ROCKAWAY PARK, New York (Reuters) - Noreen Ellis begged the American Red Cross for help a few days after Superstorm Sandy slammed into the U.S. East Coast.
A 90-year-old bedbound woman living on Ellis's block needed to be moved from the Rockaways, an eight-mile long, narrow spit of land in New York City, to a shelter with heat and electricity.
"I said, 'This woman needs to be transported. Can you help?' And the Red Cross said, 'We don't do that,'" Ellis said.
She shot back: "What does the Red Cross do?"
Ellis's frustration, echoed by many residents in the places worst hit by Sandy across the New York region, exposed a gulf between what many people expected the charity to do in times of crisis and what it actually delivers.
In interviews with public officials and Red Cross staff, as well as first responders from other aid organizations, it has become clear the Red Cross was hampered by the sheer magnitude of the disaster, by its decision to position supplies and staff well outside the areas likely to be hardest hit by the storm, and by misperceptions about what kinds of relief it would provide in New York City.
The sense of letdown is all the more stark because the Red Cross, the fifth-largest charity in the United States by private donations, is viewed by many as the place to donate money when there is a major disaster at home or abroad. It has raised nearly $120 million since Sandy - spending about $40 million of that so far.
Importantly, the Red Cross has been designated by the U.S. Congress as the only non-governmental entity with the responsibility "to lead and coordinate efforts to provide mass care, housing, and human services after disasters that require federal assistance," according to a 2006 congressional review.
But it isn't the first time the Red Cross has faced severe criticism for a slow or weak response in the U.S. The review followed its performance after Hurricane Katrina in 2005, when the Red Cross was blamed for poor outreach to victims, and after the 9/11 terrorist attacks, when the Red Cross decided to stash away $200 million in donations for future emergencies and then reversed course after a public outcry.
The Red Cross says it has been unfairly criticized in Sandy's aftermath and will use any leftover donations to help longer-term needs of affected communities.
"No one organization, no government agency, could permanently be ready to respond to a disaster of this magnitude," Josh Lockwood, the chief executive of the Red Cross's Greater New York Region, said during an interview at a food distribution site in Staten Island's New Dorp neighborhood.
Red Cross spokesman Roger Lowe added: "Are we everywhere we want to be at the same time? No, but we're everywhere we can be given the people and vehicles we have and the fact that we are facing a large geography and an enormous population that needs service."
Gail McGovern, the head of the American Red Cross, even told NBC News last week that her staff has been "near flawless" since Sandy struck.
But the Red Cross efforts got off to a very slow start.
As Sandy approached, the American Red Cross headquarters in Washington, D.C. arranged five staging areas in cities expected to be just outside the storm's path, Lowe said. Supplies and staff were moved out of the New York region to avoid damage.
One of those cities was Harrisburg, Pennsylvania, where Lowe said response vehicles and other supplies were stored. When contacted after the storm, though, local Red Cross officials in Harrisburg said they had prepared primarily to serve local victims. Only after they made sure Pennsylvania residents were all right - a process that took three days - were resources sent on to New York City, the officials said.
Similar stories were told by local Red Cross officials in Baltimore, another staging area. Local officials in the other three designated places either would not comment, could not be reached for comment or were responding to Sandy's damage to their own communities.
The Red Cross said traffic delayed by three days its efforts to serve Staten Island, the Rockaways, Coney Island and other hard-hit communities in and around New York City. That was despite all main bridges to those communities being open the day after Sandy.
As President Barack Obama paid a high-profile visit to the charity's Washington, D.C. headquarters the day after the storm to talk about relief efforts, the Red Cross had not yet sent in food and supplies to victims in New York City. It did have shelters open outside the Big Apple, though.
"If we could have gone one minute faster in our response time, I'm going to make sure we make changes to make that happen," Lockwood said. "We had the same challenges that all people in the region had, having to do with traffic snarls, trees down, telephone poles down."
The delay prompted an outburst from Staten Island Borough President James Molinaro three days after the storm, when he asked Americans not to donate to the Red Cross because the group had yet to help his constituents. The Red Cross later said that at the moment Molinaro was speaking, its trucks were en route to Staten Island, where 22 people died in the storm.
Part of the perception problem may be the massive media and advertising campaigns that the Red Cross runs when there is a disaster.
Much of the money collected by the Red Cross in the past two weeks has come from high-profile telethons on national TV networks. The Red Cross has also run advertising on TV, the Internet and newspapers asking for money "to help people affected by disasters like Superstorm Sandy" and it promises that donations will help "make the biggest and most immediate impact."
Celebrities such as Cindy Crawford and LL Cool J have tweeted links to the Red Cross, news anchors have staffed phone lines, JPMorgan Chase ATMs display Red Cross advertising, and Whole Foods asks for Red Cross donations at checkout.
These campaigns appear to give the impression that the charity can be all things to all victims. Many of Sandy's victims said in interviews that this was their view before disappointment set in.
"After Katrina I gave big money to the Red Cross, but I will never again," said Ellis, the Rockaways resident who was able to get her elderly neighbor to a shelter after a ride was arranged with a Long Island ambulance service. "It's not going to the people who need it."
In fact, the group's primary mission in a disaster is to supply food and run shelters, not to provide transportation, arrange cleanup operations or coordinate last-minute volunteers.
"People have been giving without finding out first what a group's capacity is to actually deliver services," said Ben Smilowitz, head of the Disaster Accountability Project, a watchdog group for first-responder relief agencies.
For every dollar the Red Cross raises, roughly 92 cents is used for its blood supply and relief projects, with roughly 4 cents to administrative costs and 4 cents to fundraising.
During the Red Cross's 2010-2011 fiscal year, its largest expenditure - $2.21 billion - was for its blood and plasma services, not relief work, as it helps maintain 40 percent of the U.S. blood supply. In addition to that expenditure, reported in the group's annual filing with U.S. officials, the organization spent $340.1 million on international relief and $270.6 million on domestic relief.
Indeed, the Red Cross did run hundreds of shelters on Long Island, New Jersey and New York's Westchester County just after Sandy, but in New York City, the city government serves that role, further limiting the group's visibility. Altogether, the Red Cross says it has roughly 2,200 volunteers and 160 employees on the ground, and has provided more than 1 million meals or snacks.
"Sometimes there's a perception that we're not in a community even though we've had mobile trucks that have gone through there hundreds of times, so that's a challenge in terms of perception," said Lockwood.
And some Sandy victims do give it the benefit of the doubt.
"There are things that you can't do overnight. All of this takes time," said Cecil de Silva, a driver for Meals on Wheels whose Rockaway Beach home was swamped by Sandy's tidal surge and who evacuated to Staten Island, only to be affected by the storm there as well. "People need patience."
The sheer size of the Red Cross may be standing in its way. Other aid organizations have found that a more-nimble approach helped them respond after Sandy's landfall.
The Salvation Army used a handful of its staff living in Staten Island to begin helping victims the day after Sandy left, two days before the Red Cross arrived.
Doctors Without Borders is using a small team of physicians to visit homebound patients. Team Rubicon, a relief group of mostly veterans, is coordinating volunteers and using supplies donated by retailer Home Depot Inc to clean up parts of the Rockaways and New Jersey.
And across Brooklyn and Queens, the Occupy Wall Street movement, famous for its 2011 protests against income inequality in a downtown Manhattan park and elsewhere around the country, has used its grassroots network to erect food and clothing distribution centers, volunteer coordination sites, and makeshift clinics.
Frustration with the Red Cross is palpable throughout the Occupy movement.
"The Red Cross is useless," said Nastaran Mohit, who runs the Occupy medical clinic in the Rockaways with volunteer doctors. "They come to me every day asking, 'How can we help?'
"I say, 'Send me people.' And they tell me they'll get back to me."
The Red Cross said it did approach Occupy organizers last week, but so far "we do not have specific examples of where we have worked together," said Lowe, the Red Cross spokesman.
Some other charities have even been specifically targeting those who do not want to go through the Red Cross with statements like this on their websites: "If you would like to donate to the relief effort but prefer not go through the Red Cross: the Staten Island Giving Circle can accept donations via PayPal."
Said Lockwood, head of the Red Cross's Greater New York Region: "If people want to be generous we thank them, and if they want to be generous to another organization that's great too."
Reporting By Ernest Scheyder; Additional reporting by Susan Cornwell and Jennifer Merritt; Editing by Martin Howell and Steve Orlofsky