KENSCOFF, Haiti — Filis Casey pitches and rocks in the rear seat of a slow-moving sport utility vehicle, lurching up a corkscrew mountain road until she reaches her destination: a cluster of dusty buildings with leaking roofs and unfinished walls that hold one crude toilet, dank rooms crammed with bunk beds, and 52 orphans with little supervision and little to do.

From her home in Newton, Mass., Casey has traveled the world, lifting children out of the shadows and suffering and into adoptive homes. But she has never seen anything like the problems that plague Haiti, where the overwhelming misery can easily make an orphan’s plight invisible.