Thank you for turning to the Euromed Children Health Center for medical assistance in your adoption process. The most important thing that doctor does is TONS of explanations of the medical condition of the kids for you.
Pre-adoption services
The International Adoptions professionals of "Euromed Children Health Center" offer counseling to parents who are considering adoption of a child in Russia and CIS. We help parents understand the medical, developmental and emotional needs of a particular child. We help families all around the world to make sure they know everything about their future baby's health, because adopting a child is one of the most important decisions you'll ever make.
Sometimes children being considered for adoption have medical and developmental problems that have not been identified.
At the "Euromed Children Health Center", a private children' healthcare facility, our experts in developmental and behavioral pediatrics counsel parents about the child they plan to adopt. This assessment will help parents to better understand the medical, developmental and emotional needs of a particular child.
We are sensitive to the time constraints of the adoption process. Once a preliminary assessment of kid's medical records is made, consultations with parents can be done in person, by telephone or by e-mail, whichever you prefer. Our pediatricians travel all around Russian Federation and CIS with you to meet a child, whom you plan to adopt. Our doctors have vast experience in medical assessment of babies and older children who are about to be adopted abroad. The reason why we prefer to travel together with parents - is that this way future parents can ask all the questions that bother them about their child state of health, history of medical records, vaccination schedule, care that the child will need in the future, special needs etc.
Upon your request our pediatricians may evaluate medical records of the child without actually seeing a child, but this way we can only trust either papers or pictures which doesn't always give us an objective picture of baby's health.
A pediatrician specializing in Developmental and Behavioral Pediatrics carefully reviews the child's medical records and developmental history, as well as photographs and videotapes, if they are available. Based on these we try:
- to evaluate biological and environmental risk factors and their impact on the child's health and development to date.
- to identify any developmental disabilities or delays.
- to assess the child's current level of functioning with respect to motor skills, cognitive development, adaptive skills, speech/language development and personal/social skills.
Upon the medical examination of a baby and baby's medical records our pediatricians provide adoptive family with a complete western-style medical report and full range of recommendations both in printed and electronic versions.
For other available options or acquire more detailed information on the services, please contact our Pre-Adoption Coordinators by phone/fax at 7-812-331-0000 or by email at adoption@deti-euromed.ru
We look forward to the opportunity to be of service to you in the future.
What are the reasons children before their admission to the orphanage are transferred to the hospital?
How many orphanages are there in the city and Leningrad region?
Are there any orphanages specialized for handicapped children?
What is the overall incidence of FAS?
Vast majority (almost 100%) of parents' refusals to take a child occurs right after child's birth. Babies stay in delivery houses up to the age of 2 weeks. According to the Russian legislation then they have to be transferred to a children hospital where they are kept for up to 2 months until an official permission for the admission to one of the 14 orphanages is obtained and there are no medical indications for prolongation of treatment. 4 of the 14 orphanages are designed to take in children with profound disabilities and congenital malformations, one of them takes in children with HIV positive response.
20% of babies who are abandoned by their parents have positive HCV-antibodies. 95 % of infected newborns are only carriers from their mothers. In fact, none of the babies who were brought to "Euromed Children Health Center" for medical evaluation and tested positive for HCV antibodies were found positive with HCV-PCR. Nevertheless, we do strongly recommend to test all newborns for HCV antibodies during the medical clearance.
10% of newborns are found RPR positive therefore they receive prophylactic treatment with penicillin 100.000 U. every 4 hours for the period of 2 weeks.
Incidence of FAS is 4-5%. 5 out of 200 babies examined at "Euromed Children Health Center" for the past 2 years were diagnosed consistent with FAS during the process of medical clearance before the adoption.
How many children adopted in St.-Petersburg per year?
At what age and where are children referred to after the orphanage stay?
How many personnel serve children in one orphanage?
According to our sources of information, the structure of international adoptions is as follows:
In average 400 babies are examined in St.-Petersburg each year 40% are adopted by US citizens 60% are adopted by parents who reside in Italy, France, Spain and Finland.
European families in general are not very concerned about the health state of the adopted child hence there are no strict rules that would regulate medical evaluations of babies that travel to Europe. According to Russian legislation, before the child is offered for international adoption, his/her natural relatives must officially resign from guardianship as Russian families that wish to adopt a child must refuse to adopt him/her twice.
Average age of adopted babies is 7 months.
Ratio of boys/girls is 40/60. Average occupancy rate of orphanages is 100 children
Orphanage staff consists of 50 employees in average, but usually 1 nurse takes care of 10-15 babies.
Children are kept in the orphanage until they are 4 years old. Having reached this age, they are transferred to foster homes, where they stay until they are 14-16. Unfortunately as the child grows up, he/she is more likely to face behavioral problems including disattachment syndrome, and, alas, a risk of abuse from older kids.
What are the main reasons for developmental delays and growth delays?
Why is perinatal encephalopathy diagnosed in Russia so often and what are the reasons for overdiagnostics?
One of the questions commonly asked by parents is about perinatal encephalopathy (PEP). It is a diagnosis with unclear criteria, which has no match in ICM-10 and is the sample of over diagnostics - for instance 95 % of all newborns in Russia are diagnosed to have PNEP which actually has nothing to do with what is diagnosed as encephalopathy in the US.
We have to stress that even a regular orphanage specializes in a certain medical field like heart problems, neurology etc - so when we review medical records, it is not that rare to have a child who is absolutely normal but has a list of diagnoses made at the orphanage. To be honest I have never seen a child with medical records indicating that the child is healthy (of course we are not talking about possible growth and development delays which are reflected in the records as well).
Major reasons for developmental and growth delay (in average, 1-2 months):
- lack of care (one nurse per 10-15 babies)
- sensorial deprivation and little visual stimulation
- nutritional factors (babies are fed with whatever is available at the orphanage and not according to their diet)
- lack of fresh air (babies are to stay indoors 10 months a year and only 2 months outside of the city in the summer camps)
- what we call an orphanage syndrome - a benign condition and babies recover immediately after being put in better living conditions
What we focus on during the exam:
- review maternal and pregnancy history
- review all medical records (PMHx) and vaccination records since the day of birth and adjust them to the international standards understandable for specialists in US
- physical and developmental exams using Ross's growth scales and Denver 2 test
- lab panel to test for hepatitis screen
- RPR and HIV E LISA
- further diagnostic work-ups if indicated
Schedule for pre-adoption services
I. Pre-adoption services at the Orphanage or in Clinic in Saint-Petersburg
1. Comprehensive evaluation
- Evaluation of the medical history and documents
- Examination of the child by the pediatrician
- Denver Development test
- Medical summary / report in English
- Standard set of the lab test (CBC, Hepatitis B, Hepatitis C, HIV (anti-body), VDRL (syphilis)
cost 16 000 Rub
2. Evaluation of the medical history (without pediatric examination)
- Evaluation of the medical history and documents
- Medical summary / report in English
- Doctor's consultations with the adoptive family over the phone
cost 6 000 Rub
II. Pre-adoption services at the Orphanage (distant regions of Russia)
1. Comprehensive evaluation
(at the orphanage, when traveling with the adoptive family. Please note that the doctor's daily assistance fee is charged when traveling with the family. See below for details.)
- Evaluation of the medical history and documents
- Examination of the child by the pediatrician
- Denver Development test
- Medical summary / report in English
- Standard set of the lab test (CBC, Hepatitis B, Hepatitis C, HIV (anti-body), VDRL (syphilis)
cost 16 000 Rub
2. Accompanying the adoptive family to the distant regions of Russia (doctor's daily assistance fee) - cost 7 000 Rub per day
3. Comprehensive evaluation
(at the orphanage, when the family is not traveling with the doctor personally. No daily assistance fee is charged)
- Evaluation of the medical history and documents
- Examination of the child by the pediatrician
- Denver Development test
- Medical summary / report in English
- Standard set of the lab test (CBC, Hepatitis B, Hepatitis C, HIV (anti-body), VDRL (syphilis)
cost 20 000 Rub
Effective as of April 01st, 2009
