When Sharon and Kevin Katovich flew to Russia to adopt a child eight years ago, they found the orphanage was clean and the caregivers were kind. But the institution was so impoverished, it would stew fruit, then feed the juice to babies over six months. Only newborns got actual milk.
The Katoviches were adopting two infants, a daughter, Jaime, and a son, Gavin. The children were unrelated, but the Katoviches decided to adopt them both at the same time because they couldn't afford a second trip to Russia.
At nine months old, Gavin weighed just 12 pounds. "Our goal for his first birthday was for him to be able to sit," says Sharon. "He was really very weak."
Jaime was healthier, though she had an infestation of scabies on her scalp. The Katoviches put hats on her head to prevent her from scratching.
But the physical problems were the easiest challenges to overcome. While Jaime behaved as a normal child, Gavin began to display more severe problems as he grew. He'd had so little physical stimulation as an infant that he developed a sensory-based disorder.
Back in the States, when Sharon put Gavin on a blanket in the backyard, he would crawl to the edge and no further. He couldn't stand the feel of the grass blades on his hands. On a family trip to Florida, the white sand beaches were painful to him. "It hurts," says Sharon. "For him, it's a big thing."
Gavin sees an occupational therapist, who teaches him to rub his hands together to desensitize his palms. The family also bought a trampoline for the backyard, to help Gavin understand how his body moves and how to control it. Jumping also puts pressure on his joints, which calms him. Gavin suffers some tics from Tourette syndrome, though Sharon doesn't know if the disease is genetic, or a stress reaction to his early months of neglect.
Despite studies by researchers at UW-Madison and the University of Minnesota showing the negative effects of raising children in institutions, many countries continue to place infants in orphanages.
"There's a very strong historical and emotional link to orphanages," says Dana Johnson, head of the International Adoption Medicine Program at the University of Minnesota. "They've been around for a long time."
And in impoverished countries, orphanages can actually be viewed as a place of refuge for the poor. "They've got clothing, beds," says Johnson. "It's better than what some other kids have." Visiting Russia, he saw kids sitting outside the orphanage fence, looking in wistfully.
But institutional care is not optimal, says Johnson. International aid organizations, including UNICEF, have started to push countries to move children into foster homes. In many countries, there's also a stigma associated with adoption that has to be overcome to increase domestic adoptions. UNICEF estimates that about one million children in Europe and Asia are growing up in institutions.
"I think that's a gross underestimate," says Johnson. "The orphanages are the principal social safety network for some countries."
Sharon left her job this summer to stay home with the kids. She's also one of the leaders of the Madison parent group of Families for Russian and Ukrainian Adoptions, a support group (frua.org).
She gets emotional when she talks about her children's future. She wonders whether Gavin will be able to go to college. And she worries what he'll be like as a teenager. "That's the part that scares me," she says. "He's already somewhat volatile."
Despite the struggle to overcome Gavin's disabilities, Sharon says the family is joyful. Every year, they celebrate the anniversary of the adoption by going out to dinner. "This is the best thing we ever did."