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This post is joint with Casey Friedman

Two months ago, Hurricane Sandy swept through Haiti, bringing winds and heavy rain that wiped away buildings, roads, crops, livestock, and fishing boats. By the time the extent of the damage and the humanitarian needs were understood, Americans had their attention fixed almost entirely on New York and New Jersey, not the Caribbean.

The Government of Haiti estimates as many as 200,000 people have suffered damage to their homes, in addition to the almost 400,000 people who are still homeless from the earthquake of January 2010.

But the effects of Hurricane Sandy in Haiti will surpass the immediate damage and will linger much longer than they would in a rich country.

First, the food crisis. The past six months have been disastrous for Haitian agriculture, because of drought, then Tropical Storm Isaac, and finally Sandy. Isaac was estimated to have destroyed 40% of the harvest. Farmers report Sandy-related losses between 70 and 90 percent in affected areas—including the few areas that have remained mostly untouched after Isaac. In dollar terms, the Government of Haiti estimates the combined damage to the farm sector at $254 million, including irrigation systems, livestock, and tools, alongside crops.

Crop losses and other destruction of livelihoods are likely to mean worsening hunger. One and a half million people are estimated to be severely food insecure and up to 450,000 are at risk of severe malnutrition. When people get hungry, they often sell or consume productive assets—chopping down fruit trees for charcoal or selling livestock at fire sale prices.  With roads and bridges flooded or destroyed, many people have also been out of the reach of relief agencies and isolated from markets. The loss of the harvest also means that many farmers do not have the seeds and seedlings they need for the planting season, which is already well underway.

Second, the health risks. Haiti has an epidemic of a water-based diseases. This season’s storms have destroyed a combined total of 61 cholera treatment centers, as well as several drinking water facilities.  Damage from earlier disasters, including the 2010 earthquake, was not fully repaired prior to Sandy.  The result has been an uptick in new cholera cases.

Haiti is stuck in a vicious cycle of poverty, disease and natural disasters. Each disaster exacerbates the situation and prevents the country from developing resilience. The earthquake opened the door for cholera, with the microbes themselves imported by peacekeepers (who wouldn’t have been there if the country’s political institutions were strong). Crippled infrastructure has made it harder for humanitarian assistance to reach its beneficiaries. The imperative to “build back better” aims to escape from the cycle of poverty and disaster, but getting more resilient infrastructure in place has proven to be very difficult, with weak national governments, fragmented humanitarian response efforts, and unfulfilled donor promises.

Several donors have responded to the current situation in Haiti, with pledges and calls for new funding.  This week, the United Nations launched a $144 million appeal to fund humanitarian programs.  But as we have argued before, donors must also take crucial steps to improve the quality of assistance to Haiti. High-profile disasters have led to an outpouring of public support, sometimes through problematic channels, which have often been out-of-step with the needs of the Haitian people.

We have previously recommended that NGOs and private contractors be required by USAID to provide more and better independent evaluations, and to share data on their activities through the International Aid Transparency Initiative. The donors themselves (including USAID and the US Government more broadly) can improve upon the current situation by reporting their data to IATI, or even simply by publishing quarterly reports on project expenditures.

Cash transfers are often the best way to empower disaster victims to begin rebuilding their lives while generating demand to fuel the local economy.  Where people have access to markets, the most effective relief consists of providing them with the purchasing power to get what they need. For example, the World Food Programme’s “Cash For Assets” program might be an effective way for Haitians to purchase much-needed goods and services.  In addition, some things, such as urgently-needed seeds, will have to be delivered as part of a coordinated humanitarian response, since farmers are not accustomed to purchasing seed on the market. Likewise, aerial deliveries of food and medical supplies to isolated communities are crucial—and some humanitarian agencies are very good at them.

Beyond this, the donor community needs to get serious about investing in Haiti’s infrastructure, to break the cycle of poverty, disease, and disaster that repeats itself all too often.

There are no easy solutions. Donors must stick to their pledges. Relief groups must coordinate their activities.  Above all, all parties must hold themselves accountable to the public and be transparent about the delivery of goods and services to the people of Haiti.