A frequent question I get when I am in the United States is, “Are things improving in Haiti?”  My response is an affirmative because things are improving in Haiti.  Every time I land in Port au Prince there are fewer people living in tents, less debris, and more paved roads.  On a relative scale, improvement must be acknowledged.

The follow-up question is always, “How has the aid money been spent?”  That question makes me stumble because although improvement is evident, the correlation between the sums donated to rebuild Haiti and reconstruction in place is small.

The outpouring of charitable support in the wake of the Haiti earthquake was phenomenal.  $4.6 billion was pledged to rebuild Haiti, $1.3 from the United States alone (Huffington Post).  Subsequent international disasters, the Chile earthquake in February 2010 and the Japanese tsunami of 2011 triggered only a fraction of that support.  Unlike Chile or Japan, we know that Haiti cannot stand on its own even without the burden of disaster; and the entire world understood that we would have to come to Haiti’s aid or the place would slip even further away from standards of health, education, and well-being that the rest of us enjoy. We gave out of compassion, we gave out of guilt, we gave to support people in need who are much like us; we gave to support people who seem alien;  we gave in cash and by check, online and by text.   Whatever our reasons, we donated money at an unprecedented level.

Let’s put $4.6 billion in an American context.  From my experience as a healthcare architect, that would build ten replacement hospitals, of 500 beds each, complete with operating rooms, MR’s, CT’s and emergency rooms.  Or it could build 460,000 houses at $10,000 each, far above Haitian standards.  Or it could provide 4.6 million medical treatments at $1,000 each or it could provide 3 billion meals at $1.50 each, which is the going rate for a barbequed chicken in Grand Goave.  That would buy over 300 meals for every person living in Haiti.

Not fair, I hear the multitudes cry.  The logistics of delivering aid are staggering, the clean-up alone Herculean, the subsequent outbreaks of cholera and the hurricane in 2011 further tapped aid.  I concede to every counterpoint, but it still will never add up to any demonstration that the $4.6 billion that generous citizens around the world gave to Haiti has been used responsibly.  Not for lack of goodwill or lack of trying, but because any amount of money, even $4.6 billion, is ineffective in a situation of confusion, terror and miscoordination.

We must acknowledge that our basic assumptions are wrong.  The earthquake relief money is not going to rebuild Haiti.  It is supposed to build Haiti.  Haiti was an environmentally depleted country of shacks without roads, sanitation, education, an economy, or trustworthy institutions before the earthquake. It was administered by the United Nations because the ‘public’ government was a sham, the unofficial government of the eleven ruling families steeped in corruption and the bevy of over 3,000 NGO’s made the country the beta testing ground for uncoordinated philanthropic adventure. No one donated relief money after the earthquake to recreate that.

Post-earthquake we have the same stew of chaos, plus a quarter of a million dead (estimates vary from 200,000 to 316,000) plus destruction and depravation that lead to even more hunger and disease.  We have a floodgate of pledges but few reliable hands to steer it to best use.  Even in the face of disaster, the fingers closest to the pot of gold get the biggest handfuls of coin, which is the only way we can describe how 83 percent of the USAID contracts for Haitian relief when to for-private companies around the DC Beltway while only 2.5 percent went to Haitian private companies and less than ½% went to Haitian non-profit organizations (Center for Economic Policy and Research).

The bad news is that we are more than two years out from this tragedy.  The big infusions of aid are history; people have moved on to other causes.  Still we have 500,000 people living in tents and they don’t receive the food aid, sanitary supplies and cholera medications they did a year ago, the emergency medical teams are fewer while the infrastructure for permanent medical care is still scant, and as far as I can tell the only sector of the Haitian economy that has grown is the ever ballooning presence of aid organizations.

The good news is that there seems to be consensus that the new President Martelly is an okay guy, balancing what might help the Haitian people against the almighty foreign interests that play such a strong hand in Haiti’s fate.  The aid organizations still on the ground have moved from a ‘transition’ mode to a ‘stable’ mode, focusing on creating permanent housing and schools and reliable infrastructure.  Perhaps the best news is that, by being so inefficient, only 43% of the pledged aid has been spent.  There is still over two billion dollars earmarked to build Haiti.  With a legitimate government to coordinate NGO efforts and increased emphasis on planned, systematic development, I am hopeful that the next few billion will reap more results than the last.

I have to be hopeful, it is the mindset that prompts me to return to Haiti every month and offer my hand to create change.  For I have made a conscious choice to offer my hand instead of my wallet.  I believe there are real limits to what money can do.  Money is the handmaiden of power, and as just aggregated power corrupts, so does aggregated money.  When the amounts grow to the incomprehensible range of $4.6 billion, the relative impact of additional money dissipates.  I will never disparage anyone who writes a check to help out a fellow human being, but when we have the opportunity to actually meet that person and witness their life, we allow for understanding that no money can buy.

I like to think that the orphanage and school projects are more effective than other aid projects in Haiti, yet we are riddled with inefficiencies.  It is tragic when we cannot accept donations of good quality building materials because the cost of shipping them to Haiti and getting them through customs makes them prohibitive.   It is unfortunate that we have to spend money people donated to build an orphanage in Brit’s honor to pay four security guards to watch the site every night. These are the costs of doing business in Haiti, even if your business is cloaked in the name of good.  Our stats fare well compared with other efforts.  All of our American ‘experts’ in design and construction work for free, so the lion’s share of donations directly buy building materials and pay wages to Haitian workers.   The school and orphanage are not designed to be prototypes that will be easily replicated; they are custom solutions to their unique sites and the people they memorialize.  Still, we are serious in our efforts to teach our workers skills that will enable them to build more solid buildings moving forward.

Because ultimately our goal is not to measure the effectiveness of aid to Haiti, but to help Haiti achieve enough autonomy that it no longer needs our aid.