Two top American officials say that medical assistance and food distribution are the biggest challenges the world faces as it reaches out to help Haiti recover from its massive earthquake. Reports of chaotic food handouts, Monday, highlight the difficult conditions survivors face as many continue their search for the dead, mourn those they have lost and struggle to meet their basic needs of food and water.
Outside Haiti's demolished presidential palace Monday, the situation at a daily aid hand-out site turned chaotic when a small team of United Nations peacekeepers faced off with a crowd of 4,000 desperately hungry Haitians.
At the sign of trouble, the peacekeepers first fired warning shots into the air, but then later were forced to retreat, as a massive crowd of young men trampled over people to scoop up boxes of rice and beans.
The U.S. State Department's coordinator for relief and reconstruction, Lewis Lucke, says that, although there has been a tremendous influx of food from the outside, the bigger challenge is getting it to those who need it.
"In terms of food, the thing we are worried about is not so much the availability of food right now, it's being able to overcome issues in distribution, that varies from place to place, roads, traffic, availability of trucks and so forth, all of this seems to get better every day," he said.
The massive destruction of the Haiti's 7.0 magnitude quake has left nearly one million people homeless. Thousands have fled the ruined city of Port-au-Prince. Many Haitians continue to live in the streets or in tent cities.
The Haitian government estimates the quake killed as many as 200,000 people.
Kate Conrad, a spokeswoman for the aid organization Save the Children - which has operated in Haiti for 30 years - says food, water and medical care continue to be the most urgent needs.
"Our medical teams are reporting primarily pink eye, skin rashes, things that you would commonly expect. Some cases of diarrhea, which is extremely worrying, because diarrhea kills small children, but no major outbreaks, thankfully," she said.
Lieutenant General Ken Keen says boosting medical assistance and building up Haiti's medical infrastructure is a major challenge.
"The medical infrastructure that was here - what there was here - was devastated," he said. "There was only one functioning hospital after the earthquake and that was the Argentinean hospital here."
General Keen says that international doctors and non-governmental organizations have been crucial in helping set up makeshift medical centers, throughout the capital, but more work is needed.
"We are working with the U.N. and USAID [U.S. Agency for International Development] and we feel that we need to stand up a hospital that has the capacity of 5,000 beds, to give you an idea, in order to treat the number of patients that are going to flow through the hospital ship Comfort and also that are being treated in various hospitals," he said.
Keen says that since, it arrived last week, the US Comfort, a Navy medical ship, has taken 300 critically wounded survivors on board and performed more than 100 surgeries.
In addition to medical assistance and food, U.S. officials say they are also looking for ways, together with the international community, to create jobs for Haitians.
Lewis Lucke says the U.S. government hopes to create 25,000 jobs by the end of January by hiring people to help with the clean-up, such as the removal of rubble in the streets and buildings that have collapsed in roadways.
Lucke says creating jobs will be an important part of the Haiti's recovery and a critical way of pumping money into the economy.