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New Challenges

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I ended Friday’s blog by saying that the shift in orphanage populations has significantly changed the responsibilities of nannies over the years. A decade ago, the nannies were caring for 10-15 children at a time in the main baby rooms….but on the whole, these were primarily “healthy” babies. Now they are often caring for the same number of children, but ones who have medical needs. Their jobs can be difficult indeed. I will never forget walking into a rural orphanage in a western province and seeing a nanny thread a worn looking rubber tube down the throat of a baby with cleft. She then proceeded to pour milk drop by drop into the tube. She explained that the child was unable to suck from a regular bottle, and so she had come up with this homemade NG tube on her own to save his life.

Every time I visit orphanages now, I have to steel my heart for the number of children we will see who require medical care. There will be children with heart disease, kids with cleft, babies with spinal tumors, anal atresia, glaucoma, and more. Nannies now often serve as nurses in addition to their primary caregiver roles. Another big issue we are seeing is that the babies and children entering the orphanage system often have multiple special needs. This little girl in the photo below, for example, has anal atresia, extra fingers, microtia, cleft palate and mental delays. The care these children require is often very complex, and many of the special needs are often not well understood. It is still a common belief in China, for example, that all children with cerebral palsy have mental retardation. Autism is another special need which is often misunderstood and which has little therapy options available.

The Chinese government has undertaken two major social initiatives to help with this changing population of children. They deserve a great deal of recognition and praise for the implementation of the Tomorrow Plan (TP), which has helped thousands of orphaned children receive surgery for their medical needs. Under the Tomorrow Plan, orphanages fill out an application to have a child be approved for care, and then they receive funding for the hospital costs. This system works extremely well for children with mild to moderate issues, such as babies with cleft or “minor” heart conditions such as VSD and ASD. It is extremely rare for us to be asked to help a baby with a simple heart defect now, because of the success of the Tomorrow Plan.

However, many abandoned babies only have 24-48 hours to live if they don’t receive immediate medical care. Preemies, for example, or children with anal atresia. Orphanages will call us for emergency care when a baby can’t wait for approval. We also are asked to help children with much more complex issues, such as multiple heart defects or ruptured spinal tumors. Sometimes the designated Tomorrow Plan hospital for the city is unable to provide the surgery needed, and then outside funding is needed to move children to Shanghai or Beijing for operations.

A new orphanage in Sanmenxia, Henan province.

Another national program for orphaned children is the Blue Sky initiative. The goal of this project is to build new, modern orphanages to house this changing population of kids. It’s partially funded by the Chinese lottery system, and the funds going into this program are substantial. In cities all across China, huge orphanages are being built, even in the very rural towns.

These new institutions frequently have large areas for physical therapy centers to address the needs of children with conditions such as cerebral palsy. Everywhere I go in China now, the number one request we get is for PT equipment and training. Nannies and staff want to help the children in their care, but there are still very few resources readily available for kids with moderate to severe special needs. With so many children in institutions now having birth defects and long term disabilities, the challenges Chinese orphanages are facing are extensive.

~Amy Eldridge, Chief Executive Officer

Tomorrow: Why International Adoption Still Matters

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