough to ensure that the youngsters are healthy, Miller said.