Awaiting the arrival of a child is filled with joy, but also fraught with anxiety. Will the child be healthy? Will I be a good parent? How will the household adjust? All that is true, and more, when families adopt a child from overseas. That is what makes SLU’s Foreign Adoption Clinic and Educational Services (FACES) center so invaluable.

SLUCare-SS-_5 (1)It’s been 20 years since SLUCare pediatrician Dr. Jennifer Ladage adopted her first child from Nanjing, China. She knew immediately he had health issues: rickets and a cleft palate were apparent. Ladage joined support groups for international adoptee families, but she felt the need for a better way to educate new parents about the physical and emotional problems specific to internationally adopted children. So, in 1999, with help and funding from her alma mater, Saint Louis University, she founded the clinic, now a nurturing resource for the families of children from faraway lands. “I had done my residency at SLU, so it made sense to approach them, and they recognized the need,” Ladage says.

In 2012, the SLU clinic, located at SSM Health Cardinal Glennon Children’s Hospital, began working with refugee children and their families, too. “We became aware that refugee children were having trouble assimilating at school because of unmet health needs,” Ladage explains. After an initial evaluation, the youngsters are transferred to the care of the other SLUCare physicians.

Both of these childhood populations face challenges, Ladage explains. While orphans from abroad often have problems with attachment, refugees are more prone to the effects of trauma, like depression, anxiety and PTSD, she says. “It is very likely a child coming from an orphanage has suffered from an impoverished start in life single parent situations where there may have been mental illness, drug use and other risky behaviors.” But along with a nurse, psychologist and occupational therapist, Ladage addresses and treats all the initial medical, physical, emotional and psychosocial needs of these children and their families. In addition, the clinic assesses a child’s needs prior to adoption (as best it can) by reviewing family history, medical documents and photographs.

Dana Galbraith, a doctor and former medical missionary, first met Ladage at a training session before adopting her first child from Ethiopia in 2011. “The emotional aspects [of international adoption] are huge,” Galbraith says. “You are bringing a child from a hard place.” She adds that when her boys arrived, they were malnourished and had parasites from drinking dirty water. FACES, she says, tested for infection and provided all immunizations.

Although thousands of children have been adopted from outside the United States annually since 2002, Ladage reports a general decline in numbers as the process has changed. “It’s less about money these days, and more about the well-being of the child,” she says, adding that the Hague Adoption Convention, signed by the U.S. in 2008, may have reduced many countries’ ability to place children outside their borders. While adoption numbers have declined, the number of refugee children treated by the clinic has increased; two-thirds of patients are refugees from places like Cuba, Somalia, Congo, Myanmar, Nepal, Syria and Iraq. Meanwhile, the adoptees come from China, Korea, the Philippines, Ethiopia and countries in Eastern Europe. The children find their way to the clinic by word of mouth, or adoption agency referrals and via the International Institute of St. Louis, which helps resettle and integrate immigrant populations. Working together with other caring service agencies, FACES eases the transition for young, new St. Louisans.

Based at SSM Health Cardinal Glennon Children’s Hospital, SLUCare’s Foreign Adoption Clinic and Educational Services (FACES) is a comprehensive program that addresses the medical, physical, emotional and psychosocial needs of internationally adopted and refugee children and their families. Pictured on the cover: Dr. Jennifer Ladage and a patient. For more information on services or an appointment, call 314.268.4150 or email

Cover design by Allie Bronsky
Photos courtesy of SLUCare Physician Group

Pictured: The Galbraith family