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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.

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