Logistical challenges and potentially bitter disputes lie ahead as passionate advocates of adoption press for changes that might enable thousands of Haitian children affected by the earthquake to be placed in U.S. homes.
The obstacles are daunting, starting with a need to register Haiti's dislocated children. If done right, this would enable authorities to distinguish between children who might be good candidates for adoption and those with surviving relatives who could care for them.
There also will be efforts to overhaul Haiti's troubled child protection system, update its adoption laws and boost support for family reunification programs in Haiti.
But even before those goals are pursued, there are sharp divisions over how vigorously and quickly to seek an expansion of adoptions.
A prominent leader of the campaign to bring more orphans to American homes is Sen. Mary Landrieu, D-La., who believes some of the major aid organizations active in Haiti -- including UNICEF -- are not sufficiently supportive of international adoption.
"Either UNICEF is going to change or have a very difficult time getting support from the U.S. Congress," Landrieu said in a telephone interview.
Landrieu and a few other members of Congress visited Haiti last week, meeting with top Haitian officials to discuss the plight of the devastated nation's orphans.
Since the Jan. 12 earthquake, about 1,000 Haitian children have been brought to U.S. families who had filed adoption applications before the quake. That pool of children in Haiti is dwindling, and adoption advocates are now ratcheting up their efforts to get a new, larger stream of adoptions in the works.
"There is great support in the United States to begin to open up opportunities for adoption as soon as possible," Landrieu said. "There are thousands of children who don't have parents or even extended families to be reunified with."
UNICEF says a time may come when large-scale foreign adoptions would be appropriate -- notably for older children and those with disabilities. But the U.N. agency and like-minded groups are asking for patience, saying the next priorities should be to register vulnerable children and try to improve conditions for them and their families in Haiti.
"It's complicated," said Susan Bissell, UNICEF's chief of child protection. "We've got to get a registration system in place. Once we have that, we want families for children -- and that includes adoption. We are not against intercountry adoption, but we are against exploitation."
Bissell said she was frustrated by the hostility toward UNICEF that is commonly expressed by leading supporters of international adoption in the United States.
"I find myself saddened by it, but it's not going to take the wind out of our sails," she said.
The chief operating officer for Save the Children, which is deeply engaged in helping Haitian orphans, said the tensions and disputes were likely to revolve around timing -- with some groups seeking to resume large-scale adoptions much more quickly than other groups.
"It's hard to know how big the problem is without taking the time to go through this registration process, and I know for many it's an excruciating process," Carolyn Miles said.
"There are no records," she added. "To be sure that a child is an orphan, that will be difficult -- going back to their villages, trying to find people who know their families."
An estimated 40 percent of Haiti's pre-quake population was under 14, including about 50,000 living in orphanages and more than 200,000 others not living with their parents. It's been commonplace for poor parents to abandon their children, and some are taken in by wealthier families who use them as household labor.
Hundreds of thousands of Haitian children lack birth certificates or other identification, which could complicate adoption efforts. The Organization of American States is proposing a plan to provide all Haitian minors with ID cards, but estimates this wouldn't be completed until 2013.
Landrieu hopes significant headway on registration can be made much faster than that -- but says the many groups working on the task need to coordinate better.
Looking ahead, she hopes for a sizable number of new foreign adoptions by the end of this year -- compared with just a handful at present now that the backlog of pre-quake applications has been largely dealt with.
In recent years, about 300 Haitian children annually were adopted by Americans. Landrieu believes that number could rise to several thousand a year in the future.
"Children belong in families, not in orphanages or in some amorphous kibbutz," she said. "Americans take this call very seriously."
Landrieu and other members of her delegation to Haiti came away convinced that government officials there would support expansion of adoption as long as steps were taken to guard against trafficking and ensure that children weren't being sent away from parents who wanted them.
Indeed, Haitian authorities say they are now accepting new adoption applications, though it isn't clear how long these might take to process.
The head of Haiti's child welfare agency, Jeanne Bernard Pierre, has conveyed some skepticism about efforts to speed up adoptions, saying Americans have taken advantage of the disaster to flout Haitian adoption laws.
"Since the earthquake, the U.S. Embassy has said, 'If you see a kid you like, here's the paper, you can take them with you,'" Pierre told The Associated Press.
Michele Bond, one of the U.S. State Department's senior officials dealing with international adoption, firmly disagreed, saying the post-quake transfers of Haitian children to the United States were rigorously monitored.
Bond also expressed hope that Haiti would proceed with revisions to its adoption laws, which critics say are outdated. The laws place tight age limits on adoptive parents and prohibit adoptions by parents who have biological children -- with exceptions granted only through presidential dispensation.
Chareyl Moyes of Wasatch International Adoptions in Ogden, Utah, has helped bring more than 30 Haitian children to adoptive families in her region since the quake.
Herself the adoptive mother of a 6-year-old Haitian boy, Moyes supports efforts to reunify divided families in Haiti and to improve the lot of disadvantaged children there. But even with those steps, she believes international adoption would remain the best option for many of them.
"The last thing we want to do is take a child, and then have a parent come forward and say, 'I'm looking for my child' after it's placed in the U.S. -- but there are thousands of orphans for whom that would not happen," she said.
She shares Landrieu's concern that spending another year or two in an orphanage -- while registration and assistance programs unfold -- could be damaging to some children who have been traumatized and might fare better with adoptive families.
Dr. Jane Aronson, a New York City pediatrician and expert on international adoption, plans to travel to Haiti on April 19 to help establish long-term assistance programs for orphans.
"I really want everyone to be aware: While you're working hard for adoption, you need to be working hard for the welfare of children -- for more services in-country, better care-taking and education, helping parents get jobs."
She sounded impatient with the ideological disputes over adoption.
"All the accusations have to stop," she said. "You must come to the table together, and you must believe there's a solution together."
(Copyright 2010 by The Associated Press. All Rights Reserved.)