Henry

Gratitude is the Heart's Memory

2012-01-17T11:22:00.048-06:00

The mechanics of speech are complicated, even mysterious. For example, say the simple word "cup" and you can feel, ever so slightly, a kind of involuntary closure near the back of your throat, a critical speech reflex that just seems to happen on its own. To speak well under the best circumstances requires a finely tuned concert of jaw and dentition along with a wonder of coordination among nerve signals from the brain and reflexes involving lips, tongue, hard palate, soft palate, uvula, epiglottis, and the pharyngeal tube at the top of the throat where that aforementioned closure occurs. In all this we found an epiphany moment last week during a visit to the hospital, where our doctors were able to insert through Henry's nasal passages and into his vocal cavity a thin tube with a video camera at the end. In our push to explore every possible way to surgically prepare our little guy for his school years ahead we missed an important point our doctors had been trying to make in subtle ways over the past year or so.

There on the hospital video monitor we were given an interior view of exactly how Henry manages to speak with half of his speech apparatus handmade from stretched musculature, processed donor tissue, and repositioned skin and cartilage. Point taken.

From our network of other families of children with severe clefts, we often learn of additional reconstructive procedures that can address speech or physical appearance. When we've asked whether one or more of them might be good for Henry, our doctors lately have answered with the same somewhat frustrating response. "Well, we could try that if you really want us to," they've offered, as if we weren't looking to them for advice. Then they have uniformly followed with the more sensible, discouraging warning that any more surgery we try right now would use up valuable tissue needed for more extensive corrective procedures best planned later, after the bones in Henry's face are more fully grown. But last week, as we all stared at that video monitor, our primary surgeon added a quiet note to the usual refrain, one that finally sunk in. "Listen, folks, he's talking, not perfectly, but talking, which is very, very good," he said with the unmistakable tone of someone referring to an outcome that had been far from certain. "You have to consider where he started in this."

We understand more so now that in their work with Henry, so far, our surgeons and the others on our medical team have carefully woven a miracle.

Meanwhile, Henry passed his readiness test and is officially set to enter kindergarten in August.

A very sincere thank you to those who pitched in to support physical therapy at the Pingliang orphanage after our latest call for contributions through Love Without Boundaries. It's a small world after all. We were able to raise the funds needed for the orphanage to send the additional staff members to an intensive physical therapy training program (see previous post). They left for Chongqing in October and will have returned home in time for Chinese New Year, bringing the number of staff formally trained in physical therapy at the orphanage to four. Some of you made general donations as well. LWB's other established, ongoing programs at the Pingliang CWI include a nutrition program and an aunties program, both supported by monthly sponsorships but always welcoming additional help. The nutrition program sends high quality formula and cereal with nutritional supplements to the orphanage and through on-site visits monitors the use of these supplies among about a dozen infants there. The aunties program provides the orphanage with extra caregivers, hired part-time from the surrounding community.

The music with this post is a piece titled Cherry Blossoms and is performed by Jia Peng Fang.

A Second Physical Therapy Project

2011-10-12T13:16:00.033-05:00

“If you think you are too small to make a difference, try sleeping with a mosquito.”
- Tenzin Gyatso, the 14th Dalai Lama

Love Without Boundaries this week asked if we would be willing to organize another fundraiser to help send additional staff from the Pingliang Children’s Welfare Institute (CWI) to physical and occupational therapy training. Absolutely, we agreed. Our first training project appears to have yielded very good results and the orphanage director now says the need for more staff members trained in physical therapy is a top priority.

The training takes place at Xinqiao Hospital in Chongqing, a huge urban administrative district of 29 million people located about 350 miles southeast of Pingliang, which is in mostly rural Gansu Province. It is a fairly extensive instructional program, lasting a couple of months.

The Pingliang CWI in its new quarters has a special facility for treating children with physical disabilities and two orphanage staff members were sent for the same training in our first physical therapy project. The PT/OT trained staff at the orphanage today are providing regular daily physical therapy for about 40 children who live there, but they have also begun to provide outpatient therapy services for about a half dozen children now brought in each day by families from outside the orphanage.

The orphanage staff would like to do more, which means treating a greater number of children who live at the orphanage while also expanding services for children with disabilities from surrounding communities. A Love Without Boundaries program coordinator thinks the availability of this kind of outreach service may somehow encourage families in the area to keep and not abandon special needs children. It couldn’t hurt.

This latest project seeks to support the costs of sending to the training program the orphanage’s staff doctor and one more additional caregiver (about $1,100), and could be expanded to support more staff attending if more funds are raised. You can join us in making a donation toward this project by using the online form here, selecting the category Orphanage Assistance Fund. In the notes section of the form just type: "Orphanage Assistance: Pingliang PT Training." The orphanage will use local funds to cover the staff members’ travel, housing, and other expenses.

Henry was cared for by the same general staff when he lived at the Pingliang orphanage at its old site; from the time he was first found by a roadside in September 2006 to when he joined our family in June 2008.

The orphanage does receive from occasional adoptions extra revenue that is restricted to use for capital expenses, but nearly all of its children have special needs and this limits the number of children adopted. There are a lot of children there, today about 140 of them ranging in age from a few days to 16 years old with a large portion (about 70 children) between 2 and 8 years old. There is a relatively equal balance of girls to boys. Some of the children have mild special needs while many have more serious issues including blindness, cerebral palsy, acute hearing impairments, or any of a range of developmental disorders. Many have cleft issues, like Henry.

Aside from all its other benefits, physical therapy gives these children, in this setting, special opportunities each day to be physically touched by people trained in how best to do so. Physically held.

Strength in Adversity

2011-09-20T20:01:00.044-05:00

It’s not whether you get knocked down; it’s whether you get back up.
- Vince Lombardi

Who would have guessed that we would find so much inspiration in football.

And in this we are undoubtedly not alone. Football here became a lot more than a game a few years back, even for people who previously had never thought much about it or who had turned away when the sport temporarily suffered locally from corporate threats to move. Everyone had begun to rebuild their lives and livelihoods. Many were involved in reconstructing businesses, hospitals, universities, parks, libraries, and so on, mostly from the ground up. Those who returned with families gambled nervously on schools that would require an unusual degree of participation, and patience. These things and home repair were hard and since there was always more work to be done it could all seem at times like a wearily thankless task. Until our team began to win.

Our Saints had returned to rebuild with a roster stocked with castaways and undrafted players, under a first-year head coach. Our new quarterback was recovering from a severe injury and had just relearned how to throw. Collectively they came to genuinely represent us in the premise that there is a special kind strength in adversity. Their games became epic battles, tests of both individual will and coordinated effort, and always about rising above challenges and circumstance.

Build [upon] your weaknesses until they become your strong points.
- Knute Rockne

Henry will have some challenges ahead and maybe these football lessons will help. Our doctors surprised us at our medical team visit this week when, to a one, they basically said there is not much more they can do right now to improve on his physical appearance or speech for his early years in school. Based on our earlier team visits, we had anticipated some additional surgeries this year to try to adjust his lip and nose, but it now appears that these options in Henry’s case are restricted by a lack of undamaged tissue to work with. So our team is advising that we postpone any additional lip and nose revisions through plastic surgery until the bones in his face are more fully developed, and after we have built more of an upper jaw through orthodontia and bone grafting. It is still likely that this year his doctors will scope him to gauge his VPI (velopharyngeal inadequacy) and determine whether they should attempt to readjust the length of his homemade soft palate. But no one is promoting this as a sure-footed step toward speech improvement for Henry. Our pediatric oral surgeon said constructing a temporary bridge of upper teeth may not help either, although one of our speech therapists thought it might.

Henry looks and sounds pretty good to us of course, and he is destined for a school that is unusually diverse and welcoming. Nevertheless, we will probably focus a bit more on preparing him to successfully navigate the social challenges that will accompany his elementary and middle school years. We had agreed not to advance him into kindergarten this fall with his September birthday so close to the cutoff and this is looking like a good decision since he is very happy among his current pre-k classmates. His teachers have been a great help and we will lean more on our speech therapists. But he will need to find his own strength in adversity, without becoming too tough, lest we forget on football Sundays that it is often wisest just to turn the other cheek.

Luckily we have many sources of wisdom on which to rely, apart from football.

We live, not as we wish to, but as we can.
- Meng Zi (Mencius), Chinese philosopher, 371- 289 BC

Father's Day Wishes

2011-06-21T12:39:00.058-05:00

Pingliang CWI

Henry joined us on Father’s Day in June 2008 in western China’s Gansu Province. It was a remarkable gift with some accompanying duties that were a first-hand reminder of how children can be vulnerable in ways that might otherwise be very hard to imagine, especially children with birth anomalies or special medical needs in developing parts of the world. In truth, sometimes it takes a lot more than just a village to raise a child.

That is why our thoughts so often return to Gansu Province and the orphanage in Pingliang where Henry spent his first 22 months. Today the orphanage, now called the Pingliang Children's Welfare Institute (CWI) in its brand new quarters, is a large, modern health care facility that is a stunning contrast to its former buildings where Henry lived. With a large number of children and comparatively low number of adoptions because nearly all of its children have special needs, the new facility seems to represent an earnest investment in child welfare by Chinese authorities, especially local civil affairs officials. Mrs. Yang, the orphanage's director, has obviously done a very good job in lobbying locally and promoting the important services which the orphanage provides.

Return to Clara-Li's orphanage (2005)

China’s is an extremely complex society, and our daughter Clara-Li’s orphanage in Hunan Province was distant from Henry's in many ways. A former barracks for retired solders of the Chinese army, it functioned basically as a warehouse and its staff was mostly interested in processing a lot of children into foreign adoptions while living conditions for children in the orphanage were miserable. Our focus there was to press local officials to use the adoption revenue they had received (and that was restricted to use for capital improvements under Chinese law) to improve conditions for the children. We did this by organizing outside help with the project. A large new facility was eventually built, although today less than a dozen children are housed there, which might be a small victory of sorts, drawing a close to an old bureaucratic tradition through which the ends unquestioningly justified the means. Still, maybe the only thing we can describe with certainty as good from the experience was that at its start we worked extra hard to bring our Clara-Li home from that orphanage as quickly as we possibly could.

The orphanage where Henry’s oldest sister Dorothy was from in Jiangxi Province was altogether distant still. Some staff members and their families actually lived in the orphanage building while others would bring some of the infants from the orphanage (including Dorothy) home with them in the evenings, in small baskets they would place by their own beds overnight. Today, an organization called Amity Altrusa has for more than decade built on this type of nurturing interest to help orphanages in Jiangxi maintain foster care programs as a better means of housing abandoned children. In many Jiangxi counties most children assigned to orphanages today live with foster families, leaving orphanage facilities to serve children with the most severe special needs. We have long supported one of these children in foster care. She has Hepatitis B and has been an unlikely candidate for domestic adoption since she was an infant; now that she is 10 years old her prospects for foreign adoption are also very dim. Year after year, the reports we receive on her progress say she is a quiet, sometimes melancholy child who struggles with her studies at school, sometimes because of her health. Henry's dad sometimes wonders if she might be happier here in our family and wishes he could make it so; the same wish he had for a lot of children remembered this Father’s Day.

Another of our Father’s Day memories comes in the form of a gift that Clara-Li brought home from nursery school in the early summer of 2005; a plaster cast of her tiny foot with a little card that still hangs from a door in our home, a simple reminder that it sure is good both to be and to have a dad, forever. The card reads:

When daddy walks along the street
And hurries home to me
He takes the quickest longest steps
That ever I did see
But when I go to walk with him
He acts quite differently
And takes the slowest, shortest ones
To keep in step with me

Further reading: an article titled The Realities of Foster Family Adoption in China in the June 2011 issue of LWB’s newsletter speaks well on changing patterns in Chinese foster care, orphanage care, and domestic adoption. See it here.

The Tao of the Easter Bunny

2011-04-24T19:20:00.027-05:00

As a salutation to rebirth or just a celebration here of the passing of spring to summer, Easter seems like a pretty straightforward holiday. After a grey season blooms flowering jasmine, ligustrum, and oleander. The sun burns hotter, the humidity rises, and big sacks of crawfish become readily affordable again. Yep, time for Easter.

Easter's Bunny, on the other hand, is a complete head scratcher of an idea and might be, for some, the most convoluted of children's holiday scenarios. A rabbit sneeks into one's house in the middle of the night to leave baskets filled with eggs? Really?

Of course the idea is sweetened in that the eggs are made from chocolate and accompanied by other sugary treats. And at our house, the Easter Bunny also takes some extra time to grab a big bowl filled with the hard-boiled, real eggs that our children color the day before. The bunny distributes these gems in strategic locations out in the yard. The real eggs get interspersed with little plastic egg shells hand-filled with more candy. Usually these candy eggs have their recipients' names written on them, as a guarantee of equitable sharing.

A rabbit does this? Really? Why is it that even Henry's two older sisters never roll their eyes at any of this?

But herein lays the sage lesson of the wise master Easter Bunny. Life is full of important issues and complicated problems, yet the Easter Bunny teaches us that there are times when the most important choice we can make is simply to try not to overthink everything. Live in the moment. Lighten up. Consider with appreciation the world as it should seem to a happy four year old (Henry, for example), in all its simple imaginative wonder.

Have fun, says the wise master Easter Bunny.

Kindness and Social Concern: Pass it On

2011-02-28T20:54:00.010-06:00

“To understand your parents' love you must raise children yourself.”
(- Chinese proverb)

Henry and his sisters were visited this past week by paternal grandparents, a rare species who some years ago moved from the southern United States to the far northeast in their retirement. While this visit was a long journey, they are experienced travelers, still very independent, and admirably adaptable. They had selected a hotel on St. Charles Avenue to be closer to our home uptown and their stay happened to coincide with the first weekend of Carnival parades, which sometimes made getting to and from the hotel a challenge. No problem. What better way to see their grandchildren than in parade mode. These are wise grandparents.

And they are generous. In 2005 when we were suddenly refugees, they insisted that we stay in their not quite vacated house in Texas--for nearly five months as it turned out and free of charge--before they finally sold it, maybe later than planned. The house was a comfortable place but built for older folks; condominium layout, light colored cloth furniture, white walls, almost white carpeting throughout. At the time we had two restless, worried little girls with oversize penchants for markers, sandy shoes, and food spills. No problem, said the grandparents. Somehow we never doubted they meant it. Later they would help in more ways.

For these are people whose lives over eight decades have never been particularly focused on themselves. They have collected few enduring material possessions, but over a lifetime they instead made a wealth of lasting contributions to others. This is especially so in the case of Henry’s grandfather, whose remarkable career as an educator affected many thousands of lives for the better and still reverberates today in good ideas about the relationship between public schools and their communities. But for this visit here was a quiet couple happily focused tightly on just being grandparents and they are very, very good at it.

Their ability to come through the door and reconnect instantly with Henry and his sisters with soft hugs and patient questions that begin lightly and then burrow down to important and reassuring things is a seemingly natural one. Still, what a special inheritance this all will be, as passed-along traits their grandchildren can proudly remember and then, in however many ways, pass along too.

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From Pingliang a representative from Love Without Boundaries reports that all the children from Henry's old orphanage were moved to the new facility where there are for now a total of 123 children, a number slightly down from 132 counted at the old orphanage last fall. The children range in age from a few days to 14 years old, still with a relatively equal balance of girls to boys. Almost all have special needs, some mild but some "very serious." The old orphanage site is still being used to house senior citizens or other adults unable to care for themselves, while the new site houses children only. A group of orphanage staff members is set to leave soon for three months of physical therapy training at a hospital in Chongqing, our project arranged through and funded in part with assistance from LWB but also with matching local contributions. LWB has sponsors for three aunties for its new aunties program in Pingliang and ten for its nutrition program there, which is now tracking the children involved by name, a sign that LWB is establishing a good measure of trust with the orphanage staff.

The music with this post is a piece titled Orchid and performed by Shao Rong.

Another Round for the New Year

2010-12-31T10:00:00.040-06:00

Yesterday Henry had another surgery, a relatively easy round number five in what may eventually turn out to be at least a ten-round contest. Although it went well it seemed like a longer day than anticipated, starting at the hospital at around 6 am. As usual we doubled up: our oral surgeon removed five misplaced upper teeth and laid in several rows of dental crowns; then another pediatric specialist closed a fairly large abdominal hernia. Between procedures, the cranial facial surgeon who heads our cleft team came in to look over the inside of Henry's repaired palate and nasal area, and plan for the next revisions to his lip and nose. The whole thing took about 4 hours in the operating room.

Henry still looks so little coming out of surgery in post op, still our baby boy. But now when he wakes up he talks, which is both an indicator of how incredibly far he has progressed and a new important voice in the process. Yesterday he opened his eyes, winced as he looked at the big painful intravenous needle sticking into the top of his hand, and said, "Hey, take that out."

We would have been cleared to go home in mid-afternoon but our brave little guy needed just a few extra hours to meet the release requirement of holding down 4 ounces of liquid (probably due to a small amount of blood and mucus that drained to his tummy during the oral surgery). We headed home at around 5 pm. His sisters had a sleepover with friends the night before and they are back home too. Today he is somewhat tender but seemingly none the worse for wear, glad to get back to his little toy trains.

Like Henry's cleft issues, his hernia (a hole in the muscle wall of his lower abdomen) had been a genetic anomaly. The teeth that were pulled had formed in unusual places at the front edge of his homemade hard palate and had rooted abnormally. The teeth themselves were darkened and oddly shaped.

The oral surgeon said with some concern that none of Henry's first teeth have a normal enamel covering, something she said she had never seen to such a degree. Fully formed, they poked through his lower gum line like little stubs. She guessed first that the cause for this might also be genetic but then asked, "Could there possibly have been some nutrition issues in his background?"

A New Orphanage in Pingliang

2010-09-30T16:30:00.064-05:00

Something good is about to happen for the children at the orphanage where Henry lived in Pingliang, Gansu Province, PRC. They are about to be moved, this month or early next, to a brand new set of buildings at a larger site on the outskirts of town. The old buildings at the current site are worn from overcrowding and were shaken in western China’s massive earthquake in May 2008.

Of course the bad news is that although in a new facility the children will still be in an orphanage, one with limited resources, and nearly all of these children have special needs. More than a third have facial cleft anomalies like Henry but, with new arrivals, increasing numbers have cerebral palsy or similar physical disabilities that are difficult long term challenges for the orphanage staff.

We know it is very common for children with special needs to be abandoned in rural China. We do not know why there are so many children with special needs from birth defects in this particular place, but there are. And at this orphanage, in this highway town along the path of China’s ancient Silk Road, there are more than 130 of them.

When the children are moved from the old orphanage to the new one they may eventually be joined by still more children with special needs who are currently housed at some smaller and very poor county-level orphanages that are also within Pingliang’s prefecture administrative district.

To cope, one of the new orphanage buildings will be devoted entirely to physical therapy. In partnership with Love Without Boundaries, we would like to help the orphanage pay for physical therapy training for more of its staff. The orphanage already has raised the equivalent of $1,000 USD locally for this effort and LWB has pledged to match this amount from its general donation fund. But about $500 more is needed for the training program planned and any additional amount we raise would be directed to the purchase of physical therapy equipment that is much needed too. If you would like to join us in making a contribution go to the LWB web site and in the upper right corner of its homepage click on the icon labeled “Donate Now.” Under "category" select “Orphanage Assistance,” enter "For Pingliang Physical Therapy" in the “Notes” section, and then complete the form. Meanwhile, LWB is still looking for more sponsors for its nutrition program begun at the orphanage last spring.

In China’s turbulent transformation people are leaving places like rural Gansu Province in droves. They are heading for industrial cities, especially the large population centers in the central and eastern portions of the country that have become new economic development zones. It would be easy to feel left behind in the rural west, perhaps for no one more so than a disabled child in an orphanage there. Yet it can be remarkably easy for us here to is to reach all the way across the planet to try, at least in this small way, to make things just a little bit better for that child.

The music with this post is a piece titled Cherry Blossoms and is performed by Jia Peng Fang.

Making One's Way

2010-09-08T19:04:00.087-05:00

“Being deeply loved by someone gives you strength, while loving someone deeply gives you courage.”
(- Lao Tzu)

Henry’s Baby Jaguar is nearly worn out. His cloth hide is dangerously thin and his stuffing knocked loose from so many washings, careful though they have been.

One wonders if any other little stuffed toy has ever been so loved or has ever come to its little boy owner at such a right moment. Our neighbor gave us Baby Jaguar for Henry seemingly long ago, near the first part of this story, after we arrived home from China and had quickly begun those early surgeries. She is an older woman of very modest means who lost her own home and all her belongings in 2005. During the slow exodus return she moved in with the quiet elderly man who has long lived across the street from us. In the time since, she has often given little gifts and thoughtful cards to our girls and when Henry came home she picked up the little stuffed jaguar toy for him, originally a chew toy, a promotional item from a pet store uptown. “I just thought little Henry would like him,” she said in her gentle way the day she brought the gift by. Henry grabbed the little jaguar and hugged him like he had found a lost child. And so the friendship began.

It reminded us of the special gift we found on our front porch years before, after one of our daughters first came home. Then it was the gift of a doll, an angel handmade from strips of old fabric fastened around an empty plastic soft drink bottle, heart-breaking and beautiful in its obvious painstaking construction. The word "family" was centered in the pattern on the cloth that was wrapped around its body. This tender celestial form had been made and left by another neighbor, a woman with no discernible financial support who lived with her young autistic son otherwise alone in an upstairs room in the building directly behind our home. The building was a dilapidated two-story apartment house, also eventually rendered uninhabitable five years ago and only last month finally torn down by a demolition crew. Even before the storm it had been a warren of hard luck stories looming over our cheerily contrasting domain. We have been privileged to observe that kindness has no income requirement. Here was a woman with desperate needs of her own but who instinctively saw in what she had heard about our children something she and her son very much lacked but that touched her: a sign that someone else could truly care.

Still, Baby Jaguar perhaps has been a more special gift because of how Henry took to him and how their bond never loosened, until a little bit lately. Now Henry occasionally leaves Baby Jaguar in his room instead of constantly carrying him throughout the house. The other day Baby Jaguar was inadvertently left outside after Henry had come in from playing in the yard. It rained before we remembered to retrieve him.

Henry needs Baby Jaguar less now, as he has simultaneously found his place in the circle of other little children at his new school. He listens to his teacher and follows her directions, just as the other children do. Smiling. Laughing. Wondering. Learning to leave stuff behind, he is learning to to make his way in the world. Henry is growing out of his special vulnerability, and becoming a regular child.

The music with this post is a piece titled The Sixth Station and composed by Joe Hisaishi.

Starting School

2010-08-19T20:33:00.043-05:00

Henry has an early September birth date and children here are eligible to enroll in public school kindergarten if they are five years old by September 30 of their entrance year, which means that if Henry starts school on time he will thereafter be among the youngest children in his class, if not the youngest. In New Orleans’ highly competitive process for charter school enrollment he needs a year of pre-k to prepare for kindergarten and next summer he would have to pass a test designed to determine whether he is developmentally ready. So we have this dilemma: is he ready now to start down this path?

We are about to find out since Henry is set to begin a regular pre-k program next week at the Newcomb Nursery School, joining an all-day class mostly full of little children also heading to kindergarten next year. None of them, except for Henry, have special needs. Last week we took him to visit the class and of course he immediately rejected the whole idea. He had a rare total meltdown, clung tightly to his mom, and desperately pleaded to go home. But his teacher, an obvious veteran, held firm. She gathered the other children in the class around him, began to read a story above the sound of his sobbing and made it clear that the story would continue for the next 10 minutes and then the class would go outside to play. She was true to her word, although Henry was equally persistent. He calmed a bit when we all lined up to go outside and his tears stopped once we entered the play yard. Outside he quickly found a slide to climb on and then he was smiling.

A little to our surprise, we saw that Henry did not seem to be younger in a behavioural sense than most of the other children in the class. We can understand only about 60 percent of his speech at home and this will be a greater challenge at school. But his speech is improving with therapy and at least theoretically should not alone impair his readiness for school. As it happens, Henry likes to talk. At home he busily chatters on his favorite themes and proudly emphasizes the words and phrases he knows he has mastered. One unfortunate example of late is "be quiet," but the number of other successful phrases he is connecting in clear sentences is increasing. He is shorter in stature than many of the other little boys in the pre-k class, but he is built like a defensive end. Not quite four years old, Henry can count to ten and recognizes most letters in the alphabet. And his personality, his unshakable innate sense of humor, and even his tears are noticeably informed by a set of hard experiences that none of his classmates have had to overcome. Nothing remotely close. Sure, he is different, but not necessarily in a lesser way.

So look out Newcomb Nursery School. Henry is going to give it a try.

Practically Perfect in Every Way

2010-06-13T09:00:00.058-05:00

This week marks the two-year anniversary of when Henry joined us in Lanzhou. We will have our usual family celebration, remembering that cherished event and so many milestones since, a lot of them noted in posts here. Henry, our little special man, is progressing well. But these private celebrations are really about all three of our children and all of us together, and tucked near to the heart of each are our first memories from when we somehow started all this for our oldest daughter Dorothy-Rui. The call came for Dorothy on October 3, 2002, after a couple of years of first-time paperwork and a lot of wondering. We knew in advance that a large batch of adoption referrals, including our own, was coming from the government ministry in Beijing where our file had been matched, lottery-like, to one of so many thousands of little girls waiting at the time in state controlled orphanages mostly in south central China. The call would be from our agency with translated news of who and where our daughter was, her estimated birth date, and her length, weight, and head circumference. A package would later follow with a couple of small grainy photos. Also coming was Hurricane Lili, a late-season storm that had caused us to batten down our shutters and hole ourselves up with the usual flashlights and supplies. We were holed up too with the nervous hope that our doomed phone connection would last at least until the call came through. It did and notably there is absolutely nothing we remember about Hurricane Lili after the call. By mid November that year we were in Jiangxi Province, staying in Nanchang at the old Lake View Hotel, a strange cylindrical tower that has since been demolished to make way for new construction. Nanchang that fall was cold and rainy, its air thick with hazy smoke from rice straw the city's residents then burned in small cooking stoves outside their grey block-shaped apartment buildings, many that have also since been razed. But the whole thing can be recalled in scenes still more vivid to us than those from any classic film: scenes from the hotel and the day trips to Lushan and the Yangtze River near Juijiang that we took while waiting for our documents to clear; scenes from that first revelatory visit to a nearby orphanage within the large Nanchang Municipal Social Welfare Institute; haunting scenes from a trip to Gao’an, 75 miles to the southwest, where Dorothy was said to be from and the location of both her orphanage and finding site; scenes from our treasured first moments with her, our precious first child, so fragile and small. How, before handing her to us, civil affairs officials collected the tattered outer layers of her tiny clothes to bring back for the other children and how the remaining layers, which we saved, were just rags. How we cried as we handled them. How Dorothy, called Gao Rui De in Gao’an, was growth-delayed and at the time really just a small infant equivalent, very hungry and unexposed to much sensory stimulation. And while we were complete, fumbling novices, we were startled by how instantly and naturally the transition to parenthood took place. Today Dorothy is still diminutive (by far the smallest kid in her next year's fourth grade class) but the best big sister imaginable for Clara-Li and Henry, although we know it was hard for her to relinquish to them the attention we know she would have wanted otherwise. She has grown to be a brilliant child, more contemplative than her siblings but with a highly developed imagination and a keen sense of humor. Our Mary Poppins she is practically perfect in every way, while Clara-Li and Henry are practically perfect in their own ways. They change so much and so fast as the years go by. In many aspects, so do we, as part of them, and they of us. One wonders how on earth could children such as ours, anywhere or against whatever circumstance, ever be abandoned or sold. There is no satisfactory explanation; so you just love them as hard as you can. Still, looking back over the past decade just from our own experiences, one could reasonably ask when, for the Chinese, might enough be enough.

Consider the Odds

2010-04-12T10:34:00.063-05:00

Babies are fragile under the best of circumstances and good health isn't exactly a given for any child between birth and toddlerhood, as any fretful parent knows.

So imagine the odds stacked against a baby in a crowded orphanage in underdeveloped western China, especially a child with special needs resulting from a birth anomaly, developmental disorder, or congenital disease. To improve these odds, join us to help Love Without Boundaries begin a nutrition program that will supply high quality formula and cereal to babies at the Pingliang Social Welfare Institute, which was Henry's orphanage in Gansu Province. Specifically we are looking for additional program sponsors able to give a small amount each month because child nutrition is a goal that can only be reached over time. The monthly commitment is up to the sponsor. (For a guide: the program can provide for the full nutritional requirements of one child for less than $15 monthly, of at least two for $30, and so on.) About a half dozen sponsors have pledged to sign on from the small group of international adoptive families with children who also started out at the Pingliang SWI. But perhaps there are others who would also like to help, having learned about this place, and the special children who live there, by meeting or learning about Henry.

Today at the orphanage there are 135 children, including about 55 children under the age of 3. More than 90% have special needs; 40% with cleft anomalies like Henry. New children arrive regularly, but the percentage of nonspecial needs children there seems to have declined. The total number of children has declined only somewhat since the orphanage's previous report in September 2009, when the total had nearly doubled within a year. The children remaining, because of their special needs status, are more likely to be long-term residents. Civil affairs officials and a dedicated orphanage staff raised funds locally for a new orphanage building that will replace the present one damaged in western China's massive earthquake in 2008, and the children may be moved to the new building in August. On its own the orphanage staff often enlists help from domestic charities such as the China Social Workers Association to transport some children needing critical surgeries, including cleft surgeries, to expert facilities outside Gansu Province, including a hospital in Beijing. And Love Without Boundaries is the same stable, non-profit charity noted in many of our previous posts. It helped us deliver general supplies to Pingliang immediately after the earthquake, shoes and coats for older children later that same winter, wheelchairs and other ambulatory equipment for disabled children last fall. To become a sponsor for a LWB nutrition program at the Pingliang SWI go here.

Meanwhile, Henry today is 36 lbs of densely packed enthusiasm; at 3 1/2 years old he can ride 2 mile laps around Audubon Park on his tricycle, absolutely unphased. He is talking and has a lot to say, mostly about his favorite friends of Thomas the Tank Engine, his threadbare beloved Baby Jaguar (still,) and his family. He gets help from a home-visiting speech therapist and mornings at the Bright School, a special preschool for children with acute hearing and communication disorders. We think he will be ready for regular pre-k soon and are aiming for kindergarten on schedule. Medically his ear tubes have fallen out again and will need replacement this summer, and his speech is physically missing a lot of sounds, making p-flap surgery a greater likelihood before his lip and nose revisions already planned. But, having roundly defeated the odds, Henry is now the least fragile child we know, an irresistible force at the head of his own trajectory and a presence who often causes us to wonder if we have been joined by the true 15th Dalai Lama, until he takes a grinning, good natured, little-brother swipe at his sisters.

Forever

2009-12-13T19:06:00.045-06:00

forever adv.
continually; persistently; for all time.
(- The Oxford American Dictionary of Current English)

“Time is the substance I am made of. Time is a river which sweeps me along, but I am the river; it is a tiger that devours me, but I am the tiger; it is a fire that consumes me, but I am the fire.”
(- Jorge Luis Borges)

The fundamental equations of physics all have no directionality in time. In other words, all theoretic interactions can proceed in the reverse direction without violating any physical laws. For example, bounce a basketball, capture it on video, and run the video backwards. Nothing will appear unusual. But in life, while we can reflect on past events and learn from them we cannot influence them. Therein lays one of life’s central quandaries: that, however irrationally, in our minds we can choose to dwell in either side of forever.

Or we may choose to see the whole—past and future—as a shimmering gift.

This is the gift we gave to Henry and to his sisters before him. We are their bridge from one side of forever to the other, their safe and solid ground.

The life our three children have here is as much theirs as ours. And the five of us are fortunate to live in what is perhaps America’s least homogeneous place. Far from perfection, there are wounded elements of the human condition in this otherwise resilient city, unhidden and obviously waiting to be healed. Yet there is also a genuine expectation that everyone is different and that our differences make us special. And because of what happened here there is perhaps more of a common understanding in this place that we are who are but often become much more than we may outwardly seem.

Fate in all its honesty has granted this family some uncommon lessons about home: what it is and what it means to have one, and what happens when you extend your arms as a warm place in which to truly belong.

But China will always belong to each of our children also, in a way that is not ours. It might be easy to see in this the lost side of forever. We hope not. That is because in China, also far from perfect, one does find a kind of graceful chaos, but also an enviable measure of shared reverence for aesthetic beauty in austerity and for sacrifice, and these can be missing on this side of the planet. Its ever present images of blossoms and simple fronds on scrolls or cloth are emblems of an understanding; minor decoratives only if considered superficially. Harmony and centeredness. Honor to oneself and family. To bend and not break. These are some of the ancient but enduring ideas into which our children were born, then in their ways separated in modern non sequitur. So we try to give them tools they will need to keep China in their hearts, for when they piece their puzzles together from the past we will help them look for, however much they each decide to.

China is a distance so far away that the stars Henry and his sisters see at night are in a sense last night’s stars there. But time, forever, is the substance we are made of.

There are no fixed limits.
Time does not stand still.
Nothing endures,
Nothing is final.
You cannot lay hold
Of the end or the beginning.
He who is wise sees near and far
As the same.
(- Chuang Tzu)

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A version of the above was originally posted in April 2009 and, with slight revisions, is reposted here as perhaps the best we can offer in summary as we let all this fade into our everyday private routine for now. We learned a lot from the tale accumulated in these posts so far; the path that took us once more back to China and then through the first of Henry’s surgeries at home. It’s a story we know in our family we can return to anytime as a reminder of just how truly fortunate we all really are. And that seems a thought worth remembering. The music with this post is a piece titled Forever and performed by Jia Peng Fang.

Life's Most Important Lesson

2009-11-05T13:17:00.046-06:00

Ten wheelchairs, two more with built-in commode seats, seven ambulatory shower chairs, three shower benches, two hearing aids, 53 children's winter coats, and 20 pairs of insulated winter pants. That's what Love Without Boundaries was able to deliver to the Pingliang Social Welfare Institute using funds that some of you contributed. (See previous post.)

Henry won't be defined by his humble start in life and we know that eventually he will carve out his own special place in the world. But for now his history seems important by example because the other children still at the Pingliang orphanage are important too, as are all abandoned children with special medical needs throughout China and the rest of the developing world. That such a child who so needed one today has the safe future most of us take for granted is a clear reminder of life's most important lesson: that hope, love, and help are chiefly among all other things verbs.

That almost anyone so easily can help provide a disabled child in an orphanage with a wheelchair, or supply a shivering child there with a winter coat, is simple proof of exactly the same thing.

We worry about the children at the Pingliang orphanage and how more than 120 of them have special needs from birth defects, like Henry. Families in China rarely adopt special needs children for the same reasons so many are abandoned there. And from all of Gansu Province, a very large place, there were only about 50 foreign adoptions last year. China will do more for its people but rural Chinese, nearly a billion people, earn an average $2 per day and migration of rural workers has made it more difficult to track and control disease. Increasingly, living environments there can be contaminated by pollution. All of which increases the likelihood of birth anomalies among newborns and, in turn, of more abandoned children with special needs winding up in orphanages or worse. None of which decreases what each of us can do even in small ways to make a big difference for these children, discarded save for in this case the care of an overstretched orphanage staff. From Pingliang: tè bié gǎn xiè (grateful thanks).

A Gift of Remembering

2009-09-20T03:48:00.038-05:00

Henry had a birthday this month and we had a party with many of our friends. But because he is uncommonly easy to please he didn't need more toys or stuffed animals, and he had plenty of picture books.

Really, the best gift we could all give was just to each find a quiet moment to remember where he came from.

Three years ago in rural western China, Henry entered the world with the absence of an upper lip and a gaping hole between his mouth and nasal cavities that undoubtedly frightened his birth parents. Faced with a swirling storm of questions ranging from what could account for this misfortune to how would they raise this child, a dreadful choice was made. Within a day or two Henry was found next to a roadside dumpster. He had been thrown away.

It would be better if this were not so common. Today there are 52 children with cleft anomalies of varying severity housed at the same regional orphanage where police brought Henry. The number of children there has nearly doubled in the past year to 152 children overall and 121 have significant medical special needs related to cleft issues, cerebral palsy, heart disease, blindness, hearing impairments, or any of a range of developmental disorders. This modest facility is called the Pingliang Social Welfare Institute (SWI) and is located in Pingliang, Gansu Province, about an hour's drive north of where Henry was found.

Fifty two children a lot like Henry, a terrific little guy, as good as any child we know. But we also know that cleft children, especially during infancy, can be difficult to feed and this is a challenge in a crowded orphanage. One hundred and fifty two soft little hearts that need people to care, veiled at the far edge of a far away place. We would like to help; right now the orphanage most needs ambulatory medical equipment (wheelchairs and bath chairs) and hearing aids, in addition to general children's supplies.

So we asked friends who came to Henry's birthday party to forgo bringing a present and instead make a small donation through Love Without Boundaries toward this act of remembering.

They did and then, this being New Orleans, we all had a wonderful time together.

Those Bright, Shiny Moments

2009-06-15T19:22:00.065-05:00

In our home we celebrate Gotcha Days, anniversaries of those bright, shiny moments in China when we first held our children—when we became theirs and they got a family. Each anniversary features a cake, balloons, and a few presents, but unlike birthdays we keep them within the family since they could as accurately be called Family Days or just about anything with similar meaning. We’ll continue the tradition as long as it doesn’t seem obligatory and it has been interesting to watch how our girls have embraced their Gotcha Days as they have gotten older. Each celebration has unfailingly turned out to a big day all around and at least somewhat unique to their complicated stories; that you had to be there at the beginning to completely understand is part of its special charm.

Today was Henry's first Gotcha Day and the completion of a wondrous year. Not long ago at a series of exams with our medical team, our surgeons pronounced the results of Henry's first cleft surgeries last fall to be "spectacular" and "much better than we could have hoped." There will be more surgeries, all with challenges, but Henry's new palate has not developed the holes common in cleft procedures closing much smaller gaps. Today his new upper lip looks tighter than it really is and, important for later, its center is exactly in line with the center of his face.

His receptive language, or understanding of our speech, is age-appropriate and then some. For his part, Henry can now make most vowel sounds along with the consonant sounds for b, h, m, n, and w. He can even form some words; first the ever useful uh oh and now Ma, Da (for Dad), hat, ball, hi, bye, my, up, 'nana (for banana), and wa wa (for water). Eventually his ability to form difficult hard consonant sounds like those for k and q will determine whether he will need surgery to assist his speech by lengthening his soft palate before he enters kindergarten when we already plan more reconstruction of his nose and lip.

Henry can occasionally be as fussy and sleepless as would any two and a half year old with late teeth sometimes pushing out in odd places, malformed from the same genetic material from which the front of his hard palate was built. But he could not be a sweeter little boy; happy in his world of little toy trains, soft stuffed animals, and his family who loves him.

… So there we were, then just the four of us, one full year ago, having determinedly sped from Beijing west toward China's earthquake zone to scoop up our little Henry from the Pingliang Social Welfare Institute, as if that was the most natural thing in the world and, in every way that matters, it actually was.

The Transformative Power of TLC

2009-01-07T10:32:00.047-06:00

Henry was tiny and fragile when we left China. His weight and height were below the lowest percentile curves for his age on the CDC children’s growth charts. Today he is within the 25th percentile for height and at the 50th percentile for weight, which means his weight has increased by a third and he gained nearly 1.5 pounds per month, an astonishing average for his size and circumstance. He gained weight and strength even during the months in which he recovered from his surgeries. For Henry eating became a comfortable stress reducer, which we obliged with lots of comfort food that was easy to slurp down even with a face full of sutures: soft scrambled eggs, overcooked milky macaroni and cheese, the stars from umpteen cans of Campbell's Chicken N' Stars soup. By Thanksgiving he began to look certifiably chubby, especially around his tummy and legs. But as he has grown he has also grown to be cheerily busy rather than sedentary; so he gets lots of exercise pushing his little cars or wagon in our long center hallway, chasing his sisters through the house or around the yard, and climbing ever higher onto beds or furniture. His eating has tapered off to normal and his weight is solid and better distributed on his little frame. His palate and lip surgeries seem to be holding up fairly well. Both could need adjustments sooner than later, but our doctors have been heroes so far and no doubt will be again. Speech and physical therapists now stop by for regular visits and are thoroughly smitten. More so today it appears that speech will be extremely difficult since the roof of Henry’s mouth and palate are entirely homemade and his new upper lip, so far immobile, is primarily just scar tissue. All things considered, this kind of thing is not unexpected and we have plenty of time, and confidence since he is such a quick and adaptive learner. Mainly, Henry has sturdily emerged as a very happy little guy, which is what counts. As the days pass it seems as though he has always been with us and in a sense, held softly by the better angels of our nature, he probably always has, within us all.

'Tis the Season to be Thankful

2008-12-16T12:40:00.017-06:00

From our little corner on Green Street here in no particular order are a few things for which we're thankful: friends; family; Lusher Elementary and this year's school successes; Ochsner and Children’s hospitals; people across the planet who care about making things better; holidays and birthdays; our home; Plum Street sno-balls; washable markers; parades uptown; Doppler radar and those storm path computer models; sunny mornings and shady oak trees; little voices ringing through the house.

希望您是如保佑以好运
(Hope you all are as blessed with good fortune)

Baby Jaguar

2008-11-12T16:26:00.043-06:00

Perhaps one of the best surprises of parenthood is discovering your children’s capacity to love.

What’s more, the great thing about love is that to children it just feels so much better than fear or anger. But as a choice or action it's harder for children to learn later than usual because it requires the right conditions. Still, we've found that if you can make a child feel safe and happy for long enough and often enough then you can teach them to feel tender affection, although perhaps each child differently according to his or her innate temperament and personality, which is formed through experience.

It's within these experiences where problems can occur.

Each child adapts differently to the experiences that go along with spending his or her first year or two alone in an orphanage. Yet generally it's amazing what children can overcome. This we’ve seen most profoundly in our middle child who spent the first 18 months of her life under daily circumstances that were terrible in every sense, and with her own medical issues (infection beneath her cornea misdiagnosed as crossed eyes) as insult to injury. Later once home she endured more than two years of violent night terrors that may have been associated with the anterior fontanel portion of her skull developmentally remaining unclosed for the same long period. This condition was extremely rare and eventually began to very gradually resolve itself.

Someone once wisely told us to look for and treasure those inner things in our children that enabled them each to get by on their own during a difficult infancy. There really is strength in adversity and this is in large part why our two girls are now both, unexpectedly, at this point in their lives, so well adjusted in disposition. Preschool teachers would often tell us they thought our girls seemed unusually self-aware. What they were seeing was really the surface of our daughters’ epic common stories. In Henry's story the severity of his cleft and the failure of his charity-sponsored surgery in Xi'an very likely worked to his advantage at the Pingliang SWI. These problems guaranteed him some extra attention and until the earthquake last May he never gave up his crib in the orphanage's infant room, unlike other children his age who had long since been moved to other rooms with fewer staff assigned. Still, his was also a bruised beginning that can take a while to mend. Although during the past several months there were many signs that he was adapting well we were expecting the typical long adjustment period--until he befriended a little stuffed animal that we call Baby Jaguar and that he hugs, gently chews, and rolls atop in rapturous glee. He has been doing this for weeks. It's not especially unusual for toddlers to glom onto stuffed toys, but we've noticed that Henry seems to care for Baby Jaguar with the same empathetic joy with which he plays with his sisters. He loves them (and they him).

This past week we helped Henry through his third surgery in only three and a half months. It was the last of the initial, first-round series of surgeries we had planned and with a great sense of relief we don’t expect that he will require any more for at least a year, after which he’ll need more cleft-related reconstructive work. But, looking back, it was through this first series of painful procedures that we began to see clearly that he loves and trusts his mom and dad, something hard to mistake in a child pushed to his absolute limit. He knows that we're not going to leave his side.

Of course it's good to have Baby Jaguar there too.

One Child at a Time

2008-10-31T21:21:00.072-05:00

It's a heart breaking fact that most of the children needing homes through international adoption are those least likely to find them for reasons of age, disability, war, or restrictions within their home countries.

In an ideal world all children would be loved within their birth families and none would ever be abandoned, sold by their birth parents, left alone through violence or disease, or relinquished anywhere to orphanages or refugee camps. But today there may be more than 100 million abandoned or orphaned children in the developing countries of Africa, Asia, and Latin America alone. Wouldn't it be best for those children to be adopted by families there so they could remain closer to their inherited culture? The answer should be absolutely, if adoptive families there can provide adequate care. Are there enough of those families to go around? The general answer is no, since much of the developing world is still mired in crushing poverty. The answer also can be complicated: sub-Saharan African countries with 12 million children orphaned by AIDS are understandably skeptical of help that would export people. Moreover, throughout the world most orphanaged or abandoned children are between the ages of 3 and 17. Children with challenging special needs are those most likely to be abandoned.

And the world changes, faster in some parts than others. Many observers believe that in China there are now enough Chinese willing and able to adopt the healthy babies who still wind up in state-controlled orphanages, even within the limitations of China's birth quota population restrictions. That's because rapid development in China has created a new comparatively successful urban economic class with a sufficient number of childless couples more willing today to adopt children of either gender. Moreover, since peaking in 2005 the number of children without special needs in China's orphanages has for a mix of reasons precipitously declined. However, this means that most of the children in Chinese orphanages today have special needs that are heavily stigmatized in Chinese society. In Russia, where international adoption has also been common even though Russia has long been an industrialized nation, large numbers of children in orphanages are older "social orphans," i.e., their parents are known, but incapacitated due to chronic substance abuse, mental instability, or chronic destitution. Still, all children, including those badly damaged by their circumstances, deserve to be loved in safe homes by caring parents.

The agencies that facilitate international adoptions tend to promote their services as just another means of building a family--with magazine ads that usually feature photos of the cutest, healthiest babies imaginable. Most adoption agencies have altruistic intentions in this, while a few have been involved in bad practices. Especially within poor countries, problems can occur where local corruption is a factor and problems such as child trafficking have been cited in many countries including Guatemala, Cambodia, and India. Even China's centrally managed foreign adoption program has had problems in recent years as orphanages have tried to keep up with a growing foreign adoption demand for non-special needs children. Agencies will more visibly shift toward special needs adoptions if demand shifts toward them.

Wouldn't it be great if international adoption were to help more kids like Henry? Parenting a child with special needs is hard and not for everyone, but good parenting is difficult regardless. We would encourage any sound, capable family that is considering adding a child to carefully consider adopting a special needs child. Not all adoption transitions flow as smoothly as Henry's (or that of his sisters) and not all children have as sweet a temperament. There are risks. But looking only at the surgeries that Henry has undergone already and will still require in the years ahead one wonders what fate would have befallen this perfectly good child otherwise. Our health insurance covers most of these costs. The world is full of abandoned toddlers with medical problems and doubtful futures, as it is full of sad, damaged older children looking out at the rest of the world from the grey windows of beleaguered orphanages. The only way to give them the love and hope from families that they desperately need is one child at a time.
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Yesterday at a scheduled visit with our surgeons we threw away Henry's nose stents, giving up on them because they seemed to have zero effect on shaping his nostrils, both of which have collapsed. We noticed this past week that large amounts of chewed food would occasionally emerge from his left nostril; his palate area was checked thoroughly for fistula (holes) but it looked good. It's likely that this last surgery may not have effectively sealed his left nasal cavity, and food is getting through from the area behind his new lip that will later be filled by bone graft. Tonight he bumped his lip against a table leg, which caused a small amount of bleeding in a spot along his main suture line. It seems to be holding together and there's no swelling. We'll just correct problems as they arise by adding to our surgical plan.

The Learning Life

2008-10-21T17:24:00.031-05:00

"I believe we each live two lives: the one we learn with and the one we live with after that."

So goes a memorable line from an old novel and in retrospect the posts to this blog have been a glimpse into our family's learning lives, which are probably less linear in reality, i.e., we learn for a while, live for a while, learn for a while, etc. We know that you all have learning lives too. So it's worth pausing to thank you for following ours and for your encouragement along the way. We suspected that Henry's story was larger than ourselves and that it might offer others something in the way of encouragement too. We hope it has, even as the story evolved to its inevitable hospital phase.

Entering a children's hospital can be like traveling to outer space; each time the earth disappears behind you and the natural world gets replaced by artificial light, processed air, and the beeping sounds of monitoring equipment. Then the uneasy waiting begins, often interrupted only by periodic emergencies of varying proportion. Still, it hasn't been lost on us that the other families we have seen at the hospital usually have not chosen to be there quite in the same way and often arrive with less advance planning or a lot less information. Many of these families have children who are critically ill. Some have children with terminal illnesses, which is a life lesson we can hardly imagine.

We are extremely fortunate, as we've learned before.

Henry's latest surgery has held. With a successful week behind us, we returned to the hospital Monday where our surgeons put him under anesthesia again and carefully removed the nonabsorbable sutures from his lip area. This will reduce scarring and stripped away some of the blood and mucus that had crusted around the area, and it gave us a better view of how the reconstruction has set so far (before it crusted over again). One nostril is larger than the other and the new lip is not exactly even across the mouth, but the net result looks much better than we had hoped for this stage and appears to be a good base for the surgeons to fine tune later. In other words, he looks great.

Armed with a new hard palate, soft palate, uvula, mouth, nose, and functional interior cavities, Henry now has all the necessary tools for acquiring speech. His implanted ear tubes (one of them replaced Monday) have cleared the backed up fluid that had obviously muffled his hearing. Last Saturday we met with an Early Steps evaluation specialist who will help us schedule his speech and physical therapies. For now, he's good to go.

Except for those nasal stents--which he jettisoned today with a huge sneeze that required another brief visit to the hospital. They will need to stay in for another month. Three cheers for Snuggle Wraps.

Meanwhile, in August we had arranged for the charitable organization Love Without Boundaries (LWB) to help us provide the older children living at Henry's orphanage, the Pingliang Social Welfare Institute in western China's Gansu Province, with new clothing and shoes. These are items that can seem like very personal gifts to an older child with little else, and had been requested as a top priority by the staff there.

With donations received toward this project, LWB last week purchased and delivered to the orphanage 14 winter coats, 45 sets of warm clothes, and 38 pairs of shoes (a mix of leather and sport shoes). It made a difference.

Surgery Round Two: A New Face

2008-10-15T00:16:00.022-05:00

Henry has a new face. More precisely he has the face he should have been born with had it not been for a genetic misfire in utero. It is a connected face now rather than "cleft" and the first view of this was a surprise when we joined him in the post op room after surgery on Monday. This round of surgery seemed even to affect the general shape of his head, which seems for the first time gloriously symmetrical.

From the very beginning, even as we had carefully stared at those first photos from his orphanage in western China, we accepted the idea that some of Henry's issues might not be correctable and others would be hidden. It's interesting how perfectly natural this acceptance became in person, as we learned how Henry's physical challenges were inextricably part of his remarkable character, as well as part of what made him so special as one of our children.

But Monday, as we gazed at his newly heart-shaped face with its new button nose and centered mouth, albeit stitched, bruised, and swollen, we started to think realistically, maybe for the first time, about Henry eventually appearing pretty much just as a regular kid--and how astonishing this is, considering where this all started and everything it took to get to this point.

Because two other attempts just to close the gap across Henry's lip had failed, this round started from scratch, dissecting muscle and skin across the entire middle of his face to be stretched to an intricate connection of sutures at a central point below the nose. One of the most difficult tasks in this was constructing at least the beginning of the lower portion of a nasal septum which is called a columella and this will help determine the eventual shape and height of Henry's nose, which was flat and unconnected by muscle at its wings. The length of the columella in this round needed to be set just right in order to avoid a narrowing of his upper lip as he grows. Similarly difficult was the construction of at least a properly located if not ordinary looking cupid's bow, which is the double curve of the upper lip--also important to set just right for proportional growth later on. Our surgical team finished very happy with the day's work.

This was all preliminary stuff and further adjustments will be needed to the lip and nose in a few years, but the surgeons said that overall this round went better than they had hoped. We are all hoping the result will be good enough to avoid having to later do an extremely uncomfortable skin graft procedure called an Abbe flap that is sometimes used for Henry's particular condition. In this procedure, the surgeon takes tissue from the skin between the patient's lower lip and chin, and transfers it to the upper lip under the nose. The tissue remains connected to the donor site for up to several weeks so that the graft "takes" at the site where it has been placed. In other words the patient's lips are stitched together during this time. Hence it's not something to attempt before a child is old enough to clearly understand what's going on.

At any rate, this round went better than we, his parents, had hoped as well.

For now, however, all those sutures could still dehisce and we are being very careful, especially wary that pain medication can make Henry unpredictably wobbly. We are scheduled to return to the hospital next Monday to have the hard sutures removed to avoid scarring. This means that if we get through the weekend without them coming apart the reconnected tissue should be healed well enough by Monday to hold with just the dissolvable sutures underneath. We've placed extra fasteners on Henry's arm mitts and have ordered some better ones called Snuggle Wraps.

The wraps will need to stay on well past Monday to keep Henry from pulling out the long stents embedded in both his new nasal cavities and that are connected to interior sutures. These will need to stay in for up to a month in order to create a rounded shape for his nostrils. A repair of Henry’s dislodged ear tube was postponed as part of this round due to a scheduling problem, but we’ve rescheduled that to be combined with next Monday's suture removal.

If we’re lucky the worst may be behind us. We just need to somehow glide safely through the rest of the week.

Once More into the Breach

2008-09-30T11:59:00.032-05:00

Now that things here are returning to normal after a second hurricane (this one called Ike) blew safely by the neighborhood, we’ve scheduled another lip surgery for Henry, this time a full reconstruction. Our surgical team thinks it would be better to skip another first stage lip adhesion surgery since that procedure has failed twice and might not hold a third time. One of Henry’s ear tubes has come undone and we’ll add this to the docket for this round as well.

A first stage adhesion is an initial procedure that fastens only skin, which is one reason why for Henry it keeps tearing open. The full reconstruction will dissect muscle around the lip and nose to also be connected under the skin. This will give the new lip and nasal area some natural functionality and allow for relatively even growth as the years go by. A full reconstruction is theoretically stronger but could still tear apart. We’ll just need to be very careful and Henry will get a brand new pair of those clunky arm mitts.

Henry’s new upper lip and its surrounding area will be stretched unusually tight, which could easily leave him with an under bite. But this round will be overseen by our team's senior member, known nationally for this kind of work. This surgery will be very broad in scope and will undo and correct much of the right-side healed remains of Henry’s first surgery in China, which we now know had been botched. We are glad there are charitable organizations like Smile Train and Operation Smile that organize medical teams to travel to undeveloped regions of the globe to perform reconstructive surgeries on children born with cleft conditions, including many children who have been orphaned or abandoned. But we’ve learned that occasionally doctors who participate in some charity teams do so with little expertise or little or no background in handling severe cleft cases, and that blanket promises to save lives with a single “45-minute operation” are, for most cases, hopeful exaggerations. It may be that for these children a dehisced or failed surgery is better than none; that it's simply worth the try. Then again there have been problems.

At any rate, this next surgery for Henry will be a complex set of procedures that should begin to determine how his face will ultimately appear to the world around him. We think we've chosen well with our doctors here, and once again must simply hope for best.

As is, Henry’s cleft face is normal to us and precious in a way, since it is so unusually expressive, especially when he smiles. But it is admittedly a very unusual face that garners stares and a variety of squeamish reactions in public settings. This was particularly so after his last surgery when his lip sutures tore open; the result for a while had the look of an open wound. Still, each weekday morning Henry goes to the large outdoor general morning meeting at our girls’ school, toddling about or fussily clinging like any other child his age. He accompanies us to stores, to restaurants, to parties. He basically goes everywhere, and everywhere his sisters are his ready defenders. Brows furrowed, they sometimes ask what’s wrong with people, especially other kids, who are afraid of Henry or uncomfortable around him. For Dorothy and Clara are certain that Henry is just right, even if they’re not quite certain that his cleft problems are just temporary.

But behind Henry’s unrepaired lip opening is today a remarkable new hard and soft palate that is healing well where there had been only a gaping hole prior to his surgery in August. The rest, his parents know, is doable. Unfortunately, each round, much like that last one, is also going to hurt, a lot.

Henry made two years old on September 10, which with friends we marked in warm celebration. He is a very special little child and we still can’t believe we were so lucky to have found him.

We’ll return to the hospital on October 13.

Home Sweet Home

2008-09-07T10:19:00.012-05:00

All's well that ends well, we suppose. We've all returned home after the storm. Andy returned quickly to New Orleans on Wednesday as duties called, and to check on the house which came through with minor damages. Trish and the kids returned last night, having moved on to stay with yet more kind friends farther north in Tupelo, MS, since we lost power early during the storm at our first evacuation stop. While less powerful than predicted, Gustav came onshore with unusual forward speed that carried hurricane-force winds far inland into central Louisiana, trashing main transmission lines and crippling the state's power grid. Now we are wearily keeping an eye on another large storm that also appears to be heading toward the Gulf.

New Orleans is a familiar mess, with signs and power poles askew and piles of debris temporarily lining the streets. Some new traffic lights were damaged and we are again handling these intersections as in Chinese cities, which isn't really so bad since it transforms something completely impersonal like driving into a kind of folk dance. It's this sort of thing that helps to make our city worth returning to; like that clear sense that everyone standing in line with you at the supermarket has come through the same ringer. While it doesn't erase complicated differences in race or socioeconomics it genuinely reaches across them, which is unique.

But this blog isn't really about New Orleans or hurricanes, except only indirectly. It's about little Henry and, in a larger sense, abandoned children with special needs and scarce resources--hidden away in far off corners of the globe. Sufficiently reminded by this storm of how lucky we truly are to have such wonderful friends, a special home, and each other, we'll reach into our well worn pockets to send another donation to help buy new clothes and shoes for older children at Henry's orphanage in Pingliang, Gansu.

Hoping for the Best

2008-09-01T01:02:00.010-05:00

Henry is officially a New Orleanian, since he has now evacuated for his first hurricane (this one called Gustav). Here at our destination 50 miles north of the city, in a calm break between early bands of the storm, the rest of us are considering whether there is any special advantage to having to repeat this. Maybe. Maybe not. The near misses and smaller storms of years long past were humbling but Katrina in 2005 changed us at far deeper level: it was a precious reminder of the beauty and resilience of our children and how each smile is a gift, each hug returned is a soft treasure, and each tiny hurdle overcome is a magical triumph. Everything else was just stuff. Who cared if the house got whacked? We could rebuild. We know a lot of families felt this way to varying degrees; it helped.

A second big hurricane within three years can make one remember one's stuff more wistfully. We can only hope our hard-fought home will still be intact when we return. Generally New Orleans comes through okay in storms that land west of Morgan City, LA, as it appears this one may. Large storms pushing a lot of water and spitting wind gusts in the form of tornadoes are finicky, however.

We are staying with good friends at their comfortable home in a mid-size town safely inland above the Northshore area of Lake Pontchartrain. They have a daughter who was also adopted in China, Dorothy's age. The girls are a bit apprehensive about the weather of course, but busily determined to squeeze some fun from this event. Luckily, Henry in just the last few days seems to be have been in a lot less pain from his surgery. He is a bit fussy from sudden travel but generally his happy self. His new palate is healing well; his lip area less so but our surgical team thinks it looks ready to try a third lip closure, which we were in the midst of scheduling. Both hospitals with which our surgeons are associated in New Orleans are today veritable fortresses, so for Henry the storm is likely to be just another short medical delay.

We're hoping for the best and are reasonably optimistic about our own circumstances. It's still a few hours before dawn when the worst of this hurricane should begin to reach the coast and a lot of people who left behind homes in Louisiana's rural coastal parishes below New Orleans are facing much worse odds, unprotected now by wetlands fast disappearing. You know them. They're the people who drill much of our domestic oil and gas just off shore, grow our sugar from cane, and catch our oysters, crabs, and shrimp.

Imagine New Clothes and Shoes

2008-08-20T21:53:00.007-05:00

A majority of the children at the Pingliang Social Welfare Institute--the orphanage where Henry lived for 21 months in western China's Gansu Province--are older children, longer term residents with little chance of adoption. Many if not most also have special needs. The charitable organization Love Without Boundaries (LWB) will help us provide these children with new clothing and shoes. These are the items that the orphanage's director told us are most needed. It's been our experience that this kind of simple project with direct equal benefit to a substantial number of children can be the best we can offer from this distance at a relatively low cost. A brand new set of clothes and a new pair of shoes is a very personal gift to an older child with little else. It will help.

A LWB representative in China has contacted the Pingliang SWI for information about individual sizes needed and the orphanage is anxiously targeting about 32 children for this project. The cost of clothing for ages 7+ is only around $15USD/set and shoes are around $8USD/pair. Warm sweatshirts or jackets are similarly inexpensive when purchased by LWB in China. So a donation of any amount will make a difference.

If you would like to join us in contributing to this project, you can do this easily online. Go to the LWB web site (http://www.lovewithoutboundaries.com/) and at the top of the page click on the circle icon labeled Donate Now. Under Category select Orphanage Assistance and enter "Pingliang" in the Notes section. Then complete the form. To donate by check make your check payable to Love Without Boundaries and write "Pingliang Orphanage Assistance" on the memo line. Mail your check to: Love Without Boundaries, 306 S. Bryant St., Ste. C, PMB 145, OK, 73034.

Love Without Boundaries is the same group that successfully helped us provide clothing and other supplies for young children at the Pingliang SWI immediately after the earthquake in May. It's a registered 501(c)(3) non-profit organization formed and supported by adoptive parents, and with overhead costs of only about 3%. Your donations are tax deductible.

Postscript Update

2008-08-11T20:26:00.010-05:00

Late this afternoon we returned briefly to the hospital where Henry's lip sutures were quickly removed to let his skin heal in the area surrounding them. In four to six weeks our team will try the lip adhesion again. "This is a delay not a setback," said our wise old expert, quite matter of factly, after closely surveying the affected tissue. The interior palate area surgery continues to hold, although it will be vulnerable for a few more weeks and those clunky, uncomfortable arm mitts will need to stay on. A kind friend summarized the situation best: the smile they gave us last week just wasn't the permanent one Henry was supposed to have. So for a little longer we'll have his original smile, which had always been just fine to us as temporary.

Round One Surgery Postscript: Dehiscence

2008-08-09T12:40:00.019-05:00

Still just learning to walk and likely dizzy from pain medication, Henry teetered into the side of a wooden chair on Friday night, bumping exactly the worst possible place. When we picked him up the damage was obvious. Blood was coming from both inside corners of his mouth. This instantly sent us reeling, sick at the thought of what might be happening so soon after all that Henry had just gone through at the hospital. We reached our lead surgeon at his home and he advised us how to stop the bleeding. On a second call, after the bleeding stopped, he asked us to meet him in the morning so he could get a first hand look—just in case. Later in the night we noticed under the clean bandage we had placed across Henry’s lip that his stitched area was bulging and, worse, his right nostril had widened. Sure enough, the lip adhesion was coming apart. So early this morning, his dad rushed him to meet the surgeon at the emergency room while mom watched the girls, who had already spent the entire week either at friends' or with baby sitters. End result: all Henry’s interior palate area surgery appears to be holding up for now and we added antibiotics to his meds as a precaution.

However, the lip adhesion appears to have come undone almost completely. The result looks like a very painful wound, since we know the surgery exposed bone close by in his palate area behind the torn open lip work. Some of the torn lip tissue has a sort of hamburger quality and does not appear to be reuseable at least for now. Still, we are further along than we might have been otherwise with the palate-area surgical stages Henry will need to eventually gain speech, and it seems he can hear now.

Trying a third time is of course our only option for closing his lip; we are just unsure how soon (or exactly how at this point). It's a hard fact that trying your best often fails, which is why it’s always best just to keep trying. We know too that we're certainly not the first family to run into a complicated snag in working through something that requires long-term staged reconstructive surgery. It will probably help that Henry couldn't be more loved.

Surgery Round One

2008-08-06T19:10:00.037-05:00

Henry’s surgery this week was a medical gamble, an unusual plan mapped out by a young cranial facial surgeon paired with an old master whose reconstructive successes probably number in the thousands. The normal strategy for untreated serious cleft conditions in older children is divided in careful stages, generally with the lip first and the palate later. But Henry’s cleft palate was so extreme that it caused one to wonder: why not take advantage of his unrepaired lip opening to reconstruct his palate first? Further, given that he is at an age when most children are already starting to talk, why not reconstruct his whole palate area all at once--an uvula and soft palate at the rear of his mouth and hard palate roof at the front. Include ear tubes in this round too. Then finish the surgery with the first stage lip closure, the procedure with the greatest chance of failure because of tissue damaged in an earlier attempt in China.

The clock is ticking for this little guy. Why not try to get at least a few points on the board? Our older expert considered this plan from his apprentice colleague and promptly volunteered to assist. The best approach, he explained, is the one that’s best for each individual child. We agreed, and in effect turned down a traditional approach offered less confidently by a different surgeon at another hospital.

So we arrived to be admitted for surgery early on Monday morning and handed little Henry over to be wheeled into the operating room at 1:30 pm, which was a horrible moment. The surgery lasted more than 6 hours. Toward the end our young lead surgeon came out briefly to see us in the waiting room at about 6 pm, haggard but pleased. The palate work needed to be unusually extensive and safe regenerative dermal tissue processed from donor cadavers was used to buttress the new roof of Henry’s mouth. The lip closure as a last procedure was indeed extremely difficult and the team sketched a delicate route for laying sutures in areas where the tissue was less damaged. Extra sutures were placed under the lip and stronger non-dissolving sutures were used across the top for insurance. The result: maybe an 80 % chance that the lip adhesion will hold and overall the lower part of a face that right now is swollen but already much more symmetrical and whole.

We finally saw our little guy in a post anesthesia room at about 7:45 pm. An hour later we were settled in a private room on an otherwise busy upper floor. The initial prognosis was upbeat; the surgeons pleased with their work, relieved it was over. Nurses on the floor were familiar mostly with infant cleft cases. “You could be home tomorrow.” Morphine every two hours. Tylenol codeine in between. A steroid to reduce swelling. Intravenous fluids. Mist tent to keep his sutures from drying out.

Henry did well at first, even drinking some water from a syringe late Monday night. But at about 2 am the heavy local anesthesia from his surgery wore off. From then on it was an awful night. At 5 am the doctor on the floor doubled the morphine dose. Drugs dull the senses but there is a type of spiking pain that obviously comes in unstoppable waves. By Tuesday afternoon Henry could see past the pain to recognize us and perked up a bit when we brought his sisters by for a quick visit before returning them to good friends for another sleepover. Tuesday night was better but still difficult. This type of surgery affects so many critical functions, especially one’s ability to drink, eat or sleep. At various points after 2 am Wednesday, Henry’s intravenous splint pulled away from his arm and he became entangled in his tubes and monitor wires.

But after the sun rose Wednesday we decided the wires, loud beeping equipment, and tubes were more harm than good, so the nurses agreed to remove them. By mid morning Henry was alternately eating bits of vanilla ice cream and brown gravy, and liking it. At a little after noon we discovered our release ticket: chocolate milk, a small carton of which he slurped down with help from a spoon. Within hours he was pronounced officially on the mend. We are so proud of him and how he handles these hurdles. In a few months we will need to return to the hospital for another round and temporarily we’re exhausted again. But somehow, gazing at Henry at home tonight in his own little crib, this all feels like no trouble at all. How strange, then, that back on the fifth floor of the hospital we just left there is another little boy all alone, born there prematurely five months ago, who no one but the medical staff ever comes by to visit.

Fate

2008-07-22T10:05:00.039-05:00

This week we were setting a time line for Henry's surgeries, finding that all dates were problematic. The slide show with this post was us just feeling sort of nostalgic, stunned as we are by wondrous fate.

[See the later post titled Tis the Season to Be Thankful for an updated version of this slideshow.]

The Shape of Things to Come

2008-07-10T12:54:00.046-05:00

We've settled into Henry's adjustment at home and have begun our medical visits. The adjustment is going well. From our doctors we've picked up some clues to what's next, a few details of which we offer here in appreciation of what so many other families have also chosen to go through by adopting children with cleft issues or other special needs--or often just by making the unusual commitment that is international adoption generally.

Our first medical visit last week focused on the basics. Henry got a once-over general exam by our pediatrician, who is familiar with internationally adopted children and head of the cleft team at the medical center we use here. Henry was pronounced developmentally delayed but generally healthy and, sure enough, has gained a pound or two in just the past three weeks.

Although his orphanage medical records contained some immunization info we've learned from experience with our girls that it's wise to redo all the standard vaccinations and to just get them over with all at once--rather than to prolong the pain of these shots over extra visits. The nurses who administered the shots were fast, but needles are no fun and Henry wasn't happy about any of them. He screamed through the whole procedure as well as the blood work later that was worse, but held no grudges. This week we met in sessions with our cleft team, which in addition to our supervising pediatrician includes three surgeons (oral/maxillofacial, plastic, and pediatric dental), a pediatric ENT specialist, a medical geneticist, a hearing specialist, a speech therapist, and a social worker.

In advance we were given a set of DVDs used for training surgeons in a variety of cleft reconstruction procedures. As expected, Henry will need more than one operation to redo the attempt to construct an upper lip tried in China and to close his cleft palate. It now appears that his lip reconstruction alone will require two surgeries in stages, perhaps 6-8 weeks apart. He'll need tubes for his ear canals presently holding fluid that is blocking his hearing; this could be combined with his first stage lip procedure. Additional work will be needed to construct some nasal passages and elevate his flattened nose, which could be combined with the second stage "full" lip procedure. [The clip attached to the above right image shows two of many nasal reconstruction incisions.] Palate surgery may need to wait until after his lip is complete, in reverse of the usual early treatment sequence used for infants.

Our first overall medical goal will be to close at least the rear portion of Henry's palate as quickly as possible since this is the area most important to speech development. This means we've a lot of work to do beforehand in the next several months. The wide width of his clefts, a late start, and tissue damage from the unsuccessful first surgical attempt will be challenges. The team will combine procedures where they can. We now know that each surgery will be a serious undertaking and it's obvious that we're about to help Henry through a series of very long bouts with terrible pain. We can't pretend to be prepared for this sort of thing, but we'll get through it. Milder dental work and orthodontia will follow. When Henry is about ten he'll need bone grafted from his hip into the gaps in his maxilla. Later in adolescence he may need adjustments to his jaw or nose, or treatments for scarring. The huge rewards in all this are obvious for a child who began life with the odds so stacked against him and therein lay the huge rewards for us.

Three and a half weeks of nonstop eating has made Henry's lower abdomen bloat like a beach ball on his tiny frame but his cheeks, arms, and legs are already getting that pudgy baby look and feel. Eventually his growth will even out with help from the exercise he's getting from tottering back and forth down our long center hallway at home. He still has trouble sitting up or standing up on his own but once up, he's raring to go. His radical change in food intake last week produced an extraordinary number of "exploding" diapers overflowing with a very runny light-colored poop. The treatment was patience while his system adjusted and it has.

Orphanage environments can easily produce difficult behavioral or cognitive developmental issues in children and separately the transition into a family can have traumatic consequences lasting weeks, months, or longer. Not so for Henry, who really is 21.9 pounds of incredibly resilient good nature. By now we know it's not an act. His has by far been the quickest and easiest early transition of our three. Indeed he has quite conspicuously helped himself to ease into our family--clinging to each of us, copying our gestures, blowing us kisses. He cleverly obliges his sisters when they play with him like a soft toy. One night last week he fell asleep and giggled in a happy dream before we moved him to his crib, a good sign that things are going okay. So our attachment plan over the next several weeks is simply to pour enough cement on this status quo. We suspect we'll need a foundation as strongly cemented as possible for all the physical pain ahead. But we seem to be off to an unusually good start.

A Lesson From Crows

2008-07-04T22:23:00.052-05:00

In a dream Henry and his dad are once again in Gansu Province. But they have become two crows who are peering out over the arid town of Jingchuan from one of the old caves that long ago were dug into the sides of the tall sandy cliffs along the town's southern edge.

It is daytime there and small vehicles are busily motoring about on the streets, shadowless under the sun that burns behind a hazy sky. Men and women, a few with children, are walking into and out of the stores on Zhoung Shan Road, the town's main artery. Other people can be seen in front of the small mud brick houses in the dusty back area of town just below the cliffs. Eventually the crows leave their perch; the father and his much smaller counterpart. They dip low toward the town for a moment before their wings catch the air currents swirling invisibly over the Jing River valley. They begin to climb.

First they fly north across the valley's wide floodplain and then turn to follow the gravelly river bed west, mountains on each side of the plain, fields and villages below. Carefully tended fruit orchards and irrigated terraces planted with neatly spaced rows of vegetables or wheat pass underneath, this directly below in vertigo flashes of green against backgrounds of yellowish tans. Small villages are set on either side of the highway that runs parallel to the river; more clusters of small mud brick houses with tiled or thatched roofs. Each entrance door is covered by a sheet of cloth, fluttering in the breeze. The houses are dark and most are empty since almost everyone who is not too old leaves early in the morning for work or school. Many will return only when the sun sets; many if not most younger people of working age will seldom return and some have left for good, as they have moved on, often far away, to find work elsewhere in China’s urban economy, joining nearly 350 million others who have given up on an increasingly meager subsistence in the rural countryside.

The two crows rise higher above the valley, high enough to see beyond its bordering mountains. In either direction are more dry and nearly treeless mountains as far as they can see. Almost every incline not too steep has long ago been terraced for planting, which is a solitary and back breaking occupation. Only occasionally a man or woman is seen stooped and tending to one of these terraces, always alone and often separated by a quarter mile or more from the next farmer. Small dusty trails lead up and over these mountains connecting terraces to other terraces, and remote villages to other more distant villages on mountains even farther away.

At the long valley's widest point, the black winged pair circle once over the small city of Pingliang, which they see is surrounded by the same parched and precipitous landscape. Something more about this place below feels familiar but at this moment they are pulled by a greater force and so continue on. Ahead to the west the horizon turns greener, a sign that they are crossing the narrow southern tip of Ningxia Province, the autonomous region for Hui muslim Chinese, where moisture from clouds collects in front of Liupan, the tallest mountain range in this area and a geological fortress historically remembered as one of the most difficult passages in the Red Army's Long March northwest across China in 1935.

As the two birds draw closer to Liupan Shan they can see the rare dark emerald forests of spruce trees on its steep eastern slopes. Flying fast against this mountainside the air grows thinner from elevation and damp from cloud mist. Near the top a cold updraft lifts them way above the summit, the ground suddenly disappearing below. The little crow struggles against the battering winds and dizzying height, and gives his father a frightened glance. The father crow reaches out with his claws and gently but tightly gathers his little one beneath him. Then they veer toward the orange sunset now on the western horizon and set their path toward Lanzhou.

The little crow feels safe now, having learned that he doesn't really have to fly all on his own.

Homeward Found

2008-06-28T13:00:00.033-05:00

We are home. We arrived at our last stop, here in New Orleans, after 32 hours of planes and airports, a trip that could have been a lot longer if not for some lucky breaks amidst a few intense moments. We are still in an upside down discombobulated time dimension, but home.

Our smiling hero of a friend Mike Guill was there at the air terminal exit to meet us, even though it was very late ... err uh, early ... at about 2 am, and our flight had been delayed for several hours. Rather than having to struggle with finding a cab, we grabbed our bags, which arrived with us a bit battered but safely, and piled into the Guills’ familiar van. Henry had cried through most of the last flight from Houston, having reached his limit. He cried in the van at first but, even though he hears only muffled mid-range frequencies, he stopped when we turned on a local radio station, soft trumpet and piano.

As we neared our neighborhood uptown we saw little signs posted on the neutral ground along Carrolton Avenue that welcomed back the streetcars, meaning that while we were gone repairs to this last section of the Carrolton streetcar line had finally been completed. Progress. Then we turned onto good old Green Street, our street.

There were audible sighs as we pulled up in front of our house, which friends had come by regularly to look in on. One had mowed our lawn, which isn't easy since for New Orleans it's an unusually large field of tropical growth. We've a lot for which to be thankful. One of them is having so many wonderful friends. [Thank you all.]

It was a more or less quiet neighborhood night filled with the soft voices of a zillion insects. The air was familiarly hot and damp, and smelled of night-blooming jasmine. A horn sounded from a tug boat pushing a barge through the river bend. On our big front porch the light was on to greet us.

Inside we introduced Henry to the room we had prepared for him, with its new crib and the beginning of a toy collection. He smiled at the little stuffed rocking panda we’d placed in a corner, an object that each of our girls had loved at his age. He seemed slightly overwhelmed at the size of our house with its 12-foot ceilings and at its bright colors and strange objects, and at his sisters running through the house happily yelling. He doesn’t quite know yet that this is not another hotel, that he is safe in his own home and from within it all the world is laid out before him. That will take some time.

Meanwhile, we have to admit that so far the transition from two children to three has been a little bit easier than anticipated. Some of this is because we’re fortunate that Henry is such as sweet tempered little guy. Some of it is because he is most certainly a baby and not a toddler. But a lot of it has been because his oldest sister Dorothy surprised us with a huge store of hidden maturity for someone just six and a half years old. She obviously loves her little brother dearly. Plus she travels well and always has. Clara’s position in the family has changed the most, but she is okay and we’ll just have to be careful with her.

Tuesday we will take Henry to meet his primary doctor, the head of his cleft team. But right now we are just plain flat out exhausted. We’ve found it takes about one day for every time zone crossed (12) just to get ours and our children’s internal clocks back on track after something like this. At least our stomach issues have pretty much dissipated. Henry has developed a cough, although so far nothing to worry too much about. However, our sink drain is clogged and our dishwasher is busted. Time for a groggy drive to the hardware store.

Someday we will take a long vacation trip to China. Our China trips to date, this last one probably not the least, have been something altogether different, filled with so much critical uncertainty and so many details and duties that come with one chance to get right. We hardly remember now the preparation that went into this one, but all that surely couldn't have been very easy either.

Still, there is a very warm, happy calm to this kind of tired. That’s because we know our real journey with Henry can now at long last finally … begin.

Citizen Henry

2008-06-24T23:37:00.023-05:00

Adopting our son Henry in Lanzhou, Gansu, gave him a family plus a birth certificate, a final certificate of adoption, and a Chinese passport. While he is legally as much a part of our family as any of the five of us, he cannot leave China for the United States without a travel visa petitioned through the office of the USCIS within the U.S. Consulate here in Guangzhou. This is a process that even three times through its hoops and hurdles has a few elements that to us are still mysterious.

Apparently the visa to enter the U.S. is needed for Henry but not for us because while he will be a U.S. citizen by virtue of his adoption this will not legally take effect until he touches U.S. soil. The process here includes a somewhat surreal but upbeat mandatory swearing-in ceremony, in which adopted children waiting in Guangzhou are brought to the consulate in pre-scheduled large groups for their parents to take an oath pledging that all of the documents submitted with the visa petition contain truthful information, as if acquiring any one of these documents didn't already have its own exhaustively authenticated paper trail. The parents file through lines to submit copies of their own and their child's passports through a glassed window, then comes the peculiar group oath, and then the parents are handed a brown envelope with their newly U.S. approved Chinese adoption documents that must not be unsealed until it is handed to U.S. Customs officers upon entering the U.S. Unsealing the envelope beforehand will void the child's visa. There is no photo taking allowed during the oath or the visa process.

But far be it for us New Orleanians to stand in the way of homeland security. We smile and make the best of it.

The U.S. visa process requires a medical exam at an authorized clinic, a service long performed by the local Chinese office of Health and Quarantine Services about four or five blocks from the White Swan Hotel here on Shamian Island. There sick local residents waiting for office visits stare quizzically at lines of foreign families scheduled to periodically file en masse through a special adoption examination area.

The doctors and nurses at the clinic are rather stoic but the exam is a good chance to get a general reading of your child’s current health. Henry came through his exam with flying colors on Tuesday. He is very small but healthy, all things considered. Doctors in Pingliang had repaired a bilateral inguinal hernia when he was about 5 months old and his caregivers at the Pingliang SWI had suggested that this may not have completely healed. Doctors here at the clinic said they saw no signs of any problems with his hernia. His cleft issues are what they are, waiting for our medical team to begin to address them at home.

Our little peanut weighs just 21 pounds including his clothes and shoes, but at the rate that he is eating (during nearly all of his waking moments) he should reach proportional weight for his size relatively soon after we’re home. Then we’ll start to substitute toys and other attractive alternatives to food outside of meal times.

We will leave here to begin our return almost immediately once we have Henry’s travel visa in hand, and plan to be back in New Orleans this weekend. This is probably our last blog post until we get home, as we finish up our last minute tasks and pack. [The dates on our posts seem to be about a day behind; it's Wednesday night here.] We’ll fly first to Beijing again. Then we’ll take an exact reverse route over the North Pole to Newark where we’ll make a connection for Houston then home. We’ve bought five seats for the longest stretch between Beijing and Newark, which should help. But we know from experience that the long series of flights home is usually the most difficult part of the trip.

Most children are loathe to sit for 15 minutes at a time, let alone 4 hours then 14 hours then 6 hours then 2 more hours punctuated by grueling airport layovers including one very difficult one upon re-entering the U.S. that requires rechecking all our bags through Customs quickly enough to make it to our next flight.

We know that eventually the trip will end and fade to memory then each of us will often find ourselves remembering China and all its lessons. But we will outwardly return to our regular lives as co-workers, neighbors, schoolmates, friends.

Still, we will never forget the wide-eyed adventure our girls had during the first part of this trip in and around Beijing, or anything from our time in Gansu Province, or from this (maybe our last) stay here at the White Swan. We’ll think often of many of the other adoptive families we met this time struggling through the same process, tears and joyful hope. We will never forget our Chinese friends here who we relied upon along the way--especially Chen Tianji (Steed) in Lanzhou and his young assistants Meaghan and Ester (from a Tibetan minority community in southeastern Gansu).

Lastly, we will always remember that sad highway crossroad in Jingchuan and all the other children we so regrettably had to leave behind at the Pingliang SWI. As with all our previous adoption trips (and another separate lonely trip back to southern Hunan): although we appear pretty much unchanged we will return home really not quite the same people as when we left.

A Poetry in Motion

2008-06-22T02:03:00.017-05:00

China
China is a great place. I like to feel its wind in my face.
There are lots of people nearby. I like it so much I want to cry.
It is very nice. It is like paradise.
China is the best.
- Dorothy-Rui Corrigan

Kites
China is fun.
I like it when you get to fly kites.
Henry is my brother and I love him.

Kites are like airplanes.
- Clara-Li Corrigan

Ah
Ah uh
Ah Ah
- Henry Xiaowei Corrigan

Here
Here, is the universe of the exchange out of genuine friendship of famous glutton and sunshine cook.
Here, play various beautiful edible movement every days.
Here, have collected numerous flavor snake and delicacies well known banquet.
Select here … in the beautiful edible artistic hall with fragrance everywhere and let you appetite time increase absolutely.
Here, what you taste arrives in not only the delicacies of delicious food, you can enjoy Chinese porcelain cultural place … fully refined congeal to practice an artistic marrow.
- From a Menu Description at the Sunshine Plaza in Lanzhou

Love
Love is incompatible with fear.
- Ancient Chinese Proverb

Guangzhou and Shamian Island

2008-06-21T08:57:00.032-05:00

We’ve made it to the large city of Guangzhou, historically known as Canton, in Guangdong Province on the southern coastal tip of China and a long way from Gansu Province. More specifically we are for the third time staying in the center of the city on Shamian Island, which has been sort of an Ellis Island on foreign soil for more than 50,000 abandoned Chinese children who since the early 1990s have been adopted into perhaps two-thirds that many families from the United States, since it’s been common for families, affected by their experiences, to return for more than one child.

Shamian Island is a tiny oasis of calm amidst a busy population of roughly 12.5 million people. Its older buildings are of a western colonial architecture because the island was originally divided in two concessions given to France and the United Kingdom during the Qing Dynasty in the 19th century.

Towering 28 floors over the island on a sliver of land bordering White Swan Lagoon, a wide spot in the Pearl River, is the White Swan Hotel. Surrounding the hotel and around the island generally are dozens of shops that have built businesses targeting adoptive families. This is an easy place to find diapers or baby supplies late at night or a huge variety of Chinese memorabilia, cheap extra suitcases, and squeaky baby shoes during the day.

It was a comfortable place to land in November of 2002 from a cold and foggy Nanchang, Jiangxi, where visitors like us were still relatively unusual and China was still relatively new to us—or in August 2004 from the steamy furnace of Changsha, Hunan. Then we were with travel groups of eight families, converging each time at the marvelous White Swan to join well over a hundred other adoptive families with little baby girls adopted primarily in south central provinces. It was wonderful, but a little odd. Foreign adoptions in China peaked in early 2005.

Today there are far fewer adoptive families or western visitors on the island and at the White Swan. It seems mostly Chinese again. It seems a better balance.

The U.S. Consulate is the focus of each family’s visit to Guangzhou, along with the U.S. citizenship application process that must take place there, preceded by a required medical exam. The consulate was moved to newer, larger quarters in another part of the city a year or so ago, although a fair percentage of adoptive families still choose to stay on the island.

Another change is that fewer children are winding up in state controlled orphanages in the provinces that have had the largest numbers of abandoned children and slightly more Chinese families are formally adopting healthy children. Our two girls are among well over a million girls abandoned in China since it began enforcing its one child rule in earnest in the late 1980s; collateral consequences of a generally rationalized national effort to address the country’s inability to effectively provide for all of its billion and a half people. Fewer children in orphanages may or may not reflect abandonment overall since studies of birth ratios and other population factors still don’t appear to indicate much closing of China's gender gap, an indicator of large numbers of “missing” girls in the population.

In rural China there is an old tradition of families adopting abandoned children informally, often between villages. China’s government acknowledges that only some of the total number of children abandoned wind up in orphanages. A recent development within one-child China is that a domestic market for children among childless families has been discovered by "intermediaries" who will relieve rural birth parents of the need to physically abandon a child and who can sell the child to another family for a price much cheaper than formal domestic adoption and without its wall of restrictions. This has made state controlled orphanages largely irrelevant for most Chinese seeking children. Children adopted informally have no quaranteed rights as citizenry, however.

Some of the child-related shops we remember on Shamian Island are gone now, replaced by more locally oriented businesses, and the ones that remain seem a little like ghosts from the past. Tonight we heard that the city would like to take over many of these properties, envisioning much of the island as an historic park, focusing on its history prior to foreign adoption. The White Swan has closed its baby play room. Still, foreign adoptions will continue in China for the foreseeable future, although probably at a much slower rate. Given some of the looks that Henry has generated during our travels there likely will be waiting children with special needs in this country for a long time.

But even this element of China is changing, perhaps not in linear fashion, but changing slowly nevertheless. It’s worth writing again that we know we are blessed to be adoptive parents, but wish with all our hearts for a day when there would no longer be foreign adoptions in China because children here would no longer be abandoned. It’s our greatest hope, underlying all our hopes and wishes for Dorothy, Clara, and Henry.

Henry did well on the plane from Lanzhou, about a three-hour ride. Actually, he’s doing relatively well on all counts, eats constantly, and often gets upset when food isn’t readily at hand. He has visibly gained weight over the past week and easily plays, smiles, and laughs. He likes to be tickled. He stands with help and can walk a bit, as probably the smallest walking person we've ever seen.

His sisters, however, are finally beginning to show a few signs of travel fatigue, Clara especially. She dug in her heals and screamed at the top of her lungs, as only Clara can do, as we went through security in the Lanzhou airport when security officers made her give up a soft toy to run it through the x-ray machine. That’ll teach them. We’ve had a few similar episodes, but all in all the kids are all hanging in there for this final stretch. Everyone except Henry has been hit by a nasty stomach bug, Dorothy probably the worst. Both girls were throwing up at the same time the night before were left Lanzhou.

Happily, we’re recovering here in comfort.

A Very Humble Beginning

2008-06-18T23:27:00.082-05:00

This is Henry’s dad writing. Yesterday was the third time I've stood on the spot where one of my children is said to have been abandoned. When I did this for my girls at each of the sites where they were left and found in separate parts of China far to the southeast, I felt a complicated connection to their birth parents, the people who left them, in both cases with a note on red cloth indicating a birth date on the lunar calendar and items like packets of formula—signs of hope.

As much as I wanted to, I could not find the same connection yesterday on the east side of the crossroad next to the Tian Yuan Guest House in Jingchuan, where my son had been found. From looking carefully around that place and from talking to people here, I sense that Henry was dropped by the roadside under different circumstances and without the same concerns.

Jingchuan is a mid-size town with modern buildings and businesses because it is the local administrative center for a very large county. It shares a broad floodplain with a natural hot spring and some ancient historic sites that are modestly popular attractions locally. But the town is very much part of a very rural area in which there is nothing more important within a family than the birth of a healthy son for a host of practical and not so practical (traditional cultural) reasons. Still, the practical importance of one's family here can be nearly all encompassing; it is an income unit, social support system, and rural retirement policy.

And people here, whether muslim Hui or Han Chinese, believe strongly in a kind of kharma, that what goes around comes around. “Most rural people are very superstitious so that if their son is born with a (cleft) face like a rabbit, or something else is really wrong, they are scared and think that it is punishment for something bad they have done,” went one of several similar explanations. “So they want to get rid of this punishment. For them the child is very bad luck.”

Birth anamolies are common in this region and local clinics will try to arrange help for children brought in with severe cleft and other conditions, often through charitable organizations. But there are old ideas here, illustrated by the well kept presence of the ancient hillside Wang Mu Gong Temple that watches over this town. There are more modest Buddhist temples generally overlooking almost every smaller village in the area also. These are maintained not so much for regular use, but more as a wishful means of warding off misfortune.

The Tian Yuan Guest House is a fairly new multi-story structure that is at the intersection of National Highway 312 and Zhoung Shan Road, which is the central thoroughfare for Jingchuan and lined with shops and other businesses. Highway 312 is actually an important artery sometimes called the "Mother Road" that begins on China’s east coast and ends 2,998 miles later at its western border with Kazakhstan.

Small public buses that travel up and down Highway 312 can easily bring people to this spot from any number of small villages within walking distance to the highway, as can all manner of carts, bicycles, or small three-wheel vehicles with motorcycle engines that are commonly used for tractors. Searching for answers sometimes yields only more questions and this was the case in looking around at this abandonment site--a fundamentally sad undertaking. Chen and I stayed at the site for more than a half hour, then talked with nearby shopkeepers in their stores to see if they knew anything that could help us. They didn't. I kept thinking that there was some other clue that would come to me if I just stayed and thought really hard a little bit longer. Finally we left.

At least the crossroad is a very prominent location where an abandoned child could be easily found, but the most distinguishing feature of its east side, where that taxi driver discovered this particular naked newborn child wrapped in an old quilt that had looked like a bundle of rags ... is a small public dumpster that is said to have been maintained there for a very long time.

That’s okay.

To us our little Henry, our son, could not be more precious or more perfect.

The Pingliang Social Welfare Institute is at the end of a winding, narrow series of streets on a low hill in the east end of Pingliang, about 40 miles back in the direction of Lanzhou, which is 5 ½ more dusty daylight hours away and a longer drive back at night. It is in a neighborhood that is largely muslim Hui and there is a Hui marketplace and a mosque near where these back streets connect to Highway 312, which serves as Pingliang’s main road.

The orphanage in many ways is typical of the other Chinese orphanages that by some strange twist of fate and responsibility I’ve visited over the years. It’s a facility originally designed to assist a broad range of seniors, homeless people (often with diminished mental capacity), and orphans—those without families to care for them. But it became much more of an orphanage a decade or so ago after the government began to more strictly enforce its population restrictions. Living conditions at the orphanage are understandably similar to those one might see in the tiny, exceedingly modest brick homes in the surrounding area.

The major difference here is that, rather than being populated primarily as a result of China's "one child" rule (which often results in a predominance of infant and toddler girls often free of serious disabilities), the population at this orphanage is today about half female and half male and most if not nearly all have special needs. I suspect that nowadays most children wind up here because of their special needs, not directly because of birth quotas.

A little over a third of the 80 or so children at the Pingliang SWI are under three years of age. The rest are as old as 16. There is a school in the city for the blind and deaf that some of the older children go to. A few who are able go to a regular elementary school nearby. Some just stay within the orphanage.

It is challenging and often heart breaking work to care for these children and the staff at the Pingliang SWI appears to be kind and dedicated. They have to be. Some of the babies and young children appeared to be good candidates for China’s waiting child program for special needs children, but others have issues that are probably too severe.

More than a month after the earthquake there are few signs of serious damage in the city overall, even though about 10 people were killed by the quake in Pingliang. Along Highway 312 north of Pingliang and the southern tip of Ningxia Province toward Lanzhou, Chen and I had seen homes with blue tarps fastened over damaged rooftops and Army tents used in some areas as temporary shelter. South of Pingliang toward Jingchuan and closer to the southern part of Gansu Province where the earthquake was most devastating we saw more obvious signs of continuing relief efforts, mostly trucks laden with emergency supplies heading further south, and uprooted families on the move and headed in the other direction, their small vehicles piled with their salvaged belongings.

In Pingliang the worst damages were to older, rickety brick structures and most of the newer, more modern buildings came through okay. Heavily damaged or collapsed buildings have already been demolished. At the orphanage they are concerned about cracks in the walls of both the main building and the lower, older one-story brick building behind it that houses many of the youngest children. I sensed that the buildings may still be structurally sound but officials there are somewhat spooked and cautious in this because a large one-story structure directly in front of the main building completely collapsed.

Construction of a new orphanage and social welfare complex on a different site in Pingliang is apparently set to begin relatively soon. In the meantime the staff is waiting for engineers from the provincial Earthquake Bureau to come by and carefully check out the structural integrity of their buildings. The children are cared for in their regular rooms during the day but still sleep in the tents at night, as a safety precaution.

Because the random nature of the damages in Pingliang left many of its stores unharmed and business in the city only briefly interrupted Chen and I did not have to carry supplies from Lanzhou and instead we arranged in advance to present during our visit a sizeable monetary donation to Yang Xialin, the orphanage director, with instructions to use it where it will be immediately needed most. This should not be a problem since the orphanage needs a lot. After this donation is quickly used up on general supplies, the orphanage is next most in need of a heart rhythm monitor, and clothes and shoes for the older children.

Note to Pingliang families: these clothes and shoes can be provided through Love Without Boundaries like we did with clothes and blankets for the younger children and LWB may be able to check in advance on sizes needed.

Also, we learned some hard lessons in Hunan Province about being careful in extending our trust to orphanage officials but for making responsible use of our donations I trust Mrs. Yang. She is a remarkable woman.

Five Springs Park

2008-06-17T07:37:00.014-05:00

Henry has become a momma’s boy, which is okay by Trish. He is happy and comfortable in her arms or attached to her in the front-carrying baby backpack that we brought, but he cries when he is separated from her. This is good.

This morning at breakfast once again he ate a tremendous amount of food for someone his size. The only thing he doesn’t seem to want to eat is hard fruit such as melon since it doesn’t seem to dissolve well in his mouth. We haven’t quite figured out how to remove without bothering him too much the excess food that visibly gets stuck up in his nasal cavity. His cleft is so open that it would be easy just to stick a finger in there to dislodge this stuff, and that is likely what we will do once we’re sure he trusts us enough.

After breakfast we headed with our guides to Five Springs Park. The park, which is the largest in Lanzhou, lies on the side of Gaolan Mountain, which looks out over the southern section of the city's downtown area. The story goes that in the Western Han Dynasty (206 B.C.- 24 A.D.) a famous general named Huo Qubing was dispatched by the Emperor to seek out Hun forces in the area. Having traveled all the way from Xi’an, General Huo and his soldiers were exhausted when they arrived at the foot of this mountain. They couldn't find any water nearby, so the general jabbed his horsewhip five times into the ground causing five springs to suddenly spurt water into the air. The springs are said to have flowed ever since, more than two thousand years. Buddhists built on the site several large temples, ancient structures that are still occupied by monks. In 1955, the mountain was officially named a public park. Local authorities added a zoo and small amusement rides. It is a beautiful spot and very popular, especially during weekdays as a place for older people to gather in groups to dance, practice Tai’Chi, or to sing and play traditional instruments.

Our kids loved the cute children’s rides plus they got to ride a real camel. They got to see two giant pandas among the animals in the zoo. We arranged to meet at the park one of the other families we met at the adoption ceremony yesterday. They are from upstate New York, have adopted a little boy with a repaired cleft lip who is about 3 ½ years old, and are traveling with their 5 ½ year old biological son--and also a family friend who is helping out. This was a wonderful way to spend the day while allowing Dorothy and Clara to burn off some energy.

We’ve just returned to our hotel from a big late afternoon lunch at a restaurant in an alley about four blocks away that is said to be among the city’s best for, yes, beef noodles again. Clara is sneaking around the hallways outside our room. Dorothy is teaching Henry to clap his hands and they are both laughing. “I love you Henry,” she says often and the two of them have formed sort of a natural bond. Henry is turning out to be absolutely the sweetest little child.

Things are going well for us. We are very fortunate, since it doesn’t always turn out this way. Most foreign adoptions in Gansu Province are special needs adoptions. Six months into the year ours was only the 47th foreign adoption in 2008 for the province overall.

Special needs adoptions inherently involve very serious risks that things will not go according to plan. There is a fourth family here who found that the child they planned to adopt had issues when they saw her that were more than they felt they would be able to live with. The child appears to have severe autism that apparently wasn't clearly indicated among the other special needs described in her medical reports. The family decided not to go ahead with the adoption, which is a crushing decision. A long time ago we had frankly discussed what we might do if things were to veer in this direction for us, understanding that this was entirely possible. We agreed that in deciding to proceed in the very early stages of this we would accept the consequences. But everyone has different limits and who is to say what our own real limits are.

Tomorrow morning very early Andy and Chen (Steed) will strike off for Pingliang and the area where Henry was found.

It's Official: We're a Family of Five

2008-06-16T02:11:00.018-05:00

It’s official. We adopted Henry this morning at the nearby office of the Social Welfare Bureau of the Provincial Ministry of Civil Affairs. The ceremony and paper work went relatively fast and smoothly, with two other families also adopting children from Gansu orphanages joining us, although we traveled here alone. One of the other children is also from the Pingliang orphanage, a cute little guy of about the same age as Henry but much further along developmentally.

Henry appears to be about half his actual age. Twelve month sizes fit him loosely. Changing him and putting him into some PJs last night, we looked him over very carefully. At nearly two years old his body and limbs still have an infant shape with absolutely zero body fat and some slight distention to his stomach. Sure enough, his cleft is extremely wide. We’ve learned that the surgical attempt to build him an upper lip was actually done in the large city of Xi’an in Shaanxi Province and supervised there by a visiting team of American surgeons. It still failed. His cleft does seem to affect both his breathing and his eating, but he seems to compensate well.

He does not yet feed himself, but has a very good appetite. He can stand with help but does not appear to be walking yet on his own. Indeed he has difficulty sitting up by himself in his crib, and appears to have no experience crawling. We’ve been down a similar road before since this (minus the cleft issues) is very much how we found his oldest sister Dorothy, who at 14 months appeared to be just a tiny infant. It worked well for Dorothy; her developmental delays allowed us to help her through milestones we would have missed otherwise. Eventually she built up momentum in catching up cognitively that never quite leveled off. She was as wise as a little old man when she was about three.

It took only about three hours yesterday for Henry to begin to suspect that he could get used to these new people catering to his every whim. The ice cream was a big help. By about 6 pm he had settled into his mom’s arms with a warm bottle of milk and things began to feel pretty good. After the bottle it was time to try out some of those Lanzhou Beef Noodles (chopped up) and then, why not, some chopped pizza.

After noisily gobbling up as much food as he could fit into his little stomach it was time to sit on the bed next to his sleeping sisters and try out some brightly colored stacking cups, which he found to be fascinating. He gazes at people and objects clearly and thoughtfully. He also has a good attention span and is persistent with tasks.

Orphanage life is so bland and everything now is so new.

Henry’s first big smile came last night just before bed after he spontaneously took turns shrugging shoulders with his dad. His mom read him two books, Good Night Moon and Good Night Gorilla, which he followed very closely all the way through before he fell asleep after lots of soft kisses good night.

Today there have been no tears. This means that so far he’s having a very good transition. For Henry it’s just been a day full of an overwhelming amount of new information, which he seems to be handling cautiously but very well.

To celebrate, tonight we'll all be going out for pizza.

Gotcha

2008-06-15T05:43:00.032-05:00

Shhhhh, it’s okay …
Shhhhh, it’s okay …
Shhhhh, it’s okay …

Henry has been through a lot to arrive at this moment and whatever his situation before this—even living in tents after the earthquake damaged his orphanage—he was at least in his familiar surroundings. But then he was placed in a car and driven six hours to Lanzhou. He was carried into the large and completely strange building that is our hotel, up an elevator, and handed to us.

We look and sound different than anyone he has experienced thus far. And then he was left with us.

Shhhhh, it’s okay … Shhhhh, it’s okay …

Our guides, the Pingliang orphanage director, and one of Henry's nurses from the orphanage brought him to our room at around 3 pm. The hand off is almost never very easy. [Admittedly, our Clara-Li may be the rare exception. When she was handed to her dad amidst the shuffle of families in a crowded reception room at the Hunan Provincial Social Welfare Department in Changsha, in August 2004, she melted into his arms then quickly looked him straight in the eye as if to say, simply, where have you been and what took you so long. Then she nestled back into his shoulder while around us a half dozen other babies were freaking out.]

Things improved a lot for Henry after we walked outside a few blocks to visit a photographer for some photos, and mom thought to introduce the concept of ice cream while passing an ice cream stand. The sobs stopped. Since we’ve been through this twice before, we know that eventually he will be more than okay. But it will just take a while. The girls have been a great help with this, simply by just being here. Soon he will be taking his cues from them.

Henry is 21 months old but he is physically just a small baby, much more so than Clara was at 18 months, although she had seemed more emaciated. He clearly has the major growth delays we successfully navigated with his oldest sister Dorothy. He is very thin and not so much frail as just little. His face is burned red and puffy from the sun, but beneath his clothes his skin is infant soft. He has wonderful little hands and feet; all his tiny fingers and toes.

He is beautiful.

We arrived in Lanzhou yesterday afternoon. The airport is about an hour from the city because this part of Gansu Province is filled with steep, sandy hills and mountains—less mountain ranges than barren mazes of desert valleys. Land with relative flatness is rare. The airport was small, not very busy, and quite nice actually. We were met by our Chinese guides who go by the English names of Meaghan and Steed (whose real name is Chen Tianji). Chen is in charge and both are obviously well educated, friendly, and sincere. Meaghan is a native of Lanzhou. Chen was born in Lanzhou, moved outside the city to a small town with his family as a child, but returned to Lanzhou for his university studies and now resides here.

We drove from the airport to our Lanzhou hotel in Chen’s Toyota 4-Runner, which has a lot of miles on it. One can easily see why. Western China is vast. Along the highway were only occasional tiny villages with little dry brick square houses alongside steep hills with holes dug into their sandy sides. For the past 500 years people here have been burrowing into the center of these hills, digging out the richer loess sand and spreading this on the floor of the valleys between them to grow wheat and a variety of hardy fruit trees and bushes. Until recently it was common to use the resulting caves for homes. The area is very poor. But there is an arid beauty to it.

Lanzhou sits in a wide flat stretch of the Yellow River valley bordered by these sandy mountains. It is a comparatively poor and dusty Chinese city with about 2.5 million residents. But it has a nice feel to it. Its pace is decidedly not as high-pitched as Beijing, Guangzhou or any of the other provincial capitals in which we’ve stayed such as Changsha or Nanchang. This is clearly a much different region of China with its own character. But when we would ask people in Beijing about what Lanzhou is generally known for we would universally get a long pause, a shrug, and then the answer: “beef noodles.” We had the noodles last night; they are fabulous. But we suspect there is much more to this place. This morning at the breakfast buffet a group of unsmiling Buddhist monks came in and sat at the table behind us. Hui muslim men in the area wear white tagiyah prayer caps and while this is a modern Chinese city there is a bit more of an exotic look to the place overall.

Exotic as it may be, to say that we stick out as something rather unusual here is somewhat of an understatement. We are westerners with two daughters who are Chinese and we are all fussing over a sunburned little boy who has a whopper of a cleft. Aside from all that, we’re a pretty large family in one-child China. But we simply roll with the stares and pointing. People are just understandably curious, their reactions to us tend to be characterized mostly by friendly surprise, and we are what we are.

Happy Family.

Girls and Boys

2008-06-13T16:35:00.014-05:00

“You’re adopting a little boy. That’s nice. I’ve heard that mostly girls are adopted in China.” We didn’t start out choosing to adopt a boy. Mainly our choice was to adopt a waiting child with special medical needs, after which we noticed that on the many lists of waiting children it seemed that most of the children with very serious medical needs were boys. There are comparatively small numbers of boys in Chinese orphanages and they are usually there because of medical problems or disfiguring birth anomalies that would either be socially unacceptable or medically unaffordable for their birth parents. With one and a half billion people, China has no social safety net in the form of public guaranteed healthcare or even retirement assistance and indeed only very recently has it been able to help subsidize education tuition for children through the 9th grade. The limited social welfare options available in cities and towns are usually absent in rural villages.

Then we heard that prospective parents for international adoptions generally prefer to adopt girls. Perhaps many suspect that boys might come with more behavioral or other issues.

Just one of the very difficult periods during this long process was at the very beginning; during the time we spent looking at the descriptions (generally with photos) of the children on these waiting child lists. Our goal was to step in where help was most needed, but given our ages we quickly discovered that with many of these children there were obvious risks for all concerned in trying to intervene in a situation in which a child could need lifelong special care. These children, one after another, were heartbreaking. What will happen to a small child in a poor orphanage who is, for example, blind with cerebral palsy? A small child.

One day we saw a photo of Henry and something just clicked. We knew the special challenges that children with serious clefts had in orphanages and with a little homework we were able to establish that this condition was not necessarily associated with lifelong issues. Henry’s condition could be corrected, although in his case it would require surgeries and therapies likely into his adolescence. It was doable for us, but there was something else. We sensed in Henry’s eyes peering out at us from his photo something familiar. He was ours.

Tomorrow, if all goes according to plan, we will make it so.

Time Zones

2008-06-12T16:49:00.023-05:00

One of Dorothy’s and Clara’s all time favorite DVD movies is Big Bird in China, which we have probably watched about, hmm, let’s see, … 10,000 times. It was originally a Sesame Street special, produced in 1983 when western visits to China were still a modern novelty. In it Big Bird and his/her silent friend the big shaggy dog Barkly travel to a host of Chinese landmarks, mostly around Beijing, looking for the magic Phoenix bird. Not coincidently, these have been stops on our little tour as well.

It has bugged Clara that Dorothy got to visit the Great Wall four years ago while she was still waiting for us in Hengdong, Hunan Province. So we had been anticipating yesterday’s visit to a section of the wall north of Beijing for a long time. We’ve had great weather that has been sunny and a dry sort of hot. But our internal clocks haven’t quiet fully adjusted. Both girls awoke bright-eyed and ready to go at about 2 am on Thursday, which is close but not there yet.

We arrived near the Great Wall at about 10:30 a.m., filling our little van with high-pitched shouts of, “I can see it!!! I can see it!!!.”

It was a very good day. The adrenaline collected from climbing and hiking around on the wall (keeping an eye out for sudden appearances of the magical Monkey King), making our own little movie, then visiting the familiar stone animals lining the entrance to the nearby tombs of the Ming emperors carried at least the kids through the entire day, with a close to normal sleep Thursday night.

This is a secondary purpose of this leg of our trip. Since we couldn’t meet Henry in Lanzhou before the 15th, scrambling together our arrangements to arrive in China a week in advance was intended to give us all time to adjust to the difficult time change. This is turning out to have been a very good move, since we’ll have a lot of much bigger adjustments to make next week. While Lanzhou is far to the west of Beijing, all of China retains the same time zone.

It's Friday morning here at present. Tomorrow we head to Gansu Province.

The World is Changing

2008-06-11T18:38:00.022-05:00

It may have been worth a trip here to see Dorothy’s and Clara’s beaming faces after we watched the acrobatics theatre troupe perform at the Beijing Chaoyang Theatre, which made Cirque du Soliel seem like a Richard Simmons exercise video.

We wound up with the acrobats Wednesday after a basic tour of Tiananmen Square, the Forbidden City, and a pedaled tour of the older neighborhood nearby. Touristy stuff. Riding in these pedaled carts, especially touring alongside the tree shaded waterway bordering Beihai Park, was just right for the girls. But this older familiar-styled Chinese neighborhood is now an historic district and this most definitely is not the same China of three years ago or certainly any of our other trips to China before that.

Coming from our home in a city that is struggling to rebuild at a very slow pace in the midst of the wealthiest country on earth, the new construction that is taking place here is startling, as is the obviously gigantic amount of private capital that must be driving this. Only a part of this investment has to do with hosting the upcoming Olympics, set to begin in August. The world is changing here.

A new Chinese feature film called CJ7, directed by the cross-cultural Stephen Chow, does a wonderful job of capturing in a freeze frame new urban Beijing in 2008, much in the way that Stephen Spielberg seemed with ET to capture suburban culture of southern California USA in 1982. Chow’s film was actually shot in Ningbo in Zhejiang Province, but its look is similar to Beijing, as are its relationships between those who are part of China’s new economy and those who are building the new China by hand, on wages only slightly better than those in the countryside where most of these urban laborers came from. In downtown Beijing it’s hard to remember that nearly 80% of China’s population is still rural, and still very poor. In many ways CJ7 is a better written film than ET; edgier and more socially irreverent. Like China itself it is heavy on symbolism, but it's also both very funny and very moving. In it a poor laborer works on a dangerous high-rise construction site to send his young son to a private school and hopefully on to live “a useful life,” which is a complicated Chinese concept that may not translate well but involves patience, work, and sacrifice. The boy is picked on at school but one day discovers a super cute alien who looks like a small toy animal within a strange object his father brings home from a refuse pile. The boy names it CJ7 in competition with a very expensive popular toy he sees in a store and that his school mates can easily afford. CJ7 turns out to have magical powers that through triumph then tragedy then triumph again result in a simple, powerful lesson on the value of useful living. If nothing else, today’s new urban China can also be stunning in its hopeful utility. A physical reflection of this is an architectural marvel taking shape downtown that will be the new headquarters of China Central Television. The huge building takes the form of a twisted magnet with two tall inwardly leaning towers that connect like upside down Ls at the top. It’s all about balance.

Hey, We're in Beijing

2008-06-10T05:52:00.017-05:00

We are in Beijing, having successfully crossed the globe. The long tedium of an airplane trip from New Orleans to Newark, NJ, and then directly over the North pole to China would probably test the most seasoned coach travelers. Moreover, for a child of 6 1/2, or let alone 5, a trip like this one would seem to be a theoretical impossibility. But for Dorothy and Clara we've seen that China is like an irresistable force. This is hardly a chore for them. Especially for Dorothy, who has had a little more time to quietly consider things, to touch soil here is a very special event. "Pssst," Dorothy nudged with happy anticipation as we boarded the crowded jet in Newark,"these people are all Chinese."

We arrived in the thick hazy sunshine of a Beijing afternoon and the city is a marvel of heavy construction. The mysterious old hutong narrow alleys with their tile-roofed low buildings are fast dissappearing in rubble, replaced by wide urban thoroughfares flanked by massive skyscrapers. Our hotel is downtown in a newer shopping district. We'll be here for the next four nights before heading on to Gansu. We've lots of sightseeing planned and, if things work out, we may see some Chinese friends from a previous visit here.

But we are all mostly thinking about Henry.

From the very beginning Dorothy and Clara let us know that this waiting child was already their baby brother, not just as an adopted sibling. Neither one ever seemed to guess that all babies in other families come from China or to their families under the same circumstances as they did. For them the idea of a brother needing help under similar circumstances seemed intuitively very important and they've pretty much stuck to this line ever sense. Today both said several times they were worried that Henry would cry on the trip home, now that they know the trip is so long.

Grumpiness finally erupted about halfway through an early dinner at a restaurant near the hotel, but we're all exhausted and basically just watching the clock until it's finally late enough for us to all begin a night's sleep in this time zone.

Lastly, we had read on several internet news groups that Google blogspot/blogger and Typepad blog servers were blocked in a censorship move by the Chinese goverment in advance of the Olympics, so we arrived prepared with alternative means of posting. So far we haven't needed them. The foreign Google blogspot server hosting this blog is still accessible at least from this hotel, tonight, in the heart of Beijing. Hopefully, this luck will hold through the trip.

What's in a Name

2008-06-01T09:35:00.019-05:00

Henry has been the name of everyman; of writers, poets, and baseball players. It’s been the name of kings and holy roman emperors, no less than 26 of them through the ages from Portugal, Spain, Germany, France, and England. It’s a name with some force to it and indeed a henry (symbol: H) is the unit of measurement for electromagnetic inductance. But in our house more importantly it’s the name of a little cartoon mouse with a yellow vest who is the needy cousin of Angelina the ballerina mouse, as well as the penguin friend of the colorful, kind octopus Oswald. Looming behind it all, Henry is the name of our former general contractor who somehow seemed to figure in almost every conversation in our home between November 2005 and about a year later, after which he’d disappeared with our repairs still only two-thirds complete. He loved our girls, built wonderful playhouses out of cardboard boxes from replacement cabinets, and certainly meant well. As were we all, he was just overwhelmed by his circumstances (not to mention the hapless, drunken in-laws upon who he needed to rely for a work crew). So arose a chorus when we told Dorothy and Clara about our plan and their little brother. “Let’s name him Henry!” Of course. Henry Xiaowei Corrigan.

Some Supplies Arrive

2008-05-30T06:32:00.030-05:00

Since the earthquake we've been able to send clothes, diapers, and blankets to Henry's orphanage, the Pingliang Social Welfare Institute (SWI), through two separate organizations. In each contact the orphanage director has reported that the children there are okay. She provided the recent photos included with this post to the organization Love Without Boundaries, which just delivered the clothing and other supplies we bought using a little over $1500 USD donated with help from other adoptive families with Pingliang children. (In the adjacent photo, Henry is the child on the far left, scratching at his ear.) A smaller delivery of about 25 blankets and about a dozen more warm outfits was arranged through a service provided by Red Thread China.

The children appear to have spent a lot of time out in the sun, but they look healthy. There are about 80 children at the orphanage. Civil affairs officials apparently supplied the sturdy tents seen in the photo's background, and the orphanage is said to be a high priority for local assistance. Gansu's earthquake-effected region continues to be susceptible to aftershocks. One on May 25 was centered around the Wenxian area and is said to have measured about 6 on the Richter scale. Wenxian is close to the northern border of Sichuan Province, about 200 miles south of Pingliang.

We plan to send Andy and a guide to bring the orphanage whatever additional supplies and assistance that can be carried by SUV from Lanzhou, where things are relatively tranquil. Our agency has agreed to make arrangements for this.

At this point, we've secured our visas, flights, hotel rooms, and other travel arrangements. We'll fly out on June 9th as planned and spend about four nights in Beijing before heading on to Lanzhou, where Henry will indeed join us on Father's Day (the 15th). Dorothy and Clara are very excited about the trip and for them we've scheduled visits to the Forbidden City, Tiananmen Square, and a northern section of the Great Wall to take advantage of our stop in Beijing. There should be a lot of really cool, memorable things for the kids to see in Lanzhou also, including a very old section of the western end of the Great Wall. After about a week in Lanzhou we'll head way south to Guangzhou and the U.S consulate on the 21st. We should be home by the end of June.

Travel Approval

2008-05-22T08:02:00.051-05:00

Today we received our travel approval notice from China, the last step in this phase of a long process. In other words, the way has been cleared to begin our trip, which is about giving hope to a little boy who became our son like our girls became our daughters. They were each born in our hearts long before we traveled to adopt them. We know we are very lucky to be able to do this, which is in essence our point.

For Trish, this is about again being a mom for a very special child, having discovered that to our daughters this is absolutely the most important job in the world. For Andy, this trip began with a pledge he made in China more than a few years ago now in a room full of children who were in a lot of ways much like Henry, a moment that, until now, seemed to be slipping away with time. He whispered assurances then that he would be back to do exactly what we're finally about to do. As our friends and neighbors here in New Orleans all know, we needed some time to put ourselves back in order. The repairs are complete and it is good to be in this way moving on, at least on our little corner of Green Street. Now we’ll scramble to book our travel arrangements as quickly as possible. Then we will soon be off on another adventure into the familiar unknown to softly repeat one more unforgettable promise between sniffles in a strange hotel in a far away land, that everything will be okay from now on. Our third. Probably our last. This one to Henry.

If all goes well we will meet him in Lanzhou, which is Gansu’s provincial capital and for our children a safe distance from the earthquake-effected zone. It appears likely that we will leave New Orleans around June 9 and Henry may join us on Father's Day.

We're not young or untouched by disappointment so we began this process realistically with few expectations. But when we return home with our son we will reasonably ask that more be expected of the regional district office of the USCIS in Metairie, LA. There a self-important officer, whose duties include processing a federal form required for international adoptions called an I-600A orphan petition, delayed putting a stamp on our petition for more than four months and forced us to eventually file a request for “expedited service” through the offices of our congressional representatives. This stamp simply attests that the petition has been submitted with the required documents attached. No family should ever again have to compile unnecessary, unrequired expert medical testimony to secure timely acknowledgment of a form needed for adoption of a child already documented in his or her native country as having very serious special medical needs. A similar delay had the most tragic consequences this spring for another child with the same medical diagnosis, and for the central Louisiana family in whose hearts she is carried now on wings. Our thoughts are with them.

China's Recent Earthquake and Henry's Orphanage

2008-05-20T21:32:00.042-05:00

Pingliang in Gansu Province where our son Henry's orphanage is located was apparently among the areas damaged in a series of huge earthquakes and aftershocks that struck western China beginning on Monday, May 12. The worst damage was in northern Sichuan Province about 200 miles to the south and overall some 80,000 people have been killed or are missing, mostly within the area near the epicenter of the initial quake around Sichuan's Wenchuan County. Many millions of homes have been destroyed or damaged across a very wide area.

News of quake damage in Pingliang has trickled in over news groups and largely from contacts with a few westerners working in the area. The children and staff at the Pingliang Social Welfare Institute (SWI) are said to be uninjured but staying outside in tents because of concerns about the stability of the orphanage building. The orphanage is said to be in need of more tents and instant food rations. Most of the damage at the orphanage may have occurred during an aftershock this week. Within the quake region, unfortunate rumours have been circulating about additional aftershocks expected, although neither earthquakes nor their aftershocks can be scientifically predicted with much accuracy.

Media services have reported only generally on quake damages in Gansu but early on noted significant damages such as collapsed buildings in Pingliang and in Longnan, which is closer to Sichuan’s northern border. About 400 people were killed and many more injured within the province overall, mostly around Longnan. One report said that about ten people were killed when some older buildings collapsed in Pingliang. Several news agencies carried reports of a 40-car freight train, including 12 gasoline tankers, that derailed inside a tunnel in Huixian County between Pingliang and Longnan, and that exploded in a massive fire immediately after the first earthquake struck on the 12th. This rail line has since been reopened.

A local branch of the Red Cross relief organization in Gansu has allocated Y300,000 (about $50,000 USD) to provide food, medicine and quilts to the areas around Pingliang, Longnan, Qingyang, Tianshui and Gannan within the province. In addition, 3,000 quilts and 200 tons of flour have been collected from donations locally for transport to these areas.

We are expecting travel approval at any moment, will head to China as quickly as we can, and once there will try to gather a more detailed description of the orphanage's specific needs.

Meanwhile, it is possible to make a donation now in support of the Pingliang SWI through a reliable organization called Love Without Boundaries (see http://www.lovewithoutboundaries.com/) . To make a contribution online go to the LWB web site and at the top of the homepage click on the circle icon labeled “Donate Now.” Under "category" select “Orphanage Assistance” and enter "For Pingliang SWI" in the “Notes” section. To donate by check make your check payable to Love Without Boundaries and write “Pingliang Orphanage Assistance” on the memo line. Mail your check to: Love Without Boundaries, 306 S. Bryant St., Ste. C, PMB 145, OK, 73034.

Kids and Clefts

2008-05-16T10:15:00.054-05:00

"Oh, they can fix that pretty easily nowadays. Can't they?" Oral-facial clefts are birth anomalies that in the United States occur in about 1 in 1,000 births. They appear far more often in children in developing countries and especially in Asia and Latin America. Clefts occur when the tissues of the lip, maxilla, or palate of a fetus don't grow together early in pregnancy. There are varieties of clefts: cleft lip without a cleft palate; cleft palate without a cleft lip; cleft lip and cleft palate together. In addition, clefts can occur on one side of the mouth (unilateral clefting) or on both sides of the mouth (bilateral clefting). Doctors don't know exactly what causes this condition, but both genetic and environmental factors, especially smoking during pregnancy, are strong candidates. Most children born with cleft conditions in the U.S. have early reconstructive surgery within their first 6 to 10 months and related therapies can begin even earlier.

Severe (acute) cleft conditions are those in which the cleft is wider than usual or stretches further back into a child's mouth or skull, and these can include the absence of bone above the mouth or near the center of a child's face. This is the case with our son Henry, whose cleft condition is technically described as an acute bilateral cleft lip with cleft palate III. All clefts are as a different as the children who have them, but few are easy.

We belong to a wonderful email news group called adoptcleft, which has about 1,100 members who have adopted children with cleft conditions. Discussions among this group stay remarkably on topic and as a result we've learned a lot about the complex terrain that lies ahead. We know we may for many years be up to our ears in alligators with lip repair, hard and soft palate construction, bone grafting, potential bone morphogenetic protein (BMP) therapy, obturator fittings, ear canal tubes or replacement, dental prostheses, oral surgery, fistuli (maybe), orthodontia, speech therapy, and occupational therapy not to mention food and a strong odor often emanating from Henry's nose, plus a lot of drooling.

But we also know that cleft children are the least likely to succeed in orphanages. It takes much longer and much more effort for cleft children to drink or eat, and orphanage staff must often feed dozens of small children at each mealtime. This quickly leads to nutritional problems which leads to developmental issues which leads to failure to thrive. Later, even if through international or other assistance cleft children are able to receive lip repair in their orphanages they will still be unable to speak if they also have significant palate issues. In Henry's case, a medical team in China attempted to construct an upper lip by stretching surrounding tissue across his wide bilateral gap; the result has torn open. In March this year he was below the 10th percentile on length/height and not even within the percentile curve for weight on the standard CDC growth charts. There are a lot of things that are important and then there are things that truly matter. We simply placed little Henry in that second category, where he should be.

About Gansu Province and Pingliang

2008-05-15T18:25:00.102-05:00

China is the land of contradiction, a graceful chaos that one out of every five people on the planet calls home yet a mystery for almost everyone else. Because we have scurried through China a few times already, we're careful to avoid generalized descriptions of the place. But undoubtedly the country is massive both in scale and in its human potential for success or sorrow.

Gansu Province is in China's northwest. Inner Mongolia and Ningxia Province are to the north. Xinjiang is to the west. Qinghai, Tibet, and Sichuan are to south. Shaanxi lies to the east. Approximately 26 million people live within Gansu Province's borders. The Yellow River passes through the south central part of the province, in the area near the provincial capital of Lanzhou. Like many Chinese cities, Lanzhou is rapidly growing economically and otherwise. It is also said to be among the most polluted cities in the world. While the skies over Langzhou are less hazy than in larger Chinese cities to the east, its water supply is badly fouled by waste and other contaminates.

The snaking oblong shape of Gansu was settled in ancient times alongside the first leg of the Silk Road, which led out of the old city of Xi’an and served as the primary trade route from China to the west starting around 7500 B.C and ending about 400 years ago. As a result it is still inhabited by a varied mix of cultures, notably those shared with people to the southwest on the plains of Tibet and Qinghai, and Inner Mongolia just to the north. Even among its majority Han Chinese are many who long ago converted to Islam and are called Hui.

As a frontier region Gansu became increasingly isolated from outside contact in the later imperial era. The region was also somewhat on the periphery during the later nationalist and communist periods, even though many people in Gansu supported the early communist revolutionary movement, which based itself in neighboring Shaanxi when Red armies converged there at the end of the famous Long March northwest from Jiangxi Province in 1935. Still, as in Tibet, many minorities in Gansu preferred independence.

Today in Lanzhou there is said to be a new sense of optimism linked to China’s overall economic development and a new industrial emphasis locally on mining, but Gansu is still among the poorest of China’s provinces. Per capita average annual income for its urban population is 6,657.24 yuan ($952 USD). Per capita net income in rural areas is 1,673 yuan ($239 USD).

Earthquakes are unusually common in Gansu; indeed the entire lower third of the province has apparently suffered greatly from a massive quake reported just a few days ago on May 12 and centered across its southern border in Wenchuan, Sichuan Province. Pingliang is located within the reported quake zone and we are checking now through several reliable sources on the status of conditions at the orphanage there.

At any rate, earthquakes along with periodic drought and famine have often helped to hold back the province economically. One earthquake in Gansu in 1920 measuring about 8.6 on the Richter scale killed around 250,000 people and another with a magnitude of 7.6 killed 70,000 in 1932.

Reports in the China Daily say the area around Pingliang and Jingchuan County, normally arid anyway, is in the midst of a drought, the area's worst in more than 60 years. Still, Pingliang lies in a broad valley next to a forested mountain range called Kongtong Shan. Tree stands are somewhat rare in this region and these dry mountain forests are home to an ancient Taoist temple built on the mythical site of meetings between Huangdi the Yellow Emperor (2697 BC to 2598 BC) and a legendary immortal hermit and master.

Jingchuan County, where Henry was found, is southeast of the city of Pingliang although part of its prefecture administrative district. The land there is typically hilly with steep, often terraced gullies. Its climate is very dry and cool, with only about 170 frost-free days each year. Within Jingchuan are 1,465 sub-villages, 215 administrative villages and 18 townships. Its population in 2002 was 335,447 (311,078 rural). The area is known locally for its harvested fruit, especially a Fuji apple (Jinglong brand) that is labeled “famous fruit in China," and also for several hot springs and some ancient religious sites. Annual per capita income for the county's rural wage earners is Y1,551 ($221 USD or about 60 cents per day).

For more information about Pingliang see the later post A Very Humble Beginning. It describes a visit to Pingliang, its orphanage, and the area further south around Jingchuan where Henry was found. See also A Lesson from Crows.

Jingchuan was one of four Gansu counties closely examined in a 2003 study concluding that Gansu Province had the highest rate of birth defects of any province in China. It also had the highest infant mortality rate with more than half its infant deaths due to birth defects. Causes could range from general nutritional issues, to natural radon found in soils and wells, to pollution routinely dumped onto the ground or drained into a very limited number of rivers and aquifers.