Q. My husband and I are thinking of adopting a child from overseas. One of our concerns is the child's health status. What can we do to ensure that the child's health needs are taken care of properly?
A. Children adopted frnm foreign countries often face special health problems. Fortunately, with proper medical attention, most problems can be detected early and corrected.
Americans adopt about 8,000 foreign-born children each year, mostly from third-world countries. Most children have either been abandoned or come from settings with minimal medical care. Many of their medical problems grow out of this background, so it's important that adoption agencies and physicians caring for these children be familiar with the health problems these children commonly face.
One medical study, reported in the March 1987 issue of the American Journal of Diseases of Children, looked at 128 children who were adopted from foreign countries, mainly South Korea and Colombia.
Despite their disadvantaged backgrounds, most children came to the United States in good condition. Most medical problems either had been known beforehand (such as having a cleft lip) or could be anticipated (having parasites or worms). In other words, there were few surprises in store for the adopting parents.
Although sometimes suffering from various infections themselves, the children rarely posed any danger of infection to their newfound families. One possible exception to this was chronic hepatitis B infection, a liver-damaging viral infection that can sometimes persist and be transmitted to others. While there is no good treatment for this disease, a vaccine can protect family members from chronic carriers of the virus. Hepatitis B is a common infection in adopted Asian children.
The most common health problems in the studied children were: 1) deficient immunizations, 2) intestinal parasites (worms), 3) emotional problems, 4) skin disease, 5) uncertain age, 6) impaired hearing or vision and 7) current or previous hepatitis B virus infection.
Based on their study, the investigating physicians have these recommendations: Families planning to adopt a foreign-born child should have a pre-adoption visit to discuss medical questions about the child's health. Children who are not acutely ill and who are apparently normal on arrival should have their first medical check after two weeks of observation in their new home. In addition to having a routine history, physical exam and lab tests, these children should be tested for intestinal parasites (worms), tuberculosis, syphilis and, if Asian, hepatitis B virus. If the child's age is uncertain, age estimates can be made from x-rays and other techniques.
After my recent discussion of diets for recovering alcoholics, a reader took me to task for referring to someone as "having successfully recovered from alcoholism . . ." As a recovering alcoholic himself, he correctly points out that there is no such thing as a "recovered" alcoholic in the sense of someone cured of alcoholism, only someone who has brought this disorder under control.
He goes on to mention a common misconception about alcoholism and other drug addictions, namely that if an alcoholic could just use some self-control, everything would be fine. Self-control and outside support are important, but avoiding exposure to the addicting substance is also crucial.
Along these lines, he says that some physicians need to be educated about alcoholism and related addictions. More than once, he has been handed a prescription for a tranquilizer or sleeping pill -- drugs that share in the addicting properties of alcohol -- by a doctor who knew he was an alcoholic. Sadly, the reader soon became hooked on those inappropriately prescribed medications.
The lesson to be learned is that both health professionals and people with drug addictions need to be familiar with those medications that can start or renew an addiction. Drugs in this category include tranquilizers, sleeping pills, liquid medicines made with alcohol, and narcotic pain relievers, including codeine.
For information about meetings of Alcoholics Anonymous, write to AA at 4530 Connecticut Ave. NW, Suite 111, Washington, D.C. 20008, or call 966-9115. For health professionals wishing to learn more about this disorder, I recommend attending an open meeting of AA. It's an eye-opening experience.
Jay Siwek, a family physician from Georgetown University, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington.
Consultation is a health education column and is not a substitute for medical advice from your physician.
Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Questions cannot be answered individually.