Nearly six months ago, my wife Debbie and I boated out of New Orleans. We left five days after Katrina struck. 

Debbie worked as an oncology nurse in a New Orleans hospital. She volunteered to come in during the hurricane so that other nurses with children could evacuate. 

There were about 2,000 people huddled in the hospital - patients, staff and families of staff and patients. Plate glass windows exploded in the lobby and on crosswalks and on several floors. Water poured in though broken windows, ceilings, and down the elevator shafts. Eight feet of brown floodwater surrounded us. 

The entire city immediately lost electricity. Soon the hospital backup generators located in the basement failed. No lights. No phones. Even the water system stopped. No drinking water. No flush toilets. 

You can imagine a hospital with 2,000 people and no electricity, water, food, or flushing toilets. Breathing machines did not work. Cell phones did not work. Because the computers stopped working medicines were unavailable. Elevators in the 8 floor building did not work. We quickly ran out of food because the cafeteria and food were also in the flooded basement. The gains of 21st century medicine disappeared. Over 40 people died in the hospital over the next few days as we waited for help. 

Now imagine an entire city with no electricity, water, food or flushing toilets and tens of thousands of people left behind. 

Debbie and I left five days later by way of a small fishing boat, the back of a garden truck, and the kindness of strangers. We returned 15 weeks later. Many of those left behind then who evacuated with us have yet to return. 

The Katrina evacuation was totally self-help. If you had the resources, a car, money and a place to go, you left. Over one million people evacuated - 80 to 90% of the population. No provisions were made for those who could not evacuate themselves. To this day no one has a reliable estimate of how many people were left behind in Katrina - that in itself says quite a bit about what happened. 

Who Was Left Behind in the Self-Help Evacuation? 
In the hospital, we could not see who was left behind because we did not have electricity or TV. We certainly knew the 2000 of us were left behind, and from the hospital we could see others. Some were floating in the street - face down. Some were paddling down the street - helping older folks get to high ground. Some were swimming down the streets. We could hear people left behind screaming for help from rooftops. We routinely heard gunshots as people trapped on rooftops tried to get the attention of helicopters crisscrossing the skies above. We could see the people trapped in the Salvation Army home a block away. We could hear breaking glass as people scrambled to get away from flooded one story homes and into the higher ground of several story office buildings. We saw people swimming to the local drugstore and swimming out with provisions. But we had no idea how many were actually left behind. The poor, especially those without cars, were left behind. Twenty-seven percent of the people of New Orleans did not have access to a car. Government authorities knew in advance that "... 100,000 citizens of New Orleans did not have means of personal transportation." Greyhound and Amtrak stopped service on the Saturday before the hurricane. These are people who did not have cars because they were poor - over 125,000 people, 27% of the people of New Orleans, lived below the very low federal poverty level before Katrina. 
The sick were left behind. Some government reports estimated 12,000 patients were evacuated. I estimate at least an additional 24,000 people - staff and families of patients - were left behind in the twenty-two hospitals which were open at the time. 

The elderly were left behind. The 280 plus local nursing homes remained mostly full. Only 21% evacuated and as a consequence 215 people died in nursing homes, at least six people died at a single nursing home while they waited four days for busses. The aged who lived at home also certainly found it more difficult than most to evacuate as they were more likely to live alone, less likely to own a car and nearly half were disabled. 

Untold numbers of other disabled people and their caretakers were also left behind. There were tens of thousands of people with special needs in New Orleans. 

A physician reported hundreds of people in wheelchairs were in front of the Convention Center. A comprehensive study of evacuees in Houston shelters found one in seven physically disabled, 22% physically unable to evacuate, 23% stayed behind to care for someone physically disabled, and 25% had a chronic disease such as heart disease, diabetes or high blood pressure. There were no provisions made for their evacuations. 

Children were left behind. While there are no official estimates breaking out children left behind, I know from what we saw during our evacuation that many, many children were among those left behind. About one-fourth of the people living in the areas damaged were children, about 183,000 kids, including 47,000 children under the age of 5. Over half of the children displaced were African-American and 30% of children in the damaged areas were poor, nearly double the 2000 national census rate for child poverty of 16.6%. These children were almost twice as likely to live in a female-headed home than children nationally. 

Prisoners were left behind. Local prisons held 8300 inmates, most on local minor charges awaiting trial and too poor to post bond. Thousands were left behind with no food, water, or medical attention. Jails depend on electricity as much as hospitals do - doors of cells and halls and pods and entrances and exits are electronically opened and closed. More than 600 hundred prisoners, one entire building, were left behind once the prisons were evacuated - left in chest deep water, locked into cells. 

Ultimately as many as 40,000 people took refuge in the Superdome which lost power, lost part of its roof, the water system failed and the toilets backed up. Another 20-30,000 people were dropped off at the Convention Center. Conditions at the Convention Center were far worse than at the Superdome because the Convention Center was never intended to be used for evacuees it did not have any drinking water, food, or medical care at all. Ten people died in or around the Superdome, four at the convention center. 

Unfounded rumors flew about rapes and murders inside these centers - and the myth that rescue helicopters were fired upon - have all been found to be untrue.. But those rumors so upset military and medical responders that many slowed down demanding protection from the evacuees - only to be greeted by "a whole lot of people clapping and cheering" when they arrived. 

Debbie and I left the hospital after five days. Helicopters finally came and airlifted out many patients, their families and staff. Others, like us, left in small fishing boats piloted by volunteers. The Coast Guard reported it rescued 33,000 people and the National Guard reported rescues of another 25,000 people. Louisiana Department of Homeland Security said 62,000 people were rescued from rooftops or out of water - not including those already in shelters. Many, many others, like us, were rescued by volunteers in boats and trucks. 
Some people never made it out of metropolitan New Orleans. February 2006 reports from the Louisiana Department of Health and Hospitals show 1,103 bodies were recovered from the storm and flood, with over 2,000 people still reported missing. About 215 people died in local hospitals and nursing homes. 
Where did the survivors end up? According to FEMA, evacuees ended up all over - applications came in from 18,700 zip codes in all 50 states - half of the nation's residential postal zones. Most evacuee families stayed within 250 miles of New Orleans, but 240,000 households went to Houston and other cities over 250 miles away and another 60,000 households went over 750 miles away. 

Who ended up in shelters? Over 270,000 evacuees started out in shelters. The Washington Post, the Henry J. Kaiser Family Foundation and the Harvard School of Public Health surveyed 680 randomly selected adult evacuees in Houston shelters on September 10-12, 2005. The results of that survey illustrate who ended up in shelters: 
. 64% were renters 
. 55% did not have a car or a way to evacuate 
. 22% had to care for someone who was physically unable to leave 
. 72% had no insurance 
. 68% had neither money in the bank nor a useable credit card 
. 57% had total household incomes of less than $20,000 in prior year 
. 76% had children under 18 with them in the shelter 
. 77% had a high school education or less 
. 93% were black 
. 67% were employed full or part-time before the hurricane 
. 52% had no health insurance 
. 54% received their healthcare at the big public Charity Hospital

The people who were left behind in Katrina were the poor, the sick, the elderly, the disabled, children, and prisoners - mostly African-American. 
Who Is Being Left Behind Now? 

"Hurricane Katrina likely made one of the poorest areas of the country even poorer ... Both those who were poor before the storm and those who have become poor following the storm, are likely to face a particularly difficult time in reestablishing their lives, have few if any financial resources upon which to draw." Congressional Research Service 2005 Debbie and I ultimately ended up spending several months in an apartment in Houston while New Orleans started its recovery. Loyola Law Clinic, where I work, moved into the Disaster Relief Center in Houston and our clinic students interviewed and gave assistance to over a thousand evacuees. 

We were able to come back to New Orleans for good in mid-December because our house was located close to the University and only sustained roof damage. Very few of the people who were evacuated with us have been able to return. 

It seems clear that most of the same people who were left behind in the evacuation for Katrina are being left behind again in the reconstruction of New Orleans. In fact, now there are even more being left behind. Hundreds of thousands of people have not been able to make it back. 
Drive through the city away from the French Quarter, Central Business District and the St. Charles streetcar line and you will see tens of thousands of still damaged and unoccupied homes. 

Hundreds of thousands of people have not made it back. 
There were 469,000 fewer people in the metropolitan New Orleans area in January 2006 than in August 2005. 
Why? Many reasons. 

Most of the City was still without power in early 2006. About two-thirds of the homes in New Orleans did not have electricity in early 2006, even fewer had gas. 

Seventy-three percent of the homes in New Orleans were in areas damaged by the storm. But, as the Brown University study concluded "storm damage data shows that the storm's impact was disproportionately borne by the region's African-American community, by people who rented their homes and by the poor and unemployed." 

Poor people were hardest hit and are having the hardest time returning. "The population of the damaged areas was nearly half black (45.8% compared to 26.4% black in the rest of the region), living in rental housing (45.7% compared to 30.9%), and disproportionately below the poverty line (20.9% compared to 15.3%." Renters are not coming back because there is little affordable housing. With tens of thousands of homes damaged, the cost of renting has skyrocketed. An apartment down the block from my house rented for $600 last summer - it now rents for $1400. Trailers have not arrived because of federal, state and local political misjudgments. Over 10,000 trailers were still sitting unused on runways in Hope, Arkansas in February 2006. In my interviews with evacuees who were renters, few were protected by any insurance - most lost everything. 
The little reconstruction that has started is aimed at home-owners. Louisiana is slated to receive $6.2 billion in Community Development Block Grant money and the Governor says $1 billion "could be used to encourage the rebuilding of affordable housing." So with 45% of the homes damaged occupied by renters, affordable housing "could" end up with 16% of the assistance. 

Public housing is politically out of the question in early 2006. There is no national or local commitment to re-opening public housing in the city. US Congressman Richard Baker, a longtime critic of public housing in New Orleans, was quoted in the Wall Street Journal after the storm saying "We finally cleaned up in New Orleans. We couldn't do it, but God did." As the Brown study politely observed "people who previously lived in public housing seem to have the least chances to return, given current policy. All public housing has been closed (and special barriers bolted to the doors).plans for reopening the projects or for constructing new affordable housing have not become public." 

Debbie lost her nursing job when her hospital failed to reopen. She is not alone. There are now 200,000 fewer jobs in the area than in August. 
When I teach about the working poor, I tell my students to look for the working poor at the bus stops in the morning and in the evening. The working poor have not returned. As the Brookings Institution Katrina Index tells us pre-Katrina public transportation in New Orleans averaged 124,000 riders per week; in January 2006 there were 11,709 a week, only 9% of the pre-storm number. 

The sick are not likely to return anytime soon. Healthcare in New Orleans is now difficult even for those with insurance but nearly impossible for the poor without it. While there were 22 hospitals open in New Orleans in June, in early 2006 there were 7, a 78% reduction. Before Katrina there were 53,000 hospital beds in the area, in February 2006 there were 15,000 - waits of more than 8 hours in emergency rooms are not uncommon. With so many hospitals closed, people needing regular medical care like dialysis or chemotherapy cannot expect to return. Worse still for the poor, there is no public hospital in New Orleans any more - the Charity Hospital that over 50% of the people in shelters went to has not been reopened. 

Many of the disabled are still in the areas where they evacuated to, causing financial and medical concerns in those states. Others of the disabled, who lived at home prior to the evacuation, fear being institutionalized. Children have not returned to New Orleans. Most public schools remain closed or have been converted into charter schools. Before the storm there were 117 public schools with 60,000 students. In January 2006, there were 19 open, including 8 new charter schools, serving about 13,000 students. Houston alone has nearly 20,000 evacuated students. The failure to reopen public schools in New Orleans has prompted litigation to force the charter and public schools to accept children. 

Prisoners have again been left behind. Some of those evacuated were kept in jail long after their sentences had run. Only 7 of 42 public defenders have returned to represent the thousands still held in jail. 

Even among homeowners, it is much more likely that white homeowners will have the chance to rebuild than black homeowners because of deep patterns of racial disparities in income - white median income is $61,000 compared to black income of $25,000. Black businesses were severely impacted by Katrina. Rebuilding by homeowners in mostly black low-lying neighborhoods is much less likely at the time of the writing of this article because of bulldozing plans by the city and because rebuilding in those areas depends heavily on planning and homeowners insurance and flood insurance issues, many of which have yet to be resolved. As a result, because renters, poor people and those without work are overwhelmingly African-American, "New Orleans is at risk of losing 80% of its black population." 

"New Orleans is not going to be as black as it was for a long time, if ever again," Alphonso Jackson, the secretary of the US Department of Housing and Urban Development, told a Houston audience. Recall some of the characteristics of people who ended up in shelters, then compare to the situation currently in New Orleans: 
. 64% were renters - now rents have skyrocketed and public housing is mostly closed 
. 22% had to care for someone who was physically unable to leave - now there are many fewer hospital beds 
. 52% had no health insurance - now the main center of public healthcare is closed 
. 76% had children under 18 with them in the shelter - most public schools are closed 
. 93% were black - the areas hit hardest were black and poor 
. 67% were employed full or part-time before the hurricane - there are now 200,000 fewer jobs than before the hurricane
The people left behind in the rebuilding of New Orleans are the poor, the sick, the elderly, the disabled, children, and prisoners, mostly African-American. Again left behind. The television showed who was left behind in the evacuation of New Orleans after Katrina. There is no similar easy visual for those who are left behind now, but they are the same people. 
Conclusion 
There is not a sign outside of New Orleans saying "If you are poor, sick, elderly, disabled, children or African-American, you cannot return." 
But there might as well be. 

The people left behind in the evacuation of New Orleans after Katrina are the same people left behind in rebuilding of New Orleans - the poor, the sick, the elderly, the disabled, and children, mostly African-American. 

Now that we are back from Houston, Debbie has just started a new job at another hospital. I am fortunate enough to work at one of the universities which was not severely physically damaged by the storm and floods. 
We are back. But where are our neighbors, the people we rode out of the city with? Where are the hundreds of thousands of our neighbors and will they ever be allowed to return? 

Where is New Orleans now, and more important, where is it going to be? 
Finally, if all levels of government and corporate power allow this to happen in New Orleans, do you think it will be any different in your city?