Medical Information

Travel Medical Information for Parents
Organizations with information about travel and health
International Association for Medical Assistance to Travelers (IAMAT) will give you a world directory of physicians.

417 Center Street

Lewiston, New York 14092

(716) 754-4883



CDC (Centers for Disease Control and Prevention)

Gives health risk info for countries

888 232-3228 or http://www.cdc.gov/travel/travel.html



Shoreland's Travel Health online web site--has health and safety information on 220 countries

http://www.tripprep.com



Insurance
Make sure your insurance covers you when you are in Russia. We understand there are places to get temporary insurance if it does not, but we don't have particular information on this.



Immunizations for you and your current children
Be sure to talk to a travel doctor or go to a travel clinic. Which immunizations are suggested vary. We were given multiple Hepatitis B and A vaccinations, a polio booster, and a typhoid immunization. Your children at home should also be immunized, in case they catch something from your Russian child after he/she comes home.



What to eat and what not to eat
Talk to a travel doctor or clinic! Ours gave us advice about diseases and food and gave us strong antibiotics, just in case. She also suggested we take Immodium for milder stomach upset.



As for the food, only drink canned or bottled drinks or beverages made with boiled water. Do not drink the tap water and avoid ice cubes. Try to make sure the bottled water you use is not just refilled from a tap (carbonated is safer to avoid this risk). Use bottled water to brush your teeth. Avoid leafy and uncooked vegetables (no salads). Eat fruits, nuts and vegetables only if their skin is intact and you peel them yourself, without contaminating the inside. Well-cooked vegetables are probably fine. Meats should be well-done and very hot. Bread is probably safe, as is a dry rice dish. Avoid cold meat platters, mayonnaise and creamy desserts, buffets and food from street vendors. Don't eat dairy products, which are unpasteurized. Be sure eggs are well-cooked and not runny. Always wash hands before eating. Airplane food on flights inside of Russia is included in these cautions.



Because of these risks, we ended up eating a lot of borscht (vegetable soup) without the sour cream (because it's dairy) and bread. We also had some well-cooked meat and rice in restaurants. For breakfast, blini (pancakes) worked well, and eggs if they were well-cooked.



Be careful not to be offensive to the Russians about this--don't talk to the people who are preparing food for you or who live in Russia about their contaminated food. Just order only what you want to eat, and if you get something you are nervous about, leave it on your plate.



Medical information about the adopted child
The information that you receive about your child (if you receive any) before your first trip may be alarming. But many of the medical conditions are not as bad as they appear. Most children in an orphanage seem to have been diagnosed with rickets, anemia, encephelopathy, and various other diseases. Rickets is a vitamin D deficiency, anemia is an iron deficiency, and encephelopathy is their word for being behind in development. All of these are reversible. Many children (50% in our orphanage) are also diagnosed with a false chord of the left ventricle of the heart, which our pediatrician believes is called pre-ventricular contraction in America, and is a very minor, common condition in children.

Of course, some of the children do have alarming medical conditions in addition to these, and this is why you should contact a doctor in the US who is an adoption specialist. These doctors can look over the medical information about your child before your first trip and tell you what might be a concern and what to expect. This is very helpful, because many of the Russian medical terms translated into English don't make sense to regular American doctors. Your agency should have names and phone numbers for these doctors (they can do it all over the phone). Here is the contact information for adoption doctors we know of: http://comeunity.com/adoption/health/clinics.html; http://www.orphandoctor.com/; http://www.pedes.umn.edu/IAC/default.html; http://www.russianadoption.org/; http://www.nemc.org/adoption/.

Sometimes you might want to get additional medical information about your child before you travel. You can request it, but it may or may not actually appear. You may go knowing very little about the medical state of your child.



After you get the child home, make sure you encourage your pediatrician to run all of the tests that the adoption specialist doctor suggests. Even pediatricians who have dealt with adopted children before may not be familiar with what should be tested, but the adoption specialist doctor will know.



One more medical note about the adopted child: When you are in Moscow you will have a visit with a doctor before you can take the child out of the country. This is a very basic physical exam.



You might consider bringing some medicines with you on your second trip. Tylenol or Advil for pain, cough medicine in case the child is congested, lice treatment (we understand some orphanages have a problem with this), and an antibiotic cream for cuts and scrapes. Also bring bandaids. Be sure to talk to your doctor in the US before you go about dosages for all of these medicines if your child is under the age of two.

Court in Russia

What happens overall:

The situation varies from state to state, but in the state of Amur it goes something like this:

The court includes a judge, a prosecutor (no defense), a translator (from the agency), a representative from the ministry of education, the director of the orphanage, and someone from a Russian government agency called the Registry.

First each person stands up and identifies himself or herself;
The judge explains everyone's rights and responsibilities;
The judge and prosecutor question the adoptive parents;
The ministry of education person, orphanage director, and registry person give their findings;
The judge studies the dossier; and the prosecutor gives a concluding speech.
You then leave the courtroom for the judge to decide your case.
After s/he decides (maybe 10-15 minutes), you are called back to hear the verdict.
The whole process can take anywhere from 1/2 hour to 3 1/2 hours.


Questions we were asked in Court:
v Why do you want to adopt from Russia?

v Why this region?

v How many teeth does your child have?

v How much does she weigh?

v How tall is she?

v What diseases has she had?

v How many times have you met the child?

v Do you have any evidence that she is attached to you?

v Do your children fight?

v Will your children be jealous of her?

v How will you keep her Russian ancestry alive?

v How do you keep all ancestries alive of all of your adopted children?

v Was this the first child you saw?

v How do you know you wouldn't like another child better?

v How do you discipline your children?

v What plans do you have for the child's future?

v How much will it cost you to take care of her per year?

v How much do you save per year?

v Is your income considered average?

v What would be an average income?

v In your home state, is four children considered a large family?

v If serious inflation hits the US as it has in Russia--could you still provide for her?

v Would you get government assistance for having her?

v What will you feed her on the plane?

v Follow up questions--

o Do you think a child this age can drink from a straw?

o Is that all you'll feed her, crackers, juice, and bottled baby food?

v Won't she be afraid to share a bedroom with her sister?

v Will you homeschool your child? Note: They seem to mean by this that the child is not sent to boarding school. Some people have been confused by this question into thinking the Russians wanted them to homeschool (in the American sense). We explained that the child would live at home and go to public school for a few hours, then come back home. This seemed to satisfy them.

v What do you tell your kids about adoption? (Follow-up question--Aren't you sugar-coating the truth?)

v Will the mother work?

v Have your kids ever been mocked for being adopted?

v (To the orphanage director) Is it safe for the baby to fly in her condition? Note--they were referring to a minor condition they called false chord of the left ventricle--our pediatrician says this is "Pre-Ventricular Contraction." See the section on the child's medical information.

v What if she never recovers or gets worse?

Traveling

Traveling
What to bring, what not to bring:
Bring
v An extra change of clothes in your carry-on

v Ziploc bags (for the trip when you'll have the baby to dispose of various baby leavings).

v Medicines for child--see the paragraph on medicines to bring for the child.

v Diaper rash cream

v A few diapers and wipes

v Clothes that fit the climate, raincoats or umbrellas. Check a weather website for specific information (try http://www.wunderground.com/).

v Gifts
o Personal gifts can be sticky. On the one hand, most agencies suggest you bring gifts for people who help you, and indeed, gift-giving is very common among friends in Russia. In actual practice, however, since you are not exactly close friends with the random agency representatives you meet, it can be awkward. Also, since anyone connected with adoption in Russia is in a very exposed and public position, they are very sensitive about anything that might be seen as a bribe. Our advice: give gifts only to

v those you really feel went out of their way to help you or

v those that you have developed a close relationship with, and

v anyone else your agency representative tells you to, provided you feel good about it.

o Gifts for the orphanage, on the other hand, were a good thing. Clothes and toys are especially good. If the orphanage can tell you what they need on the first trip, you can bring it on the second. American vitamins and medicines are not so good--they tend to not get used because of the language problem.

o Most things you might want to give as gifts (except touristy things from America) are easily available in Russia, so you needn't carry it all with you from home.

Don't Bring
v A lot of diapers, wipes, or baby food--you can buy them there, unless you want antibacterial wipes, which we didn't find.

v A lot of bottled water--you can buy it there, and you may have to pay for extra weight.

v Big diamond wedding rings (just a band might be better). Crime is not as bad as you might have heard--like most big cities in the US--but it is not especially wise (nor nice) to go flaunting your extreme wealth (see the section on money).


Plane
Flights from the US to Moscow and back
v Frequent flier miles are the best, of course.

v Northwest's adoption fare is 35% of their normal fare, and the dates are completely flexible. See their website at http://www.nwa.com/features/adopt.shtml. The main drawback to Northwest/KLM is that they seem to have a high rate of lost luggage in Amsterdam.

v British Airways also has an adoption fare.

v Lost luggage is common. Apparently it is especially bad in flights connecting through Amsterdam or Paris, so don't put important documents in checked bags. Bringing an extra change of clothes in a carry-on is a good idea, too.

v Be aware that on your return trip (with your child or children) your child(ren) will have Russian passports. This means that if you must stay overnight in another country on your way back you have to get a transit visa for your child to be allowed into that country. Amsterdam is very accommodating about this, and just has you fill out a simple form at the airport. France is supposedly much more difficult. Ask the airline when you book your flights about this issue.


Airlines within Russia:
You probably will have no choice about which airline you fly on in Russia.



A few things to be aware of, however:

v Bring plane snacks--most of the food they serve is not on the travel okay list see the section on what not to eat.

v The planes are very old. This can be disconcerting at first, but depending on the airline, the can be pretty well kept-up. The FAA has determined that their Russian equivalent does a suitable job of checking and enforcing safety standards. The Federal Aviation Administration gave Russian airlines an acceptable rating (see http://www.faa.gov/avr/iasa). We heard Kras air was a bit seedy, and that Transaero was better than Aeroflot, but this is hearsay.

v Airlines within Russia have strict weight limits (but they seem to be extremely variable). On the same airline and the same itinerary it can range from an allowance of anywhere from 20 to 40 kilos per person (including all carry-ons), with a fee of %1 of the cost of ticket per kilo over the limit.

v Lost and broken luggage is common.


Airports in Russia


v Airports in Russia are very hit and miss.

In Moscow:

o Sheremetyevo II is the main international airport, and is relatively clean and modern.

o Domededovo is a very new, primarily domestic airport.

o Vnukovo is quite run-down.

v Be aware that bathrooms might be unusable (even on the plane), or require payment (so keep some small change handy--the bathroom attendant generally won't have change for 100 roubles).

v Lines are not linear (but big blobs), move very slowly, and are full of people trying to cut in ahead of you. Getting checked in can take over an hour, even in a short line.



Hotels
v The Marriott Hotels in Moscow

o The Marriotts have an adoption rate. It varies, of course, but at the Marriott Tverskaya it should be in the ballpark of $170 per night instead of the regular rate of more than $220. However, be warned that this does not include extensive hidden costs like a 30% VAT, and a sneaky way they exchange the money from dollars to rubles and back again when you're billed (which will add another 10% to your total). The telephone charges are also completely unreasonable--$8.50 per minute to call a toll-free number in the US, and big fees even to use your prepaid phone card. All of this (not including any phone calls) makes your adoption rate actual bill closer to $240 per night.

o Nevertheless, the Marriotts are very nice hotels, the staff speaks English, and the food is great. They also have cribs and high chairs for babies, and it is a comfort to stay here after living in the relatively Spartan conditions of some of the outlying regions.

o The people at the main Marriott 800 number don't always know about the adoption rates, so you may have to call the hotel itself, which isn't a problem because they speak English (but it may cost you a bundle to call Russia if you don't have an international calling plan). You can find the phone numbers on the web at http://www.marriotthotels.com.

v Some Russian hotels in Moscow (all in the $70-100 range--including VAT. And as best we know, they do not do the sneaky Marriott exchange rate trick.):

o Hotel Budapest has received very good reviews.

o The Hotel Ukraina has received mixed reviews. Some really liked it, others complained of the staff's speaking little English.

o Hotel Mir appears to be below most Americans' standards



Please send us your reviews (RussianAdoption AT byu DOT edu) of the hotels you stayed in.



Other Travel Notes
v Passport control can take forever in Moscow. Don't dawdle when getting off your plane--a few minutes at the gate may cost you two hours in line at passport control.

v Bring something to do because you will have lots of free time between orphanage visits.

v Don't exchange more money than you need--it's almost impossible to change Roubles back to Dollars once you leave Russia, but it is easy to change Dollars to Roubles anywhere you need them (in Russia).

v Be careful about prepaid calling cards--they might not work outside of a few big cities in Russia. MCI and ATT cards only work in Moscow and maybe St. Petersburg--even if they tell you otherwise. They may even give you an access number, but check for yourself that the number is really valid for the region that you will be in--the American operator has no idea.

v There are usually no seatbelts in the back seat of cars in Russia--people remove them. Even if seatbelts are there, drivers often tell you don't need to wear them. You don't have to listen to them, of course. In fact, telling the translator that you like having seatbelts might (if you're lucky) get you a car with belt on the next day's trip.

v It costs $110 dollars at this writing to get a Russian visa in 3 days, but your agency may charge you MUCH more than this.

v GPS and other electronic devices are regulated in Russia--be careful and read the US State Department page on this issue http://travel.state.gov/russia.html.

v Customs--Make sure you declare the full amount of money you have with you when you enter and leave Russia.

v Sometimes you have very little warning before your trips, so try to be ready to go on a moment's notice. The shortest notice we have heard of was five days'.

v Make copies of passports and visas and keep one copy with you (separate from the originals) and leave one copy with someone you trust at home.

v Get contact numbers for the people who are supposed to meet you at the airport--just in case.