Caring for Internationally Adopted Children

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Abstract
Since 1986, families in the United States have adopted more than 125,000 children from other countries. These children, who have usually been in institutional care before adoption, come from countries with many endemic diseases, including hepatitis B, tuberculosis, and infection with intestinal parasites. The children have lived in crowded conditions, sometimes with poor standards of hygiene and inadequate nutrition. Orphanage workers are rarely if ever screened for transmissible diseases. The children themselves are often malnourished, suffer from emotional and physical neglect, and are vulnerable to infectious agents. The Americans who adopt from overseas tend to be middle-class families who reside . . .

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