Primum non nocere - First, do no harm

(Written & Posted Originally in April 2013 - Reposted today in honor of National Adoption Month, November 2015)


'Primum non nocere', perhaps you've heard that phrase? If so, you've likely heard this as one of the principle precepts of medical ethics. I'm not writing about medical ethics today. I'm writing about adoption ethics, but the same precept applies. 

First, do no harm.

I wholeheartedly believe most prospective adoptive parents set out to 'do no harm'. 

To each person considering adoption and to each person who has already completed an adoption, I share the following out of a deep concern for birth-mothers and first families. I share it as an adoptive mother, from a place of sorrow and regret.

Manno & his Papa

Recently I wrote this: I have intensely complicated thoughts about everything related to poverty, orphans, orphanages, and international adoption. Some of my thoughts are developed thoughts and others I am wrestling with as I wonder about the roles I have played in the system and as I watch injustice and unbalanced power all around me. 

For months I've been in utter and complete turmoil over many things related to international adoption. We first adopted more than 10 years ago. My turmoil has to do with my son, Isaac. It has to do with his first family. (I plan to share that story in a follow-up to this post soon.)  It has to do with the system and its multiple pitfalls. It has to do with doing harm.

The more I learn living in Haiti, the more research I do, the more convinced of the appalling issues I become. The more involved I've been with our children's first families the more I've been forced to face some difficult realities about international adoption. I recognize that I too have been part of the problem. I recognize that "do no harm" requires so much more understanding, awareness, and education than we had. 

Ketia & Julianna

In part because of my sister, who was a first-mom that placed her daughter for adoption as an infant, and in part due to my own international adoption experiences, I find myself predisposed to fight for first mothers and their rights. 

Having spent a number of years in Haiti, I have had an opportunity to slowly build relationships with many women and that has allowed me a unique peek into their lives and their reality. I've witnessed troubling exploitation of birth-mothers in Haiti. From all that I've learned, I have come to care intensely about the needs and rights of first mothers and fathers. 

"Exploitation" is perhaps an intangible term for some. When I say exploitation, I am casting a large net that refers to multiple things. As one example, I refer to a system that rarely tries to help a first mom through a difficult time but has no problem having her sign paperwork she doesn't understand and taking her child off of her hands, for good. If the child is an infant, that can easily be referred for adoption, he or she is received even faster. 

I desire reform in the area of ethical practices that go above and beyond to protect vulnerable, materially poor, marginalized, and often times uneducated first mothers/families. Even if we cannot agree how that reform should be fleshed out, I hope we can agree reform that protects poor first families is needed and overdue. 

Dieumatha & her little one

It occurs to me that our western culture of capitalism, materialism, and consumerism all play a large role in our attitude toward and approach to international adoption. Due to our wealth and ability to provide, sometimes without even realizing it we begin to believe that our material wealth makes us better suited to parent the child of a poor mother. What began as noble and pure and loving can fairly easily begin to look a lot more like ethnocentrism and entitlement. 

Prospective adoptive parents presented with proof that a healthy and able birth-mother exists rarely ask questions about why she relinquished her child. We want to be trusting people and we believe the story offered by their agency and never look back. Sadly, many later learn that nothing was as it appeared. 

(And of course, sometimes -for dozens of reasons First-mothers choose, without force or manipulation, to relinquish their child for adoption out of great need and pure motives. There are absolutely situations where babies and older children are legitimately relinquished.) 

Additionally, adoption is being marketed to us by our churches now. The cry from the pulpit to address the "orphan crisis" oftentimes creates pressure to adopt rather than a calling to adopt. I am not at all against a fact-based movement encouraging openness to exploring a new idea. I am against using guilt to propel people into uninformed or reckless action.  (Adoption as a way of solving the "orphan crisis" is marketed with sketchy numbers and without delineating "true orphan" from "poverty orphan" - which I find dishonest. Perhaps this is an entirely different blog post for another day.)  

I think most adoptive families (choosing to adopt internationally especially) enter into the process thinking they will be helping a child that desperately needs a family. Over and over adoption is marketed as- "Giving a child what they deserve:  A family."  My struggle is, most of these kids have that family before we arrive. We've not done enough to help their families have other options. We've not invested enough time in educating the birth families; first families frequently don't fully understand what they signed up for, nor do they understand what they can expect in the future. 

Wislene and her precious family

It is not a mystery why some injustice continues unchallenged in the adoption arena. Whenever people have a personal interest they are apt to protect themselves over the greater good.  Many say, "Once our adoption is done, we'll talk about what we saw, what we heard, or what we learned".  So many people that plan to talk "later" get tired or busy with a new family member to acclimate and they never follow through. Meanwhile, every day more children enter institutionalized care and new families turn over their payment and paperwork and the light does not shine on truth. I challenge all adoptive and prospective adoptive parents to refuse to be quiet when things are troubling  - to refuse to be frozen in fear - to refuse to allow the powers that be to manipulate or misinform without consequence.  

“The moment we begin to fear the opinions of others and hesitate to tell the truth that is in us, and from motives of policy are silent when we should speak, the divine floods of light and life no longer flow into our souls.” -Elizabeth Stanton

I imagine a world where a prospective adoptive parent would be every bit as willing to advocate (financially, spiritually, emotionally, and otherwise)  for the rights and justice of the poor first/birth-mother to keep and parent her child, as they are willing to push for their own completed adoption. I don't think anyone starts out wanting to trample on the marginalized but sadly it seems to be happening by default in many countries around the world.

Justice is not only about seeking fairness and equality for those without a voice; at times it is also risking our own personal happiness or gain in order to bring it.  

Those of us in the position to consider an international adoption are the ones with the most power.  Let us use our voice for good. Let us stand with the poor in support of their ability to raise children. Let us demand real and measured transparency.Let us not blindly trust what we're being fed by agencies and those that stand to gain most from the entire process. Let us be about exposing the dark parts of this system (truth telling) and educating ourselves and new adoptive families so we can all avoid hurting and oppressing the poor.      

Because I believe that with very few exceptions, most adoptive parents set out to "do no harm", it seems possible that we might all be willing to look more critically at the gray areas. If you're open to further consideration, here are some links and thoughts you can begin to read and research further:

1.  "In many countries,it can be astonishingly easy to fabricate a history for a young child, and in the process, manufacture an orphan.The birth mothers are often poor, young, unmarried, divorced, or otherwise lacking family protection.The children may be born into a locally despised minority group that is afforded few rights.And for enough money,someone will separate these little ones from their vulnerable families,turning them into "paper orphans" for lucrative export."Source: The Lie We Love, Brandeis University  
2.  PEAR - Parents for Ethical Adoption Reform (on Facebook too)
3. Multiple links regarding fraud/corruption here at Schuster Institute for Investigative Journalism - a.) Proposal for fairer adoption practices here 
4. I recently finished reading an advance copy of this book. My original perception was that it painted Christians with a broad brush, therefore some of it left me slightly defensive - BUT - there are enough/many stories and things that ring 100% true that I hope many adoptive parents will read it for themselves and not take my word for it - simply to be informed of the troubling evidence of coercion and multiple issues that exist within the current system.   
5.  Child Laundering: How the Intercountry Adoption System Legitimizes and Incentivizes the Practices of Buying, Trafficking, Kidnapping, and Stealing Children, by David M. Smolin  (This guy is smart and honest and comes at it objectively.)
6. If you are aware of North Americans using their power and inherent privilege to strong-arm or force an adoption (actually called kidnapping and called trafficking) - please expose them to authorities because every time a child somehow slips out of their birth country in an illegal and unethical way, it hurts others with legitimate and lawful adoptions.

This post does not address many other forms of fraud and deception; it was intended to be just one piece of the puzzle, focused on first families. Please don't read this post as any sort of personal attack or indictment. We are all swimming in ethically gray waters. I've become so troubled that I feel it is important to risk upset  in order to bring attention to the fact that many of our good intentions are inadvertently causing unjust results. Even though there is personal and emotional involvement - I am thankful that some adoptive parents will be moved by the Good that compels them to look harder at the broken system we have been complicit in creating and consider how we can be agents for change.

... God gives out wisdom free, is plainspoken in Knowledge and Understanding. He's a rich mine of Common Sense for those who live well, a personal bodyguard to the candid and sincere ... 

- Proverbs 2  -

~         ~         ~          ~

post script ...

Over the last several years, through the work happening here in Haiti, I've been watching Haitian mothers being offered a bit of encouragement and love. In that time I've watched over 250 women choose to parent (and not relinquish to an orphanage) their babies. Less than 1% have chosen to place for international adoption. Some are very, very poor women; some are middle-class women. With a relatively small amount of emotional support these women are choosing to parent their children. Without the benefit of wealth and material blessing they are doing a fabulous job loving and serving their little ones. 

Jacquline, her mother, and her newborn daughter

(all photos of Haitian families used with permission)

Everyone Showed Up

This beautiful thing happened yesterday:

http://momastery.com/blog/2015/10/21/love-flash-mob-global/


The results of 24 hours of LOVE are stunning:

http://momastery.com/blog/2015/10/22/so-they-did/

Overcoming

The crew that celebrated Graham's first birthday, Lydia's eighth, and Grandpa Porter's 65th together in early October

When I was in Texas a couple of weeks ago to see that delicious little grandson of ours - (Doh! - I mean - to see our big girls and their husbands and my Mom and Dad ... then of course that baby too, if at all possible) - I had a massive technology failure.   

A few weeks have passed and I am ready to talk about it now.

I arrived to DFW with my two spunky little girls and a plan to meet a friend that would hand me drugs. (Medicine for a diabetic woman in Haiti. Come on.)  When I got to the baggage claim area and turned my phone on to find out where I would meet the friend, only the voice of Siri or a woman that was pretending to be Siri came out.  The voice kept reading the home screen over and over and over to me.  "The time is 10:28pm".  Each time I tried to put in my password it would just tell me out loud what numbers I was pushing, but not ever unlock the screen.  

Like all of us do when we lose a vital organ, I began to panic.  How soon before I bleed out, I wondered!? How can I call my friend? How can I find my friend? How will I get to my daughter's house without that phone? What about the calls I promised I would make while on the long drive tonight? How will I remember which car-rental company I held the car with earlier? Where will my next breath come from?!?!?!   

"PLEASE -STAY CALM, Lydia and Phoebe",  I said.

I could continue to lay out for you every massive mountain of challenge I climbed without my phone, but I will spare you further detail and just skip all humility and tell you about my heroic ability to continue on in the face of all that affliction. 

Not only did I find the friend,  I rented a car and drove from DFW to daughter #1 without a map.  After that, I drove from Dallas to a city three hours away totally unassisted by Google Maps or a phone that is smart.  

That's right.  That really happened.

The next day I was trying to make it Troy's fault for sending me with a faulty phone to use in the USA and like he is known to do, he wrote a list of instructions detailing how I (read: Paige) could go about fixing it.  

I handed the instructions to Paige.  She sort of half-tried to follow step one and then she told me that his instructions included hitting the home button three times and that I did not have a home button.   

Huh.  Well.  Okay.  So that is done then. No fixing a phone that has no home button. Easy go, easy go. 

When I got home a few days later Troy turned the phone on, confirmed that yes indeed it was jacked up.  He then fixed it in .4 seconds by hitting the home button.   He has gone on to share this story with a couple of my friends in order for them to be able to mock and scoff with him. If my 20 year old says I don't have a home button, who am I, a 43 year old dinosaur, to disagree? 

My husband wants to focus in on the failure of not fixing the phone and also in believing Paige without question. That is not how this is going to go down. I am cementing this in history as the story of my bravery and ultimately my overcoming in the face of much adversity.  


 ________________________________________



A few kid other things I don't want to forget, so recording here...

On our way to Texas we had a long layover in FtLauderdale and shopped for a little bit. The girls asked if they could please go to the bathroom together without my help. We almost never allow them chances to test independence in public places in Haiti so I said, "Yes, you can if you stay together. If anyone gives you any trouble one of you fight and one of you scream and I'll come quickly." The girls said "okay!" and took off for the bathroom. I went back to looking at the rack I was standing near.

A few seconds later Lydie (half way to bathroom door) spun around and yelled back toward me, "Ma? I'm gonna be the one that fights, ok?!" 

I really don't doubt it.  Phoebe and Lydie are only 11 months apart in age. We are anxious to celebrate the birth of our Phoebe girl very soon.

(Written earlier)

This morning began with hysterically upset Phoebe. When we were in Texas for the birthday celebrations I bought her new underwear with the days of the week on them. She is MADLY in love with this new system of underwear organization ... takes all the guesswork out of choosing in the morning.
Well, Chestnut the ShiTzu ate Friday's pair. Phoebe discovered this today when she woke up. She dramatically explained how much this is going to ruin tomorrow and possibly every Friday for eternity for her. If you had heard her, even you would be convinced this is a HUGE problem, from which we may never recover. 

I (somewhat teasingly) suggested that we could just write Friday with a Sharpie on a pair of old undies. Tonight she came and handed me a sharpie and these underwear. Apparently my solution is actually better than wearing a pair that doesn't designate what day it is.  (Yes, she wore them and the marker survived the wash to live to see another Friday.)

Perspective: We Can Do Better

~A man walks up to the gate agent  and begins to express frustration with his flight delays.  He begins to talk louder and use his hands.  The agent decides his style of communication is a threat to her and calls the police.  The man is taken away from the gate and not allowed to fly that day.

~A group of men sit on their motorcycles at the busy intersection.  They chat and laugh  and watch traffic going by as they wait for potential customers to arrive.  A carload of visiting Americans driving by sees all the men gathered in a group on their motos and says, "This motorcycle gang seems dangerous. Why are they here?"

~Sarah is out for a morning jog in rural Haiti, in the distance she sees a man walking toward her with some sort of weapon in his hand.  She is alone on a run and becomes fearful. She turns back to run the opposite direction rather than passing the man on the road.

~We receive an email, explaining that an American family in Haiti is in need.  The email went on to explain that the family needs to leave Haiti before the elections later in October, because the country is dangerous - even more so during elections.  The family is raising a lot of money to get out of Haiti.

*          *           *           *

~The man at the airport was communicating in a very Haitian way.  Haitians can be quite animated in their communication, one minute you might observe two men having what appears to be a very heated conversation, the next minute they have their arms around one another and they are laughing their heads off while embracing.  Our observations of their communication is rooted in our own paradigm.  The gate agent was never in danger, no threat was ever made.  

~The men that sit at the corner are trying to make a living by driving moto-taxi.  They wait at a busy intersection in order to find customers that need a ride.  They laugh, tease, debate, and enjoy each others company while they wait on the next customer. They are not a "gang" and they simply hope to make a few dollars today.

~Sarah was new to Haiti.  She didn't realize that everyone in rural Haiti owns a machete. It is used for dozens of things, including working in the garden.  What Sarah saw as a threatening man, was really just a hard-working guy headed to his field to work.

~It is not so dangerous in Haiti that anyone needs to evacuate due to election season.  Like any place in the world, things can and do happen ... But, to suggest that staying in Haiti this month is unsafe is over the top dramatic and also untrue.  Sensationalizing things in order to fund raise hurts everyone in Haiti. 

*          *           *           *

Sometimes, as a family living and working long-term in Haiti, it becomes clear why there is some animosity toward foreigners.  Over the years the volume of people that have come here and misused funds, left their employees and vendors unpaid, and entered into inappropriate relationships or chosen to do things they deemed "helpful" while never asking, "What would be helpful?" is utterly mind-numbing. 

We grieve over the things that have been done here that have hurt Haiti and her people. If we (expats) are all to be grouped together and seen as a whole, it makes a lot of sense that many would look at us and judge us unhelpful, annoying, and even offensive and harmful.

Haiti does not need the media or visiting foreigners/humanitarians/missionaries to stir up drama for their own attention, fundraising, or sales. 

I think we can ask for better. 

I think we can do better.