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As to wait times, remember that just because a country may be "quick" today, it may not be so when someone actually is in process.
All kind of things can occur. A country may close temporarily or change its process. Orphanages may find that they have fewer children in a certain age range or of a certain health status than they had before. A huge increase in the number of families applying can make waits for an appropriate referral much longer. And so on.
Right now, people seem to be doing well with Kyrgyzstan and Ethiopia, but that may not be true by the time your friend is ready to apply. Both countries have seen a recent surge in popularity, meaning that there may be a waiting list for a healthy young child, especially a girl (since Americans prefer to adopt girls). Ethiopia is contemplating changes in its requirements. Kyrgyzstan is new to international adoption, and thus inherently unstable; it is not uncommon for countries in such a situation to close or tighten their requirements when they begin to see large numbers of children being adopted internationally, since there can be a political backlash.
Vietnam is a good example of a country that has seen major changes in waits in a fairly short time frame. A while back, Vietnam reopened after a shutdown of several years, related to U.S. government concerns about corruption in the adoption process.
Vietnam immediately became very popular, as it was when it was open the first time. Prospective parents liked the fact that young, healthy children were available, that the time frame was fairly short, that the process was fairly simple, etc. When China closed to singles and imposed new age, health, and other restrictions, people no longer eligible for that country, but wanting an Asian baby, flocked to Vietnam.
Soon, many experienced agencies had long waiting lists, especially for healthy infant and toddler girls. At first, some began instituting a ban on gender selection for first time parents, hoping that getting more families to adopt boys would help.
But, today, a good many agencies have actually closed their programs to new applicants temporarily. The orphanages with which they work simply do not have enough young children to accommodate even the people currently on those agencies' wait lists in a reasonable time frame.
There are also some concerns that Vietnam may be headed for another shutdown. Unfortunately, the safeguards put in place by Vietnam do not seem to have been adequate to prevent corruption, and some of the same unethical facilitators that operated in Vietnam the last time it was open appear to be back in business. The U.S. government has expressed concern about the problem, and at least some people believe that it could decide to stop Americans from adopting there again.
In short, it isn't all that easy to find a good agency that is open to new applicants for Vietnam, the wait for a referral has lengthened considerably, and there are some risks of a new closure. While your friend could probably complete an adoption of a boy aged 3-6 in a fairly reasonable time frame, it is unlikely that she could adopt a younger child or a girl very quickly.
As to health status of children, ANY child who has been living in an orphanage or foster care situation, in a country where the standard of living may be significantly lower than in the U.S., can have physical or emotional issues related to his/her birth situation and/or his/her life without parents.
Prenatal nutrition in many of the countries from which
Americans adopt can be poor, and many orphanages also do not have enough nutritious food. Medical care may be limited, even for the most affluent people in the country, and orphans may get minimal medical attention. At the very least, a child may wind up with bad teeth, intestinal parasites, etc.
Children may have seen their parents die of disease or in wars or natural disasters. They may also have been exposed to situations in their birth families, such as parental alcohol or drug abuse, which resulted in the termination of parental rights. Even if these things have not occurred, the children who are beyond infancy almost certainly have some memory of losing their birth family, and the loss can be traumatic.
Many orphanages are under-resourced. Even where the caregivers are wonderful people, they may simply be spread too thin to give enough love and attention to each child. And, of course, orphanages sometimes do NOT attract the best people, and there are occasional situations in which abuse or neglect occur. Many children in orphanages have delays or other problems related to the fact that they did not get appropriate stimulation and nurturing.
In general, older children are more likely than younger ones to come with "baggage" related to experiences in their birth families, orphanages, or foster home. It is a good idea for anyone contemplating adoption of a toddler or older child to do some serious reading about the challenges that may be associated with parenting an adopted child in this age range.
The good news, of course, is that the vast majority of internationally adopted children wind up overcoming their tough start and doing very well in their new families. Many may need nothing except love, food, and treatment of minor "bugs." Even those who need a little bit more, such as therapy for minor attachment issues, often wind up adjusting well.
But there are no guarantees. More significant physical and psychological issues may be present. Adoption requires something of a leap of faith.
Of course, a prospective parent can do some things to improve their chances of getting a relatively healthy child. Probably the most important thing is to work with an extremely reputable and experienced agency.
An ethical agency will try to get as much information about a child's health status as possible -- although the amount available may be fairly little -- and will give every scrap of that information to the prospective parent, so that he/she can make a fair assessment of whether he/she can meet the child's needs.
And in countries where it's feasible, a good agency will work to upgrade conditions in the orphanages or foster homes with which it works, to ensure that children have access to nutritious food, good medical care, nurturing caregivers, and developmentally appropriate activities.
I hope this helps.
Sharon