FRED DE SAM LAZARO, NewsHour correspondent: When the food supplies arrive in Gonaives, so do the riot police from the U.N. peacekeeping mission in Haiti. They bring some order, but not food for everyone.
A stream of mostly women leaves empty-handed.
HAITIAN WOMAN (through translator): I’m dying of hunger, and so are my kids. I came here to get food, but they’ve given it all away. I haven’t eaten anything today. I’m still hungry. I have nothing. Whatever you give me is all I’d have.
FRED DE SAM LAZARO: They are among perhaps 800,000 Haitians, 10 percent of the population, displaced by the storms, which took at least 300 lives.
One month after the last hurricane ripped through, roads are still barely usable, still covered with flood waters that are now reduced to a toxic sludge of oils and other pollutants.
PRESIDENT RENE PREVAL, Haiti (through translator): Just in Gonaives, we have 3 million cubic meters of mud. You can imagine the effort that is needed. I hope the international community understands the profound catastrophe Haiti is going through.
FRED DE SAM LAZARO: Haiti’s president, Rene Preval, has had to rely on the international community to both fund and lead the relief operation in a country where 80 percent live in what the U.N. calls absolute poverty, crippled for years by political and economic meltdown.
One key player so far has been the non-government group Doctors Without Borders. Max Cosci is a director.
MAX COSCI, Doctors Without Borders: There is a danger of some outbreaks of some diseases. We are really in a high risk at this moment, red alert, if you want to put it like this.
FRED DE SAM LAZARO: Red alert?
MAX COSCI: Yes, there is a large part of the population that doesn’t have any access to clean water. And you know after a while that you don’t find this capacity to have clean water, you start to drink what you find.
Bad water, scarce food supply
FRED DE SAM LAZARO: For 51-year-old Odette James, that meant drinking floodwaters that she stood in for hours.
ODETTE JAMES (through translator): There were bowls and plates lying around. We just scooped up the water and drank it without filtering it.
FRED DE SAM LAZARO: Just outside her temporary shelter in a school building, the doctors group began an outpatient clinic. Diarrhea from contaminated water was a common problem here.
About 120 anxious mothers with infants and a few elderly craved their first medical attention since the hurricanes. Two-year-old Kelly was triaged to the top of the line to see Dr. Louis-Jacques Ismael, with swollen face and limbs and aggressive skin rashes.
DR. LOUIS-JACQUES ISMAEL, Doctors Without Borders (through translator): The little child that you saw is malnourished. And one of the symptoms of that malnourishment is that you have the dermatitis that rises up on the skin, and this is what we are seeing very, very often now.
FRED DE SAM LAZARO: Kelly's mother received medicines and a nutrient-rich formula given to malnourished children. In Haiti, even before the hurricanes, a quarter of all children were chronically malnourished.
The key to Kelly's recovery will also be access to food and clean water, something that eludes half the population in the best of times.
Centuries of deforestation for lumber and cooking fuel has eroded the soil, washing it into rivers and streams. Now floodwaters from the hurricanes have contaminated wells, and Gonaives' water pipe network, flimsy before, is useless, says Riguelle Gilles, a project worker for the doctors group.
RIGUELLE GILLES, Doctors Without Borders: We lose 80 percent of the water from the reservoir every day, which is way too much.
FRED DE SAM LAZARO: Just so I understand it, you're say that, by the time the gets from the reservoir into the city, 80 percent of it leaks out?
RIGUELLE GILLES: Yes.
FRED DE SAM LAZARO: Non-government groups are trucking potable water from the city's reservoir in large rubber bladders, then installing these on roof tops. Transporting the water and finding available rooftops has been difficult.
RIGUELLE GILLES: (inaudible) right now, right today. We're touching around a third. The first goal we're doing now is providing potable water to maximum of population. And the next stage will be cleaning the wells.
Filling the healthcare shortage
FRED DE SAM LAZARO: Preventing disease is just one-half of the public health task. The other is to rebuild health care facilities, which were demolished by the storms.
This warehouse was spared by the hurricanes, and it's being quickly converted into an 80-bed hospital. The construction workers aren't finished yet, but the hospital work is already in full swing, since it's the only hospital now in Gonaives, a city of more than 200,000 people.
PIERRE MALCHAIR (through translator): We've got all our patients here right now, internal medicine, surgery, until we finish the other rooms.
FRED DE SAM LAZARO: Pierre Malchair is on the medical staff.
PIERRE MALCHAIR (through translator): One major frustration is there are large needs in the population but we won't have enough diagnostic facilities. We have medicines, but we don't have laboratory, we don't have radiology, and surgery is limited.
FRED DE SAM LAZARO: But the hospital is meeting its most critical need, says gynecologist Rodnie Senat.
DR. RODNIE SENAT (through translator): Since we set up the field hospital, the first day we had two deliveries. And up until now, we've delivered 15 babies.
FRED DE SAM LAZARO: Dr. Senat is volunteering here on a month's leave from her private practice in the capital, Port-au-Prince. A longer term worry is the lack of doctors; there's just one for every 10,000 people in Haiti.
Doctors from Cuba and aid agencies partially fill the void. In Gonaives, it will be months, perhaps years, before a new permanent hospital, planned for higher ground, will be ready.
Despite the challenges, President Preval and his cabinet vow Haiti will build back better than it was before. Their country, born out of a slave revolt, and beset by invasions and civil war for 200 years, has been relatively quiet, thanks, in part, to 8,000 U.N. peacekeepers.
Preval, elected in 2006, says peace is the first priority.
RENE PREVAL (through translator): The U.N. has a mission here for stability. It's called MINUSTAH, to help restore peace and democracy.
In 2005, 2006, if you'd been here, you wouldn't have been able to go to Gonaives, walk the street. Today, we have restored peace to the country. It's the beginning of the country's rebuilding.
Hope lies in rebuilding the nation
FRED DE SAM LAZARO: With a $200 million credit from a Caribbean fund, the slow clean-up is beginning in Gonaives, roads first, then homes. President Preval says a public works program will put people to work.
Odette James is not sure when or how she'll restore her livelihood as a seamstress, which is also the future, she says, for her children.
ODETTE JAMES (through translator): I lost chairs, cooking pots, kids clothing. But the only thing I really cared about was my sewing machine. And I had a lot of material to sew for school uniforms. I lost all that, too.
The money that I would have made from selling uniforms I would have used to send my kids to school.
FRED DE SAM LAZARO: The big concern for Max Cosci of Doctors Without Borders is that the recovery effort be sustained.
MAX COSCI: My fear is that the work will be done for the next month and then slowly, slowly will stop. It's a little bit what happened with the media, with the press. I was there in the first days. There was a lot of journalists, a lot of media coming, making interviews, spending time there. And now you see that slowly their attention is getting in somewhere else, because it's not anymore the news.
But the needs are still there. And I can tell you that the danger is more now than before. You had the death at the beginning, but now you have the risk to have much more death in the future, if things are not done correctly and in a massive way.
FRED DE SAM LAZARO: There's also worry about money for the rebuilding. So far, only about a third of the $108 million pledged by donor countries through the U.N. has actually materialized.