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Monday, October 19, 2015

The Flavor of the Month - Written by Drew

The last eighteen months have been tough for international surrogacy facilitators and agents.  In the wake of several high profile cases, India has continued to tighten its restrictions on surrogacy.   Thailand closed its doors in 2014 although the case of Baby Carmen continues to highlight the danger of surrogacy in a place where the legal framework is evolving.  An earthquake in Nepal didn't slow them down, but the Supreme Court in Nepal has put a moratorium on surrogacy.  The news from Mexico has not been encouraging. 

Of all the possible locations on the planet to descend upon for surrogacy, where are the international facilitators and agencies going now?

Cambodia.

 As a wise man once said, I'm not making this up.

Let's see what the US State Department (link) has to say about traveling to Cambodia.


On Crime:
"Cambodia has a high crime rate, including street crime. Military weapons and explosives are readily available to criminals despite authorities’ efforts to collect and destroy such weapons. Armed robberies occur frequently, and foreign residents and visitors, including U.S. citizens, are among the victims. The Embassy has also received reports that hotel rooms of U.S. citizen visitors in Phnom Penh were burglarized while the occupants were asleep."
"Local police rarely investigate reports of crime against tourists, and travelers should not expect to recover stolen items. It has also been reported that some police stations charge foreigners between $20 and $100 to file a police report."

The concept of someone breaking into my hotel room while I'm sleeping is creepy to say the least, the idea of this happening in a room where my newborn infant is sleeping is horrifying.  That's saying nothing about the military-grade weapons that are easily accessible.

On LGBT Rights:
"While there are no legal restrictions on same-sex sexual relations or the organization of LGBT events in Cambodia, public attitudes remain negative towards LBGT individuals, and same sex marriage is generally not permitted. There have been no reports of arrests or violence related to LBGT travelers."

The fact that there have not been reports of arrests or violence related to LGBT travelers may seem encouraging, however the cultural climate of negativity towards the LGBT community is  concerning.  What is more concerning is that despite several cases of LGBT parents experiencing legal issues in non tolerant countries, that facilitators and agencies continue to bring their clients to places where their rights are not recognized and protected. 


Most importantly, this is what the US State Department says on on Health:

"Medical facilities and services in Cambodia do not meet international standards. Both Phnom Penh and Siem Reap have a limited number of internationally-run clinics and hospitals that can provide basic medical care and stabilization. Medical care outside of these two cities is almost non-existent. Local pharmacies provide a limited supply of prescription and over-the-counter medications, but because the quality of locally obtained medications can vary greatly, make sure to bring a supply of your medications that is adequate for the duration of your stay in Cambodia. You should be wary of purchasing local medication. Counterfeit medication is readily available, often indiscernible from authentic medication, and potentially lethal."

Even if we were to ignore everything else, what about the above paragraph indicates that Cambodia is a safe and appropriate place to conduct a surrogacy?   By definition, surrogate pregnancies are considered high risk.  The increased risk of multiple pregnancy and prematurity make access to high quality health care critical for the safety and wellbeing of babies.

Likely, if you point this out to one of the facilitators or agents currently touting Cambodia as the next great option  for international surrogacy they will  tell you that "their" doctors and clinics are state of the art.  Given that they make thousands of dollars from IPs with absolutely zero accountability for outcomes, I suppose it's not surprising that they would minimize the risk.   Disappointing, but not surprising.  I mean really.... who cares what the State Department has to say as long as the facilitators "feel" good about it. 

Families through Surrogacy's website has the following to say about surrogacy in Cambodia:


Note:  The Cambodian surrogate retains parental rights under the law.   While facilitators may feel comfortable minimizing the risk that this poses to intended parents, one only has to look at the current Baby Carmen case to see just how dangerous ignoring the legal rights of the surrogate is.  

As always, we urge all hopeful IPs to consider the risks to everyone involved when it comes to weighing your options, no matter how desperate you may feel.  As has been said here before, where your baby will be born is the first decision you will make that could have serious and/or long-lasting repercussions on your baby's health.  As the first anniversary of my twins' birth and my son's death quickly approaches, I remember how we were reassured repeatedly that our surrogate was receiving the absolute best care possible, and that my twins would have access to the same level of healthcare as they would in a regional medical center in the United States.  My wife and I believed what we had been told repeatedly by our facilitator, and it wasn't until we received conflicting information in the wake of the premature birth that our facilitator admitted that she wasn't a medical professional.

As a matter of fact, none of them are.

None of them are legal experts in any of the numerous countries they have churned through over the last almost two years, either.   There is no possible way any of them could become legal experts on surrogacy in country after country after country.  

None of them are fluent in the local language, and I find it implausible that any of them could have become experts in the local customs and cultural practices in the very limited amount of time that they spend there before declaring a program "open for business." 


Yet they routinely present themselves to desperate intended parents as being experts who are able to determine whether a hospital, clinic, or even an entire country is an appropriate and safe place to bring a newborn into the world.  



Monday, September 14, 2015

When you don't know what to say to someone who has lost their child......




1.   Don't be an ass, don't insert a but after your condolences.   Try this:  "I am so incredibly sorry that this happened.   I just don't know what to say."  

2.  Do not ever say or imply that my son's  death was "for the best".   Period.   Ever.   If Johnny had lived he likely would have been neurologically devastated.   Guess what?  I love my children regardless of their abilities.   We would have loved and treasured him regardless of his potential for accomplishment.   Say this instead, "You must be devastated.   Would you like to talk about it?"

3.  Do not tell us that "god needed another angel".   Even if the person you are speaking to is religious, telling someone who has just lost their child that somehow it's because "god" needed them more than their parents did is naive at best, and insulting at worst.  Try this instead, "I'm going to be thinking about you.  I wish there were more I could do."

4.  Don't tell us when we should be done grieving.   You don't get to tell me when I "should" do anything related to Johnny's death.   Instead, say this "I know that this pain will never go away.  Anytime you would like to talk about Johnny, I would love to listen." 

5.  Don't tell us that if you lost a child that you wouldn't be able to go on.   What choice do you think I had?  Mere hours after my son died, I had to get on a plane....to take care of my daughter.   When I came home, did I want to crawl into bed and die myself?  Yes.   Was it an option?  No.  Because someone had to be there, not only for my living children, but for my husband.   Say this instead, "I can't imagine how you must be feeling.  I am so very very sorry."

6.  Don't compare grief.   Losing your parent, your friend, your sister, your grandmother or your beloved beagle is not the same as losing a child.   (Yes, these are all examples of grief comparison that I have heard.  Just say this, "There is nothing as painful as losing someone you love.   I am so sorry that this happened to you."  

7.  Don't try to make my grief about you.   You do not need to tell me how hard it is for YOU that I'm grieving.  You do not need to tell me that my son's death was hard for your kids or your husband or your best friend.   While you may be trying to show me that you're empathize with my feelings, all it does is put me in the position of having to comfort you.  I don't have the energy for that.   Try this instead, "My entire family has been thinking about you and how difficult this must be.   Please know that we care about you and want to help if we can."

8.  Don't be afraid to say my son's name.   There isn't a moment that goes by that I am not thinking about him.  Knowing that other people still think about him is a good thing.  If you are thinking of Johnny say, "I was thinking about your little guy the other day, if you ever want to talk about him, I would love to listen."

9.  Do not say "At least you have Maizy."   Please go look at your children.  Report back to me which one of them is disposable.   Of course, I am grateful that I have my daughter.   I am beyond grateful that I have all of my children.   That does not for one second take away from my pain at losing Johnny.   Say this instead, "How are the kids?  Do you think they might like to go to the park?  Would you like me to come by and hang out with them for a little while so that you could take a nap?"

10.  Don't try to imply that I, or any other parent who has lost a child is responsible for the death of their child.   Every single one of us lives with guilt and shame every day even if it is totally undeserved.  We don't need any help with that.  This is not the time to say,  "This is why I <insert did surrogacy domestically, don't vaccinate, used xyz product, etc>  If you need to congratulate yourself on what an amazing parent you are and reassure yourself that what happened to me will never happen to you-  Do it on your own time.  Say this instead:   "I am so incredibly sorry."  

Wednesday, March 4, 2015

Complete Surrogacy Solutions: You had ONE JOB - by Drew


I’ve been an IT professional for almost 10 years now.  I’ve been in my current job for a little over a year, and its been a new experience for me, as I’ve moved into a sysadmin role.  I very much enjoy my job, and I’d like to think I’m doing well in it.  If someone comes to me with a problem, I am straightforward about my ability to fix it, as well as how much time I think it’ll take.  If I misrepresent either, I’m not only making myself look bad, but my whole team’s appearance suffers.  In a similar vein, when dealing with vendor support teams, I need to be honest about my knowledge and experience in order for them to best know how to assist me.  If I were to claim I knew more than I did, I’d actually impede the process of resolving my problem.

When the disasters with our travel visas and our twins’ birth happened, I don’t doubt that on some level, Kim believes she did everything she could to help us.  The ultimate reality is she accomplished nothing that helped us.  One reason for this is that I believe that Kim, for all of her projected confidence, amiability, bluster, and bravado, doesn’t have any influence on the actual surrogacy process.  At the very least, she doesn’t have as much as she thinks she does.  Here is how I came to this conclusion.


Point 1 - Kim did not seem to have any substantial relationships with the professionals in India, and didn’t appear to have invested in the ones she may have had.

  Until she went there after we’d returned home, Kim hadn’t traveled to India since the birth of her ‘nephews’ back in May of 2013.  We know this, because said so on her Facebook page.   At the very least, despite promising us that she would, she never visited India while our surrogate was pregnant.  As a result, she never saw the conditions at Adiva Hospital.  If she had, one would think that different decisions about Adiva’s/Bakshi’s viability as a partner would have been made well before we became her actual clients.

  In all fairness, Kim did communicate with Bakshi’s office via Skype.  I know this happened at least once, as she was on a Skype call with them at the same time that I was at Bakshi’s clinic filling out our initial paperwork in November of 2014, and I saw her myself.  Even if that happened on a regular basis, if she never traveled there herself, she missed out on a tremendous opportunity to cultivate personal and professional relationships.

  There are loads of articles out there that talk about the commuting vs. telecommuting debate that many businesses contend with on a regular basis.  As an IT professional, I get asked about it, and contend with it, frequently.  I have a very pleasant working relationship with my colleague in Delhi, but I had only ever talked to him over Skype.  While I was in Delhi in October, though, I managed to meet him for the first time, took a tour of the Delhi office, and met a few of the other people who work there.  I thoroughly enjoyed doing so.  No longer was “the Delhi office” just a conceptual place to me, I could picture it.  I felt much more connected to my colleague, and he and I were able to talk about things that didn’t have anything to do with the work that we did together.  That deepened and broadened our relationship.

  Seeing the responses and reactions that Kim’s emails to Bakshi and her staff received as compared to ours, I didn’t see any real difference.  As far as we could tell, Kim seemed to be just another American emailing them with questions.  Skype is a great tool to promote connectivity with business entities in remote locations, but without that personal touch - meeting them in person, shaking their hand, exchanging pleasantries, etc. - a relationship can only be built so far.  Only so much a rapport can really be established.  Even though she was a facilitator, Kim didn’t seem to have any more of a relationship with Dr. Bakshi and her staff than we did in the beginning.


Point 2 - Kim never took an active role in our surrogacy journey

  Once we’d signed on with her, Kim sent us several documents about packages, pricing, etc.  One of them was a pre-natal schedule, which supposedly outlined when our surrogate would have checkups, ultrasounds, and the like.  Once we were pregnant, it seemed our entire lives revolved around how far along we were, and how long that meant we had to wait until we got the next ultrasound pictures.

  Almost right off the bat, we had to ask Kim when the next scheduled scan was going to take place and why there were delays.  It didn’t take us long to stop going through Kim entirely and ask Dr. Bakshi directly about the scans.  As a facilitator, Kim’s job was supposed to be preventing us from having to do that.

  We were entirely focused on the ultrasounds, as they were the only link we had to our developing twins.  As the IPs, this should be entirely unsurprising.  In retrospect, however, this was a mistake on our part.  We should have realized that if we had to chase after the clinic to perform ultrasounds on schedule, then who knows what was going on with our surrogate’s checkups?  We eventually did get the medical records for our surrogate, but by then all the damage was done.  Had we asked for these records during the pregnancy, we could have voiced our concerns about Mrs. S’s rising blood pressure and anemia.   Rhy did voice some concerns about Mrs. S’s risk of developing gestational diabetes, but was shamed into silence.  This happened more than once.  While it would have been good for Kim and Dr. Bakshi to at least hear out her concerns, it would have been ideal for them to have been proactively addressed.

  But again, this was supposed to be Kim’s job as our facilitator to ask for and obtain those records.  By being the one who was supposed to monitor the surrogate’s health status, she was supposed to be allowing us to focus on those precious ultrasound pictures.  Instead, all we got were assurances that we were having the ‘picture perfect’ twin pregnancy.  Basic monitoring of our surrogate’s health should have made it quite clear that this was not the case.

  Another set of promises that Kim made to us was that she could help us get what we needed during our stay in Delhi.  She had supposedly negotiated a special rate for her clients at the Hilton Garden Inn.  She had a deal with a local driver and his fleet.  Her package and pricing material even claimed that she would get us an Indian cellphone.  While we remarked to her at the time that an Indian cellphone would be considered quite valuable when we traveled there, we never heard any offer or mention of it again.

  We did not initially stay at the Hilton when we arrived in Delhi.  My colleague at work recommended one that my fellow Seattle-based employees stay at when they travel to Delhi.  While it was very close to Adiva Hospital, it wasn’t as good a hotel as the Hilton was supposed to be.  So we asked Kim to help us make arrangements for her reduced rate at the Hilton for the remainder of our stay.  It was then that we learned that her ‘contact,’ with whom she’d supposedly negotiated the reduced rate for her clients, had left the Hilton for another job, and had left some number of months prior to our arrival.  This is something that, if she were actively managing her relationships in India, she would have known well in advance of our arrival.  So in the end, we had to pay full price.

  Before we even left for Delhi, Kim asked Rhy to check in on another couple’s surrogate for her.  Personally, the fact that she had the gall to ask that of us infuriated me.  Our son, after all, had just died.  Rhy, however, was smart - Given that we were already upset with the level of effort Kim had put out on our behalf, if she checked on this surrogate, then that couple could be assured of a thorough, honest evaluation of the surrogate’s condition.  In exchange for Rhy essentially doing Kim’s job for her, Kim offered to pay for one of our nights at the Hilton.  Even then, she’d only made those arrangements after I reminded her to do so twice.

  She also gave us no assistance with obtaining our exit visas, despite that being one of the most important parts of her self-written job description.  The documents we’d need, the steps we’d have to take once we’d arrived at the FRRO, even the appointment itself were all arranged by Poonam Jain, a consultant in Delhi who has helped many intended parents leave India with their babies, and someone who had worked in the US consulate for many years.  Thanks to her, we were able to get in and out of the FRRO with our exit visas in about 2 hours.  All we had heard from Kim on this subject were horror stories she’d read about online, which involved couples forced to make multiple trips to the FRRO over several days, and in some cases weeks.  “Try to stay calm and give them whatever they ask for,” comprises the sum of her ‘advice’ to us.

  While we were at the FRRO, we learned that the rules had changed regarding medical visas for surrogacy that required us to register with the FRRO upon our arrival.  We didn’t know this, and because the rule change came so close to our arrival, the FRRO agents allowed us to leave despite this oversight.  I understand that rules can change often, but rules such as these are ones that Kim should have been keeping extremely close track of.  Despite us informing her of these changes, she did not pass this information on to another pair of intended parents, and as a result, they had multiple issues obtaining their exit visas, one of which was caused by this rule change.

Conclusion: Kim would seem to have very little to no influence in India.

  When Johnny died the day before Rhy’s flight to Delhi was set to depart, we sent multiple emails to Kim, the US Consulate, and Dr. Bakshi’s team, pleading with them to save a lock of his hair, or take a handprint or footprint for us, as they would serve to be the only physical link we’d have to his 10 days of life.  We have since learned that the way Indian culture handles the death of a child/infant is much different than the way it is handled here in the US, both from a medical and cultural standpoint.  To judge another culture through the lens of one’s own is the height of ignorance, so I want to make clear that this is NOT what we are doing.  Given that, though, I would presume that one would be hard pressed to find someone, regardless of cultural background, that would find our request unreasonable.  Yet when Kim made our request to Dr. Bakshi and her staff on our behalf, the answer we received is that it simply could not be done.  While we were never told why this was the case, here is what I see this is a symptom of, and the point that I have been building towards for the last 3 pages.

  Kim was a facilitator who was sending intended parents to Dr. Bakshi’s clinic.  In short, Kim was supposedly helping Dr. Bakshi make quite a bit of money.  Kim appeared to only maintain digital lines of communication with her, and did not participate actively in the surrogacies that she was responsible for.  As a result, despite the basis of their relationship, it would seem that Dr. Bakshi did not see her relationship with Kim to be important enough to warrant a departure from the standard procedure, even in the event of a premature infant’s death.



I understand and am fully aware that India is a very different country than the United States, and has a very different way of doing things.  At the same time, advertising yourself as a surrogacy facilitator in a country in which you have no ability to take or influence real actionis, at best, foolhardy.  At worst, it is reckless and dangerous.  Kim boasted to us early on in the process that if we were disappointed in Bakshi in any way, Kim would call her up and ‘read her the Riot Act.’  She claimed that she did this several times over the course of our pregnancy, yet we didn’t see Dr. Bakshi’s or her staff’s behavior change at all over time.  Had Kim actually had any of the influence she claimed to have, she could have prevented the death of our son and the infection of our daughter with an STD.  At the absolute minimum, she could have avoided having a set of grieving parents end up with no physical remembrance of their son, which is one of the worst things for the grieving parents of an infant to have inflicted upon them.  We continue to hope that no set of parents ever experiences anything like this as a result of trusting someone they shouldn’t have.

Saturday, February 28, 2015

It has come to my attention that this blog does "not paint me in a very positive light".  



Allow me to clarify.  Because I trusted the wrong people my youngest son died alone, in a filthy hospital of a bacteria transmitted by human shit.  I wake up every morning and have to confront that fact.  It is the last thing I think about at night.  Regardless of what strangers on the internet think of me, it is NOTHING compared to how I feel about my failure to protect my son.

Secondly, you are welcome to call me culturally intolerant because I have an issue with the quality of health care my child received.  Rest assured I have spoken to several doctors in India.  All of them were horrified by the conditions at the hospital, etc....    This is an example of derailing.  It's used as a way to deflect attention away from the topic at hand. 

Prior to threatening someone with a libel or slander suit, I would suggest that you familiarize yourself with protected speech.  For those who have not yet mastered the art of Goggle-fu  

negative review/ tos

https://www.techdirt.com/articles/20140924/16444828628/roca-labs-sues-customer-posting-negative-review.shtml

Friday, February 27, 2015

Complete Surrogacy Solutions/ Kim Hendrix. Review and Complaint #1


There is one issue I want to talk about today.   The first is that Kim seems to be telling people that Drew and I were not her clients.

It is true that Drew and I did not pay Kim her 8000.00 client fee.  When we first connected with Kim, she told us that she would waive this fee because as a new facilitator, it would be helpful to her to have us as clients.  We had received quite a lot of media exposure as a result of the issues with Planet Hospital and therefore would be in a position to make referrals to her.    I made numerous referrals to Kim throughout our surrogacy.  She introduced me to several people at the Families through Surrogacy conference as her client and frequently asked me to write references for her to prospective clients.

Additionally, I am aware that she was given a 10% referral fee from Dr. Bakshi.

Therefore she was paid both monetarily and in kind.

If Kim was NOT my facilitator, why did Dr. Bakshi only communicate with her when my children were being born?  Why was she given our medical records?   Why was she involved in invoicing payments to the clinic?


Kim, you can't only take credit for the successes.  That's not how this works.  It's not how it works at all.


Monday, January 12, 2015

Professional Standards for International Surrogacy Professionals: Part 2 Qualifications and Conflict of Interest

My husband and I chose to use a surrogacy facilitator not once, but twice.  One of the primary reasons we made that choice was the recognition of our limitations in terms of evaluating a medical facility on the other side of the planet.  In retrospect, we should have recognized that those same limitations applied to the facilitator.

Most international surrogacy agents do not have degrees in the health care field; it’s probably not reasonable to expect them to.  However,  absent accreditation by a credible third party like the International Joint Commission, it seems unlikely that the average layperson  has the ability to evaluate doctors or facilities in a foreign country.   Given our experience,  a hospital that does not adhere to the standards set by the joint commission is not a hospital I would feel comfortable using for high risk pregnancies or infants.  To find out if a hospital meets these standards,  click here.

The fact that a medical facility has a nice website or that it “looks” clean doesn’t mean that it adheres to international standards for patient safety.  

At the same time, if a facility cannot maintain the most basic standards for cleanliness, it seems extremely unlikely they would have the capacity to prevent the spread of infection.  In a country like India, where antibiotic resistant bacteria kill fifty-eight thousand babies  every year it should be obvious why this is critically important. 

The second and equally concerning issue is the conflict of interest in the relationship between facilitators and clinics.  Facilitators frequently receive referral fees from the doctor/clinic.  This is problematic for reasons that I think are pretty clear. At the very least, transparency would seem to require that this relationship be disclosed.

There are hospitals in New Delhi that meet the standards set by the Joint Commission. Again, you can find them here.  I would not feel safe using a doctor who delivered at a hospital that did not meet these standards.    If my agency or facilitator was recommending that I go forward with surrogacy in a country where there were no facilities accredited by the International Joint Commission, knowing what I know now,  I would not be comfortable taking that risk with my baby.

Losing a child is one of the single most devastating things that has ever happened to my family.   Sharing our experience has opened me up to vitriol from strangers and from people I used to call friends. I’ve been threatened with legal retaliation and told that this blog “does not paint me in a positive light.”  What those people don’t seem to understand is this:  My beloved son died.  The last thing I’m worried about is other people’s opinions.  Frankly, I don't deserve to be painted in a positive light because I failed  my son by being arrogant enough to think that I had the ability to protect him from half a world away.  Telling my story isn’t easy.  It shouldn't be, but it’s the only way I can think of to say this:


“Johnny, Mommy is so very, very sorry.”