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CHAPEL HILL -- Marily Nixon and Luca Rigotti had dreamed of adopting a child from Ethiopia for nearly two years. The Chapel Hill couple had gone through the rigorous process that would allow them to adopt from overseas, submitting to an invasive home study and painstakingly assembling a dossier composed of documents to verify everything from their health to employment status.
Then, one day in February, it finally happened. For the very first time, Nixon and Rigotti saw a photo of the 4-year-old girl who would become their daughter. Her name was Tsehaynesh, which means "You are Sun." The couple immediately began preparing their Chapel Hill home for her arrival, setting up a room and buying clothes for the little girl. They even enrolled her in a preschool program experienced with children who speak little English.
As Nixon and Rigotti were awaiting approval to travel to Ethiopia to pick up Tsehaynesh, they were informed that a new policy had been implemented in April by the Centers for Disease Control and Prevention that could affect their daughter.
The policy, known as the "2007 Technical Instructions for Tuberculosis Screening and Treatment for Panel Physicians," was being enforced on a country-by-country basis. It began in Ethiopia this April 1, 2009, and was put into place to help reduce the number of immigrants with tuberculosis entering the U.S., including newly adopted children who are already legally the sons and daughters of U.S. citizens.
This CDC procedure requires that each immigrant pass a TB screening, and if they fail the tests, they must wait until full treatment is administered in the country of origin before coming to the United States.
Realizing that this new policy could cause difficulties for their family, Nixon, a practicing attorney, and Rigotti, a professor at Duke University's Fuqua School of Business, requested that the American consulate in Ethiopia expedite Tsehaynesh's tuberculosis testing, rather than waiting on the U.S. government to test her during the very last days of the adoption process. Despite the fact that the request received support by congressional representatives, it was denied by the U.S. Consulate. Meanwhile, the adoption case proceeded, and the couple became the legal parents of Tsehaynesh on June 30.
Ironically, once Nixon and Rigotti were already in Ethiopia, the results of Tsehaynesh's chest x-ray were, indeed, deemed "suspicious," prompting the CDC to mandate a sputum culture to confirm a tuberculosis diagnosis, the results for which would take 8-10 weeks. To make matters more frustrating, the CDC told her new parents that no treatment was recommended, as she had not yet been diagnosed with TB. Their only recommendation was that she be left in Ethiopia until the results of the cultures came back.
"The U.S. government put us in a double bind," Nixon said. "It claimed that Tsehaynesh was sick and couldn't come back to the United States, while at the same time it claimed that she was not sick enough to get adequate assessment and treatment."
Since Rigotti was still an Italian citizen, the Italian consulate in Ethiopia was able to arrange for the American family to enter Italy and stay until the CDC would allow Tsehaynesh to come home to North Carolina. The consulate also arranged for her to receive medical care, though Nixon and Rigotti must pay for it all, as they are not permanent residents of Italy.
For these new parents, who are already away from their professional obligations at home, the financial burdens are great, especially given the fact that not a single test run by the Italian doctors has shown that Tsehaynesh has active TB, and even if she did, the risk of contagiousness is infinitesimal.
According to Jeffrey Starke, the nation's leading tuberculosis expert, "The chances of a child under the age of 12 transmitting the disease is only a fraction of 1 percent. It has only ever been reported a handful of times in medical literature."
In addition, Starke pointed out that sputum cultures are not a reliable screening tool for children.
"Only 20 to 30 percent of the samples can actually be cultured to check for the germ," he remarked.
Beyond the medical inconstancies lies speculation by the adoptive community that the CDC's policy is ultimately discriminatory, as it does not apply to children born abroad to American citizens.
"Though we applaud the CDC for the work they do, they have unfortunately developed an over-reaching policy that's not appropriate for this particular population and cannot exist in a vacuum to achieve its purpose. The CDC's policy is clearly not in the best interest of these children," said Thomas DiFilipo, president and chief executive officer of the Joint Council on International Children's Services, just one of the agencies working to change the CDC's protocol as it applies to internationally adopted children.
Still, the CDC maintains that it is protecting the American public, though it admits that it does not require similar testing for the many thousands of tourists who enter the U.S. from overseas each year.
"Tourists may not be routinely screened," said Shelly Sikes Diaz, CDC public affairs specialist, from her office in Atlanta.
Meanwhile, a world away, a little girl is wondering if, after losing her birth parents, living in two different orphanages, and now being thrown into a confusing situation in a strange country, she will ever get to go home to a place called "America."
As Nixon and Rigotti yearn for the tranquility of life back in Chapel Hill, they, too, find themselves wondering when their family will cease to be banned from their own home. For now, though, the little girl's room that the North Carolina couple so lovingly prepared sits empty awaiting the daughter they began dreaming of two years ago.
