Since last month, an outbreak of cholera has killed over 1,300 survivors of the Haiti earthquake—and the outbreak is reaching a tipping point.  Haiti is facing its first epidemic in living memory.  People have begun rioting.  The World Health Organization is projecting 200,000 will become ill within 3 months, and 10,000 could die.

But there is reason to give thanks—because there may still be time to get ahead of the epidemic.

You remember: “Text HAITI.”  Relief organizations raised $4 billion in private donations since January; another ~$11 billion was given or pledged from other sources.  Ten months later, the relief organizations have spent maybe half.  Major NGOs self-identifying as contributing to water and sanitation relief together spent 27% of the money they raised as of June 9, 2010 (the last available collected data, courtesy of Chronicle of Philanthropy).

We should shout our thanks for donors’ generosity.  But with all of that support available, cholera in Haiti should not be happening.  Most relief organizations are not moving fast enough, for an array of bureaucratic and institutional or strategic reasons (see Newsweek).  Relief organizations and the Haitian government already failed to complete sufficient work on water and sanitation infrastructure.  Now doctors on the ground are buying bleach with their own savings; hospitals can’t purchase IVs or clean needles.  The U.N. is without sufficient funds and pleading for $164 million to bring water purification equipment, medicines, and doctors to Haiti.

With proper treatment and clean water, casualties from cholera could be reduced dramatically.  And potentially billions of dollars that could be used to facilitate that treatment are sitting in bank accounts, waiting to be put to use for effective response.

The relief workers on the ground deserve constant thanks for their hard and difficult work since the quake.  But the relief organizations’ headquarters need to be prompted to spend the cash they have on hand (and be willing to take the rap if some is wasted), move the cash they cannot use to those who can put it to use, and take immediate action to fight this outbreak (see statement of Doctors Without Borders).

There are challenges, to be sure—and if more regular, detailed and specific information were made public, a more nuanced picture, one that lends itself to evaluation, coordination, and potentially improved response, might emerge.  But nothing will happen if we say nothing and allow the status quo to prevail.

The Disaster Accountability Project (DAP) has launched a petition (sign here) , covered by the Huffington Post, by which we can collectively demand that relief and aid organizations active in Haiti provide a detailed, public accounting of how donated funds have been spent, and what actions are being taken on the ground.  This transparency is likely to speak for itself.  It is DAP’s hope that such information will encourage relief organizations to spend effectively, enable them to better coordinate their efforts, and ultimately help improve their response in Haiti.

During this week of thanks, take a moment to say a prayer and give a thought for the people of Haiti and the relief workers on the ground.  And take a moment to join us in demanding accountability from the leadership of relief organizations, so they can more effectively deliver the relief they promised.

The Disaster Accountability Project (DAP) is committed to providing long-term independent oversight of government and nonprofit disaster management systems by advancing policy research and advocacy, promoting transparency, and encouraging the public to participate in meaningful oversight and community-based conversations.