PARIS, France — It's the most persistent question in the minds of Haitians worldwide: Where has all the money gone?

One year after Haiti's earthquake, the diaspora of some 4.5 million Haitians is still consumed with worry for their families and loved ones.

Those who have traveled to Haiti struggle to see tangible signs of how the billions in aid money have helped Haitians rebuild their lives.

“We struggle every day with this question and we are frustrated with the slow pace,” said Jean-Claude Fignole, country director for ActionAid Haiti, at a gathering in Boston in December.

He estimated that less than 15 percent of the total aid the international community committed to Haiti has actually been delivered.

“We have to be involved in our own recovery and lead the reconstruction process,” he told the group.

It is a message that resonates with Haitians around the world.

“People are living just like you live in hell,” said Klebert Etienne, who works in real estate in Boston but has been traveling to Haiti as a missionary for the last 20 years. “There is no way to explain it.”

Etienne was last there in July to deliver food, clothes and the gospel. He said “people live worse than animals” in tent camps. What’s worse, the 58-year-old said, it feels like, “the country is on it’s own.”

Verdieu LaRoche, pastor of the 40-year-old First Haitian Baptist Church in Boston, travels to Haiti regularly and was last there in November. He said he saw people living in squalor on top of one another in the nation’s capital. More than 1.2 million people remain in temporary shelters.

“Humans are not supposed to live like that,” he said.

Scarce information about where donated funds have ended up coupled with what people see on the ground fuels speculation and suspicion. Stories of aid workers riding around in brand new SUVs have been repeated so often in the Haitian community, they’ve become synonymous with the perceived unfairness in who has benefited from the aid.

At a donor’s conference in March, United Nations Secretary General Ban Ki-moon said Haiti's reconstruction needs would total an estimated $11.5 billion over the next 10 years. The conference was hailed a success, with the international community pledging nearly $10 billion over several years. The United States committed the largest chunk.

“That’s what fuels the cynicism,” said Donald LaRoche a 39-year-old lawyer and son of the Boston pastor. “Money is coming into the country but it is not being dispersed.”

Larger organizations that have benefited from the generosity of donors are trying to make a tangible difference. In a newly published report, Doctors Without Borders estimated that by October last year it had spent $104 million on disaster response and treated more than 358,000 patients.

BRAC, described as the largest non-profit organization in the world, opened a Limb and Brace Center in Port-au-Prince with help from a $250,000 grant from the Clinton Bush Haiti Fund, among others. To date, “the fund has raised $52 million in contributions and has committed $20 million to projects,” according to a November statement. The limb center opened in September and has already fitted more than 130 patients with prosthetics and expects to serve some 850 more this year, organizers said.

On a break from unloading boxes of ripe plantains in Paris’ ethnically mixed 18th district, Samy Louis said aid money hasn’t changed anything for his widowed father. He was still living in a tent after his house was crushed in the quake.

Instead of food rations, Louis said, his father receives condoms and water. The 50 to 100 euros he sends every few weeks for his father and two younger siblings is not much, but “I have to do something,” said the 32-year-old who has been in France for six years.

People are asking why the donated money isn't trickling down and being converted into permanent housing, roads, hospitals and schools. Why are people dying by the thousands from cholera, a preventable and treatable disease? Who is in charge of setting the priorities for the country’s reconstruction, such as sewage and waste management?

Rose-Anne Clermont, an author and journalist living in Berlin, described “a tale of two cities” with air-conditioned offices and new computers at rented villas housing the aid agencies, while Haitians forage in the sewers for food.

But she acknowledged she didn’t know of a viable alternative to the international presence that has been so instrumental in keeping the country going.

While in Haiti, she volunteered at The Clermont Center for Homeless Children, an orphanage that cares for some two dozen boys. Her family founded the center in 2003 in the rural town of Jacmel.

Post-earthquake fundraising for the center brought in more than $70,000, all of which can be accounted for, Clermont said, whether it went to purchasing school uniforms, making structural repairs to the earthquake-damaged building or digging water wells.

Major Joseph Bernadel — a founding member of the Haitian Diaspora Federation, a seven-month-old umbrella advocacy body with 47 member groups — said he “resented” the notion that Haitians abroad weren’t doing enough. He also rejected the “unrealistic” expectation that reconstruction should have happened in so little time. Even the United States, with all of its resources, was still trying to rebuild from Hurricane Katrina five years later, he said.

Bernier Lauredan, a New Jersey-based pediatrician who is the federation’s vice president, lamented the lack of clarity about how the aid money was being spent, saying much more needed to be done to engage Haitians in rebuilding their country, especially given their vast cultural knowledge.

“The money given to Haiti is not supporting Haitian organizations doing the work,” said Lauredan, who has traveled to Haiti several times.

As one side blames the other, the Haitian government also comes in for criticism.

Sitting in the barber’s chair at Fito’s salon, Widser Victor complained about a container of donated non-perishable foods, clothes and other materials he paid 3,000 euros to ship from Paris to a Haitian orphanage. The shipment arrived in August but is still held up at customs because the authorities have asked Victor to pay an additional $1,500 in fees to release it.

“It’s disgusting,” he said. Meanwhile, people are dying of hunger, said Fito, the barber.

People ask whether a country with little to no infrastructure can really handle the influx of the thousands of aid agencies without them creating an economic imbalance. Why was a presidential election held when so many of the millions displaced were not even in a position to vote? How long will the political stalemate last and who is running the country in the meantime?

“It’s not to disparage the Haitian culture but there is no trust,” said the younger La Roche. “The country is crooked. The government is crooked.”

With so much distrust of international donors, the diaspora and the Haitian government, people like Etienne, the missionary worker, are turning to small initiatives they can support directly. He plans to send money to a fellow missionary in Florida who will travel to Haiti for the anniversary.

After learning about the needs of an orphanage through her son’s school, Nadine Duplessy Kearns, who heads a non-profit organization in Washington, D.C., sent donations to Orea, which provides for 15 orphaned and abandoned children and runs a school that feeds, clothes and provides basic health care to some 86 students.

In a letter urging friends and family to donate, she described how the organization needs $200 weekly to run the orphanage and $263 to run the school. At the close of the letter, she instructs potential donors to use her name as a keyword when contributing, telling them, “I want to track donations and send you an update/account of your support.”

Such diligence is a by-product of an erosion of trust that has made people suspicious of everyone from politicians to aid workers.

On its revamped website, Yele Haiti, the foundation founded by the musician Wyclef Jean, which accepted hundreds of thousands in emergency relief donations, provides detailed pie charts accounting for its expenditures.

Marie St. Fleur, a member of Boston Mayor Thomas Menino’s cabinet whose duties include coordinating the city’s efforts on Haiti, said it was understandable that people who donated “an unprecedented amount of money” before were now directing their support to grassroots organizations.

“Non-governmental organizations experienced significant donations in the name of the Haitian people,” she said. Where is that money in relation to direct services that go beyond keeping the lights on at the large organizations, she asked?

Editor's note: This story was updated to correct the spelling of Rose-Anne Clermont.