As a teen in 1984 (in the waning days of the brutal and corrupt "Baby Doc" regime), I spent a day wandering near-blind through Port-au-Prince, Haiti, searching in vain for a pharmacy to replace the contact lens cleaning solution that was in my luggage that the airline had lost. It strikes me that most people's understanding of the socio-political complexity of Haiti (including my own) is about as clear as my vision was then: fuzzy at best. Yet we are all now confronted with the moral question of how best to respond to the January 12 earthquake (which measured 7.0 on the Richter Scale) that struck this already-vulnerable island nation.

I was there to visit the Hôpital Albert Schweitzer (HAS) in Deschapelles in the Artibonite Valley, the poorest region in the Western hemisphere, where my dad was volunteering on surgical rotation from Yale. There, I interviewed the hospital's founder, Larry Mellon of the wealthy Pittsburgh family, who in his 40s had forsaken his high-society life to attend medical school (along with his wife Gwen) so that he could tend to the "poorest of the poor" in Haiti. One thing he said imprinted itself deeply on my conscience: he insisted on charging all patients at least a nominal fee, not because the hospital needed the money (though it did), but primarily to allow patients to maintain dignity and self-empowerment, instead of submitting to charity.

Bill Baue

Mellon's words returned to me years later, reading Tracy Kidder's Mountains Beyond Mountains about another doctor committed to caring for the poorest of the poor in Haiti: Zanmi Lasante (or Partners in Health in Haitian Kreyol) founder Paul Farmer scorned the practice of charging these destitute patients (though he didn't name Mellon or HAS): "I'm going to build my own fucking hospital. And there'll be none of that there, thank you." And Clinique Bon Sauveur was born in Cange in 1985, thirty years after the founding of HAS and the damming of the Artibonite River, a "development" project that effectively diverted water needed in the Artibonite Valley to Port-au-Prince.

In the current state of emergency and disaster, donations of cash and vital resources are now imperative for humanitarian relief - the United Nations called for $562 million for humanitarian operation in Haiti. In a Miami Herald op-ed, Paul Farmer urged donors to prioritize cash donations, and limit in-kind donations to those supporting vital aid functions, such as water, medical supplies and personnel, and, perhaps most importantly, coordination support.

The corporate community is stepping up to fill these needs, with $83.2 million donated by January 19. For example GE pledged $2.5 million, Becton, Dickinson $1.2 million, and Avon, UPS, Royal Caribbean, Abbott, and PepsiCo each pledged $1 million. In addition to giving cash, many of these private sector donations include much-needed resources, such as medical supplies from BD and Abbott, transportation and logistics from UPS, supply delivery from Royal Caribbean, and water from PepsiCo. The nonprofit sector is similarly stepping up - for example, AmeriCares airlifted $6 million in medical aid, along with a team of relief workers, PSI (Population Services International) shipped millions of liters of safe drinking water, and National Nurses United deployed 7,500 registered nurses to Haiti for disaster relief.

Companies are shifting their normal operations in order to help by providing cash and on-the-ground resources and coordination. For example, CSRwire, PR Newswire and Marketwire waived distribution fees for news releases related to the Haitian earthquake, Cablevision extended free calling to Haiti, and Visa is scaling back its income from donations for Haitian earthquake relief by donating revenues from these contributions directly to the American Red Cross, and also waiving interchange fees on donations made to certain charities.

Such actions expose companies to criticism. For example, MoveOn.org launched a petition for credit card companies to waive all fees on charitable donations, and Cory Doctorow pointed out the irony that Royal Caribbean delivered not only 40 pallets of relief supplies, but also a boatload of tourists to frolic at Labadee, a private beach leased from the Haitian government that is sixty miles from the earthquake's epicenter. The company contends that the tourism brings much-needed revenue to Haiti, and the company is further donating all its proceeds from the visits to the relief effort.

Which brings us back to the thorny question of the role of charity in solving endemic problems. In the face of such a disaster, all charity plays a key role in relieving the acute suffering - the main question is, how best to coordinate donations for the most effective, targeted outcome. As necessary as it is to focus our vision closely on the immediate scene, though, what happens when we step back to look at the bigger picture? In a New York Times op-ed, David Brooks widened his perspective to point out that the 1989 San Francisco quake (which likewise measured 7.0 on the Richter Scale) killed 63, while up to 50,000 are feared dead from the Haitian quake. Accordingly, he called the Haitian earthquake less a "natural disaster story," and more of a "poverty story."

His solution? Not international development, which Brooks likens to "throwing money" at the problem, nor even micro-aid, which he considers effective though limited in reach - but ultimately, he throws his weight behind what he calls "intrusive paternalism," where benevolent local leaders adopt "middle-class assumptions, an achievement ethos and tough, measurable demands." This "father knows best" approach seems to suffer from the same tunnel-vision of solutions imposed on Haiti since time immemorial, this time viewing the problem through red, white and blue colored glasses. UN Special Envoy to Haiti Bill Clinton seeks to support Haiti to "build back better" after the earthquake. The question is whether this effort will give room for self-empowered Haitians to identify and redress systemic, symptomatic problems, or whether it will continue to wander near-blind through the haze, or perhaps worse yet, gaze through lenses obscured by benevolent paternalism.

Bill Baue is Executive Director of Sea Change Media, and Executive Producer/Host of Sea Change Radio, a nationally syndicated show with a global podcast audience.  This article was first published on CSRWire.