Thousands live in flimsy hovels, many of which were immediately toppled by the quake

WITH its hospitals in ruins and its meagre emergency services dwarfed by the scale of the crisis, Haiti is a living apocalypse.

Wounded and dying people lie moaning in the streets and the survivors are facing into a third day of sleeping in the open. The food, if there is any, is a fraction of what is required and the water is filthy. The death toll, which according to Hillary Clinton is already on a scale of the tsunami in 2004 --that claimed 200,200 lives -- is likely to rise even higher.

GOAL will be doing everything we can to help on the ground. The typically generous response from our own Government is to be welcomed, as is the even more astonishing response from the Irish people. This disaster brings home the massive gulf between the rich and poor and will demand a heartfelt global response if the unimaginable suffering is to be addressed meaningfully.

Witnesses speak of stepping on the bodies that litter the levelled streets, the last sounds of the dying trapped below the debris are still being heard. A rapid impact emergency response commensurate to the scale of the catastrophe is essential.

Back in 2008, when Haiti was hit by two devastating hurricanes, the West looked at the island and was shamed by the poverty and complete desolation left in their wake. World leaders stepped forward and an impressive €600m was pledged, but only €40m was actually ever handed over.

This time the response must be genuine. The disaster almost defies description, the country's children's hospital has been swallowed up by the quake.

Agony and anguish are everywhere; the poorest country in the West whose inhabitants live below levels of subsistence of even some sub-Saharan countries are in no position to help themselves.

As the country's president Rene Preval explained: "Parliament has collapsed. The tax office has collapsed. Schools have collapsed. Hospitals have collapsed. There are a lot of schools that have a lot of dead people in them. All of the hospitals are packed with people. It is a catastrophe."

Senator Youri Latortue believes as many as 500,000 could be dead. Those on the ground are in no doubt that 33pc of the country's nine million people could now need emergency aid. That is not too far off the entire population of the Republic of Ireland.

It is the most powerful quake to hit Haiti in 200 years. This is the poorest country in the western hemisphere and thousands live in flimsy hovels, many of which were immediately toppled by the quake.

It is critical to remember that even before the disaster 80pc of the population lived on less than €2 a day, and only 30pc have sanitation in their homes.

If the West has allowed Haiti to fall off its radar, the country has not been helped by its own politicians, who have contributed greatly to its economic ruin. Back in 2006 a new democratically elected left-wing government won power, and there were predictable promises about a new dawn for Haiti's poor. In truth progress has been pitiful, despite the levels of aid pouring in.

One inescapable conclusion to be drawn from the marked lack of improvement in living standards, according to foreign NGOs operating in Haiti, is corruption; a cancer that eats at the heart of the developing world. Stories of how aid was used to appoint the palatial homes for ministers, or to pay off grubby officials in polls, are legion.

That is why all aid must now be carefully targeted and spent with the highest degree of transparency and oversight. One lesson could be taken from the approach adopted by the EU after the 2008 tragedies.

The EU provided money for the building of roads after the hurricanes but the aid was not given to government directly. It was paid instead to a contractor who was accountable. As a direct result of this cautious and entirely practical approach, Haiti got its first proper road network.

The government has been unable to make true progress in providing homes for its population, not to mention healthcare.

As is always the case in poor countries, it is the children who suffer most. Even before the horrors of the quake were visited on the islanders, poor access to clean water and without treatment for basic illnesses, the child mortality rate in Haiti was one in five, with diarrhoea, malaria and TB the most common causes of death.

Across the country it is estimated that 300,000 children between eight and 15 are kept as "restaveks", which are effectively child slaves, or unpaid domestic workers used by rich families.

It is heartening to see that the US, China, and Europe are pulling together in trying to help.

The US is planning a massive military response to the disaster, saying that ships, helicopters, transport planes and a 2,000-member marine unit are either on the way or likely to begin moving soon.

But their arrival may be too late for thousands of Port-au-Prince residents. With so many orphans, so many sick and injured lying uncared for, this is a race against the clock to save life. Haiti will not survive another wave of broken promises.

The islanders can not be blamed for living on a piece of rock that happens to be on a fault line prone to quakes. However, the West has real moral questions to answer for the appalling levels of poverty and the "default line" which undermined its promises to build a new Haiti back in 2008.

As one overwhelmed doctor speaking from Port-au-Prince said last night: "This is much worse than a hurricane. There's no water. There's nothing."

This is a challenge that must be accepted with a meaningful response from the international community.

John O'Shea is the CEO of GOAL

- John O'Shea

Irish Independent