Accidents of Birth

M. and I just returned from 12 amazing days in Vietnam. We marveled at the lantern festival in HoiAn and were overwhelmed by the street life in Hanoi. We ate well, swam in warm water, bowed before Buddha, and visited Uncle Ho at his Mausoleum. But the undisputed highlight of this trip was an incredible over-night home-stay with a H’mong family, high in the green rice terraces of the northwest.

With the exception of two dim light bulbs, a mobile phone, and a few other household items, when we stepped over the threshold of their home, we could have been stepping back several centuries. It is a small structure constructed of sturdy hand-hewn boards and a metal and tarp roof. The floor was packed earth, and the “stove” was a pit in the floor with a metal tripod. All of the furnishings (a couple of bamboo platform beds, a low table, and several very low stools) appeared to be handmade. There was no latrine, just Mother Nature. We slept in their grain loft, next to big bags of rice that they’d grown and would sustain them throughout the year. Three hogs were in a pen just a few steps away and piglets and chickens wandered about.

Also wandering about were four small children, all under the age of 12. (There were two older children in the family as well, a daughter away at school and a son in the army.) They all wore what in the U.S. would be considered dirty rags and no shoes. Two of them had terrible coughs and regularly spit gobs onto the earthen floor. The littlest guy had some kind of splinter in the sole of his foot, which his mother attempted to extract with an unsterilized needle before we offered the tweezers and some antibiotic ointment from our little travel first-aide kit.

We went to visit the home of our other guide, and it was quite similar. (It should be mentioned that we did notice a satellite dish and a latrine at at least one other home in that village!) This home appeared to be part of a larger family compound with several buildings scrunched together on the same small, relatively flat piece of land on the hillside. Again, there were a half-dozen very small, dirty – and adorable – children racing around. We couldn’t communicate well enough to figure out who were siblings, and who were cousins, and who were just extended clan. But we did learn something that really moved us.

We were asked not to go back to part of the compound because the extended family had gathered there to mourn the death of a two-year old niece of the guide, who had passed away the day before. I think we understood that the little one had been sick for a few months, but that her death was unexpected.

What stood out to me is that this situation was probably not all that unusual for these people. More than 23 of every 1,000 Vietnamese children die before their fifth birthday. (Vietnam’s rate is between Albania and Panama. In the U.S., it’s 7.8 children.) This is actually better than I expected. But given the extreme poverty and remoteness – and apparent lack of awareness regarding germ transmission, as evident by the spitting and splinter removal - of the village we visited, I suspect the rates there are much higher than the national average.

During all of our visit to Vietnam, not just in this H’mong village, we saw so many children, in such tough conditions. I hasten to add that none of them seemed to be suffering. But so many of them were working – in the fields, on fishing boats, in the markets, or in the family’s restaurant, hotel, or shop. And we observed many, many young children who seemed to be in charge of their younger siblings, such as girls who appeared to be five or six carrying infants on their backs, with no adults in sight.

I thought a lot about poverty while we were in Vietnam. Does being desperately poor make these people unhappy? Certainly not. But does it limit the possibilities for self-determination? Absolutely. And why do poor people seem to have so many kids? Then again, why shouldn’t they? Does having one more mouth to find make them any less capable of parenting well? Unfortunately, in many circumstances, I think it does. So often, poor parents are just too overwhelmed making ends meet to have the wherewithal to provide the kind attention and support their children need to thrive. I’m not saying that there aren’t wonderful parents with very meager resources. I’m saying that it must just be so much harder when you are also struggling to put food on the table.

Of course, I was also thinking a lot about adoption and the increased opportunities we could provide for a Vietnamese child. But one of the ethically thorny things about adoption – domestically as well as internationally – that has been niggling at me is the likely role that a wide disparity in incomes often plays in placement. If I wasn’t comparatively rich, would I be able to adopt (even adoption through foster care requires a steady income, a safe home, etc.)? If certain birthfamilies weren’t comparatively poor, would they even be considering giving up their child? Am I okay with that?

I’ll conclude with what I feel is a revealing anecdote. M. and I have occasionally gone to support groups coordinated by our agency. At the last meeting, one of the fathers said that he thought it was a real red flag when a potential birthmother indicated her motivation for placement was “because she had other things she wants to do.” He felt this was a horrible reason. I told him I thought it was a great reason, and asked what he thought would be a more encouraging answer. He said he’d feel more comfortable if she was placing because she couldn’t afford to have another baby. I wondered (perhaps more out-loud than I should have) how things might be different if, rather than the agency, this birthmom received our sizeable fees directly.

I’ve wandered a long way from telling you about our trip to Vietnam. I think it is because I returned with more than just many of M.’s incredible photos, some beautiful H’mong textiles, and a touch of jet lag. I have returned with an overwhelming sense of gratitude for being born when and where I was to my wonderful, upwardly mobile family.