By JANE GROSS and WILL CONNORS
ST. PAUL — Ethiopia was not on Mark and Vera Westrum-Ostrom’s list when they first visited Children’s Home Society & Family Services here to explore an international adoption.
Ukraine was first, because of their family heritage, until the couple discovered that the adoption system there was chaotic, with inaccurate information about orphans’ health and availability.
Vietnam was second, after they saw videos of well-run orphanages. But the wait would be at least a year and a half.
Then they learned about Ethiopia’s model centers for orphans, run by American agencies, with an efficient adoption system that made it possible for them to file paperwork on Labor Day and claim 2-year-old Tariku, a boy with almond eyes and a halo of ringlets, at Christmas.
From Addis Ababa, the capital city, they traveled to the countryside to meet the boy’s birth mother, an opportunity rare in international adoption. And at roughly $20,000, the process was affordable compared with other foreign adoptions, and free of the bribes that are common in some countries.
It is no wonder, given these advantages, that Ethiopia, a country more often associated by Americans with drought, famine and conflict, has become a hot spot for international adoption. Even before the actress Angelina Jolie put adoption in Ethiopia on the cover of People magazine in 2005, the number of adoptions there by Americans was growing. The total is still small — 732 children in 2006, out of a total of 20,632 foreign adoptions, but it is a steep increase, up from 82 children adopted in 1997.
Ethiopia now ranks 5th among countries for adoption by Americans, up from 16th in 2000. In the same period, the number of American agencies licensed to operate there has skyrocketed from one to 22.
The increasing interest in Ethiopia comes at a time when the leading countries for international adoption, China, Guatemala and Russia, are, respectively, tightening eligibility requirements, under scrutiny for adoption corruption and closing borders to American agencies.
Ethiopia’s sudden popularity also comes with risks, say government officials there and in America.
“I don’t think we’ll be able to handle it,” said Haddush Halefom, an official at the Ministry of Women’s Affairs, which oversees adoption. “We don’t have the capacity to handle all these new agencies, and we have to monitor the quality, not just the quantity.”
Capping the number of agencies is one solution. And that is what some international adoption officials in the United States are now urging the Ethiopian government to do.
Of concern is the ability of agencies to handle the rising demand, which may have contributed to a recent mix-up involving two families sent home with the wrong children by Christian World Adoption, an established agency, although relatively new to Ethiopia. That case prompted inquiries by the State Department and the nonprofit Joint Council on International Children’s Services in Virginia, a child welfare and advocacy organization, and the adoption agency itself, said Thomas DiFilipo, president of the joint council.
Officials at Christian World Adoption did not reply to e-mail messages or telephone calls. But Mr. DiFilipo said the agency was reviewing its procedures and has hired immigration lawyers to resolve the mix-up.
The consensus, Mr. DiFilipo said, is that the mix-up was “an honest mistake.” But, he added, “This could be the byproduct of a staff handling 35 placements when they’re used to handling 20.”
Children’s Home Society & Family Services, founded in 1889, began working in Ethiopia in 2004. The agency completed about 300 adoptions in its first three years in Ethiopia, and expects to complete that many in 2007 alone. Along with Wide Horizons For Children in Waltham, Mass., the society is credited with helping Ethiopia create a model for international adoption.
Ethiopia, with a population of 76 million, has an estimated 5 million children who have lost one or both parents, according to aid organizations. Many African nations have outlawed or impeded the adoption of their children by foreigners. Ethiopia has welcomed American and European families who are willing to provide homes for children who have lost both parents to AIDS, malaria, tuberculosis or starvation, or who come from families too destitute to feed and clothe them. (The adoption process includes routine screening for HIV infection.)
Two elements distinguish Ethiopia’s adoption system, according to dozens of experts. One is the existence of transitional homes for orphans, in the countryside and in the capital, with services and staffing that are rare in the developing world — paid for by American agencies.
Not long ago, Sandra Iverson, a nurse practitioner from the University of Minnesota’s international adoption health clinic, the first of its kind in the United States, was invited to visit the Children’s Home Society’s Ethiopian centers.
She arrived with a neonatal otoscope, to diagnose ear infections; the Red Book, the bible of pediatrics; and scarce antibiotics. She left confident that Ethiopia’s orphans enjoyed unusual care.
“You don’t hear crying babies,” Ms. Iverson said. “They are picked up immediately.”
The other signature of the Ethiopian system is that adopting families are encouraged to meet birth families and visit the villages where the children were raised, a cutting-edge practice in adoptions. Some agencies provide DVDs or photographs that document the children’s past.
Russ and Ann Couwenhoven, in Ham Lake, Minn., recently showed one such video to 6-year-old Tariku, one of three children they have adopted from Ethiopia. The boy seemed proud of the beautifully painted house he had lived in, they said, and the uncle who had sheltered him for as long as he could.
Linda Zwicky brought 2-year-old Amale home five days before the Memorial Day weekend, with a letter from the child’s grandmother that described holding the motherless infant at her breast even though she had no milk.
Sometimes such vividness is too much. Melanie Danke and her husband, Kirk Frauenheim, of Minneapolis, adopted 6-year-old twins and a 3-year-old, all siblings. One of the twins “would work herself up until she was inconsolable” looking at photos of the aunt and grandmother who raised her, Ms. Danke said. So she has tucked the photos away for now.
David Pilgrim, vice president of adoption services at the Children’s Home Society, said the agency spends $2 million a year on its Ethiopian facilities.
At the main transitional home, on the outskirts of Addis Ababa, a staff of 170 care for about 120 children, ensuring that the children have consistent contact with adults, which experts say mitigates the most damaging psychological effects of institutionalization.
During a reporter’s recent visit, the two terra-cotta buildings where the children live, usually for no more than a few months, were spotless, with staff members scurrying to pick up toys and food spills as they hit the floor.
The transitional home has a primary school, open also to local students, where the children begin learning English. There is a medical clinic with two full-time doctors and 10 nurses. Down the road is a guest house for adoptive parents, who also can stay in a sleek hotel.
The children also enjoy the services of a “laugh therapist,” Belachu Girma. “These kids come here and are very depressed at first, all with their heads down and not talking,” Mr. Girma said. “I come in and try to help them relax.”
There was laughter also at the nearby guest house, more of the nervous kind, as American parents waited to take their children back to St. Paul from the Horn of Africa.
Araminta Montague, from Atlanta, who picked up 17-month-old Natan last week, compared her experience in Ethiopia to an earlier adoption of a girl from China (where Americans adopted 6,493 children in 2006).
“Our daughter was in an orphanage with about 300 children and she was very dehydrated,” Ms. Montague said. “We were never told her origins. Her sheet just said ‘Status: Abandoned.’ ”
Some parents anguished, as did Karla Suomala of Decorah, Iowa, when she arrived in Addis Ababa to adopt 5-year-old Dawit and his 21-month-old sister Meheret.
“It’s hard to know what the right thing is to do,” Ms. Suomala said. “Should we just give all the money we’re spending on this to the children’s mother?” Ms. Suomala and her husband, David Vasquez, had already spent time with her.
“It was obvious the birth mother loved her children,” Mr. Vasquez said. “She said to us, ‘Thank you for sharing my burden.’ ”
Alessandro Conticini, the head of child protection at Unicef Ethiopia, is one of many who believe that international adoption is a good thing but must be “part of a larger strategy” that focuses on keeping children in their families or communities, with the help of humanitarian organizations.
Indeed, the Ethiopian government has taken the unusual step of requiring foreign agencies to provide social services and document the results. As a result, agencies like Children’s Home Society and Wide Horizons have built schools and medical facilities — including one for HIV-infected children.
But Mr. Conticini, of Unicef, worries about the mushrooming number of private adoption companies that “are not properly regulated by the government” because two different ministries are involved and working at cross purposes.
At the State Department, visa applications for children adopted from Ethiopia are getting extra attention, said Catherine M. Barry, deputy assistant secretary for overseas citizens services. “We will very quickly see if patterns are emerging,” she said, “and we will intervene in a timely fashion with anyone doing less than quality work.”
While the governments collaborate to protect a delicate adoption system from the perils of growth, adoptive families arrive each week in Addis Ababa to ease their children into new lives.
Last week, these included Mr. Vasquez and Ms. Suomala. While she had no trouble escorting Meheret from the orphanage, Dawit refused to budge, so Mr. Vasquez carried him toward the gate.
There, the child grabbed the bars and would not let go. Mr. Vasquez considered prying his hands loose and thought better of it. Instead he told Dawit that it was O.K. to cry.
Jane Gross reported from St. Paul, and Will Connors from Addis Ababa.