After a devastating earthquake hit Haiti in 2010, governments and foundations from around the world pledged more than $9 billion to help get the country back on its feet.

Only a fraction of the money ever made it. And Haiti's President Michel Martelly says the funds aren't "showing results."

Roughly 350,000 people still live in camps. Many others simply moved back to the same shoddily built structures that proved so deadly during the disaster.

Martelly says the relief effort is uncoordinated and projects hatched from good intentions have undermined his government. "We don't just want the money to come to Haiti. Stop sending money," he tells Shots. "Let's fix it," he says, referring to the international relief system. "Let's fix it."

Although progress has been slow, there are signs of construction in Haiti. A neighborhood near downtown Port-au-Prince that was in shambles after the quake has been rebuilt.

Although progress has been slow, there are signs of construction in Haiti. A neighborhood near downtown Port-au-Prince that was in shambles after the quake has been rebuilt.

David Gilkey/NPR

Disaster specialist Dr. Tom Kirsch from Johns Hopkins School of Medicine agrees with Martelly. "Clearly we saved lives," he says. "Clearly we put people in tents. Clearly we did all kinds of stuff. But at the same time the level of chaos and the overall ability to reach needy people, we don't know how well we did."

Kirsch, who's been in Haiti several times since the quake, added, "We could have written a check to everyone in Haiti for — I don't know — $10,000 a piece, which would support them forever rather than the way we spent it."

So where did all that money go?

We got to put that question to reporter Jonathan Katz, author of the new book The Big Truck That Went By: How the World Came to Save Haiti and Left Behind a Disaster. He was Haiti bureau chief for The Associated Press at the time of the quake. Here are highlights from the conversation, edited lightly for length and clarity.

Shots: Aid pledged to Haiti — $9.3 billion worth from 2010 to 2012 — is about a third of all global health aid donated in 2012. What happened to the money that was supposed to go to Haiti?

Katz: Money did what money tends to do in most foreign aid situations. That is, rather than being a model in which a rich country gives a poor country a big bag of cash and says, "Here spend this on fixing things up from whatever the latest crisis was," what actually happens is that very little of the money actually leaves the donor countries.

First of all, you've got billions of dollars that are promised but just never delivered. You've got billions of dollars more that were sort of creative accounting. Donor nations say they're providing debt relief, yet those debts were never realistically going to be paid back. So some of the money is sort of fictive.

So how much actually made it into Haiti?

Even among the real money, if you look at what was labeled as humanitarian relief, in the months right after the quake, that amounts to about $2.5 billion.

Ninety-three percent of that money either went to United Nations agencies or international nongovernmental organizations, or it never left the donor government.

So you had the Pentagon writing bills to the State Department to get reimbursed for having sent troops down to respond to the disaster.

If we're talking about reconstruction, it's really a misnomer to think that relief aid was necessarily going to have the effect of rebuilding a country in any shape or form.

So what was that money spent on?

Band-Aids. Literally bandages. Short-term relief. Tarps to put over your head. Food to fill emergency gaps in supply.

But food gets eaten. Tarps wear out. Band-Aids get pulled off. And ultimately, all that money is spent, but people aren't left with anything durable.

When you hear about all these billions of dollars [in aid donations], the imagination is that they're going to go and rebuild the country after the earthquake. They were never intended to do so and, lo and behold, they didn't.

There are often complaints after big disasters about waste and inefficiencies. Was the Haiti earthquake different from any other international disaster or is this typical?

What is interesting about Haiti is the extremes.

There are lots of places that have weak governments, but Haiti's government is weak in a special way. It's the product of so many years of aid going around the government and international efforts to undermine the government. Presidents being overthrown and flown out on U.S. Air Force planes and then reinstalled and then overthrown again. That left the Haitian government in such a weakened state.

Then the disaster itself was also so much more extreme. It was so concentrated. It hit the capital city. Whether your estimates for a death toll is in the 80,000 range or closer to the government's estimate of 316,000 — in a city of 2.5 million people — it's just an extraordinary number.

It was an incredibly horrific disaster. It hit the country right at its heart and destroyed a government that was already weakened.

But beyond that, the attitude that so many foreign aid groups have regarding Haiti is that you can basically come in and do whatever you want. So there was no accountability, no coordination.

People were just running around doing what they thought was best or what they thought was best for them. And it really created a mess.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

RENEE MONTAGNE, HOST:

Three years after the earthquake in Haiti destroyed much of Port-au-Prince, that country's president had a shocking thing to say about the international relief effort. The billions pledged are, quote, "not showing results." President Michel Martelly says his dream that post-quake Haiti would be a huge construction zone never materialized. Hundreds of thousands of earthquake victims are still living in makeshift camps and only a few thousand units of new permanent housing have been built. The slow pace of progress is raising questions about how well the international community can respond to such disasters. NPR's Jason Beaubien reports.

UNIDENTIFIED MAN #1: (Foreign language spoken)

JASON BEAUBIEN, BYLINE: Statistically, 42-year-old Bibeta Louissaint is a success story. She's an example of how the international community moved an earthquake victim out of the squalid camp and back to her original neighborhood. After the 2010 quake, Louissaint set up a tarp shack in front of the collapsed national palace, along with 15,000 other people. Then she waited - for weeks, for months - as aid groups debated housing solutions, rolled out prototypes of temporary shelters and schemed about creating grand boulevards lined with apartment blocks.

BIBETA LOUISSAINT: (Foreign language spoken)

BEAUBIEN: It was wasted time, Louissaint says of the two years she spent living under a plastic sheet in the camp. Last year, the Canadian International Development Agency funded a program which had a simple goal: empty Louissaint's camp. She was given $500 and a ride back to her previous neighborhood. She fenced off an old foundation with sheet metal and officially left the ranks of the internally displaced.

LOUISSAINT: (Through translator) So you can see here there is no roof, so when it rains the water comes here and can get inside.

BEAUBIEN: In addition to killing more than 200,000 people, the 2010 Haitian earthquake left a million and a half homeless. Three years and billions of dollars later, most of the earthquake victims have been left to find housing on their own, or to move back into the same shoddy construction that proved so deadly during the disaster.

JONATHAN KATZ: That kind of was the clearest categorical failure.

BEAUBIEN: Jonathan Katz was the Haiti bureau chief for the Associated Press. That bureau collapsed around him in the quake. He's just come out with a new book called "The Big Truck that Went By: How the World Came to Save Haiti and Left Behind a Disaster." Katz chronicles how much of the billions of dollars in aid money never got to Haiti. Some of it went to writing off Haiti's debts. Some of it never left the U.S.

KATZ: You had, you know, the Pentagon writing bills to the State Department to get reimbursed for having sent troops down to respond to the disaster.

BEAUBIEN: Of the money that did reach the ground, Katz says most of it was spent on stuff to keep people alive - food, tarps, bandages.

KATZ: The food gets eaten, tarps wear out, Band-Aids get pulled off. And ultimately, you know, all that money is spent. The people aren't left with anything durable. So the imagination is that, you know, when you hear about all these billions of dollars that they are going to go and rebuild the country after the earthquake. They were never intended to do so, and lo and behold they didn't.

BEAUBIEN: Haitian President Michel Martelly is more blunt and says the international relief system failed in Haiti.

PRESIDENT MICHEL MARTELLY: We don't just want the money to come to Haiti. Stop sending money. Let's fix it. Let's fix it.

BEAUBIEN: Martelly complains that the international aid agencies poach Haiti's best and brightest to work as drivers. He says the relief money is uncoordinated, and projects hatched from good intentions undermine his government. Tom Kirsch with the Johns Hopkins Center for Refugee and Disaster Response agrees with all that. Right after the quake, Kirsch went to Port-au-Prince as a doctor to help patch up the injured. Since then he's returned repeatedly to try to assess how well the disaster response went.

TOM KIRSCH: Clearly we saved lives. Clearly we put people in tents. Clearly we did all kinds of stuff. But at the same time, kind of the level of chaos and the overall ability to reach needy people, we don't really know how well we did.

BEAUBIEN: Haiti remains the poorest country in the hemisphere, and Kirsch says he understands the complaint from many Haitians that they could have done more with the billions of dollars in aid if they'd controlled it themselves.

KIRSCH: We could have, you know, written a check in everyone in Haiti for, I don't know, $10,000 apiece, which would support them forever, rather than the money the way we spent it. And so, yeah, there's tremendous inefficiencies and stuff.

BEAUBIEN: He says that ultimately the response to the earthquake will be judged in terms of how well Haiti does in the long-term. Kirsch points out that three years after the Asian tsunami, Banda Aceh, Indonesia was still struggling to recover but now actually has rebounded significantly.

KIRSCH: It takes years to recover. People have a misconception that you have a disaster and you go on, you do some things and everything's better. Well, I'll tell you, New Orleans, after Katrina, is still recovering in the U.S. They still have hospitals closed and their economy's less and people have moved out. So even in the U.S., it's not a magic thing that happens that everything just gets better.

BEAUBIEN: Even if it's not magic, disaster relief is also not an exact science. And Kirsch says the international community needs to do a better job of figuring out what works and what doesn't after major disasters. Jason Beaubien, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

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