War-ravaged Nasiriya is caught in a deadly cycle: with no electricity to pump water, locals are breaking into the underground pipes, allowing raw sewage to seep into the system. The danger of a cholera outbreak is a real one.
It is a cycle repeated across Iraq
Eight-month-old Ali Hussein is too young to know anything about the war, but he is feeling the effects now, in his stomach.
For the past week, Ali has suffered from vomiting and diarrhoea, leaving him badly dehydrated. Now doctors have prescribed him a simple antibiotic and his mother, Zahra, hopes he will soon be on the mend. For Ali has been diagnosed with gastroenteritis, cases of which have risen sharply in Nasiriya in recent days.
Since the third day of the war, the city's electricity supply has been out of action. The combination of bombing raids by the coalition forces and the counterattack by the Iraqi army destroyed Nasiriya's infrastructure.
Without power there is nothing to pump the water. And without running water, the locals are turning to untreated supplies which they can't afford to boil because of the soaring price of fuel.
The electricity shutdown has also brought the sewage pumps to a halt, so that much of this city of half a million people is sitting on a bed of stale human waste. In places it has started to seep up to ground level.
Outside the clinic where Ali had been taken for treatment, the sewage has settled into a pool which runs the length of the dusty street before spreading out over a traffic junction. It's hard to sidestep and impossible to avoid getting a sniff of it.
The big fear is the two problems will combine into a single, lethal one. Across the city, locals desperate to tap into a ready water source have split open the municipal pipes.
We are in grave danger of a cholera epidemic by the summer - that will sweep through the population and kill thousands
Field worker Mary McLoughlin
Now sewage is seeping through the punctured holes of those pipes, so that even when the electricity is restarted, and water begins to flow freely again, it will carry potentially deadly bacteria.
With temperatures rising as summer approaches, Nasiriya could find a cholera epidemic on its hands, says one highly experienced aid worker.
Clean water, or the lack of it, is more of a problem than anything else in Nasiriya. There is no shortage of food. The central distribution system set up under the Oil for Food programme ensured everyone here had enough rations to last them through to August.
In some medical practices, 80% of patients seen are suffering from some sort of water infection. Dr Abdul Al-Shadood says his Al-Meelad clinic is seeing an average of 22 gastroenteritis cases a day, compared to one or two before the war.
Clean water is in demand
"If this is not diagnosed and treated quickly in children, they will die," says the doctor. That has already started to happen. The doctor refers severe cases to the city's children's hospital - itself working at only half capacity after a stray missile attack - and says the illness has claimed young lives.
Another worry is the lack of medicine available to treat these relatively simple maladies. The central medicine store that used to serve all medical practices in the area was seized by the Iraqi army as a battlement and subsequently wiped out in bombing raids.
Dr Shadood's clinic has run out of the most basic treatment - oral rehydration solution. Instead, he is prescribing an antibiotic called Flagyl. But he has only a few days' stock left and no deliveries are scheduled.
Again there are complications. Like many western countries, Iraq's fondness for handing out simple antibiotics to treat sickness has raised resistance among many locals.
Only now are humanitarian relief agencies starting to get a handle on what help they can offer. The Irish humanitarian agency Goal arrived in Nasiriya last week and is one of only a small group of aid organisations here.
Foul water is fetched from a damaged pipe
Field worker Mary McLoughlin says it's "no exaggeration" that if the water and sewage situation is not mended soon, Nasiriya will see a "major humanitarian crisis".
"Cholera is endemic in southern Iraq, but we are in grave danger of a cholera epidemic by the summer. That will sweep through the population and kill thousands," she says.
"The water and sewage pipes were already crumbling before the war, because of years of neglect. But now people are breaking holes in them to get the water, the real danger is of cross contamination between sewage and water.
"It's such a massive construction task to repair the years of neglect, I doubt whether they can fix the pipes by the time the really high temperatures come, which is when cholera becomes a real fear."