Health and Growth of Internationally Adopted Children

Because there are many families awaiting court next week to go get their children in Rwanda I thought I would share some info on determining your child's growth and development. The children residing at Home of Hope Orphanage in Kigali, Rwanda have all been abandoned thus their age is guessed at when they are brought to the orphanage. The younger the child the easier this of course is but there can still be mistakes in paperwork that may give you a birthdate that is off. Since you only receive the results of recent medical testing and no info regarding prior health history, I asked specifically for any records documenting our son's growth while at Home of Hope. They were able to give me a record in which his height and weight had been documented every month since he had arrived at the orphanage. His first record was in November 2007 and he weighed 14 pounds at intake. Based on his facial picture and weight at the time it was predicted that he was around 9 months of age. I think that is probably the minimun that he could have been given his facial features and the report that he was crawling when found. So I was surprised to see that his birthdate given on the Rwanda court records which resulted in his Rwandan birth certificate have him being born in November 2007, the month that he was brought to the orphanage. Not a huge deal as far as when he will start school, being a boy it will probably be better for him to start later, but it makes a huge difference when I look up his growth on any of the various height and weight growth charts. This was a aha moment for me. At age 33 months he only hits the 25th percentile for height and he is not even on the chart for weight, not even the lowest 5th percentile. So how could that be? When I translated his growth progress on the chart to US measurements he has not made steady growth over the last two years. He would sometimes gain weight, sometimes not at all, and sometimes loose from month to month. A malnourished diet could definitely be a explanation but more likely the up and down growth may be related to illness and parasites. So we are requesting a full battery of tests to invetigate every possible parasite that a child from Africa may have (learned that you need to demand this to your doctor after dealing with unidentified medical needs with our daughter). Why does this all matter so much to me? Well I think it is important to be able to assess how a kido is doing developmentally when they have spent a extended amount of time in a orphanage. He will most likely need some help to catch up to his peers. What I have observed in my daughter is that she regressed a bit after coming home and really needed to re-experience some of those early developmental periods with us as her parents. Once she was settled in with us she then made very quick physical and developmental growth the first year home but now some specific areas seemed to have stalled and we are needing some more work to do. I don't want to worry adoptive parents to much. It is very important to be optimistic and to know that children are amazingly resilient but you also have to balance out reality so that you can give them the help that they need. Sometimes that takes some extra investigation.

Home Coming!

After another delayed flight from Frankfurt to Denver we are happy to report that we arrived home late last night. We flew Luftshansa from Addis to Frankfurt and then Frankfurt to Denver. Contrary to popylar belief we had no visa issues for Leo at the Frankfurt airport. Transit visas are not required for Rwandan citizens and even if he had required it we never went through a check point or were asked. Once you exit the plane you do not pass through immigration unless you try to exit the airport at Frankfurt. We were bummed that the cafe with the great German pastries did not take visa so we ended up eating at the McDonalds in the airport. Kids were totally fine with that though! All was well untill the arrival of our plane was delayed by one hour due to bad weather and then we ended up sitting on the plane for over 2 hours while they de-iced it two times because the pilot was not happy with the first de-icing job. He actually referred to the whole de-icing process on the intercome as despicable and unprofessional. Good thing is that once in the air Lufsthansa airlines include free alcoholic beverages. Now of course we are not big drinkers and were well aware that we had to keep a eye on 3 kids but I definately enjoyed a glass of red wine to calm the nerves while my husband opted for a cold Baileys and Creme. If only every airline realized that it is that easy to help people forget about a 3 hour flight delay! The media system was awesome to so I am defintately happy with our airline choose this time around. We were blessed to be picked up at the airport by a new wonderful friend who had also surprised us by buying and setting up a fresh Christmas tree in our living room. I guess the pine tree plant that I had decorated was pretty tiny looking! As if that was not enough she also brought a huge pot of Kneopfla soap! And we actually know what that is and love it since I am also from North Dakota and make it often. Leo did well with checking out his new home. He did start to tear up and cry at one point when my husband was unloading the van and I think he was afraid that daddy was not staying here with us. Once settled he enjoyed getting into everything he could in the house. He will be sharing a room with big sister which she is actually really excited about. We did some unpacking, started laundry, gave all the kids baths and enjoyed the warm soup then piled everyone up in our big bed for story time. We were so tired that all 5 of us fell asleep squashed together. We will keep Leo in our bed for the first week as he adjusts to us. He is sleeping all night in bed with us wheras I know he would be waking up and afraid in his own bed. This morning I woke up first and watched him, he then woke up, looked at his sleeping dad and kissed him on the cheek and then layed his head in me. He is very content with us and seems to understand that this is home. Lots to do today, we have a ton of laundry to wash, need to call to make a doctor's appointment, go to the grocery store since the fridge is empty, and pick up the dogs. It is still not really feeling like Christmas but I am sure that once we decorated the beautiful Christmas tree and make some cookies this week that we will all get in the mood.

Letters to Leo: Adjustments

Dear Leo,

So much has happened since I last wrote. While still in Rwanda last week you seemed to be feeling insecure as you adjusted to having a new family. You were not fearful of us, but fearful of loosing us, especially your new daddy. For a few difficult days you only wanted dad to hold you. I understand the reason why, after all it was only women who have cared for you the last two years and you are so happy now to have a dad in your life. Of course having you scream at me when I held you was a gut wrenching experience for me. I have spent over a year planning for you, dreaming of you, and completing mounds of paperwork to bring you home. I knew though that the transition would sometimes be difficult and of course you only understand what you feel right now. We were able to do some more sightseeing in Rwanda before leaving for Ethiopia. On Thursday we did some souvenir shopping (things are actually really expensive in Rwanda!) then we went to the Dancing Pots pottery studio to pick up some pottery made by the Batwa then onto a small history museum in Kigali which is located at the renovated home of a explorer (discovered the source of the Nile). The museum was not much but it was nice to see a different part of the city and the view of the city from the top of the hill was amazing. Friday brought on a stressful morning. We were at risk of being delayed in Rwanda if the passport office was not willing to issue our passport early that morning. I went by myself and thanks to them making a exception for another adoptive family they did issue your passport to me after I sat there for two hours. We then went to the US Consulate in Rwanda to submit your US immigration paperwork. Again we went in alone and thankfully I was able to complete the form because I had obtained a example from another family. The head individual at the consulate was very nice to us and even helped me to translate some information that I needed from your court documents (they were in French). So getting all that done Friday morning was a enormous relief! We then rested in the afternoon and went out to dinner with another adoptive family in the evening. It has been nice to connect with other adoptive families while in Rwanda and Ethiopia. While everyone's experiences are different there is definitely a common bond that occurs. We had a great day on Saturday when we went on a mini safari into Akagara National Park and saw water buffalo, giraffes, gazelle, zebras, hippos, African peacocks, storks, and many others birds. Sunday we stayed at the hotel to pack up and unfortunately when we arrived to the Kigali airport our plane was late. Six hours later we were finally on a plane to Ethiopia. We arrived at the Addis Ababa airport at 12:30am with three sleeping kids. The first immigration officer at the on-site visa processing line sent me to speak to the officer in charge because typically a Rwandan citizen would require a advance visa to enter Ethiopia. He looked at all our documents called someone and left us waiting nearly a hour. I explained that your sister was from Ethiopia and we choose Ethiopia over Kenya so that she could see her birth country again. He finally agreed to issue you a visa after we told him the meaning of your sister's name. So one more hurdle jumped, we just then needed to gather up all our luggage. Your big brother woke up and was very helpful in pushing one of the luggage carts. We finally arrived at the guest house and all went to bed at 3am on Sunday! It is now Friday in Ethiopia and things have been going well here. Your medical examination went fine and your TB screening test was negative. We were therefore able to have our interview with the US Embassy yesterday and this morning we received your visa packet and stamped Rwandan passport so that you can enter the US. YEAH! There will of course be more paperwork to do in the US to re finalize your adoption in CO and to make you a US citizen but for now I am enjoying a break from worrying about paperwork. While here you have been adjusting well. We have had some tanturms here and there but that is definitely expected for a 2 year old boy! You are now laying right down with us to go to sleep and you sleep all night. You still have a bit of a preference for dad but it is lessening every day as you feel more secure. While in Ethiopia we have enjoyed eating wonderful and inexpensive food at the many restaurants (steak for US $5) who know how to cook for Muzungas! Of course I love Ethiopian food so I keep making that request to the driver. We took your brother and sister to see the Ethiopian Museum of Natural History, went to see the endangered Abyssinian Lions, visited a little amusement park, went swimming at the Hilton in their pool which is heated by a natural spring (like a giant warm bathtub), and last night enjoyed a Ethiopian buffet with a music and ethnic dance performance. This afternoon we are driving into the country to see the Emperor's Palace and the mountainside. I hear it is beautiful!

Love, Mom

Letters to Leo: The Hard Stuff

Dear Leo,
Today was a emotional journey. We started out by going back to the orphanage so that you could say good bye to your friends and so that we could tour the entire facility. As we drove down the bumpy dirt road we saw a long line of people waiting outside the brick wall. Apparently Wednesday is the day that those in extreme need come to the Home of Hope Orphanage to ask for any small food donation that they may receive. The line consisted of mostly the elderly and women with small children and babies. We drove through the gate and then began the ritual of coming to terms with this reality that was yours. We walked through the long hallway that passes the baby room (not able to enter that room) and then saw the room where you slept with the other older toddlers. We were able to see your bed, it was one of at least thirty metal toddler type beds in a long narrow room. We then passed by more rooms, one devoted to the care of disabled infants and toddlers and another the older baby room. Outside we visited the children who have been your friends and family during your stay at the orphanage. We put you down on the ground to see what you would do and you ran up and hugged one of your caregivers, which was so nice to see. It is obvious that you were loved and able to form attachments to your caregivers. You did not interact a whole lot with your friends, more so you almost seemed to be showing off to them a bit. You then ran back to us to be picked up and while dad was holding you and the kids where grabbing at your shoes you told them no and shook your finger at them. This went on for awhile, you getting down to interact and then coming back to us to be held or touched. I think this was a really good sign that you were able to make the transition from them to us and to have the change to say goodbye. Seeing the kids was hard on me, there are SO MANY toddlers and preschool aged children. Again it is clear that the nuns love them very much and it was nice to see that there were three recent college graduates here from the US volunterring for the week at the orphanage. There are just so many children and not enough adults. Lots of runny noses, running around, broken toys, and disjointed play going on. Toddler will be toddlers, especially in large numbers. I started to say to your big brother "See this is why I am always telling you how good you have it at home" and I had to stop because I started to choke up and he interrupted me with "I know, don't talk about it" indicating to me that he very clearly now understood. We then walked down to the part of the orphanage that houses the elderly and disabled adults. It is clear that they are so fortunate to be there and there are few places in Rwanda for the disabled and elderly if their family is unable or unwilling to care for them. The hardest part of the visit for me was seeing the disabled children and young adults. As a school psychologist I know just how valuable intervention and therapy is in helping individuals with disabilities. Especially those children with disabilities that render their bodies with little control but maintain their cognition in tact. This is where I just had to set my profession aside and take this all in as a mother for now. After leaving the orphanage we took a break to see a local art shop and then to grab lunch. We were joined by the girls who we had met who were volunteering at the orphanage so it made for a interesting lunch. They are young and adventerous and full of passion. Everything I wish I had been 15 years ago. One of them said that she was considering joining the Peace Corp and I openly encouraged her to do it with no reservations!

As if that was not enough for the day we then toured the Genocide Memorial. Most of the written information on the displays your dad and I had already read in many books about the genocide. It was so much more real though to see the pictures next to the text, to watch the video clips, to read about specific people who were survivors and those who took the risk to stand up to the opposition and saved lives. It was difficult seeing the actual pictures of those lost, brought in by their surviving loved ones for the memorial. Most difficult however was the children's display, the large blown up pictures of children who were ruthlessly tortured and murdered during the genocide. The descriptions of how they were killed were horrific. Small innocent children painfully killed by what could only be pure evil itself. From that room it leads outside to the memorial gardens, a beautiful, incredibly peaceful place. At the lower back of the gardens are the tombs that hold the remains of approximately 250,000 people. This number is overwhelming when you consider that it represents only a small proportion of the possible 1 million who were lost in the genocide. The world cannot forget, that what happened in your country was a holocaust and it can never happen again, not here, not anywhere. Yet I fear that it is all to easy for people to forget and to turn their heads when it happens on the continent of Africa. Someday when you are old enough I will teach you about all of these things as they are as much a part of your history as your life with us will be.

Love, Mom

Letters to Leo: Transitions and Paperwork

Dear Leo,

We had a wonderful day with you on Monday, you laughed, smiled, slept and it all was very natural to everyone in the family. We were told in the morning that we needed to leave right away because they were waiting for us at the Minister's office. We went to get you and while waiting picked up our four suitcases which had now been emptied of the donations. In the room was a enormous pile of all the stuff that we had brought. It struck me how large a pile it was, 200 pounds of clothes, toys, medicines, and shoes but really I wish I could do so much more. We then went and had your passort picture taken and then went to apply to receive your Rwanda passport. Unfortunately they told us that we could not received it untill Friday which will be very close to the deadline that we must meet to turn in your immigration paperwork at the US Consulate on Friday. We then were dissapointed to hear that in fact the Minister had not been able to sign our travel letter and so we would have to bring you back to the orphanage. Back at the hotel, we went for a walk to buy some food at the grocery across the street from the hotel and dad carried you on his back in the Ergo carrier. The men here seemed to think it was the most ridiculous thing they had every seen since in Rwanda it is the women who carry babies on their backs. You however were very content and fell right to sleep. Everyone took a long much needed nap and then we unfortunately had to take you back to the orphanage for the night. We spent the evening at a nice restaraunt specializing in more authentic African food. It smelled great and was really good. The boiled and fried bananas were wonderful. This morning we experienced some concern as we waited at our hotel unable to reach our POA. When she arrived it turned out that she was able to confirm that our travel letter had been signed so we went to pick you up and you were already fast asleep at the orphanage so we had to explain the reason for interrupting what would have been your 3 hour afternoon nap! We changed your clothes and headed to the Minister's office. We received our travel letter and were able to meet the woman who oversees the adoption paperwork. She held you and asked us about you and was very kind. It is clear that she is very busy in her position there. We then had a nice lunch of pizza and pasta and headed back to the hotel as a FOREVER FAMILY. You had a blast wrestling with your brother and getting lots of love from everyone. You definately love being carried in the sling or Ergo on mom and dad. Tonight we met two new families who have recently arrived to conduct their adoptions. We had dinner with one of the families so it was really nice to talk with another family in person about all of our experiences in adoption (you slept through dinner in the sling since you have been going to bed at 5pm at the orphanage). You are now cuddled up in bed beside your sister and between mom and dad. I wonder what you will think when you wake up in the morning? I am guessing that you will meet us with that adorable little smile of yours.

Love, Mom

Letters to Leo: In Our Arms

Dear Leo,

Today we met you for the first time. We arrived to Rwanda on Saturday night after spending 3 hours on a flight to DC, 7.5 hours on a flight to Brussels and another 7.5 hours on a flight into Kigali. Your brother and sister did so well on the long flights and really enjoyed eating on the plane! Our POA met us at the airport and our massive pile of luggage was transported to the hotel. There was some mix up at the hotel and our room only has one king size bed. We were so tired that mom, dad, big brother and sister all slept well despite the crowded room. Turns out that there are no rooms with double beds so our POA negotiated with the hotel and they set up a single bed in a larger room that has a king size bed in it. We woke up early this morning and enjoyed the breakfast buffet (included in the price of the room) and met the other families who are ending their trip in Rwanda to adopt their little ones. After breakfast we loaded up our suitcases with donations and headed to the orphanage. We tried to pay attention to as much as possible on the way and took pictures to remember all of this for you. At the orphanage there was some confusion and we were taken down and out to the area where you and all your friends were running around. We were immediately met by tons of toddlers, some coming straight to me wanting to be held. Our POA then arrived and we were shuffled back out to the entrance area where after waiting a few minutes a nun brought you out to us. You were so brave! You looked worried but you did not cry. I was amazed at how small you looked compared to your picture. We held you for a bit, took some pictures, and played with some toys that we brought with for you. This seemed to relax you. We then loaded back up into the van and you held on tight to me and fell asleep on the way to the hotel. We spent the day relaxing and playing. Within a few hours with us you were smiling and laughing! Your 2T pants fit and while your 3T shirt was a bit big it was o.k. Since we could not obtain our travel letter from the Ministry's office on a Sunday we had to take you back the orphanage at 5pm. You fell asleep again on the way there and looked worried when we handed you back to the nun but you did not cry. We then went straight to a coffee shop/cafe that had great coffee. The other two families who are here from our agency were there (one family flew out to Ethiopia this afternoon) and we were also joined by the CEO of the adoption agency. I actually did not realize who he was at first but we had some good conversation about international adoption issues and ethics. We headed back to the hotel with the other families so that your brother and sister could go to bed early and dad walked across the street to a little super market to buy us some bottled water. Tommorrow morning we will come pick you up again and will work on some paperwork to start the process to obtain your passport. I am hoping we can also stop by the Minister's office and check in on obtaining your travel letter but that may not happen untill Tuesday. If so it will be very difficult to bring you back to the orphanage again tommorrow, especially after you adjusted so well today.

Love, Mom

LIft Off in 9 hours

Good morning everyone! Bags are packed, dogs are at the kennel, braided my daughter's hair, sewed a hole in my skirt and again I am so running on adrenaline that I am still awake. We will leave the house for the airport in 6 hours so I really should get a few hours of sleep. It reminds me of my last few days of pregnancy with my son, excited, uncomfortable, exhausted but not able to sleep. We will fly from Denver to Washington, DC for a layover then onto Brussels and from there straight into Kigali to arrive around 7pm on Saturday night. We probably will meet Leo Sunday morning as the children go to sleep very early at the orphanage. I have a bag of small items to help engage him when we meet. Toddler are not to keen about being picked up by a unusual looking stranger. It helped so much when we met our daughter that we did not touch or pick her up right away but just engaged her in playing. Please pray that our trip goes hassle free and that my children adjust well to the time change. Because we booked our daughter's ticket later we will have some seating assignments to get fixed. Obviously a 6 year old child cannot sit 6 rows away from her parents. If anything one of us will just switch seats with her. That actually might work out well if we take turns getting rest breaks if the kids are high energy on the plane. Wow, random thoughts going on here. Need to sleep!

Sleep?

Hmm, sleep? Who needs that? I will have plenty of time to sleep on the airplane, well maybe, I am bringing 2 kids with. More tasks were completed today and many more on the to-do list for tommorrow. We can't find our vaccination record for one of our dogs and that vet is closed tommorrow so I may actually be making a trip to the vet with a unhappy dog before I can take them to the kennel. It is always something is it not. I am used to it by now.

"Blessed to be Stressed!"

Getting Ready!!!!!!!!!!

In 60 hours we will be on a plane to meet our new son. I FINALLY spoke to a human
at the US Visa Center who after looking us up in the system and saying that our visa did not exist checked a third time and there it was! Turns out it had been there afterall and it was sent to Kenya. Since they cannot forward onto Ethiopia without USCIS instruction I contacted the USCIS officer directly who I met with last week. He called the National Visa Center and confirmed to me that he had sent our second visa packet to the NVC electronically and in the mail. He also emailed me a new copy of our I-171H form that says it is going to Ethiopia! This really felt like a monumental accomplishment so I have faith that it is on its way to where it needs to be. I also emailed the US Consulate in Nairobi, Kenya and asked if they could forward the visa to Ethiopia. So one way or another it will get there, I am faithful. Our agency apparently had a change of heart as well because they are going to allow us to travel as long as we agree that we are responsible if we get stuck in Ethiopia. I completely agree and would not actually mind spending some extra time in Ethiopia since we will be off work at that point anyways.

So now onto the full-throttle travel plans! We are bringing both our children so that they can share in this amazing (and very educational) experience. My son is pumped that he will actually be touching ground in 5 different countries (I did explain that for 3 of them we will not leave the airport). I am functioning on very little sleep to get ready in time.

Got vaccinations and meds today for our daughter- Check!
Finished shopping for all the odds and ends that we need for the trip - Check!
Found a great buy on really cute 2 and 3T boys short sleeve tops and shorts- Check!
Made a reservation to kennel the dogs-Check!
Have a volunteer to drive our car back from the airport from a new AMAZING friend-Check!
Received more donations to bring from our church and 4-more organization - Check!
Packed all the donations into 4 suitcases-Check!
Packed children's and husband's clothes - Check!
Printed and copied paperwork to bring to Rwanda and Ethiopia - Check!
Wrapped the Christmas gifts - Check!
Paid the bills - Check!

And I got a great surprise today from my fellow special education staff where I work. They brought food for lunch and a cake and gave us a giftcard. I was so surprised as I have not worked at this specific school very long. They are a awesome group of VERY smart women and I really appreciated their acknowledging the importance of our adoption. Tomorrow will be my last day of work before my leave so that I have a full day on Thursday to finish packing my own clothes, running errands, and getting all those odds and ends packed away.

Update and Vent

We have made the decision to bring our daughter with us to Rwanda and Ethiopia as well as our son. I was previously worried about how the trip might affect my daughter who was just adopted from Ethiopia 1 year and 9 months ago. But I think it will be a good experience for her and I think she is best of with all of us together as a family. So I worked some more miracles today and was able to book her airline ticket and we have a appointment with the travel clinic tommorrow. There is however one miracle yet to be completed and that is for our visa packet to arrive at the US Consulate in Addis Ababa, Ethiopia. I know it was resent to the National Visa Center last Wednesday because I was sitting there with the USCIS officer when it was confirmed to me. However I have not yet received a email reply from the NCS saying that it was received and their phone line is constantly busy. I am setting my alarm at 5:30 am to call them ASAP when they open. Since I am still up very late that equals barely any sleep tonight. I just do not understand why this should be so difficult. We payed the US Government over $800 to process this paperwork and all they did was loose it and now there seems to be no rush to fix the problem. And the big problem is that our international adoption agency told us that 12/4 to 12/18 were our confirmed travel dates and that if we did not go now then we could not travel untill January. Now at the same time we are being told that we cannot confirm our travel arrangements with them (hotel, transporation, food) untill the consulate in Ethiopia confirms that they have the visa packet. Should the agency not have known a little sooner that our visa packet was not where it was supposed to be? What am I paying for? Well since I am not going to leave my son waiting for us, while he watches four other families come and go with their children at the orphanage this week, I booked our tickets and we are leaving for Rwanda regardless. I am prepared to make our own travel arrangements and to take care of the paperwork myself in Rwanda and Ethiopia if necessary. I am however confident that our visa information will arrive to Ethiopia before we get there. I have done everything that I can from the ground to take care of this (including contacting our congressional representative) and the rest can be done by email and phone.