When long suffering Haitians took to the streets last month to voice their anger at the cholera epidemic sweeping the country, they weren’t the only ones getting mad. The state of the country nearly one year after being leveled is of international concern as well—especially for the millions who donated to relief efforts.

“The leadership of the major disaster relief and aid organizations operating in Haiti allowed cholera to become a threat because they did not do their jobs,” according to a recent statement by the Disaster Accountability Project (DAP). “The international community and Haitian government failed to sufficiently invest in clean water and sanitation after the quake. Now, living conditions are so deplorable and infrastructure so poor, the situation is ripe for a cholera epidemic.”

The conditions led DAP, a watchdog organization that has closely followed charitable spending since the earthquake, to circulate a petition denouncing humanitarian groups working on Haitian water and sanitation for neither doing enough nor spending all at their disposal. The petition calls for more transparency, detailed public accounting of expenditures, and regular updates on spending, “not just aggregate figures, anecdotes, blog stories, and Facebook and Twitter updates.”

“It is the individual aid workers on the ground that deserve our gratitude for doing the back-breaking work to help those in need,” DAP stated. “Meanwhile, the headquarters of these major relief/aid organizations raised billions of dollars … and apparently chose to spend less than half. Potentially billions of post-earthquake relief dollars, intended for the Haitian people, are just sitting in U.S. and foreign banks.”

While that’s frustrating in the face of current conditions, experts say there are reasons for not putting all aid in one basket. Among those reasons is a need to balance donations—the bulk of which are received immediately after an incident—along a longer arc that includes both relief and recovery.

Although the dynamics differ for each disaster, often organizations have to make the donations received in the first two months last throughout the process, Center on Philanthropy Research Director Una Osili told USA Today. And in some cases, organizations might be spending their money as quickly as the situation allows, Saundra Schimmelpfennig, Good Intentions Are Not Enough blog author and the creator of Charity Rater, told the Chronicle of Philanthropy.

“Just because money was spent quickly does not mean it was spent well…. Conversely, just because an organization has not spent all their money does not mean they were not operating at top efficiency given the realities on the ground.”

That’s consistently been the case in Haiti, where organizations are thwarted from making progress by everything from the debris clogging streets to politics clogging the bureaucracy. Those building shelters can’t get land ownership records, those working to prevent floods can’t remove canal debris fast enough, and those offering healthcare can’t get workers to operate modern medical equipment.

"You ask: Why are people still in camps?” Nigel Fisher, chief of the UN humanitarian mission, told the Washington Post. “You might as well ask: Why are Haitians poor? It is not rebuilding in Haiti. It is building.”