SAN JUAN, Puerto Rico (AP) — Dozens of children are stuck in orphanages across Haiti, unable to leave the increasingly volatile country and start new lives with adoptive parents because a US policy change has unleashed a rush for passports at Haiti’s main immigration office.

US President Joe Biden announced last month that the US will accept 30,000 people a month from Haiti, Nicaragua, Cuba and Venezuela if they pass a background check and have an eligible sponsor and a passport to travel.

The ensuing demand for Haitian passports has overwhelmed Haiti’s passport office in the capital, Port-au-Prince, where people with appointments cannot squeeze through the aggressive crowd or secure new appointments.

Meanwhile, adoptive parents say the US State Department has declined to grant passport waivers as they worry their children will succumb to hunger, cholera or gang violence.

“It’s infuriating,” said Bryan Hanlon, a postal inspector who lives with his wife in Washington.

They became the legal parents of Peterson, 5, and Gina, 6, last year and fear they won’t be able to secure passports for the children and fly them out of Haiti, which has been in a downward spiral since the July 2021 assassination of President Jovenel Moïse.

Last year, the number of reported kidnappings in Haiti soared to 1,359, more than double the previous year, and 2,183 killings were reported, up by a third from 2021, according to the United Nations. Gangs also are raping women and children at an alarming rate, including those as young as 10, officials say.

More than 1 million children are not going to school as a result of social unrest and other issues, with 72 schools reporting violent attacks since October, compared with only eight during the same time period the previous year. Armed groups have attacked more than a dozen schools and set one on fire, and they also have killed one student and kidnapped at least two teachers, according to UNICEF statistics released Thursday.

Haiti also is fighting a deadly cholera outbreak and a spike in starvation.

Last year, 5-year-old Peterson became malnourished and had to be taken to a clinic, where he was treated for a couple of months.

Then in October, the siblings had to flee the orphanage with a caretaker as gangs raided the neighborhood, killing dozens of civilians and setting homes on fire. The violence that erupts as gangs fight over territory has left tens of thousands of Haitians homeless.

“That was the worst day of our lives,” Hanlon said. “We didn’t know if they were alive or dead.”

With their orphanage abandoned because of the violence, the children had been taken by one of their caretakers to her home in southern Haiti, where they have remained, he said.