SELECTED ARTICLE
Author
Alla Gordina, MD, FAAP 
Article Title
Availability and Reliability of Records in Russian Orphanages - Part 1 
Posted Date
12/15/2005 

"We are one of those families who got four pages of nothing out of an extremely thick file we were never allowed to review. 6.5 years later, our daughter, now almost 14, has told us about several hospitalizations, etc that we knew nothing about so we'd like more details." Adoption from the Former Soviet Union had its unique benefits, one of which is the direct contact with caregivers and the possibility to obtain the variety of documents. You just have to ask.

Unfortunately families do arrive with newly adopted children but with minimal (if any) information about them. Even more, families, adopting through the visiting programs and those adopting through one trip system are in the biggest disadvantage - everything is so hectic, nothing is usually prepared and the result - minimum information about the child(ren)... Did I see cases when families were given the complete medical and educational chart? Yes, I did. But that is usually more the exception, then a rule.

Did I see the cases when families were openly lied to and crucial information was illegally withheld from the adoptive parents? Oh, yes... Unfortunately - more often then I would want to. Even most of records below can be found in your child's file, it is another question, if (a) you will be allowed to copy or even see them, (b) they are accurate and (c) they will be complete. So, here are Do's and Dont's of collecting information about your children.

You can and you should:

  • Educate yourself on what documents are available.
  • Be assertive.
  • Make sure that your agency is backing you up and that neither orphanage nor your coordinator will prevent you from getting the originals (or at least the photocopies) of medical, educational and developmental documents.
  • Explain to the orphanage/school/coordinator that those records are crucial in providing proper continuity of care in medical and educational services for the newly adopted child.
  • Cite American doctors, teachers and developmental professionals, that it is them, not you, as a family, demand presence of those documents for proper treatment, placement and services (which is actually a true statement).
  • Request as many sources of the same information as possible (i.e. Vaccination records from the medical chart, form 63 and adoption medical).
  • Ask questions and question the answers.
  • Trust your 'gut feelings" if something looks strange to you, most probably you are right.
  • Write everything down in great detail. "everything" meaning including rumors, your questions and comments. You would not be able to remember what you were told, your concerns and questions; or decipher your shorthand later.

You cannot and you should not

  • Settle for those 1-2-3-4 pages of nothing, called "medicals". Request every document by name.
  • Expect that the orphanage (school, hospital) will willingly provide you with the information you need and that the information provided will be accurate, up to date and reliable.
  • Miss any inconsistencies and alterations.
  • Trust such statements as "this child is only here for 3-6-12 months, so we don't have any reviews, progress reports and so on". Children are being evaluated at the time of placement, through the process of "adaptation" and at least bi-annually if not quarterly thereafter.
  • Trust such statements as "that's all what we have" or "you don't need anything else" or "we will give you more information later today, tomorrow, after the court"
  • Accept "take it or leave it" attitude

Reviewing the reliability of records

A. Degrees of reliability

  • Original (still can be forged)
  • Photocopy
  • Transcription (re-written "copy" - the most common way of providing copies in the Former Soviet Union and the known cause for serious mistakes for thousands of years...)
  • Translation (local language to English) / Conversion (from Metric system to Standard)
  • Transliteration (writing the words in one language using another alphabet)
  • Interpretation (providing the diagnosis, rather then description of the problems - i.e. developmental delays vs. what exactly child was able to do and at what age)
  • Rumor (still a very important source of information)
  • Omission/addition
  • Deception

B. Factors affecting reliability

  • Sources of the similar information
  • Presence of conflicting data
  • Correlation with local routines and not with the American schedules and rules
  • Aging of the records
  • Surprises
  • Attitude

What are the available records?

A. Medical records

  • Orphanage medical chart (admission notes, progress notes, annual reports, etc, growth statistics monthly for the 1st year, quarterly for 2nd and 3rd, bi-annually thereafter)
  • Outpatient chart (for those who was placed in the orphanage later on in life)
  • School medical chart
  • Vaccination record
  • Vaccination deferral record
  • Laboratory reports
  • Consultation/evaluation reports
  • Transfer/discharge summary from the maternity hospital (for those abandoned at birth)
  • Transfer/discharge summary from the children's hospital at the time of admission to the orphanage
  • Discharge summaries after admissions to the hospital and sanatoriums

B. Educational and developmental records At ANY age, even in the baby house

  • Orphanage educational and developmental summaries (quarterly and annual)
  • Speech pathologist evaluations and treatment reports
  • School/orphanage educational and behavioral reports
  • "Life book"
  • Artwork School-age children
  • School communication/assignment book
  • School transcripts
  • School workbooks and notebooks
  • School textbooks
  • School curriculum
  • Awards, honors and artwork C. Administrative and social reports
  • Police reports
  • Court records
  • Social worker's report
  • Abandonment documents
  • Shelter report/transfer note
  • Birth certificate
  • Death certificate(s)
  • Baptismal certificate

The information appearing here is intended for educational purposes only. It should not be used as a substitute for professional medical advice tailored to your child's individual needs. If you have questions or concerns regarding your child's physical or mental health, please seek assistance from a qualified healthcare provider.

References
GLOBAL PEDIATRICS is an international adoption medical support service that has specialized in assisting families adopting from the Former Soviet Union through every step of the adoption process for the past ten years. Dr. Gordina's unique professional background and attention to detail ensure the highest possible level of service. She is recognized by her patients and peers as a leader and pioneer in the field and has presented her adoption-related research at sessions of the AAP, JCICS, NACAS and other meetings. Dr. Gordina has both participated in and organized several humanitarian missions to pediatric clinics and orphanages in the Former Soviet Union. For all questions regarding our services please check www.globalpediatrics.net 
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