What went through your mind the moment the earthquake struck?

‘Nothing. I tried to save myself. That’s all.’

The story of survival in Haiti is always the same. In those 37 interminable seconds of destruction, there was no time to think. But the real emergency in what was once called the Pearl of the Caribbean is only now beginning as emotion gives way to realization. And, however generous the global community’s aid efforts are, they are now confronted with the worst natural disaster to hit the Americas since the time of Columbus.

With 230,000 dead, 300,000 injured, and 12 percent of a population of 8.3 million left homeless, the Haiti disaster has taken on a tragic toll, proportionally similar to the amount of casualties suffered by Germany, the UK, France or Italy in World War II.

The Haiti tragedy, however, was not an unforeseeable calamity. It was the result of chaotic development, poor building, unregulated growth, and the suffocation of its tropical vegetation under endless flows of cement. Today, Port-au-Prince is a city of 4 million inhabitants surrounded by pancaked shopping centers and shameful slums. Shrouded by dust rising up from its ruins and its permanent traffic jams, it literally risks death by suffocation.

“Il y avait l’embouteillage.” Bottleneck traffic. The most common explanation for why it takes two hours to travel 5 kilometers in this Third World country.

And yet the geologists had issued ample warnings. The 10 km-deep fault line located near Port-au-Prince sooner or later would have unleashed a devastating earthquake. They just didn’t know when.

Thus, the only solutions for avoiding a catastrophe would have been either to move the Haitian capital elsewhere or rebuild it according to antiseismic criteria. In other words, due to Haiti’s economic plight, averting the disaster would have been a utopian impossibility.

Port-au-Prince now resembles a torn-up anthill. Arrogant edifices, government buildings and apartment blocks, built quickly and poorly, now lie in frantic ruins along with churches and hovels, trapping tens of thousands of people beneath them.

Since the days of ‘Papa Doc’, little has changed. According to a recent UN inquiry, Haiti ranks 149^th out of 182 countries in terms of quality of life. The devastating earthquake has now delivered Haiti’s coup de grace. The brutal tremors that brought Port-au-Prince to ruin has reduced 30 percent of its buildings to rubble and left one million people homeless. Areas outside the capital, though sparsely populated, suffered even greater levels of devastation. 60 percent of the coastal city of Pétit Gouave, for example, crumbled. The hospital is severely damaged, the dead still line the streets, and there is no electricity.

So, how are the rescue efforts taking place?

In front of the Presidential Palace, flattened like a layer cake, an extreme free-for-all is underway. At the Place des Heroes de l’Independence, where all the ministerial buildings collapsed, documents flutter about the square carried by the slightest breeze. One of them, signed by Health Minister Hénri-Claude Voltaire, confirms the receipt of a donation of 14 million condoms from the UN. In the city’s park, thousands of people have camped out under trees with plastic sheets. A naked woman washes herself, then reuses the water to wash a young boy as an elderly woman waits her turn nearby. At the cemetery, a sign written in Creole reads “Tou o plen, nou pakà pran ankò.” The cemetery is full; we can’t take any more bodies. But someone has knocked down a wall in order to dump the naked, swollen corpse of a woman by a small mound of earth and refuse. Not far away, the decomposed bodies of two children are covered by a swarm of flies.

One can feel indignation for the treatment of the dead, abandoned like trash on the streets. But the real problem remains the thousands of sick and injured who desperately await urgent treatment. In the chaos of the General Hospital, where US Marines do everything from keeping order to improvising as nurses, doctors operate in open-air surgeries, swatting flies away with their free hands.

“We came here from all over the world as volunteers, full of enthusiasm and the desire to help. We brought the best teams, the best medicines and the best equipment,” says a young doctor from New York University. “But there is little coordination. This is a Noah’s Ark where everyone makes tremendous efforts but each group works separately: French, Norwegians, Swiss, Americans, Cubans, Chinese, Russians, Italians, even the Sisters of Mother Theresa and the Church of Scientology. More often than not, our equipment is rendered useless because it’s not compatible or the generators don’t work. When we amputate, we frequently use morphine as an anesthetic, as was done in the 1800s.”

It is obvious to all that Haiti will never be able to recover without foreign assistance. To understand this, one need only go to Port-au-Prince’s port, closed to sea traffic, except for the flotilla of military ships arriving from around the world. There is the US aircraft carrier Vinson and the Italian aircraft carrier Cavour with their fleet of helicopters, water purification systems, and field hospitals.

But this is not enough to solve Haiti’s historic ills.

Matieu Derisse, the author of a comment posted the day of the earthquake on Haitian President René Preval’s blog, appears to concur. “For 206 years,” he writes, “the mulatres [the mulatto caste] have dedicated themselves to the sacking the country, and through Haiti’s Chamber of Commerce, otherwise know as the Chambre des Grands Dons Mulatres, they have managed to seize all the political and administrative power in the country. It’s our slave mentality that is the sole culprit for our social ills.”

Renzo Cianfanelli is a journalist and international contributor who has worked for Corriere della Sera, Il Secolo XIX, and the BBC.