Joey Adler could barely contain her anger when she returned to Canada recently from Haiti.
Ms. Adler had been on her third trip to the country, delivering medical supplies on behalf of the Montreal-based OneXOne Foundation, which she founded. When she arrived at the Port-au-Prince airport to board her flight home, Ms. Adler saw nearly 100 pallets loaded with bottles of water sitting on the tarmac, going nowhere. "I was so angry," Ms. Adler recalled. "People were starving and thirsty in the streets."
She added that on each trip to Haiti, she has seen ever-increasing piles of emergency supplies stuck at the airport. "I don't know what it is and I'm not blaming anyone," she said. "But there is something wrong. There is something drastically wrong."
As the earthquake relief effort in Haiti enters its fifth week, there's growing concern about the effectiveness of the global response and whether the hundreds of millions of dollars, and thousands of volunteers, pouring into the country are making a crucial difference.
The problems stem from a combination of the overwhelming number of aid groups operating in Haiti and the lack of government capabilities. Haiti has relied on a patchwork of outside assistance organizations for so long that the government has never learned how to deliver services to the country in the best of times. Add to that a massive disaster and a swarm of hands trying to help, and the abundance of good intentions overwhelmed the scarce capacities of the country and the organizations.
"It was pretty frustrating," said Scott Lewis, co-founder of Eagles Wings Foundation, a U.S. non-profit group that distributed more than two million meals in the week after the quake. Mr. Lewis recalled having 12 of his trucks turned away from a World Food Programme warehouse one day because his volunteers had failed to tick off one of 30 boxes on a form. "That was absolutely horrendous," he said, noting the hassle came from a private contractor hired by the WFP.
Rick Davis, a Florida volunteer with the Salvation Army, said he and a couple of other volunteers put together a list of roughly 30 orphanages around Port-au-Prince that needed food. They sent the list to 20 non-governmental organizations, or NGOs, and United Nations agencies to see if they could help. "Nothing happened," Mr. Davis recalled. He added that the Salvation Army eventually stepped in.
"There are no bad guys," Mr. Davis said. "It's just there is no method of co-ordination. It drives me crazy."
The United Nations, which operates out of a sprawling base near the airport, has been trying to co-ordinate the relief operation by setting up 16 "clusters." Each cluster is made up of several NGOs that are assigned specific tasks such as food distribution, logistical support and water supplies. The structure is complex, often involving 30 or more NGOs in each cluster and a constant stream of meetings and paperwork.
UN officials have acknowledged the operation has been frustrating and fallen behind schedule. In fact, the UN has met just half of its target for food distribution, although improvements have been made recently, and it is far short of its goal of putting 200,000 Haitians to work on cleanup projects (35,000 had been employed as of Friday).
And, while more than $1-billion (U.S.) in donations has poured in from around the world, many UN operations remain underfunded. The Cash for Work program, which has been among the most effective in putting money into the hands of Haitians, has $12-million in financial commitments but needs $36-million to meet its objectives. The WFP has said it will now need $750-million, more than twice its original estimate, to fund its earthquake response operations this year.
One of the biggest problems, many aid workers say, is the sheer number of NGOs operating in Haiti. Roughly 900 groups have registered with the UN since the earthquake hit, but many more "do-gooders" have simply arrived, with varying degrees of preparedness. Many have done more harm than good, aid workers say, by tripping over each other and duplicating efforts of the UN clusters.
"Everybody flew down here in the beginning and wanted to help out, which didn't help things," said Adam Rogers, a spokesman in Haiti for the United Nations Development Programme.
"It was utter chaos at first," says Mark Fried, spokesman for Oxfam Canada. "It's actually up to the [NGO]agencies to provide the up to date information to the UN on their activities so there is co-ordination."
NGOs have played a controversial role in Haiti for years, and the earthquake only exacerbated some of the problems.
By some estimates, more than 10,000 NGOs have operated in Haiti in the past decade. They range from giants such as Care and World Vision to small neighbourhood groups that run a single program. Over all, NGOs operate 92 per cent of the country's schools and provide 70 per cent of the health care, according to a 2006 study by the World Bank. The result is a patchwork of unco-ordinated, unregulated services of varying quality that operate outside the already weak government institutions.
"The fact that there are more NGOs per capita in Haiti than in any other country in this hemisphere is in part a reflection of need, but also in part a reflection of overreliance on NGOs," Dr. Paul Farmer, the UN's deputy envoy to Haiti, told a U.S. Senate committee last month.
"The aid machinery currently at work in Haiti keeps too much for overhead for its operations, and still relies overmuch on NGOs or contractors who do not observe the ground rules we would need to follow to build Haiti back better."
Haiti's history of corrupt politicians has also prompted many countries to channel their foreign aid through NGOs, bypassing the government and further weakening state institutions.
"This means that the NGOs are very much in charge," said Robert Fatton, a foreign affairs professor at the University of Virginia who grew up in Haiti. "When the [NGOs]are large, sometimes that makes sense. But when they are so small that you have little projects everywhere and no co-ordination, [there is]a lot of duplication and a lot of competition."
When the earthquake hit, killing more than 200,000 people including close to 100 UN officials, many of these issues complicated the initial response. Weak government institutions meant there was no emergency preparedness, even though Haiti has faced other emergencies such as severe hurricanes. There was also no attempt to mobilize help, or government officials, from communities outside Port-au-Prince that had not been affected by the earthquake.
Communications Minister Marie Laurence Jocelyn-Lassègue recently talked about the chaos immediately after the earthquake, telling reporters she saw two cabinet ministers riding away on motorcycles and then frantically began calling international media to plead for help from Haitians living abroad. She added that in the days after the earthquake the government handed control of the airport to the U.S. military and had no idea what NGOs were doing. "The NGOs did not do it [in concert]with our priorities," she said.
President René Préval, who has faced mounting criticism over his handling of the crisis, has complained repeatedly since the earthquake about the lack of co-ordination with NGOs. When he recently made an international plea for 200,000 tents to house some of the estimated one million homeless, several NGOs and the UN contradicted him, saying plastic sheets were preferable because the city was too crowded.
Mark Fried, a spokesman for Oxfam Canada, and Mr. Rogers of the UN insist co-ordination has been improving in recent days, and that some UN clusters are working with Haitian government entities.
Volunteers such as Ms. Adler of OneXOne hope they are right.
"If there continues to be this negativity, all of a sudden people are going to think the next time there's a problem, they are not going to give," she said. "They just aren't going to give."