Even a short list of the issues people adopting children from foreign countries face is pretty formidable.
There is the endless paperwork, parts of which always seem to get lost. There are unstable governments, with borders that open and close with the political climate, and the strain of dealing with foreign adoption agencies that may be less than reputable.
Then there are possible developmental issues with the child, who may be malnourished, have iron, Vitamin A and/or calcium deficiencies, been exposed to lead and be infected with parasites.
That's the short list.
That's why so many people turn to Dr. Jane Aronson.
A pediatrician with a speciality in infectious diseases, Aronson for the past six years has run International Pediatric Health Services, one of the few practices in the city specializing in helping people adopt children from abroad.
"You can call me an adoption medical specialist," Aronson said. "I shifted my practice in the early '90s to only deal with children who are being adopted from abroad."
Aronson knows what her clients go through. She adopted her sons abroad, Desalegn, now 9, from Ethiopia, and Benjamin, 7, from Vietnam. She estimates she's helped more than 6,000 such adoptions - Angelina Jolie and Brad Pitt consulted with Aronson before adopting Zahara from Ethiopia.
Yet for all of the children lucky enough to be adopted by Americans - and Americans adopted some 22,000 foreign-born children in 2004, the latest year for which figures are readily available - an estimated 150 million children are living without parental care worldwide.
"Those are children living in the streets without their parents, living in refugee camps, going in and out of orphanages, children who have lost their parents to poverty and disease," Aronson said. "Poverty, that's the big P."
Aronson has figured out how to help many of them, too.
Ten years ago she founded the Worldwide Orphans Foundation, a group dedicated to "enriching the lives of children living in orphanages around the world."
The foundation's programs work to expose orphans to art, sports and music as a way to improve their mental growth and socialization.
A major part of that effort is the foundation's Orphan Ranger program, by which students and medical professionals are commissioned to live and work in orphanages abroad, with the aim of helping orphanage staff improve the children's lot.
"The conditions that children live in in orphanages are sparing, and dark, and unstimulating, and difficult, painful and traumatic," she said. "The vast majority of children living in orphanages will never be adopted. Adoption is an answer, but not the answer. The vast majority of them do not have families and will not have families, so we have to figure out how to help them get a better life."
Aronson now runs Orphan Ranger programs in Russia, Ukraine, Kazakhstan, Bulgaria, India, Ecuador, Vietnam, China, Serbia, Montenegro and Ethiopia. Her group also funds HIV treatments for children in Ethiopia and Vietnam.
The group is having its 10th anniversary benefit on Oct. 15 at Cipriani Wall Street. "CBS Evening News" anchor Katie Couric is host, and New York State First Lady Silda Wall Spitzer will be honored.
For more information check the Web site, www.wwo.org, or Aronson's page, www.orphandoctor.com.
