I lived in China from the age of 1 through 18. Growing up in an expatriate family, I led a relatively sheltered life. My myopic view of the world drastically changed when, at the age of 13, I visited a Chinese orphanage for the first time. Walking among the cribs, I was powerfully moved by the sight of so many children who found refuge in that orphanage. Because of China’s one-child policy and the cultural desire for sons, most of these children are foundlings, abandoned for being born female or born with disabilities. State-run institutions have limited resources and staffing for the number of children. Foreign-run institutions act as a pop-off valve for the system, taking in children with disabilities or complex medical needs. Both kinds of orphanages also support local foster homes. The quality of care and attention given to the children vary greatly among these different settings, from significant neglect to doting nannies.
In my first year of college, I co-founded a group dedicated to helping orphans in China and supporting adopted Chinese children in America. In addition to local cultural playgroups and mentoring programs, we partnered with orphanages in China to fundraise for children in need of specific medical interventions. The motivation behind our efforts became tangible to me when I visited a medical children’s home in Beijing, where babies in need of more complicated surgeries wait for available surgeons and funds. Holding in my arms the very children I had only seen in pictures online, I realized that above all else, what these babies needed was a chance to live, to grow, and to be loved in a family. This was the beginning of my journey to pediatrics, eventually leading to my residency at CHOP.
As I landed on this chosen profession, I wanted to continue advocating for orphans and adopted children. I learned that adoption medicine was a small but real entity. Not unexpectedly, CHOP’s International Adoption Health Program (IAHP) is one of few programs in the nation experienced in supporting children and families before, during, and after adoption. In the winter of my intern year, I did my first elective with IAHP. Armed with a new toolbox of medical knowledge and trained observation, I felt empowered to learn the role of a pediatrician on the journey to international adoption. Through shadowing the IAHP physicians, I saw the countless hours poured into reviewing each file, analyzing each photograph and video of a child overseas in lieu of a physical exam in order to identify health or developmental concerns. In office visits, I witnessed the process of acculturation and attachment beginning for children who just came to their adoptive families and the outcome for children in for their last follow-up visit years later.
Beyond physical medical concerns, IAHP addresses the emotional, behavioral, social, and cultural adjustments that these families face, all of which contribute to the overall health of the children. I am grateful for opportunities at CHOP like IAHP, and look forward to more time with the program.
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