On the eve of the first anniversary of the devastating earthquake that killed 220,000 Haitians and made 1.5 million others homeless, United Nations humanitarian agencies Tuesday looked back at a year of achievements, albeit at times spotty, and forward to the enormous challenges still ahead.

"The task has been Herculean – a humanitarian worst case scenario in one of the world's poorest countries, with massive casualties, multiple catastrophes, the decimation of the nation's civil service, reams of critical records destroyed and staggering damage to the country's critical infrastructure," UN Children's Fund (UNICEF) Executive Director Anthony Lake wrote in an opinion piece in the Miami Herald newspaper.

"Delays in pledged aid have further complicated the recovery effort," he said, noting the added complication of the cholera epidemic that has claimed some 3,600 lives and infected almost 150,000 people so far even before cresting.

"These are enormous, unprecedented obstacles. But as we look back, we should remind ourselves not only that it might have been far worse, but that real progress has been possible, even in such dire circumstances." Mr. Lake cited the thousands of children who have been reunited with their families and the nearly 100,000 youngsters benefiting from a network providing psychosocial care.

"This is only a start. In Haiti, as in every emergency, we can and must do a better job channeling pledged aid to people and communities in greatest need," he wrote. "We need to ensure better coordination among government, the international aid community and local NGOs. And we need to do more to support communities' efforts to drive their own recovery.

"When so much remains to be done, and when so many continue to suffer, it is no time for self-congratulation. But neither should it become an occasion for self-flagellation. To do so risks discouraging those who can still provide help – to the absolute detriment of the people who so desperately need it. And it is both a denial of the small victories achieved and a disavowal of the heroes who are still out there, every day, helping to rebuild lives and restore hope." UN World Food Programme (WFP) Executive Director Josette Sheeran stressed the daunting nature of the catastrophe, noting that in the six weeks immediately after the quake, the agency delivered food to 4 million Haitians and continues to provide food aid to some 2 million through school meal and cash-for-work programmes and nutritional support to pregnant and nursing mothers and their children.

"While much has been achieved in the year since the earthquake, much still remains to be done," she said in a statement. "Our ongoing food assistance programmes that nourish the very young, provide cash for work, and include the local purchase of food from Haitian farmers, are part of a massive recovery effort that will continue to need international support in the months ahead.

"Access to nutritious food is essential if Haiti is to build back better, and WFP will continue its work providing the right food at the right time to those – like the very young – who still remain vulnerable." The UN Food and Agriculture Organization (FAO) warned that greater support to agriculture is crucial to meet the country's development objectives and help it prepare for future emergencies, noting that it is shifting from direct input distribution to seed multiplication and other more sustainable activities as it moves from emergency aid to longer-term rehabilitation support.

It also stressed the need to reduce risks related to natural disasters such as flooding from hurricanes. "Natural resource and watershed management activities need to go hand in hand with measures to improve agricultural productivity by enhancing access to land, inputs, water and markets," the FAO Representative in Haiti, Ari Toubo Ibrahim, said.

In Port-au-Prince, the capital, UN Humanitarian Coordinator for Haiti Nigel Fisher released a report reviewing in detail the humanitarian achievements of the past year and the challenges ahead, noting that the signs of recovery are still barely visible for Haitians on the ground.

In the report, the UN's top envoy in Haiti, Edmond Mulet, stressed the need for the international community to provide a more systematic approach to help Haitians reinforce a State of rule of law and social and economic progress in a country where political uncertainties arising from November's disputed first round of elections could lead to more turmoil.

"In the absence of significant progress in the field of a State of law in Haiti, all current and future efforts for Haiti's recovery, notably in reconstruction, economic and social development, humanitarian aid, security and political stability, risk going up in smoke," he warned.

As Lake concluded in his opinion piece, which began with the tent cities still filled to overflowing, and the tens of thousands of children still in need of protection: "There is no denying that today in Haiti, rubble still remains, cholera still kills, and political turmoil still imperils progress.

"But the time has come to look beyond the rubble and the ruin, and to look ahead to a stronger Haiti. One year later, we have a choice – to wring our hands or to join them together in renewed commitment to help Haitians rebuild their wounded country. For how we can despair, when so many Haitians have not?"