I started my day at 6:30 am on Oct. 9, reviewing a pre-adoption medical abstract from a country abroad for a lovely American family. I am wearing my hat as Dr. Jane, the adoption doctor today... When I saw this little boy's photos in my inbox from the Jones family, I was eager to learn about this child. He was sweet and shiny and alert, just a few months old, and I felt hopeful for a moment. Then I read the social history.
He was found by a local older woman on the grounds of the market place when she heard his hungry cries. Having had babies herself, she knew that distinctive cry and raced in its direction. She found him swaddled tightly in a colorful scarf and he was clean and not ill appearing. She picked him up and felt a crinkly paper note under the scarf, which upon inspection had his date of birth and given name. He was a month of age and she instantly felt compelled to hold him close. The woman walked back to her market stall where she sweetly spoke to him in motherly high-pitched tones and used his name and brushed her soft cheek against his soft cheek. His eyes sparkled and he made such gentle sounds that she was transported back in time to her life as a young mother.
She found a policeman in the marketplace and the police took her and the baby to the local station where an interview took place. The police began the usual investigation and interviewed a lot of people at the market. The woman who found the baby thought that she might know this baby's mother and mentioned this to the police. They thought that the mother was a commercial sex worker. The police found the birth mother and brought her in for questioning. The baby was placed in a local orphanage within hours of his being found.
The birth mother was found guilty of abandonment; there was no trial and she was placed in jail with a sentence of one year. The mother's parental rights were terminated. The mother had a medical exam and was found to be HIV positive. The baby was tested at the orphanage and his first HIV test was reportedly negative.
So here I am on a Sunday morning reviewing the baby's history because he has been referred to an American family for adoption and they want me to help them with the medical issue of a baby born to a mother with HIV infection.
There is more here than the science. I am focused on the moral issues: What will happen to this young woman who is HIV positive in jail? Why was there no trial? Why didn't this woman have an opportunity to talk with a social worker so that she might not have abandoned her baby? She left him in the market place with a note. She cared about him, but was desperate. A report noted that she knew he would become HIV positive if she breastfed him and that is why she left him. How smart! Was their legal counsel to help defend her rights?
He will likely not be HIV positive if the initial test is negative and he will be adopted by this family. He will have a good life -- and some might say that this is just fine. And I say that the issues are more complex.... Are you with me here? The consequences of extreme poverty and desperation are staring at us once again.
Commercial sex workers can be counseled and if they get pregnant, they can make a choice to keep their babies or not. They can get an education and leave that desperate world. All they need are social services and legal counsel. They can get HIV testing and medication if they are HIV-infected. This woman will die in a jail in a developing country. I won't bother with the statistics...that is her destiny. She will die and her baby will go to America. This is not a just solution.
Social services must be made available in impoverished countries. If women can talk about their lives with a social worker, they can get the support and resources they need and their lives can be turned around. And women who abandon their babies should not go to jail. There are simple, compassionate, and just ways to help those in need.
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