PORT-AU-PRINCE, Haiti - Last week, the United Nations pleaded for hundreds of millions of dollars in additional donations to pay for food, medicine and other urgent needs still unmet since the Jan. 12 earthquake tore open Haiti's capital.
But while the United Nations scrambles for more humanitarian relief, international aid groups are holding on to at least $500 million - money the aid groups say should go to reconstruction, not relief.
When reconstruction will begin, no one can say.
Six months after the earthquake, Haiti's government, foreign donors and aid groups are struggling to map out a plan to rebuild this country while still providing life-sustaining aid to the 1.5 million or more Haitians left homeless and hungry by the massive temblor.
At the same time, donor nations have been slow to provide $5.3 billion in promised long-term aid to Haiti over the next 18 months - further delaying plans to remove rubble and find more stable housing for the displaced, crucial steps for any recovery.
The result is that Port-au-Prince today looks not much different than it did in the first weeks after the earthquake: a city piled with debris and pocked with sprawling tent cities sustained by a network of humanitarian aid groups, but with little physical evidence of durable progress.
"No, we are not satisfied," said Claire Doole, spokeswoman with the International Federation of the Red Cross. "How can we be satisfied when you see the needs out there? But we are all doing our best in a very difficult situation.''
An outpouring of donations in the weeks after the earthquake helped charities and aid groups amass more than $1.2 billion. But the lack of concrete improvements has left many - including Haiti's prime minister, Jean-Max Bellerive - questioning where these donations have gone.
"Millions and millions have been received and we have no idea what they have done with that money,'' Bellerive said in an interview with the Miami Herald.
Until now, aid groups have focused mainly on managing the tent camps, providing drinking water, medicine, shelter and food for the vulnerable. Reconstruction has been slow in coming, they say, because the earthquake's devastation was so great and because it was centered in a teeming urban area, making cleanup and logistics more difficult.
"The scale of disaster is to some extent without parallel since the Second World War," said Sam Worthington, chief executive officer of InterAction, a coalition of nongovernmental organizations, or NGOs, with 81 member groups in Haiti. "We will see people in camps for months, if not years. It will take years simply to remove the rubble."
Some worry that the immediate humanitarian crisis remains so dire that it will overwhelm any long-term plans, potentially siphoning money from reconstruction efforts and repeating a cycle that has plagued Haiti's past attempts to recover from hurricanes and floods.
"This simply cannot take up all the resources, or you will have nothing to rebuild with," Worthington said.
But Haiti is still in survival mode. At least 1.5 million people now live in more than 1,300 tent camps dotting Port-au-Prince and nearby cities struck by the disaster. The United Nations' World Food Program has estimated that 2 million Haitians are vulnerable to malnutrition. The cost of the quake damage has been estimated at $7.8 billion - more than Haiti's gross domestic product last year.
In February the United Nations first asked for almost $1.5 billion in donations for emergency needs such as food, water, shelter and medicine through the rest of the year. To date, only $530 million has been collected - 36 percent of what's needed.
"We don't have the resources to do everything. We are trying to do our best," said Nigel Fisher, the United Nations' chief humanitarian coordinator in Haiti.
Worthington said InterAction's agencies have raised about $900 million in private donations, with $400 million earmarked for humanitarian aid and the rest to go toward rebuilding.
So far, InterAction's NGOs have spent $250 million on emergency aid - a pace that will drain their emergency money before the end of the year.
"That $150 million isn't going to last the next six months. At this rate, the money will run out," Worthington said. "The concern is that one will run out of resources and may need to tap reconstruction resources."
This strategy of setting aside reconstruction money that might otherwise go toward relief efforts has brought criticism to some high-profile organizations - most notably the American Red Cross, which has spent only about one-fourth of the $465 million it has raised for Haiti relief.
While the Red Cross has provided humanitarian aid - more than 110,000 tarps for cover, vaccinations for 152,000 people, meals for 1 million Haitians for one month - the agency is now focusing on long-term development programs, said Julie Sell, a Red Cross spokeswoman in Haiti.
The Red Cross has begun building the first of 30,000 transitional homes it has pledged in all of the quake-struck cities, including in Jacmel and Leogane, in an attempt to move people out of the tent camps over the next several months - before the heart of hurricane season. Only 5,500 of the targeted 127,000 shelters have been built countrywide so far.
"We are now in a kind of transitional phase," Sell said. "What the Red Cross is trying to do is not spend money fast, but spend money wisely."
Sell and other NGO representatives say the housing plans for Haiti have been stymied by questions of land ownership in areas planned for resettlement - disputes the Haitian government must solve.
Bellerive said the government has a pipeline full of projects, but it well not commit the mistakes of the past by making promises without funding in place.
Even where Haiti's government has responded, the NGOs have been slow to follow. The government has cleared huge swaths of land at two camps, but neither has temporary shelters yet - and frustration at those camps is growing.
"People are suffering under the tents, because they have yet to build any provisional shelter for us," said Jeannette Dufresne, 53, who now lives at a camp inside the city of Tabarre. After losing two homes in the quake, she sleeps in a tent that leaks in the rain and bakes in the heat.
At Corail Cesselesse, an emergency camp expected to anchor a new city, plans to install 1,310 shelters have been frustrated by unexpected problems, from high staff turnover to frenzied rumors that first lady Michelle Obama would be providing homes, said World Vision spokeswoman Mary Kate MacIsaac.
"It's that complicated and frustrating game of doing aid," said MacIsaac, noting that construction will begin any day now on 525 194-square-foot wooden structures with a porch and extra door per residents' request. "It is our greatest need and probably our biggest challenge."
The government has ceded the reconstruction plans to an interim commission headed by Bellerive and former President Bill Clinton, now the United Nations' special envoy to Haiti. This 26-member committee met for the first time last month, and it has not yet proposed any specific rebuilding projects.
In March, dozens of countries promised to donate almost $10 billion to finance the bulk of Haiti's reconstruction - including $2.5 billion expected by the end of this year. But through June 30, only about 10 percent of the promised money for 2010 had been disbursed, according to data compiled by Clinton's U.N. office.
The United Nations' Fisher said he believes donors have been waiting for the reconstruction commission to get up and running before cutting checks. The commission, which meets again this month, does not yet have a permanent director.
The U.S. Congress could vote this week on a bill that includes more than $700 million for Haiti reconstruction. The United States has promised almost $1.2 billion in recovery aid, including $253 million in debt relief.