Two and a half years after Hurricane Katrina, 38,000 families, or approximately 114,000 people, have yet to receive the compensation promised by the federal government and are still living in cramped trailers provided by the Federal Emergency Management Agency (Fema).
But just when it seemed that post-Katrina New Orleans could not bear witness to greater suffering or government incompetence, Fema made a stunning announcement. Families living in many of these trailers have been exposed to toxic levels of a cancer-causing chemical.
Formaldehyde is an industrial chemical that also occurs naturally. It is often found in materials used by the construction industry, with the effect that minute quantities, on average 16 parts per billion (ppb), are found in most homes. Indeed, the US Environmental Protection Agency allows no more than that proportion in the air of new buildings constructed for its own use. However, recent tests of 519 randomly selected trailers, carried out by the Centres for Disease Control and Prevention (CDC), found that some had levels as high as 590ppb. The study stated that such a concentration would make 5 per cent of adults sick and would cause breathing difficulties for a third of children and elderly people.
The federal government has yet to investigate how this could have occurred. One theory is that after Katrina manufacturers of trailers were faced with such large orders - 144,000 families ended up in mobile homes - that they ran out of low-emission materials.
Incredibly, internal documents show that Fema was aware of the difficulty as long ago as March 2006, when reports began coming in of severe health problems. Yet Fema did not run any tests. Emails from its legal department advised that testing for the toxin "would imply Fema ownership of the issue" and that the agency would have no option but to act. Another email read: "Should [tests] indicate some problem, the clock is running on our duty to respond to them."
In the past two years, trailer occupants have complained of rashes, headaches, asthma, nosebleeds and sore throats. A few have mouth tumours. There are even suggestions that the toxic trailers have killed. A child living in one in Texas died in August 2006. The Fema agent investigating reported that her nose began to burn after her short visit to the trailer. That same year, in St Tammany, Louisiana, a man who had complained about formaldehyde fumes was found dead in his trailer.
Louisiana's Republican governor, Bobby Jindal, has called Fema's inaction "simply inexcusable", while the state's Democratic senator, Mary Landrieu, has accused the government of "gross incompetence".
Visiting last August, I noted surprising numbers of people coughing despite the summer heat. At the time, I presumed this was due to Louisiana having the second-worst health-care indicators in the entire country. But July temperatures can reach as high as 40°C; it is thought that as trailers bake, the concentration of the chemical increases greatly. So the CDC tests, carried out this winter, probably understated the scale of toxin exposure.
Fema is now acting urgently to move people out of the trailers before the summer, and all the elderly within two weeks.
This will not be easy, as New Orleans is desperately short of housing. Rents are 40 per cent higher than before Katrina, which destroyed 41,000 lower-income apartments. The city's mayor, Ray Nagin, fears that trailer occupants will now be forced out of the city once again, and warned of a "second great displacement" in an open letter to President Bush. Then there are the city's 12,000 homeless, many in a makeshift colony below an overpass less than a mile from the city centre.
Even if the mass evacuation is achieved, there are huge health implications, especially for small children whose immune systems have been weakened by two years in these trailers. A pregnant mother who had her trailer tested after her little girl kept falling ill found the level of formaldehyde to be 2,400ppb. The CDC has announced that children who lived in Fema trailers will now be the subjects of a long-term study. In his letter to the president, Mayor Nagin demanded "guaranteed access to state-of-the-art medical care for any future formaldehyde-related medical conditions".
Mass actions representing tens of thousands of trailer occupants are now being launched against trailer manufacturers. Lawyers representing trailer residents say that Fema itself is likely to become a defendant in the near future.
Donald Powell, Bush's federal co-ordinator for rebuilding the Gulf Coast, resigned last month, voicing hope that his time in office had helped to restore in Katrina victims at least a "fragile" trust in the federal government.
Yet the reality for many victims of Hurricane Katrina is that, denied compensation for the destruction of their homes and threatened with eviction from New Orleans for a second time, many must struggle to hold the government accountable for the destruction of their health.