Most difficult relief effort in history

The relief effort in Haiti could end up being the most difficult, faith-testing recovery from a modern disaster, perhaps even exceeding that from the 2004 Asian tsunami, according to United Nation officials and aid groups with experience in large-scale catastrophes.

Haiti, already the poorest nation in the Western Hemisphere, was barely showing signs of recovery from the 2008 hurricane season when the earthquake flattened its capital, Port-au-Prince, crippling the country’s already weakened transportation and service delivery network.

Local aid groups that would normally help guide international efforts were damaged themselves, while the United Nations lost at least 70 staff members, and 146 more remain unaccounted for.

“You’re talking about a country that pre-earthquake had limited resources and capability, and what resources it did have were concentrated in the capital,” said Kim Bolduc, who is coordinating the relief effort for the United Nations. “This context helps explain why this emergency is probably the most complex in history, more than the tsunami, more than the Pakistan earthquake” of 2005.

The difficulties have confounded aid workers across the country, even those who have dealt with some of world’s worst disasters in recent years. At a first aid tent in the middle of a soccer field where hundreds of people are now living in Jacmel, a coastal city that was among the worst-hit, a French doctor threw his hands in the air.

“I am very, very surprised,” the doctor, François Sarda, a volunteer with Aides Actions Internationales Pompiers, said of the three days it took the aid group to get in and the chaos he found when he finally arrived. The group was forced to fly to Santo Domingo in the Dominican Republic and take a boat from there. “At least in the tsunami we had some infrastructure,” he said.

To help manage the chaos, the United Nations and the United States signed a two-page memorandum of understanding on Friday to formalize their roles and end the tensions that flared earlier in the week. The United Nations had complained about the American military’s handling of flights at the airport here, saying critical deliveries of food from the World Food Program were being unnecessarily delayed.

Under the memorandum, Haiti maintains overall control of the aid and rescue efforts, though the United Nations is in charge of coordinating the work. But the memorandum does not put American soldiers or other personnel under United Nations command. The Americans remain focused on delivering aid, while the United Nations handles peacekeeping.

Still, the United States is known for throwing its considerable weight around in international aid efforts, so it is unclear if the new agreement will solve the earlier problems.

Doctors Without Borders has complained about the American military’s running of the airport. The group has landed some planes, but has had others diverted, forcing it to truck in supplies from the Dominican Republic, according to Marie-Noëlle Rodrigue, deputy director for operations for Doctors Without Borders in Paris.

“It’s a very confusing situation and difficult to understand,” Ms. Rodrigue said. Jason Cone, a spokesman in New York, said much of the confusion involved who was coordinating matters. He said airport access had improved in recent days through direct contact with the Pentagon and the United States Agency for International Development.

Maj. Nathan Miller, with the Air Force’s 23rd Special Tactics Squadron, said that the military was not playing favorites, and that military planes now arrived during off-peak night hours to make more room for international aid flights.

The challenges faced by some Haitian organizations are confounding. Danièle Magloire, a senior director of Fokal, a Haitian human rights organization, began working from an empty room in a friend’s apartment building after her own home and office were damaged. The room still lacks electricity and water, like most buildings in the city. Residents of the neighborhood whose homes were destroyed camp outside on the street.

“We cannot possibly make it alone in the struggle to rebuild,” Ms. Magloire said. “The United Nations, with its immense bureaucracy, cannot make it alone. We need all the help we can get, and we know that it must come from the United States at this critical moment.”

Despite the troubles, the recovery effort is finding better footing by the day. Though rescuers are still hoping to defy the dwindling chances of finding anyone alive in the mountains of rubble 10 days after the earthquake, aid workers are shifting their focus to delivering shelter, water and medical care to hundreds of thousands of injured, hungry and displaced Haitians. They are racing against the approach of the rainy season, which aid groups fear could unleash disease.

United Nations officials said Friday that most surviving supermarkets would reopen next week, and that cellphone service should be fully restored by Saturday, with 40 banks also reopening. Lines for gasoline have also eased, with officials reporting that 30 percent of the city’s gas stations were now operational and that there was no longer a shortage of gasoline.

But problems persist bringing in diesel fuel, hobbling efforts to gear up aid distribution, Edmond Mulet, the chief United Nations official in Haiti, said in a videoconference with reporters.

Although enough food is on hand to reach many more people, only 100,000 received such aid on Thursday because of a lack of trucks and fuel, he said.

“We have the food to be distributed,” he said. “We just don’t have the vehicles.”

The United Nations needs to bring in 10,000 gallons of diesel per day from the Dominican Republic just to keep water trucks circulating, Mr. Mulet said.

Ms. Bolduc is coordinating the humanitarian efforts, but how many aid groups are now roaming the country is anybody’s guess, she said. About 375 have registered with her office, but she says she believes that there are many more that have found their own way into the country and are providing relief.

American rescue teams were among the first to experience the knot of troubles. Usually, when they set down in a country after a natural disaster, the local government has already identified buildings where there are known survivors so they can race to the scene. But here, without government input, they had to drive through the city themselves, making snap assessments about where survivors were likely to be found.

They had trouble getting their equipment; its arrival at the airport was delayed for several days. Then they faced a shortage of vehicles, gas and drivers at the United States Embassy.

“We have zero infrastructure here,” said Louie Fernandez, one of 80 rescuers from Miami-Dade County in Florida. “What are you supposed to do?”

Despite the monumental obstacles that must be overcome, Ms. Bolduc said, “It’s not mission impossible, if all the players work together.”