Ukraine is a blind referral system. The family must travel to Ukraine to receive a referral.

referral = Ukrainian government employees (SDAPRC department) met with an approved family for 1 hour to discuss specific children.

Family may not receive a referral that mets their expectations on gender, health or age. Under the old system with the NAC department, this happened to about 1% of adoptive families every year. So some families would return home without meeting a child.

2005 was an awful year. This seemed to happen much more frequently.

This hasn't happened to any family happened to the Schnitzel family under the new SDAPRC department.

After agreeing to a referral, a family travels to visit the child. They travel by train, airplane or car to the orphanage. The family may hire a Ukrainian doctor to examine the child. Or the family may be using an adoption doctor.

Regardless.... It is the adoptive family's responsibility to make arrangements for any medical evaluation.

For anyone who wants additional information... here is a good link Ukrainian medical system.

After meeting the child, the family may not feel a connection. Or the child's medical issues are beyond what they are prepared for. Families need to be sure about what medical conditions are acceptable before traveling to Ukraine.

The word healthy is very subjective. A missing leg is no big deal to 1 family. A family may recognize the signs of Fetal Alcohol Syndrome but don't care because they feel connected to the child.

Meeting the child and turning down the referral can be a very emotional experience. Occasionally families will return home rather then getting another referral.

This also happened to the Schnitzel family. They felt awful being away from home at Christmas time. They decided to leave Ukraine without asking for another referral.

Families can return to the SDAPRC for another referral after turning one down.

And there are some rare situations where families return from Ukraine without a child. Each of the examples below really happened.

Family member got sick/died (at home or in Ukraine).

Husband and wife arrived in Ukraine and couldn't stop arguing. They decided the trip was a mistake.

Family received referral. They traveled and visited with child. Husband wanted to adopt child. Wife didn't. Experience was so emotional and overwhelming for the wife that she convinced husband to return home.