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Aid Workers Race Against the Clock

PETIONVILLE, Haiti - Haitian physician Reginald Lubin wanted to help earthquake victims at a hospital in this suburb of Port-au-Prince on Sunday, but medical supplies and equipment were scarce.

"What would I say to the patient?" Lubin lamented. "Look at them and say, 'You are hurt?' "

"The government is decapitated," Lubin said. "People come here to help, and they do not know what to do or where to go. This is terrible."

The worldwide effort to rescue battered Haiti entered its second week today with thousands of frustrated Haitians saying they are still waiting for food, water and medical care and are worried about violence.

As the United States and other nations stepped up their efforts Sunday to get aid to millions of people in need, some aid groups said the effort was in disarray.

"I'm satisfied that we're doing everything we can," said Army Gen. Ken Keen, who heads the military effort and was at an outpost with the 82nd Airborne. "Is there frustration? Absolutely. We see it. We feel it. We understand it. . . . We need to do more, and we're going to do more."

In one example of the logjam occurring in Haiti, Doctors Without Borders said one of its cargo planes carrying an inflatable surgical hospital was blocked from landing at Port-au-Prince Saturday and diverted to the Dominican Republic, causing a 24-hour delay. A second plane landed Sunday.

Aircraft have been barred from landing if they can't take off with the fuel they have on board, said George Hood of the Salvation Army.

"You have to fly in with enough fuel to get out," he said. His group has 1 million meals waiting in Miami to be shipped once transit can be arranged.

Throughout the country, injured victims still await the arrival of doctors and medical supplies. Doctors Without Borders teams are working in five Port-au-Prince hospitals, but only two are fully functional. A third "operating theater" has been created for minor surgeries only.

Those lucky enough to escape injury face the rising threat of disease and death while awaiting food, water and medicine. A makeshift camp in Petionville with 450 displaced people received its first aid since the earthquake Sunday: packets of crackers and bottles of water.

Clemente Dirre, 29, a mechanic, said aid has yet to reach his neighborhood. "People are dying. They are thirsty. They are hungry," he said.

In Dirre's neighborhood and others, people asked the same question: When would aid arrive? Handwritten signs hung at the entrance to tent camps announced the obvious: "We need help."

"The kids are barefoot. They are poor. They don't have anyone to direct the aid people their way," he says. "The problems are from the top."

Obama administration officials in charge of the relief effort defended the decisions, noting the airport is the only major hub in Haiti.

"It's a challenging, challenging situation," U.S. Agency for International Development administrator Rajiv Shah said. "We're aware that we're racing against the clock."

U.S. forces arrived over the weekend with more than 600,000 humanitarian rations. Keen said paratroopers from the 82nd Airborne delivered more than 70,000 bottles of water and 130,000 rations Saturday, a pace that should accelerate each day. More supplies are arriving at the airport than can be delivered because of transportation issues.

"As we move other equipment in here, we'll be able to get more ground transportation to increase our tentacles out into the countryside," Keen said.

U.S. officials also began distributing 250,000 liters of water to 52 distribution sites over the weekend. On Sunday, six water purification units arrived from Dubai, for a total of 10 since the earthquake hit.

Some relief agency officials say the first days of a disaster are always tough, particularly when aid workers have been affected by the disaster.

"Everybody here went through the earthquake," said David Toycen, president of World Vision Canada, which has Haitian staffers who lost relatives and homes. "They are traumatized at some level. I'm reluctant to be overly critical."

Caryl Stern, president of the U.S. Fund for UNICEF, said Haiti's density presents the opposite problem posed by the 2004 tsunami, spread among 14 countries. Unlike Hurricane Katrina in 2005, there are no nearby airports, hospitals or stores to use.

"None of that exists in Haiti," Stern said. "I think they're doing the absolute best they can with what they have to work with."

Veterans of relief efforts and experts on the process say there's a disconnect between an operation's effectiveness and what people see on TV.

"You can't mobilize that fast," said Andrew Natsios, who headed the U.S. Agency for International Development in 2004 when the Indian Ocean tsunami killed nearly 230,000 people. "That does not mean the relief effort is not working. It simply means it takes time to put everything in place."

Shah, the U.S. AID administrator, told USA TODAY during a visit Saturday that he shares people's frustrations, but he defended the response so far.

"We went ahead and identified what is needed and are working with the president of Haiti and with the United Nations to provide it," Shah said.

Some private relief groups sympathize with U.S. officials and say everything possible is being done to reach victims. The problem, said Joy Portella of Mercy Corps, is that "no one can get in or out or move around" because of logistical problems.

"It's hard to reach people," said Henrietta Fore, U.S. AID administrator in 2007-09. "The transportation is an enormous limitation."

Jack Harrald, a Virginia Tech professor and expert in disaster management, said the problems begin with Haiti's geography. "First of all, it's an island," he said. "It's not like we can drive a bunch of 18-wheelers down there."

With the main port decimated by the earthquake and the main airport slowly returning to life, all relief materials are "going through a very small pipeline," Harrald said.

That would be the airport, which is operating without a tower and terminal that have been condemned. It has one runway. Despite that, U.S. military forces have supervised more than 600 takeoffs and landings in five days, said Col. Buck Elton, who arrived Wednesday to take charge of the airport. "As soon as one aircraft departs, we have another one arrive," he said.

Roads are slowing aid down as well. Along Haiti's eastern border with the Dominican Republic, only two roads are passable, said Ben Hemingway, director of international operations for the International Medical Corps. A bottleneck is forming as refugees stream toward the border. Dominican authorities, fearing an influx of refugees, have clamped down on border crossings.

"All of these things are slowing down their ability to process large convoys," Hemingway said.

'Going to get more difficult'

Government officials past and present agree on one thing: The problems will only mount. With the Haitian government severely hampered, a central question must be answered: Who's in charge?

The Obama administration refuses to step forward, insisting it is helping Haiti and the United Nations, along with other international partners. But there's little question it is playing the dominant role.

The United States has "very appropriately taken the lead internationally," said Tom Ridge, the nation's first secretary of Homeland Security. "There's no country better positioned to help orchestrate it or lead it than the United States."

With Port-au-Prince prisoners on the loose and residents desperate for food and water, safety is becoming an ever-present concern.

Just outside the Port-au-Prince cemetery's gates Sunday, a young man shot three times lay dying on the sidewalk. Residents said he and three others had been shot by police for stealing. Three of the men died.

"They lined up all four and shot them. This one took three shots," said Clifford Cadet, 15, who watched from across the street.

Lubin, the doctor in Petionville, said people are attacking others on streets and in parks that have become temporary homes.

"People are getting mad and worried," he said. "Things are going to get out of hand . . . It's starting already. You will not give it to them? Fine, then they will come and take it."

After Hurricane Katrina struck New Orleans, hundreds of thousands of residents fled to Houston, Atlanta and other cities for shelter and services. In Haiti, there's nowhere to go.

Former FEMA official Mark Ghilarducci, who responded to an earthquake in Kobe, Japan, in 1995, says military-style tent cities may be needed first.

"This is a very complicated situation because of the fact that Haiti's so isolated," he said. "There may be a segment that needs to be moved to another place in the world."

Faced with all those problems, Kerline Auguste, 16, sees no hope for Haiti. She survived two days under the rubble of her house with her 18-month-old son; her parents and her son's father perished.

"The only thing I dream about is leaving this country, because I have no hope in the future," she said. "Even God can't help us. The situation is too bad."

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