Even before the January earthquake, international aid agencies played a huge role in Haiti. But the United Nations and some relief organizations say that's one of the reasons Haiti remains so entrenched in poverty. With Haitian President Rene Preval poised to present a $3.8 billion reconstruction plan for his battered country, the U.N. is pushing for a new approach.
The issue is under debate as international donors gather in New York for a conference Wednesday.
The largest aid agency operating in Haiti is the United Nations. U.N. bulldozers are clearing fields to make camps for people to live in. The World Food Program distributes food. The World Health Organization has carried out mass vaccination campaigns. White U.N. dump trucks, SUVs, backhoes, fire trucks and buses are all over the capital.
A Haitian driver working for American journalists looked out at a convoy of U.N. trucks recently and declared cheerfully, "The U.N. is taking over my country."
Dorestante Phillipe with the International Organization for Migration says the U.N. is absolutely vital in Haiti right now. Phillipe is coordinating a distribution of tarps in Port-au-Prince for people who lost their homes in the earthquake. He says without blue-helmeted U.N. troops to provide security, his organization wouldn't be able to move through the city never mind distribute the desperately needed supplies.
And the U.N. is just one part of the massive humanitarian apparatus in Haiti.
Edmond Mulet, head of the U.N. mission in Haiti, estimates that more than 10,000 nongovernmental organizations are working there.
"This is the largest concentration of NGOs per capita in the world," he said. "And most of them don't care about coordination. They do their own thing on their own. They don't share what they do. We don't know what they do. And probably they don't want us to know what they do."
The U.N. launched its first development program in Haiti in 1948, yet it remains the least developed country in the hemisphere. Haiti has a long, tragic history filled with violence, political instability, corruption, imperialism and other ills.
But Mulet says another significant problem has been that international aid has stifled the development of public schools, clinics and other infrastructure.
For example, private schools supported by international donors have flourished while the public education system has floundered. International aid may have benefited some Haitian children, but it has left others behind. Haiti has one of the lowest literacy rates in the world.
"If we want to really change, this is the time for the international community to work with the state, through the state and government to build their own capacities," Mulet said. "If we don't do that now, we will be here for the next 200 years addressing these issues."
Mulet acknowledges that this is an awful time to ask the Haitian government to step up to the plate; most government ministries collapsed in the quake.
But he says the only way to build a lasting social infrastructure in Haiti is through the government. And among the elite — priests, business leaders and politicians — there is a growing sense that Haiti's dependence on aid has serious shortcomings.
Patrick Elie is a former Haitian minister of defense and, in his own words, a "militant for democracy."
"We should be careful that this tragedy does not become the occasion of a humanitarian coup," Elie said.
As the country embarks on rebuilding, he says, Haiti can't be working off a plan "devised in some foreign capital" and imposed on the Haitians by international donors.
He calls the earthquake both a tragedy and an opportunity.
"I hope it has convinced the Haitian elite that the way they've been leading this country is wrong, and they were building a country on sand," Elie said.
As billions of dollars flow into Haiti in the coming months to rebuild from the quake, Elie says, Haitians need to control and coordinate that money.
Given the country's corrupt past, that might not sit well with some donors. But who controls the reconstruction of Haiti and who provides the overriding vision could have a huge effect on what kind of country gets built.