Even before the storm, they were some of the country's neediest kids. Now, the children of Katrina who stayed longest in ramshackle government trailer parks in Baton Rouge are "the sickest I have ever seen in the U.S.," says Irwin Redlener, president of the Children's Health Fund and a professor at Columbia University's Mailman School of Public Health. According to a new report by CHF and Mailman focusing on 261 displaced children, the well-being of the poorest Katrina kids has "declined to an alarming level" since the hurricane. Forty-one percent are anemic—twice the rate found in children in New York City homeless shelters, and more than twice the CDC's record rate for high-risk minorities. More than half the kids have mental-health problems. And 42 percent have respiratory infections and disorders that may be linked to formaldehyde and crowding in the trailers, the last of which FEMA finally closed in May. The "unending bureaucratic haggling" at federal and state levels over how to provide services and rebuild health centers for the Gulf's poor has made a bad situation much worse, says Redlener: "As awful as the initial response to Katrina looked on television, it's been dwarfed by the ineptitude and disorganization of the recovery."

Some kids may end up with permanent developmental and cognitive delays, but many can still be helped. The first step will be finding them. FEMA was supposed to provide Louisiana with contact information for the families that moved out of the trailers; it has not done so. The agency's case-management program also "has yet to provide any services for thousands of families," according to the report, and funding for the program expires in March. Redlener is optimistic that funds will be extended at least through mid-2010, since all that will require is "a stroke of the pen" from the new administration. But, he adds, he's "not Pollyanna-ish about how rapidly" the disaster-planning system will get its act together and come up with long-term plans for the impoverished families—or whether that will be accomplished in time "to make sure this doesn't happen again" with the next storm.