Ten months after a magnitude 8.0 earthquake killed more than 200,000 Haitians and destroyed an already decrepit infrastructure, some 1.3 million impoverished souls are still barely surviving in tent cities around the country. Living conditions are deplorable and after nearly a year, optimism about a way out of what were once dubbed “temporary” camps has dimmed.

Now more than 1,100 people have died in a cholera epidemic, and riots that began in the northern city of Cap-Haitien spread to the capital of Port au Prince last week. Protestors allege that the United Nations peace-keeping mission brought the disease to Haiti. The jury is still out on the source of the cholera, but the unrest has taken a further toll.

And so it goes. Just when you think things can’t get any worse, more poverty, violence and sorrow conspire to increase the sense of helplessness in what is the ultimate economic basket case in the Western Hemisphere. Millions of people the world over watch from afar and wonder why something can’t be done.

Here’s the $64 million question: Is Haiti’s seemingly intractable misery the result of a society and culture that is incapable of organizing itself to create civil order and a viable economy? Or is it the consequence of ruling kleptocrats—abetted or at least tolerated by influential foreigners—treating every economic transaction in the country as an opportunity for personal enrichment?

Evidence abounds that it is the latter. So why have the U.S. and the U.N. refused to take even small steps toward shutting down an official corruption racket that pushes millions of helpless people into lives of desperation? Instead they’ve put Bill Clinton—whose political family famously went into business with the notoriously corrupt former President Jean Bertrand Aristide—in charge of rebuilding the country with billions in foreign aid.

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Getty ImagesA cholera victim in a Doctors Without Borders treatment center near the slum neighborhood of Cite Soleil, Nov. 19.

Development takes generations, and nation building by outsiders is a fool’s game. But often there is a simple change that can yield fast returns. One no-brainer target in Haiti is the port at Port-au-Prince, where the bulk of imports must enter the country, but where Haiti’s legendary mafia will only release containers after sizable bribes are collected.

A report this year by the Rand Corporation describes the port’s importance this way: “The costs of shipping through Haiti’s ports have imposed a major burden on Haitian consumers and businesses. Because imports play such an important role in consumption, investment, and business operations, the cost of imports is a key determinant of living standards and economic growth.” And yet, Rand says, “importing a container of goods is 35 percent more expensive in Haiti than the average for developed OECD countries.”

Haitian officials like to blame inefficiency at the capital’s port on a lack of modern infrastructure. But Haitians know that’s only part of the story. Writing for the online magazine The Root in October, Haitian-born business consultant Yves Savain explained that pulling a container out of the port in the capital “takes walking the documents from office to office to secure an unspecified number of signatures.” The full cost, which he said includes “legitimate and illicit duties,” constitutes “a substantial and arbitrary financial drain on all sectors of the national economy.”

Mr. Savain was being diplomatic. On a visit to the Journal offices last week, former Haitian ambassador to the U.S., Raymond Joseph—who resigned in August—was more direct. “The corruption situation in the ports was one of the major reasons I decided I could no longer defend this government,” he says.

In the aftermath of the earthquake, Mr. Joseph says, “I had so many [nongovernmental organizations] calling me and saying ‘ambassador, could you help me get our things out of the port?’ They kept telling me [port officials] want so many thousands of dollars to get the things out.” Mr. Joseph says that by calling the minister of finance he could sometimes get the goods out but that he wasn’t always successful.

Another example: A Nov. 14 CBS “60 Minutes” report featured the case of six containers destined for an NGO housing project that had been “stuck” in the port for months. No one could figure out why the goods couldn’t be released, but the NGO was still forced to pay $6,000 to the Haitian government for an “imposed storage fee.”

Haiti holds elections on Nov. 28 for parliament and president, and enemies of representative government want to disrupt that process. This partly explains the recent violence. Yet it would be foolish to write it off as solely the work of the nefarious underworld.

Haitians are fed up with the squalor that seems to promise an end only in death. They are angry not only with their own crooked politicians but with the way in which outsiders turn a blind eye to their tormentors. The fact that Washington and the U.N. have refused to rein in the extortionists running the port demonstrates the lack of international political will to alter the status quo.

Write to O’Grady@wsj.com