Clinic offers medical insight for parents pursuing international adoption; "Most Rhode Islanders would go to Russia to pick up a child, but they wouldn't drive to Boston to visit a specialist," physician says.
International adoptions often mean adding to a family a child with an unknown medical history. That's why Boris Skurkovich, M.D., opened the International Adoption Clinic at Hasbro Children's Hospital last November.
To determine how well a child is growing and developing, and to advise a family accordingly, Skurkovich will review any videotapes, photos, medical histories or reports provided by an adoption agency to a family.
"Say you're told by an agency that the child is six months old," said Skurkovich, clinical associate professor of pediatrics in the School of Medicine. "After reviewing the available information, we may suggest that a family ask the adoption agency to find out if the child can roll over, sit up or smile. These indicate a particular developmental stage."
Video from Russia, which recently surpassed China in the number of children placed through international adoptions, is particularly revealing because Skurkovich was born, raised and educated in Moscow. "We will see a child but also listen to what's being talked about behind the camera," Skurkovich said. "The person hired by the adoption agency is asking questions, such as `is the child quiet?' or `does he behave?' Information from an interchange may be more valuable than medical records."
Once a child is home, Skurkovich will examine the youngster, screen for diseases specific to the child's country of origin, and counsel parents on developmental issues, immunizations and other medical matters. This service typically supplements efforts of a family's primary care provider, who often makes the referral.
One such referral came from Nancy Palmisciano's pediatrician. Palmisciano, a Providence lawyer, has two adopted daughters from China. Both had unknown medical histories. Cristina, now 4 years old, came home June 29, 1997, and mother and daughter made several trips to Boston, location of the nearest international adoption clinic at the time.
On Dec. 9, 1999, Palmisciano brought home Ana, now 21 months. The Palmisciano family has visited the International Adoption Clinic at Hasbro twice.
Although helpful, a family physician can do only so much in an international adoption case, Palmisciano said. "I wanted all the necessary tests. With no medical history, I don't even know if Ana is allergic to any medications. Dr. Skurkovich is helping rule out the problems, so we get as clear a picture as we can. We're looking to fill in the gaps.
"The worst danger is to come home with a healthy-looking child...and not gather any more facts," Palmisciano added. "The presumption is that a healthy appearance is a healthy child. That is simply not so."
Despite the relative proximity of the Boston clinic and another in New Haven, Rhode Island needed its own international adoption clinic, Skurkovich said. "Most Rhode Islanders would go to Russia to pick up a child, but they wouldn't drive to Boston to visit a specialist," he said.
"It's really important for every adoptive parent to at least have a consultation with an international adoption clinic," Palmisciano said. "Dr. Skurkovich is a blessing. He is a nice man who listens. You can tell he will do well working with adoptive parents. To be a good physician, especially in working with internationally adopted children, you have to begin with the ability to listen."
For more information on the International Adoption Clinic, call 444-8360.