Nepal became an important source of children for international adoption in part because adoption is not widely practiced or accepted among the Nepalese, an attitude that is prevalent across South Asia.
But the United States and several other countries have recently stopped adoption of abandoned children from Nepal because of allegations of fraud.
Some critics opposed to the U.S.'s decision say it only punishes the children left behind and sentences them to a life stuck in an institution. It's a position that Elizabeth Bartholet, director of the Child Advocacy Program at Harvard, strongly agrees with.
"The easy thing to do is what our regulators do, which to say let's punish the children. Let's just imprison the children who have done nothing wrong," Bartholet said. "It destroys a lot to keep kids in these institutions."
The State Department's Susan Jacobs defends the decision to clamp down on adoptions from Nepal. She says the sole goal is to ensure international adoptions are ethical—the U.S. had no choice but to stop adoptions of abandoned children after finding that documentation provided by the Nepalese government was often fraudulent and unreliable.
"Our goal has always been to protect the child, the birth parents and the adoptive parents because I can't think of anything worse than completing an adoption and then finding out a week or month or a year later that there is a parent out there looking for their child," said Jacobs.
One orphanage tucked away in the outskirts of Kathmandu, Nepal, however, is seeing the effect of this policy change first hand.
Sapna Ekta Rana runs the Sagarmatha Children Home. She says as international adoption has dried up, so too have the funds needed by the orphanage to sustain its regular operations. And in the Sagarmatha Children Home, that means providing food, education and shelter for children is getting harder and harder.
"The main source of funding is from adoption parents...there is no government support," said Rana.
Before the recent policy change, when parents adopted a child from Nepal through the international adoption program, they were required to pay the child's orphanage a fee or "donation" of $5,000. That money, Rana says, was used to fund the rest of the children at the orphanage who hadn't been adopted or could never be adopted.
And without that regular income coming in, Rana says they have no choice but to shut their doors. "Right now we are not able to take in any children because the home is full," said Rana.
Rana notes that without the ability to adopt out children from her orphanage internationally, the future of many Nepalese orphans is grim. Once a child turns 16, the orphanage no longer is able to support him or her. That's when many Nepalese orphans might find themselves abandoned with nowhere to turn.
Many international organizations, including UNICEF, have urged the Nepalese government to finds ways to increase domestic adoptions. They argue that international adoption should be considered a last resort, and countries such as Nepal must first try everything they can to take care of orphans within the country.
The State Department's Jacobs urged the Nepalese government to implement stricter oversight of its adoption program.
"There are countries, and not just in the west, but all over the world, that can do this properly. And there is no reason that Nepal can't. All it takes is a little bit of political will," said Jacobs.
Jacobs says the political turmoil that Nepal has faced over the last decade cannot be used as justification to ignore the need for better adoption oversight.
"I know there is a lot of political chaos there. It's a difficult place to be right now, but they could do this. They need to do this for their children. The children are the most important thing in a country and they are just letting these things happened to them and there is no excuse for it," said Jacobs.