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Apparently close to tears at points during the interview, Madonna refuted claims that her move was a stunt to generate publicity, insisting that she and her husband, the film director Guy Ritchie, had been thinking about adoption for two years, not knowing exactly from where they would choose a child.
She said that her attention first came to David after she saw video footage from a documentary about orphans in Malawi, which she is funding.
"An 8-year-old girl who is living with HIV was holding this child. I became transfixed by him. … But I didn't yet know I was going to adopt him. I was just drawn to him," she said.
On her subsequent trip to Malawi, the singer said, she was accompanied by a paediatrician who assessed the child’s health. Although David tested negative for tuberculosis, malaria, HIV and other common illnesses found amongst African orphans, he was nonetheless extremely ill with pneumonia, for which she sought treatment.
"He's still a little bit ill, not completely free of his pneumonia, but he's much better than he was when we found him," she said.
David was flown to the UK last week after Malawi’s High Court granted Madonna and Ritchie an interim adoption order. Last week the singer issued a statement about the proceedings but has yet to speak on TV.
Although the pre-recorded broadcast is due to be shown this afternoon, details of the interview had already emerged by this morning, with several audience members telling of Madonna’s comments and her composure.
"She was upset at the attention the adoption has brought and when Oprah asked her about allegations that it was publicity stunt, you could see she was holding back tears but she took a breath and composed herself," said Sharon Lynch, who was in the audience. "She said: ‘There is nothing I can say to change their minds.’"
Other audience members said that Madonna told the chat show host that she plans to take David back to Malawi once or twice a year and wants him to become a spokesman for the country.
Madonna was originally due to speak on the show to publicise her new children’s book, but appeared to change the subject of discussion having been stung by criticism that has tainted the adoption.
Dates with other US talk shows are set for coming days in what is sure to become a major PR offensive for the multi-millionaire star.
The saga took a new twist when Mr Banda, a peasant farmer, said that he only agreed to let Madonna take his little boy on the assurance from the government that she would be a temporary carer.
But he told Time magazine that he would not fight the adoption because his son would have a better life with the singer. He said: "I don’t want my child who is already gone to come back. I will be killing his future if I accept that."
Mr Banda was adamant that he had not understood what was happening when he agreed to the process. "It is true that I was not told properly that my child will be taken for good," he told the magazine.
"You know, I am not educated so the way I was told, I thought it would be the same as keeping him at the orphanage, the only difference being that he will be kept by a rich, respectable lady and in America, which is far away.
"I never understood it as my child being taken for good."
Later this week, a coalition of human rights groups will ask a judge in Malawi to review the case, claiming that the country’s laws prevent international adoption, even by celebrities.
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