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From the heart: Personal experience gives International Adoption Clinic codirector unique insight into both challenges and rewards

When she talks about international adoption‚ Cynthia Howard, M.D., truly speaks from the heart.

Associate director of the Global Pediatrics Program‚ Howard recently was named codirector of the University of Minnesota’s International Adoption Clinic‚ which helps children from other countries and their new families cope with health and related issues. Howard is also the mother of two sparkly-eyed adopted daughters‚ Christine and Loice‚ who in their four short years have already overcome more challenges than many of us encounter in a lifetime.

“My credibility comes from being an adoptive parent‚” Howard says.

Christine and Loice‚ identical twin girls‚ were born October 28‚ 2001‚ to a family living in the Democratic Republic of Congo. Conjoined from their chest to their abdomen‚ they were brought to Kampala‚ Uganda‚ where Howard‚ then a member of the University of Maryland faculty‚ was teaching medical students and residents as part of an exchange program with Makerere University in Kampala. Howard arranged to have the girls brought to the University of Maryland Hospital for Children to be separated.

The surgery was successful‚ but the twins’ parents found themselves unable to care for the two girls‚ and they ended up in an orphanage.

“We decided the best place for them was in my home‚” Howard says‚ “and they’ve been with me ever since.”

Her subsequent first-person experiences with international adoption‚ immigration‚ and citizenship proceedings have given Howard a unique perspective for her work with the International Adoption Clinic. In Maryland—the family just moved to Minnesota last year—the girls received great medical care but no resources tailored specifically to international adoptees.

“If I had known about the International Adoption Clinic‚ I would have come out here‚” Howard says. The advice she now offers to others— “all those little pearls for parents I learned the hard way” —would be incredibly valuable‚ she says‚ were she to do it all over again.

Thanks to clinic founder and codirector Dana Johnson‚ M.D.‚ Ph.D.‚ Howard‚ and others in the International Adoption Clinic‚ parents here don’t have to learn the hard way. The clinic provides counseling and health care from before adoption through the first two years the children and parents are together as a family. Pediatricians‚ pediatric nurse practitioners‚ occupational therapists‚ and child psychologists help with preadoption medical evaluations‚ post-adoption health screening‚ and ongoing specialized care. They counsel adoptive parents on how to deal with special needs‚ such as chronic health problems and separation anxiety.

“Our responsibility is to take care of international adoption children and their families coming into this region‚ and to do excellent research that informs us and our colleagues here and in the rest of the world‚” Howard says.

Being an international health expert and an adoptive parent alerted Howard to issues that need to be addressed. She has worked to streamline appointments‚ improve accessibility‚ and boost research to establish best practice guidelines for the clinic. She also hopes to help improve the immigration and citizenship processes‚ which she found costly‚ frustrating‚ and inadequate from a health standpoint.

“I thought‚ this is an area we need to research‚ publish‚ change‚” she says. “I’d like to be part of the change.”

Meanwhile‚ she’s part of other big and delightful changes as well. Christine‚ strongwilled and affectionate‚ is learning to swim. Loice‚ stubborn‚ tenderhearted‚ and fascinated by insects and other animals‚ now composes her own music. Both love books.

“It’s been fun‚” Howard says. “I enjoy being a mom.”

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