Until the global decline of transnational adoption in 2004, "40,000 kids a year were getting really good homes and moving from devastating circumstances," according to Bartholet. "That's an amazing social program that changes people at no cost to the home country. To shut that down is tragic."
Craig Juntunen, a former quarterback in the Canadian Football League and an entrepreneur who retired at age 43, toured a Haiti orphanage in 2006.
The experience changed his life, as he watched children "climbing over each other" to get a hug.
Later that year, he and his wife adopted three children from Haiti.
"Looking into their eyes when they first came, we were filled with a happiness we had never felt before," said Juntunen, who lives in Scottsdale, Arizona. "But, I was constantly reminded of how kids living in institutions, deprived of such simple things as human contact, are robbed of the opportunity to grow into happy, healthy people."
He wrote about his experience in a book, "Both Ends Burning," which is now the name of the international adoption advocacy group he founded.
The group produced a documentary, "Stuck," documenting the travails and successes of people attempting to adopt in Vietnam, Ethiopia and Haiti. In each case, children matched for adoption continue to spend years in institutions while adoption requests move at glacial speeds across two countries.
Juntunen's group took the film on the road, showing it in cineplexes, film festivals and churches across 60 cities in 78 days, culminating in an "empty stroller march" on Capitol Hill in Washington.
A goal of Juntunen's group is to raise international adoption in the U.S. to 50,000 children a year and cut the average time to approve adoptions to nine months.
In 2011, fewer than 10,000 overseas children were adopted in the U.S., with an average wait time of three years.
"We have to create the social and political will to deal with these things," he said.
The boom-bust cycle
To debunk the idea that corruption is the exception in the current international adoption systems, critics point to Guatemala, which was shut down in 2007 for adoption after allegations of families being coerced and children kidnapped to feed U.S. demand.
Before Guatemala closed to U.S. adoptions, the ratio of children adopted hit one per every 100 live births, according to the Adoption Council -- more than double the rate in Latvia, the next-highest nation.
Two years later, the number of foreign adoptions from Guatemala dropped 90%.
As Guatemala closed, adoptions in Ethiopia -- now the second-largest supplier of orphans to American families -- skyrocketed from fewer than 900 in 2003 to 4,564 in 2009.
"International adoption tends to work in this boom-bust cycle ... one country closes, and another country becomes this popular hotspot," said Kathryn Joyce, author of "The Child Catchers: Rescue, Trafficking and the New Gospel of Adoption."
Many adoption agencies went from Guatemala to Ethiopia where "the number of agencies leaped from five to 50 in a few short years," said Joyce, who traveled to Ethiopia while researching her book.
Brokers who source children for agencies can earn as much as $5,000 per child -- "five times the amount they might expect to earn a year," she said. "The influence of all this U.S. money can be distorting."
Whole economies can emerge when international adoption blooms in a developing nation. Employment from agencies, new guesthouses and hotels for the influx of prospective parents, and even a rise in "searchers" -- people paid to investigate the birth origins of a child like Lemma when U.S. families begin to doubt the stories agencies provide.
"Adoption is a business, there is no question, sadly," said Susan Soonkeum Cox, vice president of policy and external affairs at Holt International, a nonprofit Christian adoption agency based in the U.S. "Many people got into this because it's an opportunity to help (orphans), but for other people it was a lucrative business opportunity. You could see this in the explosion of adoption agencies and practitioners.
"There are so many cases of corruption ... as an adoption agency, no one is more appalled, because we all get stuck with it and have our reputation smeared."
Haiti earthquake and adoption theology
The international adoption debate played out on the world stage in the aftermath of the devastating 2010 Haiti earthquake, which killed 200,000, when a group of U.S. Christian missionaries were accused of kidnapping "orphans."
Laura Silsby led a group of 10 missionaries from Idaho that was stopped at the Dominican Republic border as they tried to cross the border with 33 children without proper legal documentation.