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A year ago this week, Haiti buckled when it was hit by a huge earthquake. Americans responded by giving nearly $2 billion to hundreds of charities. Much of that money remains unspent, leading to criticism that the international aid response has not moved fast enough. NPR's Carrie Kahn reports.

CARRIE KAHN: About 200 young people gather on the back patio of the headquarters of the American Red Cross in Haiti. All have on clean white t-shirts with the charity's bright red logo emblazoned on the front and back.

Unidentified Man: (Foreign language spoken)

KAHN: They count the number of small soap bars as they fill up Red Cross backpacks.

Mr. JEAN LOUIS EMMANUEL: (Foreign language spoken)

KAHN: Jean Louis Emmanuel is one of the young health promoters. He says, everyday they head out to 60 tent encampments throughout Port-au-Prince. He shows people how to properly wash their hands, especially after going to the bathroom and eating, to prevent the spread of cholera.

Mr. EMMANUEL: (Through Translator) Without this job, I would have no work at all.

KAHN: The American Red Cross says it has helped hundreds of thousands of Haitians and spent more than a quarter of a billion dollars in the past year. However, it raised nearly twice that amount and has been criticized for not spending more.

The Red Cross isn't the only charity with much of its donations still in the bank. A survey of 60 U.S. charities, by the Chronicle of Philanthropy, shows that less than 40 percent of the nearly one and a half billion dollars they raised has been spent.

(Soundbite of vehicles)

KAHN: Julie Sell of the American Red Cross says it would be foolish to spend so much money so quickly.

Ms. JULIE SELL (Spokesperson, Haitian Delegation, American Red Cross): The Red Cross has a real commitment to spending those dollars, wisely and transparently.

KAHN: You can see aid deliveries all over the city. But there are still nearly a million people living under tents and tarps. Few reconstruction projects have begun and cholera continues to claim lives.

Doctors Without Borders head, Unni Karunakara, says it's unconscionable that aid groups launched cholera fundraising appeals when their coffers remain filled.

Dr. UNNI KARUNAKARA (President, Doctors Without Borders): We are indeed accountable to the Haitian people. I think we have a lot of explaining to do.

KAHN: Oxfam just released a report criticizing the slow pace of recovery. And watchdog groups, like the Disaster Accountability Project, are pushing U.S. charities to divulge more information about their activities.

Ben Smilowitz heads the project.

Mr. BEN SMILOWITZ (Executive Director, Disaster Accountability Project): If a donor is going to invest in an organization to do relief work, they should know how detailed that organization's activities are. Go to these groups' Web sites, and try and figure out how sustained their operations are with the information they're given.

KAHN: His organization sent a survey to 200 groups, working in Haiti, about their programs - only 38 responded.

Dr. NIGEL FISHER (Deputy Special Representative, Stabilization Mission in Haiti, United Nations): I think the criticism is simplistic and it shows a lack of understanding.

KAHN: U.N. Deputy Special Representative Nigel Fisher coordinates the work of non-governmental agencies, NGOs. He says there are thousands of groups working in Haiti, but the vast majority are small, faith-based organizations. Much of the work is done by about 20 large NGOs and he admits coordination was difficult at first.

Dr. FISHER: Coordination is about persuasion, it's about getting consensus. It is about deciding on priorities, when people have different points of view. And sometimes you can't do that overnight.

KAHN: Aid workers say it's challenging working in Haiti. It's the poorest country in the Western Hemisphere, with few resources. Many say it feels like for every step forward, they take two back.

(Soundbite of sawing)

KAHN: Take the situation in this tent encampment near Cite Soleil, one of the largest slums of Port-au-Prince. Construction of 18-by-9 foot wooden shelters is fast and furious for many of the 800 families who've been living under tents and tarps.

The land is owned by the Haitian government, but it took until last summer for federal authorities to finally allow the Red Cross to build sturdier homes. Then, a local official stepped in and took away half the land to build a school. That means hundreds in this camp will remain in tents indefinitely.

Wislyn Jean Charles was one of the lucky ones who got a new shelter.

Ms. WISLYN JEAN CHARLES: (Foreign language spoken)

KAHN: She says now they can stand up inside a dry home. She has plastic flowers decorating the walls and a huge framed painting of the Last Supper over a full size dining room set.

Ms. CHARLES: (Foreign language spoken)

KAHN: She says she is so thankful to the foreigners for their help and hopes they all have long lives.

Carrie Kahn, NPR News, Port-au-Prince.

MONTAGNE: You're listening to MORNING EDITION from NPR News.

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