Six years ago today, on May 12, 2011, 13-year-old Ethiopian adoptee Hanna Williams, born Hana Alemu, died from hypothermia and malnutrition in the backyard of her adoptive home. In September of 2013, her adoptive parents, Larry and Carri Williams, were convicted of her murder, and will be in prison for decades to come.

While many of us adoptive parents of Ethiopian children have mourned her death, I don’t think we can underestimate the impact Hana’s death has had in Ethiopia. The news of her death made headlines there, and the subsequent trial and sentencing of her adoptive parents reverberated in many corners and conversations in Ethiopia. The circumstances that led to Hana’s death–the isolation of eating outside from the rest of the family and not being allowed to participate in Christmas or birthdays, the punishments of water on sandwiches and frozen vegetables for dinner, having her head shaved for cutting the grass too short, having food withheld as punishment, being forced to shower outside, being hit for failing to stand the right way, and being locked in a small, dark closet for hours at a time–are harrowing at best. The jury at the parents’ trial agreed that the treatment met the standard of torture, and that is not an easy legal standard to reach.

Hana Alemu (Williams)

For Ethiopians in government and in the Ministry of Women’s Affairs, for the average Ethiopian aware that thousands of Ethiopian children were sent each year to other countries for adoption, and for the Ethiopian parents who have placed children for adoption, the news of Hana’s life and death after only three years in America was heartbreaking and infuriating. My sense is that her death has been an undercurrent in considerations of policy changes regarding international adoption from Ethiopia.

We can say it was a rare case, and that’s true. It does not give solace. There may be some resolution in knowing that Larry and Carri Williams will be in jail for over 20 more years. That knowledge though is tempered by the fact that Immanuel, the other Ethiopian child they adopted and abused, will probably be haunted for the rest of his life by the trauma of his time with them. Their 7 biological children, who witnessed the abuse and testified about it at their parents’ trial, have also been badly damaged by the abuse and the death–which several of them witnessed–of Hana.

None of us can know what went on in Hana’s mind and heart as she endured the cruelty of the people who were supposed to love her and keep her safe. Three-year-old Hyunsu O’Callaghan, adopted from Korea, was killed by his adoptive father about four months  after he arrived in the United States. Hana and Hyunsu’s fates crush the popular narrative of adoption: the orphan in search of a family, the parents who take her in, the happy life then lived by everyone.

Another crushing blow to the fairy tale narrative is the reality and tragedy of suicide in the adoption community. Again, yes, it is rare, for which we are all grateful. Still, when we hear about the death by suicide of adopted persons, especially for example the suicide of a 14-year-old Korean adoptee just 11 days ago, all of us in adoption need to look at ourselves and what we are doing to educate and help.

I don’t know if there is a unique poignancy to the deaths of adoptees, but it feels that way. Adoption is supposed to mean a better life, right? That can be true (depending how you define “better”), but another larger and vital truth is that adoption follows loss. Loss can also be trauma. Adoption can be full of love and equally full of deep sorrow and grief. Many people struggle with depression and anxiety, and as a society, we are still reluctant to recognize those struggles as real. As an adoptive parent, I have known many adoptees, both young children and adults, who wrestle with depression that may well be rooted in having been adopted. That’s true for people growing up in deeply loving families who provide all available resources for mental health challenges, as well as for those whose adoptive parents are abusive. For those who get help, the struggle can still be difficult. For those who don’t, it can be excruciating. Add in the complexity of growing up as a person of color in our racist society (much of which does not/will not believe we live in a racist society), the bullying which has aways existed but is exacerbated by social media, the lack of racial mentors/mirrors/role models for adoptees, and a history of neglect and abuse prior to adoption, and it’s easy to see how a delicate balance can be tipped into despair and worse.

Please let me offer some takeaways from these haunting deaths:

Adoption is rooted in loss, in the cases of infants placed at birth with adoptive parents, in the cases of children removed from abusive or neglectful situations, and in the cases of adopted children who grow up with loving families. It doesn’t mean therefore all adoptees are doomed to despair and ruin. It does mean that as adoptive parents, we must be aware of the role that trauma and loss can play as our kids grow up, and even well into adulthood.

The screening process for prospective adoptive parents must include serious discussions about possible struggles with depression and anxiety for adoptees. Parents need to hear directly from adopted persons about their struggles. Anyone involved with preparation for prospective adoptive parents and with counseling of parents and adoptees must step up their services prior to adoptive placements to encourage families, after placement, to reach out for help and not live in isolation, as the Williams’ family essentially did. There is no shame in asking for help in difficult circumstances, whether children or parents are struggling.

Everyone, with or without a connection to adoption, should file away the phone number of the National Suicide Prevention Lifeline: 1-800-273-8255. If the Def Jam artist Logic can release a song about it, the rest of us can surely keep the phone number, share it when needed, and learn about suicide prevention. There are many resources available to anyone considering suicide and to anyone who fears that someone may attempt suicide.

And please do not think I am ignoring the needs of first/birth parents, and the loss and trauma that they experience. While my focus here is on Hana and other adoptees after an adoptive placement, I recognize that first/birth parents also need support and resources for depression or other challenges post-placement.

I keep Hana in my heart. What happened to her should never have happened to any child. The notion of children dying by suicide is wrenching as well. I know many adult adoptees are especially grieving the loss of their young counterparts, and looking for more ways to help. We need to keep conversations open, especially around adoption, depression, and loss. We need to acknowledge the pain and complexity, to speak up for vulnerable children, and to offer help to struggling families.