PORT-AU-PRINCE, Haiti  The floors were concrete and the windows were broken.

There was no electricity or running water. Lunch looked like watery grits. Beds were fashioned from sheets of cardboard. And the only toilet did not work.

But the Foyer of Patience here is like hundreds of places that pass as orphanages for thousands of children in the poorest country in the hemisphere. Many are barely habitable, much less licensed. They have no means to provide real schooling or basic medical care, so children spend their days engaged in mindless activities, and many die from treatable illnesses.

Haiti’s child welfare system was broken before the earthquake struck. But as the quake shattered homes and drove hundreds of thousands of people into the streets, the number of children needing care grew exponentially.

Chronic problems  like inadequate services, overwhelming poverty and shady orphanages  have only intensified, while the authorities fear that some of the less scrupulous orphanages are taking advantage of the chaos to round up children in crisis and offer them for sale as servants and sex slaves.