Each year, thousands of children, almost exclusively young girls, are adopted from the People's Republic of China. In the last five years, as many as 10,000 of them have found new homes in the United States.
These girls represent just the tip of the iceberg of a profound social phenomenon in China-the abandonment of hundreds of thousands of baby girls each year and the resulting development of an overburdened orphanage system to care for and raise them.
This trend, which has existed for almost 20 years, is the result of complex forces in Chinese society as the country struggles to limit its population growth. Such social engineering-sometimes subtle, sometimes overt-has attracted the attention of human rights activists worldwide. Further, it is likely to result in profound implications for China in the next 10 to 20 years and beyond.
The one-child policy
In the 1950s, China's leader, Mao Tse-Tung, urged his people to have more children to strengthen the country. The resulting growth of the population led to great concern in the 1970s that China would be unable to feed them in the near future. Sustaining China's population has always been a challenge because about 85% of its 1.2 billion people live on one-third of its land that can be cultivated.
In 1979, the Chinese government implemented a one-child policy, to be overseen by the State Family Planning Commission. Government officials created the policy to limit families to having one child, with the intent of keeping China's population to less than 1.3 billion by the year 2000.
The extent to which Chinese officials have enforced the policy has varied over time. For example, the government has allowed rural farmers, fishermen and ethnic minorities to have two or three children. Elsewhere, it is possible for parents to get permission to have a second child if their first child is a girl. Cities traditionally have been stricter in enforcing the policy, although Beijing, Shanghai and Guangdong province in recent years have allowed families to have two children to counteract declines in population growth.
China has used a variety of approaches to achieve compliance with the policy. It has promoted the benefits of smaller families in its media and supplied family planning assistance, but for the most part, it has used coercive pressure to achieve compliance with the one-child policy. For example, families that have an unauthorized second child may face monetary fines--reportedly up to three years' salary. Human rights organizations also charge that family planning officials have coerced women to undergo abortions, including late-term pregnancy terminations, as well as sterilizations. These government workers also are said to track women's fertility cycles as well as the implantation of birth control devices.
The impact on females
Increased enforcement of the one-child policy, particularly beginning in the late 1980s, has had a huge impact on families and the nation because of the preference for sons in Chinese society, particularly in rural areas. There are many reasons why families prefer to have sons:
However, analysis of population composition suggest that reductions in the growth rate of China's population has come at the expense of female births. In the book, "China Wakes," authors Nicholas Kristof and Sheryl Wudunn note that China has far more male births than female births than is typical worldwide. In comparison to a normal ratio of 106 male births to 100 female births, the ratio in China is approximately 112 newborn boys to 100 newborn girls overall.
For second-born children, the ratio is even more pronounced in favor of males. A 1992 survey by the Chinese government found 118.5 male births for every 100 female births. Kristof and Wudunn extrapolate China population ratios to estimate that, if a normal ratio is 105.5 to 100, then in 1992, 12% of all girls born annually in China are unaccounted for, which would represent approximately 1.7 million females.
Kristof and Wudunn contend that second-born daughters are particularly at risk, because if a family's firstborn is a girl, the parents would not want to "waste" their permission to have a second child on another girl. They theorize that peasants have dealt with this dilemma through infanticide, and they contend the recent increased use of ultrasound scanners in determining the sex of a fetus has led to more abortions related to sex preferences.
Infanticide has been forbidden in China for 50 years, since the Communist government made laws against the practice, but it is widely believed the practice has revived since the imposition of restrictive birth control in the late 1970s.
In the past 10 years, Chinese parents who don't want a baby girl have reacted to pressures of the one-policy by abandoning a significant number of female babies. This practice, while not condoned by the Chinese government, apparently is not penalized because the practice is so widespread.
Infant abandonment in China takes a variety of forms. In some areas, a childless couple may find an abandoned child on their doorstep. These "informal" adoptions circumvent the many bureaucratic imposed on Chinese couples face in adopting-for example, both parents in a domestic Chinese adoption must be childless, older than 35 and supply proof they are unable to conceive a child, unless that child is an orphan whose parents are known to have died.
But more frequently, infants are abandoned in public places where they will be found quickly, such as busy streets, parks, railway stations or in front of public buildings. Most abandonments occur within the first two months of life, usually within the first few days.
Besides females, handicapped or obviously unhealthy babies are at risk to be abandoned. This is because most parents, particularly in rural areas, don't have the financial resources to provide extensive medical care beyond that which the government would typically provide, and there is pressure not to "waste" the opportunity to have a child on one that may not be healthy. Those with cosmetic problems, such as cleft lip, cleft pallet, extremity deformities, missing limbs and missing or too many digits, also are at risk to be abandoned.
There is no official government figure for the number of infants abandoned annually in China. A 1995 article published in the Chicago Tribune quoted an estimate of 150,000 by the Chinese government, but U.S. experts in Chinese adoption place the number much higher, in a range of 500,000 to 800,000 abandonments annually.
Kay Johnson, professor of Asian Studies at Hampshire College, has studied abandonment in depth in Hunan province, where the provincial government in 1991 investigated the practice. Johnson noted that abandonments increased greatly in the late 1980s. The provincial report found 16,000 abandoned children were brought to Civil Affairs departments in the province between 1986 and 1990. The vast majority of the children were said to have come from rural areas. Some 92% of these children were girls, and most were very young.
In metropolitan areas in China, abandoned infants receive initial health checkups before being brought to welfare centers for continued care and upbringing. A 1996 report by the Information Office of the State Council of the People's Republic of China said the country has 73 welfare homes for children set up by local governments, "offering guardianship and rearing to 8,900 orphans and abandoned or ill disabled children." In addition, the report said China has more than 1,200 social welfare institutes in urban areas and homes for the aged contain children without parents. The Internet Web site of the Chinese Embassy in 1997 reported that 100,000 orphans are in these facilities.
Other adoption experts suggest that smaller orphanages, not included in those totals, provide provide care for orphans, particularly outside of urban areas. Overall, China may have as many as half a million orphans under its care.
The information office report contends that "there are a total of nearly ten thousand organizations serving orphans and disabled persons in communities throughout China, such as schools for orphans, rehabilitation centers, training classes for mentally retarded children, rehabilitation stations, as well as about a hundred social welfare institutions established by individuals or organizations."
The information office report was written, in part, as a response to accusations contained in a 1995 British television documentary and a 1996 report by a Human Rights Watch/Asia that Chinese orphanages intentionally allowed small children to die by denying them medical care and nutrition. In particular, the human rights group's report, based on information from one orphanage in Shanghai, charged that a high percentage of orphans throughout China die in orphanages.
In an addendum to the information office's 1996 document, it vigorously denied the charges, disputing both the methods in which information was gained, the veracity of the sources and the way in which it was presented. Those knowledgeable about Chinese orphanages believe mortality rates are high in the system-rates of as much as 40% in urban institutions have been quoted as government statistics, and the percentage is believed to be higher in rural orphanages-but that the deaths do not reflect the intentions of the system.
"While the poor conditions within welfare centers certainly play a role (in high mortality rates)...even a well-equipped and devoted staff would face a daunting task," writes Kay Johnson. "A significant percentage of children brought to welfare centers are in extremely poor condition when they arrive, owing to exposure, dehydration, malnutrition and sometimes congenital disabilities. Institutionalized care of infants inevitably contributes further to the difficulty," as lack of individualized care can contribute to infants failing to thrive, a finding substantiated in previous studies in other countries, she notes.
Chinese orphanages have limited funds to provide care for orphans. The Chinese information office report notes that, "in economically developed areas, the average expense per child per month is 400 to 500 yuan (about $50 to $63 U.S.), while in less developed areas, the amount is 200 to 300 yuan (about $25 to $37 U.S.)."
However, the 1995 Chicago Tribune article says a survey conducted by the Qing He Child Welfare Institute in Beijing reports a less rosy picture. The survey reported that a Beijing resident spends 193 yuan ($24 U.S.) on food monthly, while the orphans at the institute are allotted 92 yuan (less than $12) monthly.
Adoptions of Chinese children
In recent years, China has allowed its orphans to be made available for adoption internationally. While the numbers of such adopted orphans has been growing, it still represents only a small percentage of the number of children abandoned annually.
Before 1990, China permitted very few international adoptions. For example, adoptions of Chinse orphans by U.S. citizens ranged from a low of 10 to a high of 62 in the years between 1986 and 1991.
China relaxed international adoption laws in early 1994, partly as a response to pressure after the Tiannamen Square incident in 1989, in response to media attention in 1993 to its increasing numbers of orphans, and as a result of changes implemented by the reform-minded vice minister of Civil Affairs, Yan Mingfu. Those changes were endorsed by Jiang Zemin, himself an adopted child, and adoption numbers increased rapidly. For example, from 1992 to 1997 (according to U.S. fiscal year figures, all ended Oct. 1), Chinese adoptions by U.S. citizens have totaled 263, 388, 856, 2,193, 3,333 and 3,553.
Experts in Chinese adoption believe that parents in about half a dozen other countries, including Canada, Denmark, Great Britain and Norway, can adopt from China. The total number of children adopted from China is believed to be about 4,000 this past year.
China is popular with many adoptive parents because their demographic profiles often fit hand-in-hand with China's adoption law requirements. It requires that parents, either married or single, be at least 35 years old and childless to qualify for a healthy child. Parents who are younger than 35 or who already have children also may adopt, but they must be willing to accept a child with special health or medical needs. However, until recently, a large percentage of these parents have been assigned children who are healthy or have minor or easily correctible health problems.
U.S. parents also favor China as a source for children because, compared to domestic adoptions, the process is relatively short (about 18 months), uncomplicated, fairly certain to result in the assignment of a girl and unlikely to result in a birthparent returning to claim the child.
Costs for a China adoption range from $15,000 to slightly more than $20,000. That total includes travel costs, domestic adoption fees and a contribution to the orphanage from which the child comes. Particularly in the U.S., that amount is within the reach of older parents who have no children because they frequently have pursued individual careers.
In the U.S., parents typically work through one of about 100 adoption agencies that facilitate Chinese adoptions. These agencies face no formal qualifications, but the Chinese government seeks to work with agencies that have a proven commitment to child welfare, knowledge of international adoption, appropriate licensing and a professional staff.
Parents seeking to adopt a Chinese child must be approved by a social worker licensed in the state in which they reside. The social workers conducts a personal and background investigation of the applicant. Also, parents compile several documents required by the Chinese government; this dossier includes birth and marriage certificates; letters confirming sufficient financial assets, employment, good health and clean police records; pictures of the parents, family members and residence; the case study report of the social worker; and other forms or letters as required. U.S. government approval, from the Immigration and Naturalization Service, also is required.
Dossier documents are translated into Chinese by adoption agency staff and then sent to the China Center for Adoption Affairs in Beijing, which is under the direction of the Ministry of Civil Affairs. The CCAA then matches parents' dossier applications with available children. As of late 1997, this process has been taking about 10 months for childless, over-35 parents and about 12 to 14 months for other applicants. Children's ages, at the time of referral, have been about 10 months or older, although ages vary widely.
After the CCAA makes a match, it sends any pictures or medical records back to the adoption agency, which then sends it to the parents to see if they will accept the referral. Upon acceptance, parents usually receive approval from the Chinese government to travel to China within two months to get the child.
In China, most adopting parents face a short perfunctory interview by Chinese officials, who ask them about why they wanted to adopt from China and how they intend to raise the child. After obtaining a passport for the child from the Chinese government, U.S. adopting parents travel to Guangzhou to be processed at the American embassy before their return trip.
In this country, many of the children adopted from China are formally re-adopted in their new home state. Parents eventually seek U.S. citizenship for their child by applying to the Immigration and Naturalization Service. That process takes about one year; re-adoption is not a prerequisite for citizenship.
Many children adopted from China are reasonably healthy, although they initially may be undernourished or developmentally delayed. Many also are prone to respiratory infections, skin conditions and parasites, all of which often disappear in response to improved medical treatment. A small minority, however, have longer term disabilities, and about 5% carry the hepatitis B virus, which is more prevalent in China than it is in the U.S.
Adoptive parents generally have shown interest in giving their Chinese children exposure to Chinese culture. Particularly in urban settings, parents are forming chapters of Families with Children from China, a national group that now includes about 3,000 members. Mary Chamberlain, an adoption facilitator with 15 years of experience with World Child International, says, "Families who have adopted from China are the most active group I have witnessed in my years in the adoption business in keeping the culture alive for the children." Parents are exposing their children to Chinese culture, crafts, language school, holiday celebrations and contact with Chinese people.
The future in China
Recently, some Chinese officials have acknowledged that strict enforcement of the one-child policy has been a two-edged sword. While successful in containing population growth, they concede it will have far-reaching consequences. Some worry that males born over the last 15 years will face a shortage of females when they are old enough to marry.
Also, there are growing indications that the declining population growth rate could pose problems when those born in the 1950s and 1960s prepare to retire, because there may not be enough workers to support them in their old age. "Some of us think we should not have had a one-child policy at all," said Tu Ping, a demographer and marketing professor at Beijing University who was quoted in an October 1997 Los Angeles Times. The resulting sudden shifts in the composition of the population are bound to create long-term problems "that makes policy planning more difficult," he said.
An official attending the 23rd General Population Conference in Beijing admits that easing the one-child rule could help correct imbalances in the population. "When more people have two children, the age structure will be more balanced," said Zhang Erli, a department director at the State Family Planning Commission quoted in an article by Reuters News Service. "This will be advantageous to the ratio between old people and children."
An October 1997 article in the Wall Street Journal say Chinese officials admit the policy has "ravaged fertility and led to outright population declines for three years running."
Chinese officials suggest that the one-child policy may be may relaxed nationwide. While the national government is not dismantling efforts at controlling births, each province can amend the one-child policy "according to its needs," said an official quoted in the Los Angeles Times article.
Some say that another loophole in the one-child policy will allow those who are only children born under the one-child policy to have two children when they marry, and thus their adulthood will mark the unofficial end of the rigid controls.
"By 2005, nearly every couple will be eligible to have two children," said Peng Xizhe, a demographer at Shanghai's Fudan University, quoted in the Los Angeles Times article. "Along with the exceptions in the countryside, the one-child policy as we know it will be over."
Currently, the Times article says, Chinese officials are in the ironic position of encouraging couples to have more babies, saying that last year in Shanghai, a city of 14 million, only about 4,000 couples had a sanctioned second child. In one district of the city, officials contacted 2,800 childless couples to ask why they hadn't had a child. Many couples don't want large families, or any children at all, to get in the way of a career and the prosperity they may enjoy from relaxed rules regarding capitalism.
Recently, Shanghai television aired a program on the success of the one-child policy, reports a 23-year-old resident of that city, and encouraging families to have children if they are entitled to have one.
Still, many expect that infant abandonment will continue to be a burden that China will carry for at least another decade. While widely practiced, it still remains an act of great shame for many parents who feel they have no other option.
Exemplifying this dilemma faced by Chinese parents, professor Kay Johnson tells of a note left with a child in Hunan.
"This baby girl was born on XX-X-1992 at 5:30 a.m. and is now 100 days old. She is in good health and never has suffered any illness. Owing to the current political situation and heavy pressures that are too difficult to explain, we, who were her parents for these first days, cannot continue taking care of her. We can only hope that in this world there is a kind-hearted person who will care for her. Thank you. In regret and shame, your father and mother."
Fred Bazzoli is an editor for a health information technology magazine based in Chicago, Ill. He and his wife, Margaret, adopted their daughter, Ellen, from Nanchang, Jiangxi province, in November 1995, to join sisters Carolyn and Meredith.
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