Isle adoption pipeline deceiving, critics say
Rob Perez
The women travel more than 2,000 miles from the Marshall Islands to Hawaii to give birth to their babies. Then the infants are given up for adoption.
This trans-Pacific practice, repeated again and again over the past several years, has transformed Hawaii into a hub for the commerce of Marshallese newborns.
Adoption agencies are arranging to bring Marshallese women typically seven or eight months pregnant to Hawaii so their babies can be born here, easing the way for American families to more readily adopt the infants -- who become U.S. citizens at birth -- for prices that can approach $25,000 to $35,000 a child.
The money goes to the adoption agencies and their representatives, not the women, critics of the practice say.
So far this year, nearly 50 babies born to newly arrived Marshallese have been adopted by families from other states. Not included in that number would be any newborns adopted by Hawaii families.
This adoption pipeline from the Marshall Islands, a tiny poverty stricken nation in the Western Pacific, is garnering increased attention here because some critics believe the women, who typically don't understand English and are unfamiliar with Western-style adoptions, are being exploited by the agencies.
"To me, the outrage is this is trafficking in babies and the mothers are being used as the mules," said Nancy Partika, executive director of Healthy Mothers, Healthy Babies Coalition of Hawaii. "That's a horrible thought, but that's exactly what's occurring."
Critics also note that most of the women come to Hawaii having had no prenatal care and often are suffering from pre-existing medical conditions, such as sexually transmitted diseases, raising the chances that complications will arise during or after birth.
At the direction of the adoption agencies, many of the women sign up for the state Medicaid insurance program, meaning taxpayers, not the adoption agencies, foot the cost of medical care. Hospitals also shoulder some of those expenses because Medicaid reimbursements don't cover the full cost of services.
If complications arise, the tab for care in a single case can quickly climb above $50,000 or even $100,000, according to David Heywood, vice president of Hawaii Pacific Health, which operates several local hospitals.
"Hawaii is being used as a quick and cheap place for the for-profit adoption agencies to do business," Heywood said in testimony to the Legislature earlier this year.
Enough questions have been raised about the Medicaid practice that the Attorney General's Office recently launched an investigation.
Legislators also have discussed the issue. A bill that would have required adoption agencies to reimburse the state for medical care for Marshallese and other birth mothers from Pacific nations was introduced in the last session, but the measure didn't pass.
Eric Seitz, an attorney who represents Adoption Choices, one of the agencies that brings Marshallese women to Hawaii, said his client hires translators and social workers to fully explain to the birth mothers the ramifications of giving up their babies for adoption in the United States. The agency also pays to have an attorney who represents the birth mother's interests exclusively when the adoption goes to court for approval, Seitz said.
He said he wasn't aware of anyone accusing his client of improprieties, although allegations have been leveled against at least one other agency and against the Marshall Islands-Hawaii adoption pipeline in general.
"Adoption Choices has dotted every 'i' and crossed every 't' in an effort to try to assure the process is done properly," Seitz said.
Up until an adoption is formally approved by the court, a birth mother can change her mind about giving up her baby, and even though the agency pays for her airfare to Hawaii, temporary housing, food, medical care (if not covered by the state) and other expenses, the mother does not have to reimburse the agency, Seitz said.
He said Adoption Choices has cooperated with the AG's investigation, providing documents related to clients.
Advocates of the adoption program say the Marshallese infants, with their parents' blessing, are being removed from an extremely impoverished country with horrible conditions and placed in a more prosperous country with families who can offer improved health, education and financial support.
Under the compact agreement that governs relations between the two countries, Marshall residents are free to travel to the United States without a visa -- a key element that enables the adoption pipeline to exist. Marshallese also have access to health care, education and other institutions in this country.
The number of Marshallese women who have come to Hawaii to give birth to adoption babies has increased over the past several years, according to health care providers and others who deal with the women.
One reason for the increase, they say, is that the Marshallese government approved a law that in effect makes it more difficult for foreign residents to adopt babies in the Marshall Islands. The Marshalls used to have the highest per capita rate of adoptions in the world. That island nation also has extremely high birth and infant mortality rates.
In addition to strengthening the adoption process in the Marshall Islands, the new law prohibits anyone from soliciting or encouraging birth mothers to leave that country for the purpose of giving up their babies for adoption. The law is being openly flouted via the Marshall-Hawaii adoption pipeline, according to critics, although the trans-Pacific practice does not appear to violate U.S. law.
"We really don't agree with that program," said Biuma Samson, consul for the Republic of the Marshall Islands' consul general office in Hawaii. "It's really against our values."
Historically, traditional adoptions in the Marshall Islands have been akin to Hawaii's hanai system, where a child was raised by another family, usually related. But it wasn't uncommon for the Marshallese child to eventually return to the birth parents, something unlikely to happen in Western-style adoptions.
The differing cultural perspectives were underscored in 2001 when Jini Roby, a professor at Brigham Young University in Utah, surveyed 73 Marshallese birth mothers and nearly 90 percent said they would not have agreed to give up their children had they known the children would not return to the Marshalls upon becoming adults.
Many Marshallese women can't fathom the legal notion of permanently giving up parental rights to their children, Roby said. "It's really illegal juxtaposed against their cultural beliefs."
Millie Phillip, a case worker at Kalihi-Palama Health Center, said her organization is helping an 18-year-old pregnant Marshallese who came to Hawaii to have her baby adopted but recently changed her mind. The adoption agency, Southern Adoptions Inc., had told the mother that her child would return to her once the child turned 18, but after talking to a family member in Hawaii, the mother realized she would lose all rights to her child if the adoption went through, according to Phillip.
When the woman informed the agency about her change of heart, the agency wrote a letter for the woman to sign that included a statement that she was not misled by Southern Adoptions into believing her child would return after the adoption, according to the letter and Phillip.
The woman was asked to get the letter notarized, something she couldn't do because the adoption agency had taken possession of her passport and had sent it to a mainland office, Phillip said. The woman was told the agency needed the passport and her social security card to process the adoption papers, according to Phillip. The expectant mother has asked that the documents be returned.
Taking possession of someone's passport "is very irregular," said Pat McManaman, who heads Na Loio, a provider of legal services for indigent immigrants. "It's outrageous."
A call to Southern Adoptions mainland headquarters seeking comment was not returned.
The practice of using Hawaii as a hub for adopting Marshallese babies is raising so many questions that Samson, the republic's consul here, is calling for the governments of both countries to come up with a way to stop it.
Like other critics, Samson sees the practice as a way to circumvent Marshallese law.