Life or death

GREENVILLE, S.C.-When an Ethiopian woman found an abandoned baby girl on the steps of a government building outside the capital city of Addis Ababa in 2008, she reported the discovery to local police and called the baby Bethel: The woman prayed the needy child would eventually belong to a Christian family, and knew that Bethel means "house of God."

More than two years later, the child is fulfilling her name: Grace Bethel leans across the couch in the living room of her Greenville, S.C., home, watching a video of the day her adoptive parents-Scotty and Kerry Anderson-met her at an Ethiopian orphanage. "That's you, daddy!" she says to Anderson, an associate pastor at a nearby church. The curly-haired toddler makes another observation: "I was a tiny baby."

It's true: Like many children in impoverished Ethiopia, Grace was underweight and underdeveloped when the Andersons met her in 2008, but that quickly changed, says Mrs. Anderson: "Three weeks after we brought her home, she rolled over and sat up."

Joseph and Heidi Bayly can relate: When they met their adopted son in an Ethiopian orphanage in 2009, the 8-month-old weighed just 12 pounds and functioned like a small infant. But Bayly says Tate quickly improved: "In just a couple of months we went from having a 1-month-old to having a 10-month-old."

On a recent Sunday afternoon, Tate swayed in the living room of his Indianapolis home, strumming a tiny guitar and singing the Doxology. Bayly-a pastor in Indianapolis-contemplates what a few more months in an orphanage might have meant for his son: "In the case of Tate, it may well have been that he died."

Video provided by The Good Shepherd Band

That reality adds sobering weight to an announcement that has jolted families trying to adopt children from Ethiopia: The U.S. Embassy reported that Ethiopian officials plan to process new adoption cases at a dramatically slower rate-as few as five cases a day.

For a country that processes some 4,000 inter-country adoptions a year-including 2,500 to the United States-such a slowdown would mark a dramatic decline: Ethiopia represents the second-largest source of international adoptions to American families over the last two years. (Only China processed more adoptions to the United States in the same time period.)

The Ethiopian government hasn't offered an official reason for the slowdown, but the announcement followed at least two developments: Government officials said the swelling volume of cases overwhelmed their limited capacity, while U.S. news reports claimed that corruption had permeated the system.

The first problem seems likely: A small staff in a developing country could struggle with processing a rapidly growing number of adoption cases. But evidence of the second accusation-widespread, systematic corruption-seems far less clear.

Indeed, a deeper look reveals a different picture: Adoption experts say that while problems exist in the Ethiopian system, grievous adoption scandals in countries like Guatemala and Vietnam led Ethiopia to build a better system with more oversight of the process.

And the U.S. State Department reported encouraging results from a January visit to Ethiopia to examine 4,000 adoption cases: Officials said that while they found problems in the program-and the system needs improvement-the children they investigated met the U.S. definition of an orphan.

The Ethiopian slowdown represents a critical moment for one of the largest populations of orphans in one of the poorest countries in Africa. For government officials, agencies, and parents, the moment calls for a crucial balancing act: evaluating claims of corruption fairly, offering practical help to improve the process, and remembering children who will never be adopted.

Ethiopia burst onto the international adoption scene as the rate of foreign adoptions dramatically declined over the last several years: International adoptions by Americans fell from a peak of 22,991 in 2004 to 11,058 in 2010.

The reasons varied: Countries like China tightened adoption requirements, and a handful of orphan-related disasters tarnished the international process. One of the most egregious: In April 2010, a Tennessee woman placed her adopted Russian son on a Moscow-bound plane with a note saying she could no longer care for the child.

But beyond isolated debacles, adoption programs closed in Guatemala and Vietnam after reports surfaced of systemic corruption. Guatemala's adoption program had grown quickly: The country was the second-largest source for U.S. adoptions in 2006. By 2008, Guatemala had surpassed China for the most adoptions to U.S. families: Americans adopted 4,112 Guatemalan children that year.

But problems also grew: In March 2007, the U.S. State Department advised Americans against adopting from Guatemala, saying investigations revealed the system was "rampant with fraud." By 2008, Guatemala closed its international adoption program to new cases, saying it would improve the process. The program remains shut down.

Similar problems plagued Vietnam: The U.S. embassy in Hanoi began investigating reports of fraud in the country's growing adoption program in 2007. By January 2008, U.S. Ambassador to Vietnam Michael Michalek cabled the U.S. State Department with the results: "These cases offer compelling proof that government-run clinics and orphanages are actively engaged in baby buying and are lying to birth mothers to secure children for international adoption." Later that year, the United States didn't renew its adoption agreement with Vietnam, closing the program to Americans.

As adoptions to Americans in the two countries ended, Ethiopia's program soared: In 2004, during the peak of U.S. international adoptions, Americans adopted 284 Ethiopian children. By 2010, that number had risen more than tenfold to 2,511.

The swelling adoption program brought serious concerns: How could Ethiopia avoid the pitfalls that ensnared other countries? Tom DeFilipo of the D.C.-based Joint Council on International Adoptions says the scandals pushed Ethiopia to develop a better system.

The Ethiopia model-developed in conjunction with adoption agencies and advocates like DeFilipo-includes government audits of orphanages and adoption agencies, and a demanding process with layers of protections.

Consider an adopted child's journey: Since Ethiopian law doesn't allow a birth parent to surrender a baby to an orphanage, the parent presents the child to local officials. The officials investigate and report to regional officials. The regional officials review the case and refer the baby to an orphanage. The orphanage reviews the child's background and eligibility for adoption and forwards the information to an agency.

After the agency reviews the case and matches the child with an adoptive family, agency workers forward the information to the Ethiopian government. The Ministry of Women, Children, and Youth Affairs issues a letter of approval before a judge reviews the case in an Ethiopian court. When that process is complete, the adoptive family forwards the paperwork to the U.S. Embassy. The embassy reviews the information and approves the child for a visa, paving the way for U.S. citizenship.

That's a far different process than Guatemala's system: The country allowed adoptive families to work through notaries who handled many parts of the process for a fee, instead of allowing layers of government checks.

But layers of checks don't make corruption impossible: Birth parents could lie about why they need to surrender a child. Officials could fail to investigate adequately. Orphanages could fail to check a child's background or-worst-case scenario-solicit children for adoption. Courts could falter. Agencies and parents could ask too few questions or fall into corruption of their own.

DeFilipo believes the layers of safeguards do protect against systematic fraud in Ethiopia, but he doesn't deny the potential for trouble: "There's no such thing as eliminating corruption in any human endeavor."

Allegations of corruption in Ethiopia have surfaced on internet adoption forums: Some adoptive parents say their Ethiopian children later told them they weren't truly orphans. Others reported deplorable living conditions in some orphanages.

Last year, a CBS News report about Christian World Adoption (CWA), a Charleston, S.C.--based adoption agency, included an interview with an adopted Ethiopian teenager alleging that CWA paid her father for her and her sisters. In an interview from his Charleston office, CWA's attorney, Curtis Bostic, told me: "CWA pays nobody-period-for children, and there's no need to do that."

Bostic also disputed the report's implication that a CWA worker tried to recruit Ethiopian children for adoption. A video showed the worker telling a crowd of Ethiopian villagers: "If you want your child to be adopted by a family in America, you may stay."

Bostic said the CWA worker traveled to the village with a local orphanage at the invitation of village leaders interested in establishing an orphanage for needy children. He says the worker was explaining the purpose of the team's visit. Bostic also said that an Ethiopian investigation of CWA didn't return negative findings, and that the government allows the agency to continue facilitating adoptions.

A month after the CBS report, the U.S. State Department said it was concerned about media accounts of agencies recruiting children in Ethiopia. An April 6 State Department notice said adoptive families must file more information for the U.S. Embassy to complete investigations of adoption cases. The Ethiopian government also announced additional steps for adoptive parents. By December, the State Department repeated concerns, but didn't warn families against pursuing adoption.

The obvious question surfaced: If corruption had infected the Ethiopian adoption system, how bad was it?

A series of reports by news agency Voice of America (VOA) painted a dire picture. A Dec. 14 article-"Ethiopia Plans Crackdown on Baby Business"-said Ethiopian officials planned to close dozens of orphanages they said served as transit homes for adoptions.

The article also cited a study by Parents for Ethical Adoption Reform (PEAR) that reported evidence of unethical practices by adoption agencies. But the article didn't mention that the PEAR website reports that 134 families responded to the survey-far fewer than the 4,000 cases the U.S. State Department later investigated.

Three days later, a VOA report proclaimed the Ethiopian system "rife with fraud and deception" and quoted a UNICEF official calling the adoption program "a free-for-all." But the report's evidence of widespread corruption was limited: An Ethiopian judge said she believed some birth families lied about their history because they are destitute; some adoptive families shared bad experiences online; and the U.S. embassy reported it had identified "a few bad actors" in the system.

Three months later, the Ethiopian government made a dramatic move: Government officials told the U.S. Embassy in March that they would reduce sharply the number of cases processed each day. The U.S. State Department warned adoptive families to expect "significant delays," and American families braced for long waits.

One thing seems clear: The growing number of adoption cases has stretched the Ethiopian government's limited capacity. As early as 2007, Haddush Haleform, an Ethiopian official, told The New York Times he didn't think the country could handle the swelling work load: "We don't have the capacity to handle all these new agencies, and we have to monitor the quality, not just the quantity."

With a small staff to review paperwork-and a single court to approve adoption cases-the country faces a steep task to manage a bustling international adoption program.

Since the announcement, the U.S. State Department has offered resources to help the Ethiopian government manage the system. (Resources could include anything from more computers to more training for staff.) The State Department says the Ethiopian government hasn't yet indicated what it might need.

But the larger question still looms: Is the program systemically corrupt? A month after Ethiopia warned of a slowdown, the U.S. State Department offered a significant assessment of the country's program. Officials from the State Department and U.S. Customs traveled to Ethiopia to review 4,000 adoption cases by U.S. families. The results: The children generally fit the U.S. definition of an orphan.

That was good news for orphans and adoptive families. It meant that while the system has problems, the State Department wasn't reporting large numbers of exploited children, and it wasn't declaring the system a free-for-all.

But the good news came with concerns: The State Department reported logistical problems in the Ethiopian system, including inconsistencies in paperwork and missing documents. The U.S. embassy has asked agencies to improve documentation about how children arrive in orphanages, and to include more information about their backgrounds.

Sometimes that information is hard to track: Some children are abandoned, leaving their background a mystery. Other children don't have birth certificates. Some birth mothers are reluctant to share the circumstances of their pregnancy, especially if it involves abuse.

But adoption experts agree that some orphanages and agencies could do a better job managing documentation. Chuck Johnson of the D.C.-based National Council for Adoption says agencies and parents could be tempted to bend rules in a foreign country with needy children: "But we're saying: No bending rules."

For adoption agencies, the process brings a dilemma: Agencies need to maintain a healthy distance from children before orphanages recommend them for adoption. This ensures that agencies aren't recruiting children. But despite the distance, agencies are also accountable for ensuring the children are truly orphans.

Daniel Lauer of Holt International-one of the oldest adoption agencies in the United States-describes the dilemma. "At one point we're being asked to be intimately involved with our [orphanage] partners, and also kind of hands-off," he says. "That's a real tension."

That tension has led to painstaking measures for at least three U.S. agencies facilitating some of the largest numbers of Ethiopian adoptions: America World Adoption (AWA) and Bethany Christian Services-both Christian adoption agencies-and Children's Home Society and Family Services (CHSFS) say they conduct independent investigations of every child's case.

After an orphanage refers a child for adoption, each agency says it sends Ethiopian staff to investigate paperwork, travel to the child's village, and videotape interviews with family members, villagers, or local police if possible.

Sara Ruiter of Bethany says her agency contracts an independent company to conduct the video profile and employs a full-time investigator trained by the U.S. Embassy: "We're taking it on ourselves to make sure that any case that comes to us has all the i's dotted and all the t's crossed."

The agencies say they have found cases that need further review, but they haven't found cases of blatant fraud. And Ruiter says when Bethany grew concerned about one orphanage's inconsistent paperwork, the agency stopped working with the orphanage.

With UNICEF estimating as many as 5 million Ethiopian children have lost one or both parents, only a small percentage of Ethiopian children will find adoptive homes. Agencies are working to help non-adopted children, too. Indeed, adoption agencies say that international adoption should be the last option for Ethiopian children: The first priority is to help families keep children.

Holt International reports it helped 3,400 Ethiopian children last year, serving half through family preservation programs that include education, nutrition, and micro-business, according to Lauer: "Everything from capital for a small roadside store to an ox to plow fields to a donkey to move goods to chickens to produce eggs."

Bethany conducts child welfare projects in Ethiopia. AWA helps single mothers develop life skills, and the agency is developing a domestic adoption program. Kjersti Olson of CHSFS says her agency has provided two schools for local children-one serves 625 students in a rural community with no other school. The agency also runs a maternal and child healthcare clinic that serves 40,000 patients a year and conducts family development projects. "A lot of it is family preservation," says Olson. "And a lot of it is trying to break the cycle of poverty as well."

Agency workers say newer adoption cases have moved at a significantly slower rate since the announcement. And while they hope the program doesn't slow even more dramatically, they support the government's desire to make sure they are processing adoptions correctly.

The U.S. State Department says that it's committed to the Ethiopian program and that the agency is considering a pre-approval process that would add another layer of investigation before cases reach the U.S. Embassy for final approval. Adoptive families, who already pay at least $25,000 per adoption (including travel costs to Ethiopia for two adults), can do more by making sure they choose agencies with good track records and with clear policies on how they review the backgrounds of orphans.

Back in Washington, DeFilipo says he hopes a resolution comes quickly so that children eligible for adoption can avoid spending more time in institutions. For children already struggling with health issues in the impoverished country, more time in an orphanage could produce long-term problems.

For families like the Baylys, they've seen what an adoptive home can mean for an Ethiopian child like their son Tate. And they're hoping to adopt again: The couple decided to continue with plans to adopt another Ethiopian child just days after the government announced a potential slowdown. Mrs. Bayly says contemplating the possibility of a long wait is difficult, but they've already seen the rewards of waiting for their first son: "You start to process every delay by knowing that this is God's sovereignty directing us to the child that He wants to place in our family."

Back in Greenville, the Andersons say they saw the same dynamic in their own family when they brought Grace home. "It's very clear that she knows who her parents are," says Mr. Anderson. "And there's not a hesitation in the world."