New Announcement from USCIS on Haiti
USCIS has issued a new announcement regarding the status of Haitian children. The announcement and two USCIS documents can be found below.

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The USCIS Office of Public Engagement understands that you are anxious to find out about the status of your application and wants to make sure that you receive the most accurate and up-to-date information. We are therefore forwarding two documents for you reference.

Please note that USCIS has established a special mailbox to address the questions and concerns of prospective Haitian adoptive parents and stakeholders. If you have a specific question regarding your case and are unable to find an answer to your question on our website (www.uscis.gov/haitianearthquake) please email inquiries to: HaitianAdoptions@dhs.gov. The adoption team is making every effort to respond to all inquiries within 48 hours. However, please note that the team receives a large number of emails and is therefore grateful if you can limit the number of emails you send so that the team can respond to everyone.

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Interim Recommendations for Initial Domestic Medical Screening of
Haitian Orphan Parolees
NOTE: Will be updated as more information becomes available
DATE: February 1, 2010
PURPOSE: To provide medical screening recommendations for diseases of public health
importance in orphaned children entering the United States from Haiti under humanitarian parole
status.
TARGET AUDIENCE: Domestic medical providers evaluating orphaned children being
evacuated from Haiti
BACKGROUND
The January 12, 2010 earthquake and multiple aftershocks created enormous devastation and
loss of life in the heavily populated city of Port-au-Prince, Haiti and outlying areas. Although the
exact numbers of deaths is still unknown it is estimated that more than 200,000 people lost their
lives since the event. There was an estimated 380,000 orphans in Haiti as of 2007, but since the
earthquake this number is unknown. (http://www.unicef.org/infobycountry/haiti_statistics.html).
The health status of orphans in Haitian orphanages is considered to be very poor. Even before
the earthquake, Haiti had a high prevalence of bacterial and protozoal diarrhea, hepatitis A and
E, typhoid fever, dengue fever, malaria, leptospirosis, tuberculosis, and HIV. On January 18,
2010, the Department of Homeland Security (DHS) announced a humanitarian parole policy
allowing orphaned children from Haiti to enter the United States to ensure that they receive the
care they need.
Normally, before admission to the United States, all internationally adopted children are required
to have a medical examination in their country of origin, specified by CDC, performed by a
physician designated by the Department of State. However, given the urgency of the current
situation, Haitian orphans entering the United States under parole status have been allowed to
bypass this overseas medical screening examination prior to departure. Therefore, this document
presents recommendations for screening for communicable diseases of public health importance
that is meant to take the place of the overseas medical screening exam– referred to hereafter as
the initial domestic medical screening for orphan parolees. This medical screening should be
performed as soon as possible after arrival and consist of a general medical screening, as well as
screening for tuberculosis (TB), vaccination status, HIV, intestinal parasites, malaria, syphilis,
and mental health. A subsequent more comprehensive medical evaluation is recommended in
accordance with the American Academy of Pediatrics guidelines on the Medical Evaluation of
Internationally Adopted Children for Infectious Diseases (Red Book®: 2009 Report of the
Committee on Infectious Diseases – 28th Ed. 2009). Although these examinations may be
performed together, the immediate screening described in this document should not be delayed to
accommodate the comprehensive examination.
INITIAL MEDICAL SCREEING
All orphans should have a medical history (if known) and physical examination. Components of
the medical history should include;
 History of trauma
 Symptoms of communicable disease (i.e. fever, coryza, cough, rash, diarrhea, vomiting)
 Past medical and surgical history including any known chronic diseases
o Specific history of TB and HIV should be solicited
o Medication history
Components of the physical examination should include:
 Vital signs and assessment of hydration status
 Height, weight, head circumference (if age appropriate)
 Obvious injuries that may have resulted from trauma
 A full physical examination with particular attention paid to signs that may indicate
underlying medical problems such as heart disease, asthma, chronic malaria (e.g. tachycardia,
heart murmurs, labored respirations, abdominal tenderness) or undetected but subtle injury
from trauma (e.g. splenic rupture).
 Assessment of nutritional status (looking for signs of malnutrition)
If fever is present, there should be a high clinical suspicion of malaria, dengue fever, and
typhoid. Consideration should also be given to detecting clinical conditions requiring isolation
(i.e. typhoid, TB, measles or chickenpox). Optimally, evaluation should be performed in
consultation with an expert in infectious diseases or tropical medicine.
Orphans with known chronic medical conditions (e.g. asthma, congenital cardiac conditions,
seizure disorders) should be carefully evaluated and treated, particularly since previous therapy
may have been disrupted. Orphans with known chronic cardiac and respiratory disease should
have vital signs assessed including oxygen saturation (portable oximeter) as soon as possible.
Orphans with diabetes should have a glucose measurement as soon as possible.
Further, in 2009, the Haitian National Nutrition Survey found an acute and chronic malnutrition
to be 4.5% and 24-35%, respectively.
Laboratory screening tests should include:
 Complete blood cell count with red blood cell indices
 HIV testing
 Malaria smear (if symptomatic)
 Stool examination for ova and parasites (3 specimens)
 Stool examination for Giardia spp., Cryptosporidium, rotavirus antigen (if symptomatic);
strongyloides serology if eosinophilia
 Syphilis serologic testing
o Non-treponemal test (RPR, VDRL, ART)
o Treponemal test (MHA-TP, FTA-ABS)
 Serologic testing for vaccine preventable diseases (if indicated—see text)
 Tuberculin skin test or Chest radiograph (see text)
TUBERCULOSIS
The incidence of TB in Haiti is one of the highest in the Western hemisphere, at 306/100,000 for
all forms of TB. By comparison, the US rate is 4.2 per 100,000 (source: Global Tuberculosis
Control: epidemiology, strategy, financing: WHO report 2009.

http://www.who.int/tb/publications/global_report/2009/pdf/full_report.pdf).

Because of the high incidence of TB in Haiti, in addition to the living conditions of most
orphans, all orphan parolees should be evaluated for TB disease after arrival. This evaluation
should consist of medical history, physical examination, and if adequate follow up can be
guaranteed, screening orphans 2-14 years of age with the tuberculin skin test (TST) or
interferon-gamma release assay (IGRA) is recommended. Physicians should be advised that
some experts prefer TST in children younger than 5 years of age. There are relatively few
published reports documenting the performance of IGRAs in young children, obtaining sufficient
blood is more difficult, and there is concern that IGRAs may perform differently in very young
children who are at greater risk of a poor outcome if infection is undiagnosed. If the TST is ≥10
mm or IGRA is positive, a chest radiograph (CXR) (anteroposterior or posteroanterior view and
a lateral view for applicants <10 years of age; posteroanterior view for applicants ≥10 years of
age) should be performed.
If adequate follow-up cannot be guaranteed, the TST or IGRA can be omitted and a CXR can be
done as the initial screening test.
The following categories of children should provide sputum specimens:
 Orphans with signs and symptoms of TB
 Medical history suggesting TB
 CXR findings suspicious of TB
 HIV infection
Three sputum specimens (or alternative specimens such as gastric aspirates if the child cannot
provide sputum specimens) should be provided to undergo microscopy for acid-fast bacilli
(AFB), as well as culture for mycobacteria and confirmation of the Mycobacterium species, at
least to the M. tuberculosis complex level. Orphans diagnosed with TB disease should be started
on treatment with treatment delivered as directly observed therapy (DOT).
For any child requiring sputum specimens to be sent, the medical provider should contact the
local health department of the final placement location of the child, to ensure appropriate followup.
Once the orphans are in a long-term placement, those not diagnosed with TB disease and started
on DOT, and without documented TST or IGRA results from their initial screening, should be
evaluated for latent M. tuberculosis infection (LTBI). LTBI evaluated should consist of either a
tuberculin skin test (TST) or interferon-gamma release assay (IGRA). Orphans with a negative
test for TB infection should have LTBI testing repeated 6 months after arrival.
Receipt of bacille Calmette-Guérin (BCG) vaccine is not a contraindication to a TST, and a
positive TST result should not be attributed to BCG vaccine. A patient with a known positive
TST should not have the skin test repeated as it may provoke a local reaction.
Elements of the medical history for TB should include;
 Previous history of TB
 Illness suggestive of TB (such as cough of >3 weeks duration, dyspnea, weight loss, fever, or
hemoptysis)
 Prior treatment suggestive of TB treatment (especially if incomplete of discontinued)
 Prior diagnostic evaluation suggestive of TB
Children are less likely than adults to present with “classic” signs and symptoms of TB such as
night sweats, hemoptysis or cavitary findings on chest x-ray. Children more frequently present
with generalized findings such as fever, growth delay, and weight loss. Children are also more
prone to extra-pulmonary TB, such as meningitis, and disease of the middle ear and mastoid,
lymph nodes, bones, joints, and skin. Clinical symptoms can be subtle. The clinician should
keep in mind that TB can present with virtually any sign or symptom and should be included in
the differential diagnosis of most abnormal clinical findings.
Pertinent elements of the physical exam specific for TB include;
 Thorough pulmonary examination
 Inspection and palpation of appropriate
lymph nodes
 Inspection for scars of scrofula, and
prior chest surgery
VACCINE PREVENTABLE DISEASES
Vaccine preventable diseases (VPD) are another important public health consideration for this
population. Haiti provides BCG, diphtheria, pertussis (whooping cough) and tetanus (DTwP);
5 measles rubella (MR); oral poliovirus (OPV); and tetanus and diphtheria toxoids (Td), as part of
its routine immunization schedule (along with Vitamin A). However, vaccination coverage rates
are low for most of these vaccines. For example in 2008, coverage for measles vaccination was
58%, third dose DTP 53%, and third dose polio 52%. Moreover, Haiti does not provide a 2nd
measles dose, hepatitis A, hepatitis B, Haemophilus influenzae type b (Hib), rubella, varicella,
rotavirus, meningococcal, or pneumococcal vaccinations which are considered routine childhood
immunizations in the U.S.
Children and adolescents adopted from Haiti should receive immunizations according to the
recommended schedule in the United States for healthy children and adolescents (see:

http://aapredbook.aappublications.org/resources/IZSchedule0-6yrs.pdf).

In general, when data are available for the orphans in a country, written documentation of
immunizations (if available) can be accepted as evidence of adequacy of previous immunization
if the vaccines, dates of administration, number of doses, intervals between doses, and age of the
child at the time of immunization, are consistent internally and comparable to current US or
World Health Organization schedules (http://elib2.cdc.gov:2801/cgi/content/full/2009/1/1.5.13).
However, given the limited data available regarding verification of immunization records in
Haitian orphans, and the known low vaccine coverage rates in Haiti, it may be preferred to reimmunize
the child presumptively. It is also acceptable to perform serologic evaluation of
concentrations of antibodies to vaccines for certain antigens (i.e. measles, mumps, rubella,
hepatitis A, polio, tetanus and diphtheria) (CDC. General Recommendations on Immunization.
MMWR 2006;55 (No. RR-15):[34]). Because the rate of more serious local reactions after
diphtheria, tetanus, and pertussis (DTaP) vaccine increases with the number of doses
administered, serologic testing for antibody to tetanus and diphtheria toxins before reimmunizing
(or if a serious reaction occurs) can be considered if appropriate immunization is in
question.
Serologic testing for the surface antigen of the hepatitis B virus (HBsAg) should be performed
on all children to identify chronic infection. If serologic testing is not available and receipt of
immunogenic vaccines cannot be ensured, the prudent course is to provide the immunization
series.
Ideally, adoptive parents, family members and other close personal contacts should ensure they
are immunized or otherwise immune to hepatitis A virus infection before international travel to
pick up the child. If this is not feasible, serologic testing of the orphan for hepatitis A IgM and
IgG is recommended, to identify current/recent or past infection. If a child has no evidence of
previous infection, the child should be immunized against hepatitis A according to the
recommended immunization schedule. If IgG tests positive, indicating past infection, no
immunization will be required for the child. If IgM is positive, indicating current/recent
infection, all close contacts and family members should be immunized. Orphans or their
household or other close contacts with symptoms consistent with acute viral hepatitis should be
evaluated promptly.

HIV
Screening for HIV should be performed on all orphans from Haiti. Transplacentally acquired
maternal antibody in the absence of infection can be detected in a child younger than 18 months
of age. Hence, positive HIV antibody test results in asymptomatic children of this age require
clinical evaluation, further testing (follow-up serologic and PCR), and counseling.
INTESTINAL PARASITES
In a nationwide survey on intestinal helminths in 5792 urban and rural school children conducted
in Haiti in 2002, 34% of stools tested positive for intestinal helminths with the following
parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator
americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis
(0.2%) (Champetier de Ribes et al, Bull Soc Pathol Exot. 2005 Jun; 98(2):127-32).
Most experts would perform three stools for ova and parasite (O&P) testing collected on three
consecutive mornings on all children, regardless of symptoms. If stool O & P examinations are
negative and the child has eosinophilia (absolute eosinophil count exceeding 450 cells/mm3),
then strongyloides species serologic testing is recommended as stool O&P have poor sensitivity
for this infection and the disease can be chronic and lead to serious morbidity (Red Book®: 2009
Report of the Committee on Infectious Diseases – 28th Ed. 2009).
If gastrointestinal tract signs or symptoms are present, send stool specimens for culture, and stool
antigen testing for giardia, cryptosporidia, and rotavirus.
MALARIA
Over 99% of the malaria parasite species that causes malaria in Haiti is P. falciparum, where it is
endemic. It has been reported that up to 75% of the population of Haiti lives in malarious areas,
especially at altitudes <300 m above sea level (Garcia-Martin, Am J Trop Med Hyg. 1972;
21:617–33). Therefore, it is recommended to screen symptomatic orphans for malaria with a
malaria smear. Treatment guidelines can be found on the CDC website
(http://www.cdc.gov/malaria/pdf/treatmenttable.pdf).
SYPHILIS
Clinicians should screen each orphan for syphilis by reliable nontreponemal and treponemal
serologic tests. Children with positive treponemal serologic test results should be evaluated by
someone with special expertise to assess the differential diagnosis of pinta, yaws, and syphilis
and to determine extent of infection so appropriate treatment can be administered.
MENTAL HEALTH
Because of stigma in Haitian culture around mental illness, many children may be reluctant to
discuss or admit to mental health problems. Likewise, prior caregivers in Haiti may not have
fully explored such issues, even prior to the earthquake. The experience of the January 2010
Haitian earthquake would be expected to impact greatly on many of the orphans exposed.
Clinicians should consider potential mental health and developmental issues. When mental
health referrals are warranted, added care should be made to explain and arrange such referrals to
the patient and his/her caregivers in a culturally sensitive, supportive, and non-stigmatizing way.
CONCLUSION
This document presents recommendations for an immediate medical screening of Haitian
orphans entering the US under humanitarian parole status. This is not a comprehensive
examination, and it is strongly recommended to have a comprehensive medical history and
physical examination once they arrive at their final destination to evaluate other medical and
developmental issues in the child, including hearing and vision assessment, evaluation of growth
and development, blood lead concentration, complete blood cell count with red blood cell
indices, newborn screening and/or measurement of thyroid-stimulating hormone concentration,
and examination for congenital anomalies (including fetal alcohol syndrome). (Red Book®: 2009
Report of the Committee on Infectious Diseases – 28th Ed. 2009).

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Office of Communications
Questions and Answers February 4, 2010
Information for U.S. Citizens in the Process of Adopting a Child from Haiti
Introduction
On Jan. 12, 2010, Haiti experienced an earthquake of devastating proportions. This set of questions and answers provides information for United States citizens that have adopted a child or are in the process of adopting a child from Haiti prior to Jan. 12, 2010.
Questions and Answers
Q. I am in the process of adopting a child from Haiti, what can I do to bring the child to the United States?

A. Department of Homeland Security (DHS) Secretary Janet Napolitano has authorized the use of humanitarian parole for the following categories of orphans in Haiti:
Category 1 Cases Description: Children being adopted by U.S. citizens prior to Jan. 12, 2010, who have been legally confirmed as orphans available for inter-country adoption by the Government of Haiti (GOH) through an adoption decree or custody grant to suitable U.S. citizen adoptive parents.
Required Criteria:
Evidence of availability for adoption MUST include at least one of the following:
 Full and final Haitian adoption decree; or
GOH custody grant to prospective adoptive parents for emigration and adoption; or
Secondary evidence in place of the above.
Evidence of suitability MUST include one of the following:
 Approved Form I-600A, Application for Advance Processing of an Orphan Petition; or
Current FBI fingerprints and security background check; or
Physical custody in Haiti plus a security background check.
Please note, some of the children in this category will receive immigrant visas and others will receive humanitarian parole, depending on the completeness of the cases. Those who enter with immigrant visas will enter as aliens lawfully admitted for permanent residence. Those who enter with humanitarian parole will need to have their immigration status finalized after arrival through an application for adjustment of status.
Category 2 Cases Description: Children who have been identified by an adoption service provider or facilitator as eligible for intercountry adoption, were matched to prospective American adoptive parents prior to Jan. 12, 2010 and meet the below criteria.
Required Criteria:
Significant evidence of a relationship between the prospective adoptive parents and the child; AND of the parents’ intention to complete the adoption, which could include the following:
 Proof of travel by the prospective adoptive parents to Haiti to visit the child;
Photos of the child and prospective adoptive parents together;
An Adoption Service Provider (ASP) “Acceptance of Referral” letter signed by the prospective adoptive parents;
Documentary evidence that the prospective adoptive parents initiated the adoption process prior to Jan. 12, 2010, with intent to adopt the child (filed Form I-600A, Application for Advance Processing of an Orphan Petition, and/or Form I-600, Petition to Classify an Orphan as an Immediate Relative, completed a home study, located an ASP to work with in Haiti, etc.).
Evidence of the child’s availability for adoption, which would include the following:
 IBESR (Haitian Adoption Authority) approval;
Documentation of legal relinquishment or award of custody to the Haitian orphanage;
Secondary evidence in place of the above.
Evidence of suitability MUST include one of the following:
 Approved Form I-600A, Application for Advance Processing of an Orphan Petition; or
Current FBI fingerprints and security background check.
If the child you have adopted or are adopting meets these criteria, please send U.S. Citizenship and Immigration Services (USCIS) detailed information about the adoption case at HaitianAdoptions@dhs.gov. This e-mail address is dedicated to collecting information about adoption cases still pending in Haiti. Please include the name of the prospective adoptive parent in the subject line of the e-mail. Once we have your information, we will contact you with further information.
Q. How do I request Humanitarian Parole for the child I am in the process of adopting?

A. If you want to request humanitarian parole for a specific child you are in the process of adopting from Haiti, please send the request to HaitianAdoptions@dhs.gov. Please include the name of the prospective adoptive parent in the subject line of the e-mail. You do not need to file Form I-131 or submit a fee for these cases.
Q. If parole is authorized, how will my child get out of Haiti?

A. The Department of State and Department of Homeland Security are coordinating the transport of Haitian orphans with approved travel documents to ensure their safe arrival into the U.S. Currently, children are traveling by both military and private aircraft. We urge families not to make individual arrangements and to assist us in coordinating with the orphanages on the ground. To obtain more information on the process for scheduling appointments for Orphan Screening at the U.S. Embassy in Port-au-Prince, please see the Q&A below on scheduling.
Orphanage directors should first schedule an appointment before taking their group of children to the Embassy for processing. Individuals or groups that appear at the Embassy without prior coordination may be turned away.
Q. If humanitarian parole is authorized, may I travel to pick up a specific child?

A. The Department of State (DOS) Travel Warning urges U.S. citizens to avoid travel to Haiti. Communications and transportation in Haiti are extremely limited and nearly all available resources are dedicated to the immediate search and rescue of Haitians. Updates to the DOS travel warnings for Haiti are available online at http://www.travel.state.gov/travel/cis_pa_tw/tw/tw_4632.html
Once a child receives a visa or is authorized for humanitarian parole, we encourage you to work with your U.S. adoption agency and the orphanage staff in Haiti to identify an escort to bring the child to the United States.
Should you intend to travel to Haiti, USCIS strongly urges you to contact USCIS through Haitianadoptions@dhs.gov before traveling to ensure that all the paperwork necessary for your child to be paroled into the U.S. has been completed and that, if you have not been fingerprinted, you are fingerprinted in the U.S. Getting fingerprinted in Haiti may delay the processing of your case.
Q. Many documents were destroyed in the earthquake. What kind of secondary evidence can be submitted in the place of primary documents?

A. Secondary evidence may include, but is not limited to, copies of records or correspondence referring to the existence of the destroyed or missing document, as maintained by an Adoption Service Provider or the prospective adoptive family, as well as affidavits of individuals with knowledge of the document or event.
Q. I am a prospective adoptive parent in the process of adopting a child in Haiti, but the adoption was not finalized prior to the earthquake. If DHS authorizes humanitarian parole for a child who was not legally adopted in Haiti, how will I obtain the legal authority to take the child into my home?

A. If you received an order from the Government of Haiti granting custody of the child to you, then the child may be paroled into your custody upon verification of the order, your identity and that of the child after the child’s arrival in the United States.
If you have not received a formal order granting you custody from the Government of Haiti, then the child may be placed in your care but some additional procedures must be followed first. These procedures are intended to protect children and ensure that those without final adoptions are placed with families that are able to care for them. These additional procedures may take a little time, but they are critical for keeping children safe. Children who cannot be placed with prospective adoptive parents will be well cared for. The Office of Refugee Resettlement (ORR) within the Department of Health and Human Services (HHS) has contracts with organizations around the country to care for unaccompanied children who are not U.S. citizens. For more information on this process, please review the information for adoptive parents available on the U.S. Dept. of Health and Human Services website at http://www.hhs.gov/haiti/adoptionrelease.html
Whether you become a sponsor or not, you will need to adopt the child under the adoption laws of your place of residence in order for the child to acquire permanent residence in the United States. More information regarding the process for finalizing the adoption in the U.S. will be provided on the USCIS website once available. If your child is over the age of 14, please contact us immediately by forwarding
an email to HaitianAdoptions@dhs.gov. To ensure that your request is processed correctly, please follow the instructions below: 1. In the subject line of your email type: “Child in U.S. – Over age 14″
2. In the body of the e-mail be sure to include:
 Your full name
Your home address
Your child’s name
Your child’s date of birth
Information about how to best contact you
Q. I am a prospective adoptive parent in the process of adopting a child from Haiti. What should I do if my Fingerprint Clearance has expired?

A. USCIS will review each prospective adoptive parent’s request for humanitarian parole on a case-by-case basis. If we determine that your fingerprint clearance(s) has expired, you do not need to take any action. USCIS will electronically rerun your prints. (Please do not send a request for updated fingerprint to HaitianAdoptions@dhs.gov.) If you have not been fingerprinted by USCIS at any stage of your adoption process, please send an e-mail message to HaitianAdoptions@dhs.gov and we will arrange a fingerprint appointment for you. Please include “FP Request” in the subject line of the e-mail.
Q. Is there any other way I can help orphans in Haiti?

A. We understand that some Americans want to respond by offering to open their homes. We certainly appreciate this generous impulse, but note that it can be extremely difficult to determine whether children are truly orphans. Children may be temporarily separated from their parents or other family members, and their parents or other relatives may be looking for them. In the first instance, we believe it is most important to focus on re-uniting separated children with their relatives. Some individuals may wish to assist by contributing to a reputable relief or humanitarian organization working in that country. More information can be found at the following Web sites:
 Department of State – http://www.state.gov or http://www.state.gov/p/wha/ci/ha/earthquake/index.htm
United States Agency for International Development (USAID) – http://www.usaid.gov
 International Committee of the Red Cross (ICRC) – http://www.icrc.org
 Interaction – http://www.interaction.org
Q. I have heard the Government of Haiti has stopped allowing orphans to leave Haiti. What will happen to my child if I am still in the process of adoption?

A. The United States government is working closely with the Government of Haiti to establish an efficient and transparent procedure to allow eligible children to depart quickly while also ensuring the best possible protection of unaccompanied and separated children.
The government of Haiti has not stopped allowing orphans to leave Haiti. USCIS is continuing to process cases that meet the DHS Secretary’s criteria for category 1 and 2, however we are unable to issue travel letters for each child to depart until we receive approval from the Government of Haiti (GOH). Once approval is received, we are able to issue travel documents to authorized children.
Q. Once the children in an orphanage have been screened, and evaluated, should the orphanage director bring the children to the U.S. Embassy?

A. We recommend against attempting to enter the U.S. Embassy, particularly with a group of children, without first scheduling an appointment in advance. There is a possibility that you may be turned away and scheduled to come back another day.
USCIS is proactively scheduling appointments at the U.S. Embassy in Port-au-Prince to screen Haitian children who were adopted or were in the process of being adopted by U.S. citizens prior to the January 12 earthquake. Whenever possible, we will schedule all children from the same orphanage/facility, at the same time.
To obtain more information on the process, please review the How to Schedule an Appointment for an Orphan Screening at the U.S. Embassy in Port au Prince fact sheet at www.uscis.gov/haitianearthquake.
Q. What are the medical screening requirements for adopted children from Haiti?

A. Before internationally adopted children come to the United States, they are usually required to go through a medical exam. However, due to the lack of available medical screening facilities and the burden of emergent medical needs in Haiti as a result of the January 12 earthquake, we anticipate that many children arriving as humanitarian parolees will not have completed their medical exams before they depart Haiti. Medical examinations are not required as a part of the humanitarian parole program.
As a result, it is important that all arriving adoptive children from Haiti undergo a medical screening process soon after arrival to screen for infectious diseases and other general health concerns. Additional guidance regarding medical exams for adopted children from Haiti is available from the Department of Heath and Human Services, Centers for Prevention and Disease Control Web site at www.cdc.gov/immigrantrefugeehealth/exams/parents-adopting-children-haiti-earthquake.html
Q. If my child is traveling from Haiti, are there any specific provisions I should know when he or she arrives in the United States?

A. Please note that a U.S. Customs and Border Protection (CBP) officer must inspect all individuals traveling to the United States when they arrive at a port of entry. For more information on the process for obtaining the legal authority to take into your home your child or the child you are in the process of adopting, please review the questions above or view the information for adoptive parents available on the U.S. Dept. of Health and Human Services (HHS) website at http://www.hhs.gov/haiti/adoptionrelease.html.
Q. I submitted the original adoption decree and other documents to the USCIS field office in Port-au-Prince. How do I get these documents back after my child arrives in the United States?

A. To request the return of original documents submitted to establish eligibility for an immigration benefit, please fill out Form G-884, “Return of Original Documents,” which is available to download from the forms section on USCIS’ Web, http://www.uscis.gov/forms

-Joint Council
http://betheanswerforchildren.wordpress.com/

News Bureaus Report on Children Taken to Dominican Republic

CNN and other news bureaus have reported that 10 American and Dominican citizens were arrested by the Haitian authorities while transporting 33 children into the Dominican Republic. The article reports that a U.S. government official stated that there are no indications trafficking was involved. According to CNN, the U.S. official also stated that it appears the orphanage was damaged and the children were being moved to their facility in the Dominican Republic but failed to obtain exit visas from Haiti. On January 24, the Haitian government instituted a policy of requiring government approval for children leaving Haiti.

In a BBC report, the AFO new agency quoted Haitian Social Affairs Minister Yves Christallin saying “This is an abduction, not an adoption.”

Other news bureaus, such as KMVT in Twin Falls, Idaho, reported the border crossing as an illicit adoption scheme, despite the statements of the Haitian Social Affairs Minister and U.S. government officials.

The announcement by the Haitian government that government approval must be given for any child leaving Haiti has been reported widely, including by Joint Council. Any violation of this requirement, regardless of the motivation, must be investigated and if appropriate, vigorously prosecuted. Failing to take aggressive action against individuals involved in illegal activity only compromises children’s rights and adds to the trauma experienced through institutionalization and compounded by the earthquake.

Allegations in the media that this is somehow an “illicit adoption scheme”, despite the reported statement of the Haitian Social Affairs Minister and U.S. government officials noted above, do little to advance the protection of children. Without substantiation, the association of illegal border crossing with adoption, damages the valued institution of intercountry adoption and may contribute to the elimination of a child’s right to a family.

Joint Council again calls on all who provide services to children, to adhere to the requirements of the Haitian government. While the situation in Haiti continues to be a crisis for children, services must be provided in Haiti unless prior approval for travel is obtained from the Haitian government.

The motives, as reported in the media, highlights both the need to know and comply with Haitian requirements and the need to immediately provide safe shelter, nutrition, water and medical care to children in need.

-Joint Council
http://betheanswerforchildren.wordpress.com/

Adoption Learning Partners: A Special Event for Parents of Children Traumatized by the Earthquake in Haiti
Adoption Learning Partners in cooperation with the Joint Council on International Children’s Services, the Evan B. Donaldson Adoption Institute,and the Heart of the Matter Seminars is hosting a webinar for families who are adopting Haitian children. We urge all parents of Haitian children impacted by the earthquake to participate in this very important learning opportunity. The webinar feartures Dr. Bruce Perry who will present on the trauma experienced by Haitian children. Please see below for details.
Layers of Trauma for Haiti’s Orphans:

A Webinar featuring Dr. Bruce Perry

Monday, February 1st, 2010 from 7:00 to 8:00 PM Central Time
(a recorded version will be available subsequently)
This free webinar features Bruce D. Perry M.D., Ph.D., the Senior Fellow at

The ChildTrauma Academy. He will discuss the likely impact of the many traumas children coming home from the orphanages in Haiti have experienced.


The webinar will help prepare families who are now awaiting or have already received placement under the United States’ expedited program.

He will cover the impact of the multiple traumas on this group of kids, explain what parents can expect, and give advice on how they can ease the transition for their child. The webinar will have practical advice for adoptive parents, adoption professionals, and interim caregivers.

Please forward this invitation to any family awaiting a placement from Haiti as well as staff and/or interim caregivers for these children. In order to give priority to those families who will benefit the most from this live webinar, we ask that you refrain from inviting families who are just starting to explore the option of adopting from Haiti.

Dr. Perry will address specific trauma-related questions from the audience as time allows. We ask that you submit questions in advance through the registration form.
PLEASE NOTE: this session is intended for those families who were in process of adopting from Haiti prior to the earthquake and are therefore receiving an expedited placement of their child. The Haitian adoption process itself as well as advice for those looking to start the process of adopting from Haiti will not be covered.
This webinar is brought to you by Adoption Learning Partners in cooperation with the Evan B. Donaldson Adoption Institute, the Joint Council on International Children’s Services and the Heart of the Matter Seminars.

http://http://www.heartofthematterseminars.com//

Haitian Government Announces New Exit Requirement for Children

It is Joint Council’s understanding that the government of Haiti, in protecting against the inappropriate movement of children to the U.S. and other countries, has announced that the Haiti government must approve the international movement of each individual child. This includes children that are bound for the U.S., whether through the visa process or humanitarian parole.

It is also our understanding that the U.S. government is actively engaged on this issue with the Haitian government. The US Citizenship and Immigration Services, which authorizes humanitarian parole for each child, continues to process cases at the US Embassy in Port au Prince.

The new requirement of the Haitian government may cause a delay in the travel of children who qualify for a U.S. visa or humanitarian parole. It is understandable that adoptive families who have yet to be united with the child they are adopting, may be concerned. Joint Council urges adoptive families to remain diligent and continue to seek humanitarian parole for the child they are adopting.

It is Joint Council’s understanding that this new requirement is in response to concerns that children who were not in the process of adoption, leaving Haiti for the U.S. and other countries. Joint Council shares in the concerns over the inappropriate movement of Haitian children.

Joint Council again calls on the U.S. government, UNICEF and others engaged in child protection to provide transport of Haitian orphans to safe shelter including nutrition and medical care, regardless of their adoption status. Any delays necessitated by this new child protection requirement only further support Joint Council’s standing advocacy for the safety and well-being of Haitian orphans and other children.

-Joint Council
http://betheanswerforchildren.wordpress.com/

When we hear about one rumor, we usually don’t post about it. But when we hear from numerous sources, we reach out for confirmation and then let you know…so here you go.

Rumor #1 – The US Embassy in Port au Prince has stopped issuing visas and had canceled all appointments.

We can confirm that the US Embassy has not stopped issuing visas.

Rumor #2 – The US Embassy will be closed for the weekend.

We can confirm that the US Embassy will be open for the weekend and will continue to process humanitarian paroles.

-Joint Council
http://betheanswerforchildren.wordpress.com/

Hello,
Just wanted to let you know that we found out that we are in Category 1 and will be getting our son Fauberson any day now. So it is very close for all of us. It is good that we all kept in contact with each other and didn't go "rogue" on getting our kids out. It sounds like that is causing a lot of problems and confusion. Kids have been taken out that shouldn't have been. Some of these "rogue" missions have taken away time from the State Department and the Department of Homeland Security focusing on getting every child home. So, let's continue to follow the lead of Karin, Rebecca, Hand in Hand, Dillon Adoptions, the State Department and the Department of Homeland Security and we will get our kids home to us.

A Voice from Haiti:

Dear Tom and Rebecca,

The only way to describe Haiti right now is a living nightmare. The lack of coordination and the practicalities of traveling from the Embassy to the airport and back to the orphanage makes it impossible to work with any efficiency and we can accomplish very little. Today we spent over 3 hours trying to get to the Embassy with 15 children – 14 under the age of two – and then spent 9 hours at the Embassy. We walked out with few parole visas and were advised that DOS had left for the evening so we would get our adoption visas the next day. After risking my life to enter an extremely damaged building to recover files and lugging them to the Embassy it was frustrating to say the least to have accomplished so little. In addition, I know I will need to stay up all night tonight to go over 40+ cases to assess the documents and to organize them, all while under a tent and using a flashlight. We are too scared to try to sleep inside and who can sleep anyway when every little noise or jar wakes you up in fear? The conditions are unfathomable and I cannot understand why we do not have a centralized location to serve these orphans – those already established as being in need of a family before the earthquake. I am so thirsty, but cannot drink as often as I would like because we are running out of water and I cannot take what the kids may need, although we came into Haiti with more than enough for us, we have to share what we have.

I have to stay strong here and not fall to pieces but the situation is truly impossible and is leading to unnecessary delays and continued and increased risk to children already established before the earthquake as orphans (as well as MANY others). I have so many fears – another aftershock that woke us so roughly on Wednesday morning and a wall tumbling down on our heads, children starving, the orphanage being looted as the frustration continues to grow regarding the delay in distributing supplies, children dying from sickness (almost all the children here have a deep cough and we have few meds. to offer), and ultimately, what other diseases will result from the conditions here.

The children are sleeping outside on soiled mattresses and in wet sheets – there are not enough diapers for them to be used as needed. They are scared to death and will cling to anyone who reaches out a hand. All of the people who experienced this horrific catastrophe seem to be suffering from post traumatic stress – quite understandably – and yes, I am qualified to diagnose.

I am having such a hard time seeing that orphans are once again being used as political pawns in spite of this monumental tragedy. I am standing in the midst of a nightmare where I am thirsty and hungry and scared – but I have a US passport and eventually I have the chance to go home to a warm bed, plenty of food and people who love me. When did common sense exit the entire equation regarding children’s welfare and establishing what is in the best interests of a child? How many children must die unnecessarily in the midst of this crisis because of bureaucratic red tape when simple and temporary solutions are not that difficult? But, I guess I should expect this – because we are dealing with very poor orphans and how high on the priority scale do they fall? When I initially heard about the US response to the orphan crisis in Haiti I was SO PROUD. I was so grateful that Obama was our President, Hilary Clinton was our Secretary of State and that for once we were going to get this right. Unfortunately, it seems that the US has again bowed to outside pressure to be politically correct and back down from what we know to be morally right. I do not think there is any person with an ounce of compassion who could view this situation and not believe that immediate and decisive action is necessary to save the children of Haiti. Enough will die without us contributing through inaction and inefficiency.

Please pray for all of us here. We need it desperately.

-Joint Council
http://betheanswerforchildren.wordpress.com/

U.S. Day Care…in Port au Prince
This just in from a ‘man on the ground’ in Port au Prince…

“You can’t believe how many kids are inside the embassy. It’s like a day care center.”

-Joint Council
http://betheanswerforchildren.wordpress.com/

UPDATE: Haiti

It is Joint Council's understanding that there are currently well over 200 children on the way to the U.S. Embassy from orphanages throughout Haiti. It is our understanding that the situation at the Embassy is very chaotic with hundreds of people outside. If at all possible, we ask that orphanages do not go to the Embassy for processing. Joint Council has given a list of orphanages to the the Dept of State, it is our understanding that they are in the process of contacting each orphanage with instructions. Joint Council is also providing the U.S. Dept of State with updates as information is given to us from families and adoption service providers.


I understand that this is a very difficult situation and I wish I had other news.

-Joint Council
http://betheanswerforchildren.wordpress.com/

From REBECCA HARRIS | Joint Council on International Children's Services |Director of Programs and Services|

Haiti Call to Action

UPDATE: Haiti
It as come that time that we request are dear friends and family help us ensure the safety of children in Haiti. Please read the message below and contact your Senators and Representative.

To find your senators go to, www.senate.gov
To find your representative go to, www.house.gov
Suggested Talking Points

Hello, my name is…

I am in the process of adopting a child from Haiti…
OR

My …
OR

I am concerned about the orphan children of Hati...

I know that many Members of Congress continue to support efforts on behalf of Haiti’s orphaned children. I extend my thanks to the Congressman/Senator.

I am calling because…
* We need your help to get our adoptive child out of Haiti safely.
* Water, food and medicine are running out.
* Gangs have looted some of the orphanages and even travel is not safe for the children.
* The Department of Homeland security has granted humanitarian parole, but it is only the first step.
* The devastation from the earthquake is vast and our child’s safety - and even life - is at risk.

Joint Council on International Children’s Services, the Congressional Coalition on Adoption Institute, and a team of congressional offices and relief organizations are working to coordinate a staging and housing center to provide:
* Physical safety
* Medicine
* Food
* Water
* A Staging Center for USCIS (U.S. Citizenship and Immigration Services) to process humanitarian parole

The groups working to launch the staging and housing center already have most of what the children need.
But they do not have
* Water
* Security to protect the children and supplies from gangs
* Transportation to bring the children into this safe haven

We are asking that (name of Member of Congress) personally call:
* Secretary of State Clinton, and
* Dr. Shah, Administrator Designate at USAID

And specifically request that they authorize security forces be sent to the offered staging center and assist in the extraction and transport of these children from their orphanages to the staging center. All other pieces of a successful operation of this staging center are currently in place, but all hinge on this authorization of security and transport.

If this security does not reach the site within 24 hours, children being adopted and many other children will continue to suffer and may in fact not live long enough to be united with my family and the other 300 U.S. families.

Dear Haiti list,

For those of you that were unable to attend the Joint Council conference call I wanted to just send out
a recap, hitting on some of the key points.
First let me say that I thought the call went very well, was informative and helped give agencies/families some
Hope and direction.
Joint Council talked about the four groups of orphans of High priority in Haiti;
First those children that were at the visa stage or close to the visa stage prior to the quake
Second those who will now fall under the Humanitarian Parole
Third children in orphanages that have already been relinquished and are in the full custody of the orphanage
Fourth children in the orphanages that have not been relinquished
Joint council is concerned with the well being of all these children and will do all they can to protect these children
And keep them safe.
Right now the emphasis is on the first two groups of children, and getting them out of Haiti.
Joint Council hopes to have a secure sight in Haiti soon where the children can be brought not only to be process them
To come to the US but to be able to give them some medical attention and food and shelter.
Next Joint council is trying to secure a location in the US where the children can be brought and meet their parents,
Receive additional medical care.
This is the ideal situation but we are only waiting for approval from the US government to do this, we have
Transportation for the children and are pretty close to having all the volunteers in both countries ready to do
This but need an approval from the US ASAP.
Rebecca Harris will follow up with an email on how agencies and families can help.
If there was anyone else on the call that wants to add to this please feel free.
I do want to add one more thing, Joint Council is still urging families/agencies/orphanage staff
To NOT go to the embassy in Haiti, it is not safe and they are not prepared to have mass numbers of people
Show up there, hopefully soon the compound/uscis processing center will be up and running.

Again, we cannot thank Tom and Rebecca and the staff at Joint Council for all their hard work!

Chareyl Moyes
Joint Council Haiti Caucus Chair

received some information regarding New Life Link from the recent conference call-in and they seem to be doing alright, they have food and water. That is all I now for now, if I get more information I will share it as soon as I can.

Fact Sheet Jan. 18, 2010

SECRETARY NAPOLITANO ANNOUNCES HUMANITARIAN PAROLE POLICY FOR CERTAIN HAITIAN ORPHANS

On Jan. 18, Department of Homeland Security (DHS) Secretary Janet Napolitano, in coordination with the U.S. Department of State (DOS), today announced a humanitarian parole policy allowing orphaned children from Haiti to enter the United States temporarily on an individual basis to ensure that they receive the care they need—as part of the U.S. government’s ongoing support of international recovery efforts after last week’s earthquake.

DHS and DOS are working together to issue travel documents (either immigrant visas or humanitarian parole authorizations) for children who fall into the two categories described below. Once these children are cleared to travel, the U.S. Embassy in Port au Prince will facilitate their evacuation to the United States so they may be united with their American adoptive parents.

Under applicable laws, unaccompanied minors entering the country without a parent or legal guardian will be turned over to the Department of Health and Human Services (HHS) Office of Refugee Resettlement.  

All cases will be evaluated by U.S. Citizenship and Immigration Services (USCIS). Depending on their circumstances, and information available some children will receive immigrant visas with permanent immigration status and will require no further processing. Those who enter under humanitarian parole status will need to have their immigration status resolved after arrival.

Eligibility for Humanitarian Parole

Category 1
Children who have been legally confirmed as orphans eligible for intercountry adoption by the Government of Haiti, were in the process of being adopted by Americans prior to Jan. 12, 2010 and meet the below criteria.

Required Criteria
Evidence of availability for adoption, which MUST include at least one of the following:
Full and final Haitian adoption decree
Government of Haiti Custody grant to prospective adoptive parents for emigration and adoption
Secondary evidence in lieu of the above.

Evidence of suitability for adoption, which MUST include at least one of the following:
Notice of Approval of Form I-600A, Application for Advance Processing of an Orphan Petition
Current FBI Fingerprints and background security check clearances
Physical custody in Haiti plus a security background check

Category 2
Children who have been identified by an adoption service provider or facilitator as eligible for intercountry adoption, were matched to prospective American adoptive parents prior to Jan. 12, 2010 and meet the below criteria.

Required Criteria
Significant evidence of a relationship between the prospective adoptive parents and the child AND of the parents’ intention to complete the adoption, which could include the following:
Proof of travel by the prospective adoptive parents to Haiti to visit the child
Photos of the child and prospective adoptive parents together
An Adoption Service Provider “Acceptance of Referral” letter signed by the prospective adoptive parents
Documentary evidence that the prospective adoptive parents initiated the adoption process prior to Jan. 12, 2010 with intent to adopt the child (filed Form I-600A, Application for Advance Processing of an Orphan Petition, and/or Form I-600, Petition to Classify an Orphan as an Immediate Relative, completed a home study, located an ASP to work with in Haiti, etc.)

Evidence of the child’s availability for adoption, which could the following:
IBESR (Haitian Adoption Authority) approval
Documentation of legal relinquishment or award of custody to the Haitian orphanage
Secondary evidence in lieu of the above

Evidence of suitability for adoption, which MUST include at least one of the following:
Notice of Approval of Form I-600A, Application for Advance Processing of an Orphan Petition; OR
Current FBI Fingerprints and background security check clearances

Other Orphaned or Separated Children
Given the severity of the disaster in Haiti, we understand that there are additional children that have been orphaned and/or separated from relatives and may also be in varying stages of the adoption process. DHS and the U.S. Department of State continue to evaluate additional eligibility criteria and will provide additional information as soon as it is available.

USCIS encourages U.S. citizens with pending adoption cases in Haiti to send us detailed information about their cases to HaitianAdoptions@dhs.gov.

Please visit the USCIS website at www.uscis.gov and the U.S. Department of State website at www.adoption.state.gov for more information and updates.

- USCIS -

Press Office
U.S. Department of Homeland Security

Press Release

January 18, 2010
Contact: DHS Press Office, (202) 282-8010

SECRETARY NAPOLITANO ANNOUNCES HUMANITARIAN PAROLE POLICY FOR CERTAIN HAITIAN ORPHANS

WASHINGTON—Department of Homeland Security (DHS) Secretary Janet Napolitano, in coordination with the U.S. Department of State, today announced a humanitarian parole policy allowing orphaned children from Haiti to enter the United States temporarily on an individual basis to ensure that they receive the care they need—as part of the U.S. government’s ongoing support of international recovery efforts after last week’s earthquake.
                                                                                                       
“We are committed to doing everything we can to help reunite families in Haiti during this very difficult time,” said Secretary Napolitano. “While we remain focused on family reunification in Haiti, authorizing the use of humanitarian parole for orphans who are eligible for adoption in the United States will allow them to receive the care they need here.”

Humanitarian parole into the United States may be granted by the Secretary of Homeland Security to bring otherwise inadmissible individuals into the country on account of urgent humanitarian reasons or other emergencies. The humanitarian parole policy announced by Secretary Napolitano today will be applied on a case-by-case basis to the following children:

Children who have been legally confirmed as orphans eligible for intercountry adoption by the Government of Haiti and are being adopted by U.S. citizens.

Children who have been previously identified by an adoption service provider or facilitator as eligible for intercountry adoption and have been matched to U.S. citizen prospective adoptive parents.

Under applicable laws, unaccompanied minors entering the country without a parent or legal guardian will be turned over to the Department of Health and Human Services (HHS) Office of Refugee Resettlement.  

Today’s announcement expands the humanitarian relief that the U.S. Government is extending to Haitians in response to the devastation caused by the earthquake. Last week, Secretary Napolitano announced the designation of Temporary Protected Status for Haitian nationals who were physically present in the United States as of Jan. 12, 2010—allowing eligible Haitian nationals to continue living and working in the United States for the next 18 months. Those who attempt to travel to the United States after Jan. 12, 2010 will not be eligible for TPS and will be repatriated

More information about humanitarian parole and TPS is available at www.uscis.gov or by calling USCIS toll-free at (800) 375-5283. DHS encourages U.S. citizens with pending adoption cases in Haiti to send us detailed information about their cases to HaitianAdoptions@dhs.gov.

###

E-mail from Gladys Thomas, Pres., FEH

All the children at Haiti Home for Children (HHC) including Adeline, the Supervisor, are safe and doing OK. The little ones are still very scared and traumatized with each aftershock. Everyone sleeps outside so far in fear of the shocks. Still no news of a few more employees. Will update you as we know more.

Lots of supplies have come in that I will be taking with me and up to 12 other people and my kids going along via the DR on Monday. Mario St. Laurent, a pediatrician and Board member, and his son are also going.

CROSS International sent $10,000.00 to the Dominican Republic via CURE Int'l for us to use for medical supplies. We will have someone taking care of the purchasing and establishing a liaison between the DR and PAP. Praise God for that gift and the possibility of getting the needed supplies.

Many have already died at the hospital. Natalie, administrator of the hospital, and the rest of the staff are doing the best they can, but they are emotionally breaking down. Keep them in your prayers.
Most of us have not slept since the news. Pray, Pray.

Damaged areas in the hospital are being repaired so that we can consolidate. Some major poles need repairs near the operating room areas. Pray for fuel as well as we need that for the generators. Natalie was trying to get some from Maurice our board member, but only one gas station was open. I will try to get some from the DR as well as gas for the anesthesia machine.

Thank you so much for all the comfort and love. Will keep you posted as I have more info.

Blessings,

Gladys