How Adoption Made me an Ally

Twenty-three years ago when we first contemplated the adoption of a child, I imagined how it would change a child’s life. Our family was able to offer two loving parents, three siblings and an upper middle class lifestyle. At the same time, I had misgivings about taking a child out of their culture and replacing it with another and the hole that might create in their future life. When we made the decision to adopt a second time three years later, I had those same thoughts. Now that these two children are young adults, I realize that adoption changed both their life and mine in ways that I hadn’t imagined and have made me an ally for the complex emotions and stories that define transracial adoptions.

I recognized that our family would look different to outsiders – three biological sons and 2 Asian daughters, five kids when the norm was two. What I didn’t realize is that the interactions my daughters had with the outside world beyond our family, the circumstances that led to the disruption of their original family and the more recent charged conversations around immigration would forever change how I view the world.

International American adoption has benefitted when societies undergo social disruption and are unable to care for families and orphans. It started with the orphans created by the Vietnam War, continued with the social disruption after the Korean War, the One Child Policy of China, extreme poverty in Central and South America due to militia governments and most recently the physical disruption of Haiti after the earthquake. Over the years I have learned that the majority of these adopted children are not true orphans but placed for adoption or abandoned by their families due to a lack of social supports, malnutrition, unaffordable medical bills and desire for a male heir. I have had to struggle with the knowledge that my participation in this system works to perpetuate these structures by infusing money into a country that does not see a need to change their internal policies.

When others remarked how “good, blessed, lucky, fortunate” our daughters were to be raised in an American family, I instantly thought of the opposite connotations that raised regarding their biologic families. The Chinese and Korean families that had been affected by our daughters adoptions made choices that I don’t know if I could have made if faced with similar circumstances. Would I be willing to walk away from one of my biologic children if I thought they had a chance for an improved life outside of our family?

Over the past 4 years as immigration has led to heated discussions and my daughters have moved beyond our protected household and out into the greater world, I have had to reconcile the immigration story of our family with the stories of families south of the US border who have fought to keep their children by making a harrowing journey to a better life. Why is our family put on a pedestal by other Americans while those families waiting in refuge camps are seen as opportunistic and dangerous? Does our American culture value your black/brown body more if you are raised in a white household?

Adoption is complicated… and so is being a parent. I would not change anything about our journey and am immensely grateful that my life and view of this world has been affected by each one of my children. My ongoing task is to be an ally – one who listens to the experiences of others outside of mainstream white America and helps to amplify their voices.

The new Wild West – Procuring PPE

Although it has just been 5 weeks since the United States went into quarantine, it seems much longer for hospitals and clinics that are not only trying to care for both Covid and non-Covid patients but also attempting to secure supplies of personal protective equipment (PPE) for their health care workers. Hospitals have first priority for masks, leaving clinics woefully under-supplied. Luckily, I am part of a large group of women who volunteer their sewing skills to create reusable menstrual pads for distribution in developing world countries. We repurposed the cotton used in the construction of the Days for Girls menstrual kits to make fabric masks. Other groups throughout the city had the same idea and soon elastic for the ear loops was difficult to obtain.

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Ingenuity during this pandemic has been incredible and others have shared their solutions via the internet. The University of Florida designed a mask using recycled blue surgical wrap, normally thrown away after it has been used to protect sterilized instruments. This material is flexible, 99% impermeable to pathogens and can be re-sterilized multiple times for reuse. Our sewing group moved from fabric masks to the blue wrap material without a hitch in the process and soon had constructed 500 masks for both clinic and hospital use. Since then we have welcomed five additional sewing groups and will have finished 2500 masks by the end of this week. The masks are being used at both North Memorial Hospital and Voyage Healthcare clinics. As shipments of mass produced surgical masks make their way to our healthcare businesses, we hope to redirect the energy of all these seamstresses and provide masks to local organizations who may need them in the coming months.

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Why American doctors and nurses are ill suited to handle a pandemic

This statement includes me. Healthcare in America is different, both good and bad, than anywhere else in the world. When questioned, most Americans think of our country as leaders in medical technology and innovation. This pandemic is showing that perception to be far from the truth, as well as bringing to light the flaws in our training and how we practice when faced with a serious contagious disease.

Infectious disease pandemics don’t happen on our shores. We hear about Ebola in West Africa, dengue fever in South American, hepatitis and SARS in Asia, malaria in Africa, but we don’t experience the day to day reality of what that means. Our only experience is influenza, and despite the availability of a vaccine for this infectious disease that kills 30,000 to 40,000 each year, only around 40% of our population is immunized. Basic infectious disease precautions, such as hand-washing or staying home when we are sick, are often overlooked in our efficient and rushed society. Physicians have been shown to have the poorest performance in the hospital setting when it comes to sanitizing their hands between patients.

American healthcare is a disposable society. Nothing is reused between patients, even if it can be re-sterilized, to prevent cross contamination and increase infection. Three months ago we would have been reprimanded for wearing the same mask between two patients. Now we are reusing that same mask for a week. Surgical drapes and gowns are disposable. In my work in Haiti and Vietnam, almost all instruments are reusable, gowns and drapes are cloth and rewashed and sterilized, masks are worn until they are unusable. Healthcare in America needs to learn to use our resources better, especially in a time of plenty so that we have reserves for times such as these.

Most of us are highly specialized. As an ob/gyn, I have never managed ventilator settings and only performed one intubation in medical school. I would be ill equipped to help out in an ICU setting. The same is probably true for the majority of American doctors if we were called into service to start IVs and draw blood. In hot spots such as NYC and New Orleans, fourth year medical students are allowed to graduate early if they are willing to work in a hospital caring for Covid patients. These newbie physicians have more of the needed skills than those of us 10 years out from medical school.

As physicians and nurses, our daily work most often results in the recovery and improvement of a patients health. We are not accustomed to caring for a patient for 2-3 weeks, with all of the medical technology that we have available, and then seeing that patient die despite our best efforts. In places like New York City, health care workers are not returning to work as they are unable to psychologically handle the senseless deaths they see daily. America has not experienced a war zone on its shores since the Civil War. This is a war zone when it comes to death, an experience that other parts of the world have seen more recently.

Informed consent is something that is drilled into our heads from early on in our training. Patients need to be given all of the options for their medical care, free from our personal judgement, along with the risks and benefits of each option. Covid doesn’t allow us that luxury. Often, patients have to be intubated emergently and informed consent is not an option. When ventilators are in limited supply some high risk patients, such as those with a terminal disease, may be offered comfort care rather than aggressive management.

When Covid is still fresh in our minds, but not in our bodies, Americans and healthcare professionals need to reexamine how we can change our medical system for the better so that our future response to an infectious disease is more streamlined and less chaotic. We need to use the innovation that makes us world renown to equip us for a new tomorrow.