Hawaii hosts Marshallese baby market

Friday, November 21, 2003

Hawaii hosts Marshallese baby market

Pacific Business News (Honolulu) - by Kristen Sawada Pacific Business News

Hawaii has emerged as a staging ground for Marshallese women who come here to give birth and relinquish their newborns to American adoptive parents.

It has become a free enterprise marketplace for Marshallese babies -- a lucrative industry that has skyrocketed since the late 1990s.

So far this year, the state has had 47 adoption referrals for Marshallese children born in Hawaii, according to Child Welfare Services, which says adoptions have increased over the last few years though statistics weren't readily available. The cost to adopt a child is estimated at between $25,000 and $35,000.

"It's really human trafficking and no one is really accountable," said Julie Kroeker, an anthropologist and program director for Small Island Networks, a federally funded nonprofit agency that works with Marshallese and Micronesians living in Hawaii. "It's not illegal but it's certainly unethical in my mind."

The Marshall Islands saw a surge in adoptions since 1997 because of highly flexible programs and fewer regulations compared to other countries, Kroeker said. Americans adopted more than 500 children from the Marshall Islands from 1996 to 1999 compared to an average of seven adoptions annually prior to that period, according to her research in the Marshalls for a 1999 University of Hawaii paper detailing the practice.

The practice isn't illegal in the United States. But, because of the prevalence of Marshallese foreign adoptions -- and potential abuses in the system -- the Marshallese government implemented a new law Oct. 1 prohibiting agencies from coercing mothers into giving up a child or facilitating the transport of mothers to the United States for adoption of their babies.

The law -- intended to ensure that all Marshallese adoptions are done in the nation -- created a Central Adoption Authority, a regulatory body that imposes penalties of up to a year in jail and $1,000 fine.

While the Marshall Islands' new adoption act can't restrict the travel of Marshallese women to Hawaii without violating their constitutional rights, internationally licensed adoption agencies in the Marshall Islands can no longer facilitate and solicit adoptions, said Michael Jenkins, who oversees the new Central Adoption Authority.

"Without solicitations it's almost unthinkable that women on their own would be pursuing stateside adoptions," he said. "Given the cultural context and cost effectiveness, they wouldn't know the systems that they would negotiate and it's expensive."

Lina Morris, who has operated Pacific Children Adoption Agency for eight years in Majuro -- the capital of the Marshall Islands -- is closing the business and moving to Dallas, where her daughter runs the state-based firm.

"The new law says that [we can] no longer work here, I can't be a facilitator because the Central Adoption Agency here is now taking over that," she said, adding that Marshallese mothers are intimidated and refuse to go to the new authority. "I feel like I've let them down when I'm leaving. I'm also like a bridge between them and their adopted family. "

Kroeker says agencies that currently help pregnant Marshallese come to Hawaii for adoption are circumventing Marshallese law and U.S. Immigration and Naturalization Services regulations for international adoptions since a baby born here becomes a U.S. citizen and a domestic adoption -- a simpler, faster and arguably cheaper process.

The 1986 Compact of Free Association -- an agreement made by the federal government and the freely associated states of Micronesia, the Republic of the Marshall Islands and the Republic of Palau -- allows Pacific Islanders unrestricted access to residence, employment, education and health care in the United States in exchange for military defense and security stakes in the Pacific.

"Under Marshallese law what is being done is illegal; under U.S. law it appears we are turning a blind eye, specifically in Hawaii," said Nancy Partika, executive director of Healthy Mothers, Healthy Babies Coalition of Hawaii. "What we're hearing is these adoption agencies know how to push it through the court system."

She added: "The Marshall Islands have two things of value: a missile-launching location -- a range which the United States uses in return for the Compact of Free Association -- and infants who are worth a lot of money."

A growing, profitable industry

It's well known to neighbors at the Moanalua Hillside Apartments that Mississippi-based Southern Adoptions houses pregnant Marshallese women there until they give birth and relinquish their newborns to adoptive parents.

Multiple neighbors who didn't want to be identified confirmed that more than 20 Marshallese mothers-to-be occupying at least three "nests" came here to give up their babies.

A translator for Southern Adoptions who answered the door at one of the apartments with four Marshallese mothers said the agency has eight women living in the complex. The Marshallese mothers refused to comment on why they're giving up their babies.

"It could be a horrific situation of using women as baby mills," said Sen. Roz Baker, D-W. Maui-S. Maui, who will introduce legislation in 2004 to try to force adoption agencies to pay the medical expenses of birth mothers, who generally are placed on the state Medicaid program. "The taxpayers in Hawaii end up subsidizing a private business. These people are being brought in for a specific purpose. It's not as if these Marshallese decided that they wanted to relocate to Hawaii."

Kauai adoption attorney Linda Lach, who has done about 900 adoptions in 20 years, says she's assisting birth mothers who ask for help in placing a baby and is giving the babies a chance for a good life. She said she doesn't know how many Marshallese adoptions she's done, but that it's a relatively small part of her business.

Lach says her office doesn't place Marshallese birth mothers on Medicaid and charges adoptive parents a fee for their medical expenses.

"I know what my ethics are and how I sleep at night," she said. "One way is I don't expect the state or federal government to pay someone's medical bills for an adoption."

The average adoption through her office costs between $25,000 and $35,000, which includes the mother's travel expenses, medical bills and accommodations. Lach's initial prenatal fee from the adoptive parents is $3,000 and she collects $10,500 when a baby is successfully adopted -- a process that generally takes between 12 and 15 months, she said.

"If [a mother] is legally here and what we're doing here is legal I fail to see the problem," Lach said. "I don't think anybody is circumventing anything -- we're doing everything according to the adoption law. If I weren't comfortable that what I do is legal, ethical and moral I wouldn't do it and it sure as hell isn't for the money."

Lach maintains she's not doing anything illegal or unethical because birth mothers aren't coerced into the adoptions.

"If a birth mother says she doesn't want to do it then we send her home," she said. "They're entitled to make up their own minds. Ethically, legally and morally it's our obligation to be sure that they're doing what they want to do."

But Marshallese -- who have a tradition and culture of extended-family adoptions where a child sometimes returns to his or her biological parents as an adult -- may not understand American adoptions, Kroeker said.

"It's a tradition of cementing family bonds and community ties through adoption," Kroeker said, adding that 42 percent of the Marshallese population is below age 15. "Even once someone adopts your child in Marshallese culture the child is still your child. Adoption is seen as useful in many ways, not just to serve the child. Adoptions by Americans have become a possible economic strategy."

Biuma Samson, consul at the Republic of the Marshall Islands Honolulu consulate general's office, says the Marshallese government doesn't have a handle on American adoptions and the nation's new law is meant to stop the practice, which goes against Marshallese cultural values.

"It's way beyond imaginable," Samson said. "To give up the kids to people outside of our island or outside of our country is really against our tradition and the values we inherited from our great, great grandparents. The system was to have the adoption only among our family."

Drain on Medicaid, state resources

Marshallese often come here for health care and get onto the state Medicaid program, which spends $7.3 million annually on health insurance for Compact citizens. The state Department of Human Services spends a total of $12 million on health care, financial assistance and other social services for Compact citizens. As a whole, combined with state agencies and private providers, Hawaii spends significant sums to care for Pacific Islanders, said Lillian Koller, DHS director.

"There's another strain they put on in terms of our hospital system," she said. "There's other expenses the state is making on Compact folks that is still of a health nature, like emergency rooms, community clinics."

While it's legal for Marshallese to come to Hawaii and sign up for Medicaid, sources say adoption agencies are exploiting the system by placing them on Medicaid but charging adoptive parents for their medical expenses.

"They're definitely taking advantage of the system," said Dave Heywood, Hawaii Pacific Health vice president, adding that the hospital system loses $4 million to $5 million annually on health care for Compact citizens. "Typically that's what adoption agencies try to do and because of the Compact agreement anybody can come to Hawaii and declare that they're going to reside here and go immediately onto the Medicaid or Quest program. One of the sad things about that is it certainly appears some adoption agencies are taking advantage, putting these people on the state Medicaid program and then pocketing a significant fee."

In addition, many Marshallese mothers arrive in Hawaii late in their pregnancy with pre-existing medical conditions and no prenatal care and are placed immediately on emergency Medicaid, Partika said.

"They're coming in with [sexually-transmitted diseases] and other health conditions that put both the mother and baby at risk," she said. "Some local facilities here at one point were seeing more than 10 a month of these adoptions coming through within the last year."

Beyond costs, this is a social justice issue involving the health and welfare of infants, mothers and families, she said, adding that the state and federal government must develop clear policies on adoptions to eliminate potential abuses and injustices.

"The bottom line is these children and parents and families are being exploited," Partika said. "These Pacific islands have so few natural resources; their children are their future. Hawaii is participating in the exploitation of these children being taken away from their homeland permanently. I don't think we can just stand by and say it's not our responsibility."

Reach Kristen Sawada at 955-8036 or ksawada@bizjournals.com.

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