Orphan children play in their bedroom at an orphanage in the southern Russian city of Rostov-on-Don. (VLADIMIR KONSTANTINOV/REUTERS)

Dima Yakovlev lived at the orphanage here and so did Maxim Kuzmin. Both were adopted by American parents, and, five years apart, both died in the United States. Two young boys from this out-of-the-way town, they became symbols for those who successfully agitated to stop the flow of Russian children into American homes.

Something must be deeply wrong if two defenseless children from the same small orphanage both die within months of their move to America, said Pavel Astakhov, Russia’s children’s ombudsman and the country’s primary opponent of international adoption.

And, in a country where someone can always be blamed, prosecutors here in the Pskov region, along the border with Estonia, have opened an investigation into employees of the local child-custody agency. Criminal charges, possibly trumped up, could result, but they won’t get at the heart of what really ails Russia’s Soviet-legacy child-welfare system, critics say.

“The system does not work,” said Yulia Yudina, who runs the Moscow-based adoption-advocacy group Change One Life. Looking for scapegoats in Pechory will ruin innocent people’s lives and won’t solve the problem, she said. “It’s doubly disgusting.”

Russia has 600,000 “orphans,” although 70 to 90 percent of them have birth parents who are alive. This is Russia’s third great wave of orphans, the first two coming on the heels of the two world wars.

A number of factors are at work, but central to all of them is the lack of assistance to families under stress. Russia traditionally has one approach when dealing with disabled children and children of parents who cannot cope: The state takes custody.

A majority of orphans end up with relatives, but the orphanages also are full. Children’s advocates stress two points: The country must do much more to try to keep children with their families, and when that fails, it should concentrate on promoting adoption and foster care for toddlers and older children.

“But the system doesn’t want to be transformed,” said Boris Altshuler, a longtime advocate for dissidents and children. “It doesn’t want to let children out. The people who run it are protecting a system that destroys Russian families.”

Many orphans are disabled

Children in Russian orphanages are almost certain to have at least one disability. The disabilities can be congenital or related to alcohol consumption by the mother during pregnancy — or they have arisen because of the loss of emotional contact that comes with life in a state orphanage.

Every month in an institutional setting has a physical impact on the brain, said Chuck Johnson, head of the National Council for Adoption, in an interview in Alexandria. “Every child will come with some developmental delays.”

Adoptive parents, he said, need to know they can get help after the adoption, because they will need it. In Russia, there is scarcely any assistance. As many as 10,000 Russian orphans are returned to orphanages every year by frustrated adoptive parents, according to Lev Shlosberg, an opposition politician in the city of Pskov, the regional center.

About 60 children, all younger than 4, live at the orphanage here in Pechory. (After their fourth birthday, they move to a different institution.) Closed to the media, it was described by volunteers and local child advocates as being in good repair, with decent physical equipment and caring, if low-paid, staff members.

Natalia Vishnevskaya, the orphanage director for the past 30 years, knows that is not enough. “Children suffer from an insufficiency of attention, of individual attention,” she said in an interview. There aren’t enough teachers here (or at virtually every other Russian orphanage) to provide that.

So she has become a strong advocate for adoption, and that distinguishes her from many of her counterparts in the country. It’s one reason that international adoption agencies, working through the child-custody agency, found several hundred matches in Pechory over the years, including Dima and Maxim.

Dima, renamed Chase Harrison, was left in a car in a Virginia parking lot and died in 2008; Maxim, by then known as Max Shatto, died this year while playing in his back yard in Texas.

Their deaths, according to those who are familiar with the orphanage here and the system of adoption, were nothing more than a horrible coincidence. They haven’t shaken Vishnev­skaya’s commitment to adoption.

“The main thing is that our children will have loving families,” Vishnevskaya said. “It doesn’t matter what country they go to.”

But now, in Russia, it does matter. American adoptions have been prohibited since January, and Astakhov said that all foreign adoptions should be banned. Russia, he said, should stop “selling” its babies.

“That’s an absolutely irresponsible statement,” Vishnevskaya said, “especially on such a painful issue.”

Even Astakhov’s representative in the Pskov region, Dmitri Shakhov, cast doubt on the accusation of baby-selling. “That would be an international crime,” he said. “If there are any facts — well, we don’t comment on statements by federal officials.”

(The United States has barred adoptions from Guatemala and Vietnam over allegations of baby-selling, but no Russian case has aroused suspicions, according to an American government official who is familiar with the situation here and who spoke on the condition of anonymity because he was not authorized to speak on the record.)

Increase in drinking, drug use

Alina Chernova, a Pskov journalist who writes about children’s issues — and volunteers at the Pechory orphanage — said that the surge in Russian orphans stems from the Soviet collapse but is handled by a system that is still largely Soviet in its outlook.

Drinking and drug use have increased since the early 1990s, she said. The consequences of poverty are more dire than they were under the Soviets, and families are falling apart now that there is less state control of private life — through the workplace and housing, for instance, she said.

A study of orphans in the Murmansk region in 2007, led by Laurie Miller of the Tufts Medical Center, found that 60 to 70 percent of the children had signs of fetal alcohol syndrome. That’s not necessarily a guarantee of disability, Miller said in a recent interview in Boston. “Some kids do well. There are resilient rascals.”

But she said as many as 25 percent of American parents who have adopted Russians report 10 to 15 years later that they don’t believe their children will be able to live independently because of developmental disabilities.

In the Soviet era, disabled people were kept out of sight, because they were considered an affront to the Soviet ideal. Mothers of newborns with any disability were urged so strongly to give up their children that few resisted. There was a belief that Soviet institutions knew better how to raise such children than their parents would — and that belief lingers.

There was also a more pragmatic understanding that in Soviet — and now Russian — society, resources available for families with disabled children are few.

Some people are trying to change that. Andrei Tsaryov runs a private school for 44 disabled children in Pskov; the school is based on the belief that these children are better off at home than in an institution. It was set up with assistance from the Evangelical Lutheran Church in Germany.

“We try to encourage parents not to give up their children to the state,” Tsaryov said. At home, his students learn to exercise some control over their lives. “I want to get up late and boil an egg. You cannot do that if you are in an institution,” he said. “You are in a system which reduces your freedom as a person, as a personality.”

The physiological effects of institutional life on the developing brain amount, he said, to “artificial retardation.”

But it’s an uphill struggle, he said, and there’s little understanding or support from the bureaucrats at the ministry for social protection.