When the world confronted the challenge of reviving earthquake-stricken Haiti last January, I wrote that the key was to cling to "the stubborn belief that, this time, failure is not an option."

How naive. Of course failure is an option when it comes to Haiti; it's the course the world usually takes there and seems to be taking once again.

Ten months after the earthquake, the humanitarian response "appears paralyzed," says Refugee International.

That was last month — before the current cholera epidemic left 1,400 dead in its wake and sickened another 70,000. Before the number of projected cases soared to 250,000.

A woman in downtown Port-au-Prince throws garbage into a refuse-clogged canal in November 2010. Little wonder that cholera, a water-borne disease that causes excessive vomiting and dehydration, has broken out. (Eduardo Munoz/Reuters)

In today's Haiti there are still over a million people barely surviving in 1,300 makeshift camps, in which women and children often live in a state of terror. According to the report from Refugee International, incidents of rape and abortion, sometimes with children as young as 12, have tripled since the earthquake.

"No one is saying this is in perfect order. It's not," said Martin Nesirky, a spokesman for UN aid efforts, in October.

Since then, of course, the security collapse has been overtaken by the cholera epidemic.

But the reality that world leaders still don't want to address is that much of this nation is in a state of catastrophic failure on all fronts — social, political, economic, security, education, infrastructure. Literally all.

Cholera is a game-changer

For such a besieged nation, 10 million of the world's poorest people, the UN has come up with only 11,848 soldiers and civilian police, mostly in small units from all over the world.

(What's more, in keeping with the pattern that there's no bottom to UN misfortunes when thing go wrong, UN troops from Nepal are widely suspected of having introduced cholera to the area in the first place.)

It's in this atmosphere of insecurity and chaos that Haiti is now holding a national election for president with 16 candidates running for the highest office.

It's an enormous undertaking for such a stricken society. But the rub here is that, while relief efforts have had trouble distributing clean water and cholera kits, close to 5,000 campaign workers have been out setting up voting centres.

To some tired and fearful aid teams, Haiti shouldn't be even thinking of such a luxury at this time.

"Cholera is a game-changer in the most fundamental sense," says Melinda Miles of the Let Haiti Live Group. "It is an immediate and critical crisis that requires all hands on deck in response.

"No election in the midst of the current crisis can be considered credible."

Shifting priorities

Other aid organizations have voiced their agreement with this but world leaders seem to be of the view that this country is in such desperate need of some form of government that the vote must go ahead.

No one has a clue who will win or what form of government will emerge, whether better or worse than the seemingly disengaged regime of René Préval.

Alas, much of this failure was predicted 10 months ago. Experts in failed states warned that disaster would follow disaster if aid groups and the UN and any country that felt it needed a say engaged in the usual squabbles and miscommunication that so often blight relief efforts around the world.

I have had many years experience covering disasters and I know volunteer groups do heroic work and save lives.

But as I warned back in January, "they are often handicapped because they have to work on short-term budgets and shifting priorities, which can make co-ordination difficult."

What is needed here is actual heft. But too often outside — and especially media — attention focuses on the billions pledged in aid, when the most urgent issue is who will have the authority and necessary international backing to ensure change happens.

A reproach to the world

Experts I respect have urged the need for some form of international mandate to protect Haiti, basically from its own corrupt leadership and lack of governance, until some workable security and legal system can be established.

A young girl with cholera is brought to hospital in the Cite-Soleil slum of Port-au-Prince in November 2010. There are currently nearly a quarter million projected cases. (Kena Betancur/Reuters)

Who owns title to a piece of land? How is housing zoned? Where does one appeal an injustice?

To these questions there is still no answer.

Canada, Brazil, plus the U.S., Britain and France, all big donor nations, were seen as the natural interim leaders.

In Ottawa, top military staff was keen to take on such a challenge, even while dealing with Afghanistan. The images of suffering were so horrific, and Haiti was only a few hours flying time away.

Politically, however, it was a non-sell. Significant military involvement at the top horrified the diplomatic set. It would be seen as neo-colonialism, some said.

So, instead, a risk-averse government and its allies yet again embraced the traditional loose approach of some of this and a little of that. And here we are again, going deeper into the mire.

The U.S. Rand Corporation recently completed an extensive study of Haiti and it shows that all the predicted failures have indeed come about. It is a reproach to the world.

According to the Rand study, there wasn't, predictably again, enough co-ordination among humanitarian groups. There wasn't a lead "contact" among the big donors to help launch real state-building.

"State-building may not have the same appeal to international donors as erecting new buildings, but it's got to be done if Haiti is to successfully rebuild itself," the report says.

Then it goes on to point out something that by now should be obvious to all:

"Haiti has been a focus of concern for donors of humanitarian and development assistance for two generations. Nonetheless, Haiti's economic, social and political situation has deteriorated."

They did not make my mistake of suggesting that failure now was "not an option."

It is. And that's what should terrify us all.