The satirical newspaper The Onion reported two weeks ago that "American anthropologists have confirmed the discovery of a small, poverty-stricken island nation, known to its inhabitants as 'Haiti.'"

The Onion quoted a made-up expert: "Of course, there have been rumors in the past about a long-forgotten Caribbean nation whose people struggle every day to survive, live in constant fear of a corrupt government, and endure such squalor and hunger that they have resorted to eating dirt. But never did we give them much thought.

"Had it not been for this earthquake, I doubt we would have ever noticed Haiti at all."

Satire often reveals truths too uncomfortable to speak. The challenge for the world today, more than a month after the Jan. 12 earthquake that killed at least 230,000 people and leveled the Haitian capital of Port-au-Prince, is what to do about it.

France, which first colonized Haiti, and the United States, which long exploited its natural resources, have a particular obligation. Both nations, and their individual citizens, have responded magnanimously to the disaster.

To cite but one example, the Post-Dispatch's Phillip O'Connor and J.B. Forbes reported Feb. 7 on the ingenuity of Pat Bradley of Oakville, Mo., who runs a small humanitarian organization, and a company of U.S. Marines. The Marines had landed with food, water and emergency supplies to deliver, but had grown frustrated with the slow response of the United Nations.

Mr. Bradley and Dennis Russell, a pastor from suburban Atlanta, scrounged up some trucks and, with the 3/2 Marines, began loading and delivering supplies. "Two men and truck," the Marines called them.

Their partnership became a template for U.N. emergency operations once the United Nations, hampered by jurisdictional disputes, access to airports and seaports and the complete disappearance of Haitian government control, finally got started.

It's tempting to blame the United Nations, with its vast, acronym-happy bureaucracy, but Haiti has long defied either control or simple solutions.

The Clinton administration encouraged a chaotic and feckless democracy under Jean-Bertrand Aristide; the Bush administration saw Mr. Aristide as a Marxist and encouraged a kind of neo-colonialist approach. Neither did much for the people.

On Thursday, The Boston Globe reported that Paul Farmer, a Harvard physician who has worked in Haiti since 1983 and now is U.N. special envoy to Haiti, suggested that the earthquake might offer a chance to put things right.

"Might addressing the acute needs of the displaced and injured afford us a chance to address the underlying chronic conditions?" he asked at a conference at Harvard's Medical School.

Anyone who read "Mountains Beyond Mountains," Tracy Kidder's 2004 biography of Dr. Farmer, was left with the idea that the 50-year-old epidemiologist is at once both a genius and a saint. At once skeptical of government programs and open to them, he told Mr. Kidder, "God gives us humans everything we need to flourish, but he's not the one who's supposed to divvy up the loot.... You want to see where Christ crucified abides today? Go to where the poor are suffering and fighting back, and that's where he is."

What's needed in Haiti, he said, are 500,000 paying jobs and systems to deliver services effectively. Those needs could be met by governments, individuals, a U.N. protectorate or an international commission led by former President Bill Clinton.

Absent its own functioning government — President Rene Preval did not inspire confidence by admitting that for the first two week after the quake, he was too shocked to lead — it's not likely Haiti can manage itself. What's important is that the work begins, and more important, that it continues.

As Dr. Farmer once said, "For me, an area of moral clarity is: you're in front of someone who's suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, and you act."

REPRINTED FROM THE ST. LOUIS POST-DISPATCH.