Haiti earthquake anniversary: the state of global disaster relief

He's also the first to receive their anger. Fitzgerald once stayed away from the camp for a day after a retaining wall fell and killed two children. Although his organization, Minnesota-based American Refugee Committee, had nothing to do with the wall's construction, he was fearful the residents would hold him responsible.

"It feels like being the mayor of a town at times," he says. "Everything is my problem, only I don't have the jurisdiction to deal with it."

And the problems are enormous. Despite nearly $10 billion in short- and long-term aid pledged in the past year, and the presence of at least 10,000 nongovernmental organizations, a year later, roughly 1 million Haitians are still crammed into 1,200 camps, rife with violence and such tight, unsanitary conditions that cholera has begun to spread. Port-au-Prince's streets are still filled with rubble and collapsed buildings. And only $1.6 billion in humanitarian assistance has actually been spent, according to the UN Office for the Coordination of Humanitarian Affairs. (OCHA estimates that $1.9 billion more has been committed to programs, so far.)

So, a year after the quake riveted the world's attention and sparked an outpouring of goodwill, it's easy to ask: Is the global humanitarian system accomplishing its goals? Is it leaving societies better off – and should it be? Are global expectations, formed by 24-hour news coverage and instantaneous social networking, increasingly disconnected from the realities of what humanitarian agencies can accomplish in the first place?

Disasters – whether sudden and dramatic tsunamis, slow and devastating droughts, or intractable civil conflicts – have always afflicted humankind. But shoring up humanity on a large scale after massive upheaval is a modern idea – it wasn't until after World War II that governments and individual donors began to mobilize money and hands-on help, taking on a crucial role in crises around the globe.

Today humanitarian experts say they are responding to more disasters – perhaps, they say, because of climate change, perhaps because more people are moving into vulnerable places, but definitely because awareness of need through the media is now instantaneous.

And the world is responding with a fury. Communications and globalization, technology and transportation have made once-isolated corners of the world accessible to aid groups, journalists, militaries, and volunteers. The way aid is funded, shepherded, delivered, and evaluated is constantly evolving and, ideally, improving.

The humanitarian business is booming, says Antonio Donini, who worked with the United Nations for 26 years and now studies the evolution of humanitarian aid at the Feinstein International Center at Tufts University in Medford, Mass. "From a marginal activity in conflict [zones] with the International Red Cross and a few others present to alleviate the suffering of combatants, it has become a huge enterprise" that mobilizes billions of dollars a year and employs 250,000 people.

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