Wrapped in a bundle of warm blankets and lucky to be alive, four-month-old Thomas Bekele still faces a precarious future.
Orphaned three weeks ago when his mother died from tuberculosis, he is one of the almost five million orphans in Ethiopia - a mushrooming crisis that the government warned was "tearing apart the social fabric" of the country.
The rising number of orphans has, however, raised the demand for adoptions to a record high. Some 1,400 children made new homes abroad last year, more than double from the previous year.
Adoption agencies also doubled to 30 in the capital Addis Ababa in the last year, a highly lucrative market with some agencies charging parents fees of up to US $20,000 per child.
Bulti Gutema, who heads the country's adoption authority, says adoption of orphans poses many moral quandaries to his government. He blames the growing number of orphans and the increasing numbers of adoptions on poverty.
"We would prefer these children to remain in Ethiopia because it is their country," he says. "Adoption is the last resort because it doesn't help alleviate poverty in Ethiopia."
Bulti, however, admits that the $115 million a month needed to care for orphans in Ethiopia is simply out of the question, when compared to the country's annual health budget of $140 million. It means, for some children, overseas adoption is the only option, he says.
In a move to help stem the growing orphan crisis in Ethiopia, the US government announced a $20 million project in December to help the 530,000 HIV/AIDS orphans.
"We can't afford to look after every orphan," Bulti adds. "That is why adoption is one of our existing alternative child-care programmes, although it really solves the problems of just a few children."
Ethiopia has strict adoption laws, but the process can be pushed through in 10-15 days if the paperwork is in order, according to Balti.
An international convention, established in 1993, exists to protect children who are adopted overseas. It has been approved by 66 nations, although the Ethiopian government has not signed it yet.
Most orphaned children from Ethiopia go to France, Australia, the US and Ireland. Couples are turning abroad because of the huge delays - four or five years sometimes - to adopt within their own country.
"Parents adopt from Ethiopia because of the poverty and the children are beautiful and attractive," said Tsegaye Berhe of Horizon Homes, a halfway house where children from orphanages wait until they are selected by parents from the US.
"It is not difficult to adopt here, the Ethiopian government has few restrictions for adoptive parents. Organisations like his will pay orphanages a small amount for upkeep of a child.
"This should not be seen as though we are purchasing a child," says Tsegaye. "We are just refunding the costs incurred by the orphanages."
Most adoption agencies are non-profit. His organisation, which opened last year, received around $6,000 a month to cover the expense of looking after the 32 children it sent to America. Next year, they hope to send more than 50 children.
For accountant Russell Giles, 33, and his wife Vivian, 30, who have four of their own children, they expect to be in Ethiopia for three weeks while they adopt brother and sister Philimon, 5, and Bersable, 6.
"The government here has been very open and willing," said the couple from Salt Lake City, Utah, who are adopting privately from an orphanage, rather than through an agency. "Other countries appear very open, but clamp up once the process has started."
While they meet Philimon and Bersable for the first time in a nervous encounter, just a few metres away, 15-year-old Genet Girma was trying to give her two children up.
"I have nothing to give them," she said of the two tiny eight-week old twins strapped to her front and back. "I am too poor."
Most mothers will simply abandon their children near a police station or church rather than turn up at orphanages, where by law, they must be turned away. Any children that turn out to be HIV-positive cannot be put up for adoption.
Daniel, a three-year-old, bright-eyed boy who is HIV-positive, sits and stares each day as new prospective parents walks around the orphanage, often crying when they leave.
"It is very hard for him to see children leave with new moms and dads because he never leaves and he doesn't understand why," says Sister Camilla, who has worked in the country for more than 30 years.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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