MOSCOW Family Christmas cards and smiling snapshots of children sent by their adoptive American parents fill Galina Sigayeva's office in Russia's second city St Petersburg.
Many of them were crippled by illness and in desperate need of medical care before her agency helped organise their adoption into U.S. families, she recalls.
Children's rights campaigners say children like these will suffer most if President Vladimir Putin approves a law barring American adoptions that has been rubber-stamped by Russian lawmakers. The act retaliates against a new U.S. law that will punish Russians accused of human rights violations.
Critics of the bill say Russian orphanages are woefully overcrowded and the fate of vulnerable children should not be used as a bargaining chip in a bilateral feud.
"These children are not even offered to foreigners until they get a certain number of (adoption) refusals from Russians," said Sigayeva, a neatly styled brunette who heads the New Hope Christian Services Adoption Agency.
"These are children with complicated diagnoses, really complicated. They are very ill children."
She smiled as she flipped through photos of children embraced by their adoptive parents, playing with family pets and enjoying presents and other trappings of holiday cheer.
"What surprises me is that here they all look so healthy, so fantastic, but you should see what they look like when they are taken from here," Sigayeva said.
"Some had to be carried to the border. We had a girl with hepatitis whom we helped from the emergency room."
Both sides in the heated debate surrounding the bill agree Russia's orphanage system is overwhelmed, riddled with corruption and most failing to place children in families.
More than 650,000 children are considered orphans in Russia - though some were rejected by their parents or taken from dysfunctional homes. Of that total, 110,000 lived in state institutions in 2011, according to the Ministry of Science and Education.
By contrast, in the United States - which has more than twice Russia's population - about 58,280 children were living in group homes and institutions last year, according to the U.S. Department of Health and Human Services.
Adoptions by Russian families remain modest, with some 7,400 adoptions in 2011 compared with 3,400 adoptions of Russian children by families abroad.
Russian politicians say it is an embarrassment that the country cannot care for its own, and supporters of the measure argue it will help stimulate reform and domestic adoptions.
"Foreign adoption is a result of the state and society's lack of attention to orphans ... It is, if you will, a result of our indifference," Prime Minister Dmitry Medvedev told officials at a ruling party congress last week.
American families adopt more Russian children - 956 last year - than those of any other country. Of the children adopted by Americans in 2011, 9 percent - or 89 - were disabled, according to official Russian figures.
Opponents of the legislation, who include senior officials such as Foreign Minister Sergei Lavrov, say politicking should not deprive orphans of this chance at better life.
"Russia is not able to provide for all its orphans," Boris Altshuler, director of the Moscow-based Rights of the Child advocacy group, said. "Although 1,000 is a small fraction - it was a help."
Deputy Prime Minister Olga Golodets has said the ban would violate international treaties on child rights, and the Kremlin's own human rights council called it unconstitutional.
The ban responds to a U.S. law known as the Magnitsky Act, which punishes Russians suspected of being involved in the death in custody of anti-graft lawyer Sergei Magnitsky in 2009, and of other human rights violations, by barring them from entering the United States.
In a pointed echo of the Magnitsky Act, Russia's legislation is named the Dima Yakovlev law, after a Russian-born toddler who died of heat stroke after his American adoptive father left him locked in a sweltering car.
His death and that of 19 other Russian-born children in the hands of U.S. citizens in the last decade has helped drive support for the bill and for tougher adoption rules in a deal with the United States in June.
"It's American roulette," said Pavel Astakhov, Russia's Children's Rights Commissioner and a supporter of the ban.
"One handicapped girl from Russia got lucky. She was Jessica Long - a Paralympic champion. Another did not. She was Masha Allen ... who was raped by her paedophile adoptive father."
If Putin signs it into law, the ban will come into force on January 1, most immediately affecting the fate of children whose adoption is in the works.
The placement of 46 children with American families will be cancelled, Astakhov told the Interfax news agency on Wednesday.
"There is terrible irony in the fact that America's decision to speak out against human rights violations may cause the Russian government to deny many thousands of Russian orphans the possibility to grow up in loving, adoptive families," said Chuck Johnson, president of National Council For Adoption, a non-profit advocacy group based in Alexandria, Virginia.
Sigayeva, of the New Hope Christian Services Adoption Agency, said a six-month halt on American adoptions until a new bilateral deal entered force in November showed how it would aggravate problems in Russia's strained child-protection system.
"Hospitals were overwhelmed. There was no room in orphanages or hospitals for children whom their parents had rejected. So what's next then?" said Sigayeva, whose agency has helped place some 200 children in American families since 1992.
Advocates who work with disabled children say a reform proposal drafted by Astakhov ignores their plight. They say it calls for a reduction in the number of institutions caring for children with disabilities without explaining how they will find foster homes and medical care.
"No concrete measures are being suggested. Nothing exists but a lot of children's pain, which will only increase now," said Sergei Koloskov, a campaigner for children with Down's Syndrome.
"They are being left parentless in addition to being ill."
(Additional reporting by Alexander Chizhenok in St. Petersburg and Corrie MacLaggan in Austin, Texas; Writing by Alissa de Carbonnel; Editing by Douglas Busvine and Peter Graff)