About 1.3 million people lost their homes in the January earthquake
Wednesday's UN conference in New York on co-ordinating assistance to earthquake-hit Haiti raises an awkward question - what has foreign aid ever done for Haitians?
The country has received an estimated $5bn (£3.3bn) over the past decade.
Thousands of charities have been operating there - yet even before the quake devastated the capital, Haiti was a wretched place.
It is the poorest country in the Americas. About 80% of the population lives on less than $2 a day and nearly half is illiterate. Jobs are scarce, public services woeful and corruption rife.
Haiti, says US political scientist Terry Buss, is largely run by "an army of NGOs and some international development organisations" whose programmes "cost a lot of money and don't make any difference".
Mr Buss - author of the book Haiti in the Balance, Why Foreign Has Failed And What We Can Do About It - cites as an example Haiti's judicial system, which he calls a "shambles".
The US government, he says, has tried to promote reform by running seminars for judges.
But few Haitian judges have extensive legal training, and teaching them US jurisprudence has not led to a noticeable reduction in the number of prisoners languishing without due process in Haiti's overcrowded jails.
One of the reasons donors get little bang for their aid buck is the scattered nature of their efforts.
"One of the problems is a lack of co-ordination to make the most of the generosity of groups and people," says Ruth Levine, from the Center for Global Development, a Washington think tank.
Poorest country in the Americas
80% of the population below the poverty line
Two thirds living on small scale farms
GDP per capita: $1,300 (2007)
NGOs and church groups, she adds, tend to get involved in short-term, local projects and move on.
"It's a Band-Aid approach," Ms Levine says. "It's not a sustained effort, so it's hard to build up the kind of trust with the community that would provide ongoing services."
Governments too can be fickle. The US, for instance, stopped funding family planning programmes - particularly crucial in Haiti - because of concerns over abortion.
Another factor affecting the efficacy of aid is the tendency of donors and charities to bypass local authorities.
Such mistrust can be understandable, as Haiti has a long history of oppression and misrule.
But by providing services directly, the aid community in effect takes on government functions, reinforcing the divide between officials and the people.
"It's the worst (form of) government you can possibly imagine," says US writer Tracy Kidder, author of Mountains Beyond Mountains, a book about Haiti.
"It is a government whose activities are not co-ordinated and that is not in any way accountable to the people it's supposed to be governing."
Meanwhile, Terry Buss says, Haiti's nominal government never feels pressure from people they do not serve. "They don't expect to deliver public services because it never does," he says.
Tyranny of emergency
Some charities ensure that they work with the Haitian authorities, rather than undermine them.
One is the US charity Partners In Health (PIH), which has 10 clinics and hospitals in Haiti. They are run jointly by the health ministry and are staffed with Haitian doctors and nurses.
"What we do is really make it a priority to strengthen the institutions in which we're working," says PIH's Donna Barry.
However PIH's efforts to involve Haitians are not the rule.
According to Pastor Michel Morisset, who heads Eben-Ezer Mission, a local charity in Gonaives, most aid workers regard Haitians as wards rather than partners.
"Instead of coming and doing everything for us, they should ask us where the problems are, where we suffer, and help us. Coming with ready-made programmes and dumping things has never worked," he says.
"We have been treated as helpless victims and that has stayed with us."
The earthquake, according to Pastor Michel Morisset, has reinforced a feeling of helplessness and dependency among Haitians.
"We have become a perpetual emergency," he says. "We are ruled by the tyranny of emergency."
On the bright side
Is Haiti doomed to remain in the grips of well-meaning but ineffectual benefactors? Not necessarily.
Jean-Louis Warnholz, a former economic adviser to the Haitian prime minister, speaking to the BBC in January, said that under the current government the country has enjoyed stability and good relationship with the international community.
Reforms have been undertaken, and a quarter of the foreign debt was cancelled last June.
Last year Haiti's economy grew by about 3% - not a stellar performance, but an encouraging one in the aftermath of a devastating hurricane in 2008 and amid a global financial crisis.
Before the earthquake the garment sector was the country's fastest-growing industry, with factories near Port-au-Prince supplying such major brands as Gap and New Balance. Thanks to a new trade deal, Haiti exported $512m worth of apparel to the US in 2009.
Tourism is another promising sector in a country with plenty of sunshine and pristine beaches.
Royal Caribbean Cruises recently spent $55m upgrading the northern port of Labadee, and sent the world's largest cruise liner there on its maiden voyage last year.
Mr Warnholz believes that even after the earthquake, the potential for growth remains.
"The pockets of opportunities that still exist need to be expanded," he said. "I don't think that Haiti is forever cursed."
Few deny that outsiders have a key role to play in Haiti. An impoverished country that has suffered as many deaths in a single region as the 2004 tsunami inflicted across the Indian Ocean needs all the help it can get.
However, as donors gather to discuss reconstruction aid for Haiti, the key question may not be how much they pledge, but whether their efforts are channelled in a way that avoids the failures of the past.