New TB policy could disrupt overseas adoptions

NEW YORK — Advocates of international adoption are furious over a new federal policy related to tuberculosis testing that could disrupt plans for families adopting children from China and Ethiopia.

The policy already has forced one distraught couple from Virginia, Jay Scruggs and Candace Litchford, to leave China without the daughter they had spent two weeks bonding with.

"That was a cruel thing to put a 4-year-old child through," Litchford said in a telephone interview Monday. "How is she supposed to trust us now?"

The anger stems from a directive issued by the Centers for Disease Control and Prevention in 2007 intended to minimize the number of immigrants entering the U.S. with multi-drug-resistant tuberculosis.

Earlier this year, the CDC announced that immigrants over the age of 2 from Ethiopia and China — a country that for the past decade has been the leading source of foreign adoptions for American parents — would be subject to the new protocols. The policy applies to all immigrants, including children adopted abroad by U.S. citizens.

Adoption advocates say the required testing procedures — and treatment in the case of positive tests — could cause delays ranging from several weeks to 12 months for obtaining a visa to bring adopted children back to the U.S.

Several major adoption organizations are circulating a petition asking the CDC to exempt adopted children from the requirements. The groups contend that the risk of TB transmission is minimal for infected children under 12 and contend that adopted children, unlike some adult immigrants, are virtually assured of obtaining top-level health care as soon as they reach the U.S.

Chuck Johnson, chief operating officer of the National Council for Adoption, expressed fear that some children adopted by Americans would, because of the new delays, die in their homelands for lack of state-of-the-art medical care they might have received in the U.S.

"Some of these bureaucrats are going to have to answer for that," Johnson said.

Johnson and his allies are trying to mobilize congressional support for exempting adopted children from the policy. They are gathering testimonials from medical experts to back the contention that children, in contrast to adults, are extremely unlikely to transmit TB.

The CDC defends the policy as medically necessary.

"We agree it's a rare circumstance that children can transmit TB, but the reality is it can happen," said CDC spokesman Glen Nowak.

He also said the CDC did not have the legal authority to exempt children being adopted by U.S. families from rules applying to other immigrants.

As for Scruggs and Litchford, Nowak said, "We appreciate that this is frustrating. ... We are doing what we can to make this go as fast as possible."

The policy does not apply to children under 2. However, Thomas DiFilipo, president of the Joint Council on International Children's Services, noted that China was emphasizing special needs adoptions for older children, so that many hundreds of families could be affected by the rules.

Any policy change will come too late for Scruggs and Litchford, both architects from Alexandria, Va.

They traveled to China last month and met their adopted daughter, Harper, on July 27, but had to return home without her last week after a wrenching farewell that they captured on a video posted on their blog.

Litchford said she and her husband were aware of the new regulations and also knew that Harper — being adopted under the "special needs" program — had asthma-like health problems.

However, Litchford said they were told Harper tested negative for TB, so they went ahead with their trip, hoping to bring her home. After arriving in China, they were told that Harper actually had tested positive for TB and that, under the new CDC regulations, she would have to undergo a series of tests to ensure she was TB-free, with results not expected for at least six weeks.

The couple sought a waiver so they could leave with Harper in tow, but were unsuccessful and returned to the U.S. without her, in part for financial reasons and also because they had left their 6-year-old adopted son, Ivan, back in the U.S.

Litchford said Harper already had spent time in two hospitals and with a Chinese foster family that eventually decided it didn't want her.

"She's scared to death," Litchford said. "Every time she walks into a new situation, she thinks she's being left again. And then we had to leave her, the worst thing that could happen has happened."

In the video, Scruggs tries to assure Harper that he and Litchford will return to take her home. But the girl nonetheless bursts into sobs and clings to her father as he tries to leave.

Harper will stay over the next several weeks with a family near Guangzhou, and her parents hope she will be cleared for travel to the U.S. at some point in September.

"This is not an immigrant — it's not someone who has no address in the U.S. and no support network," Litchford said. "It's a child with a family who's going to care for her. But now we can't. We can't take care of our daughter."

Long term, the problems faced by Scruggs and Litchford may be alleviated by a bill recently introduced in Congress. It would extend U.S. citizenship immediately to children adopted abroad by American parents, replacing the current policy in which citizenship is extended only after the child reaches the U.S.

Had the bill been in effect this summer, Harper would not have been treated as an immigrant and would have been allowed to travel to Virginia with her parents.

Adoption advocates say the bill is unlikely to win approval this year, so they are hoping the CDC might ease the procedures for adopted children in the interim.

"I don't believe the CDC intentionally put this policy into place to harm adopted children — I just don't think they were considered in the mix," said McLane Layton, founder of Equality for Adopted Children. "The policy needs to be re-evaluated in this regard, the sooner the better."

Layton, one of most vocal critics of the CDC policy, has been following the difficulties of Scruggs and Litchford as they sought to bring home Harper.

"You wonder about the psychological and emotional impact it will have," Layton said. "When her parents come back, how much will it take for her to believe they're not going to leave her again?"


Traveling, with illness

A while ago (July 23, 2009) I was reading an article called, "'Go back to your disease-ridden country!' What the French said to British schoolchildren with swine flu" and a major response written by readers has been this:

 exchange trips should all be stopped it is unfair to spread this even further to other countries with low cases of swine flu!

If a very young child tests positive for TB, wouldn't international travel be the VERY LAST THING a parent would want their (newly acquired) child do?!?

This is ridiculous!

This is nothing more than yet another example showing how adoptive parents only care about getting what they want, when they want it. They didn't meet "their daughter" until 12 days ago, and the parents admitted had they known the child was sick, they would not have gone to get her.

"So, instead of starting life with her new family in the United States, Harper remains in China, the visa she needs to enter the country blocked because of federal regulations aimed at limiting the number of immigrants entering the country with tuberculosis. If her parents had known she was sick, they would have waited for her to finish treatment before they visited, they said."

Now they want others to help pay their travel bills and have politicians push for sick children to enter our country?

These people are SICK! I agree, this is not about immigration, it's about controlling deadly illnesses as much as we can. It's about closing borders when there are health risks and unknown diseases killing innocent people.

If you are an adoptive

If you are an adoptive parent, and you write enough letters, rules do not have to apply to you.

"leaders of key organizations within the international adoption community, including the Joint Council on International Children's Services, have urged the CDC to exempt pre-adolescent adoptees from the policy. They have also asked adoptive families to become involved by contacting their representatives and signing the Build Families, Not Barriers petition.

It is unclear at this point exactly why the CDC reconsidered their decision in the case of Harper Yue Ye Scruggs. Whether it was the strong support of the initiative to protest the policy for adoptees or other evidence presented in Harper's case may not be ultimately important right now."

Playing by the rules

A strongly worded letter... suggesting something (like votes/financial support) will be taken away if requested help is not provided.


Nice to know that's what it takes.

if you only knew...

Adopted children who have/are:  Hep B carriers, contagious chicken-pox, iffy blood work for TB, etc... these have always been let into the country. 

What did I ever do to deserve this... Teddy

Harry Holt law...

In the 1950's  Harry and Bertha Holt did change the laws by writing lots of letters, having lots of money, and enlisting thousands of seeking PAP help to change the laws.

What did I ever do to deserve this... Teddy

Pound Pup Legacy