"Boil your water," the doctor tells a mother in an Iraqi TV advertisement, as she listens to a child's heart with a stethoscope in the hospital.
It's the same advertisement airing now that the United Nations Childrens' Fund (UNICEF) ran before the war. But now the message is even more relevant, with many of Iraq's water and sewage plants still in disrepair 18 months after US-led forces invaded the country.
"Cases of water intoxication and diseases related to water are very high, especially in the south of Iraq," Muhammad Al-Obeid, a doctor at a hospital in Al-Sadr city, a Baghdad suburb, told IRIN.
More than US $600 million has been spent on water and sanitation projects in Iraq since the toppling of Saddam Hussein's regime, Mahmoud Sami, deputy minister of public works, told IRIN. Now, another $500 million is needed to complete work, he said.
"Investment is being made to help rebuild the water and sanitation systems in Iraq," Sami said optimistically. "Together with the NGOs, we are going to have a prosperous future for the Iraqi people."
But officials say that if security doesn't improve soon, they won't meet their goal of fixing all the country's water and sanitation facilities by August 2005.
The kidnapping of foreigners and almost daily car bombs and mortar attacks have slowed the work. Two American construction workers taken hostage by militants were killed in recent days. The kidnappers demanded that women prisoners be released from Iraqi jails after taking the two US citizens and a British colleague.
Most international workers from aid agencies have already left the country, following the early September kidnapping of two Italian female aid workers and two Iraqi colleagues from the Bridge to Baghdad and Intersos aid agencies in central Baghdad.
"If we work together with the understanding of the Iraqis, very soon we can provide a better life for them and assure them that the development of our country will go very far," Waleed Al-Hassan, planning adviser for the Ministry of Water Resources, told IRIN.
INCREASE IN DISEASE
Experts at the Ministry of Health say there has been an increase in diseases caused by dirty water. They fear that unless water and sanitation problems are resolved soon, it will be difficult for people to recover. Children are considered to be most at risk.
"In Baghdad, the situation is somewhat under control, but we need special attention for the suburbs, because the situation there is tragic. Most of our cases come from those areas," Al-Obeid said. Raw sewage flowing in some streets has caused many of the health problems.
"You cannot imagine what it is like living in a place where the smell of raw waste is constantly inside your home. It is terrible and the hot temperatures makes it worse. Sometimes I have to go to my parent's home to get away from it," Rabab Muhammad, 32, living in Sadr City, told IRIN.
More than half of the country's sewage treatment facilities are not working, according to USAID. In Baghdad, only one of three major sewage facilities has been rehabilitated since last July. Two others are still being repaired.
Outside Baghdad, most sewage facilities were only partially operational before the conflict. A shortage of electricity and chemicals has exacerbated the situation in recent months. Residents have no option but to put up with the stench of raw sewage that fills their streets and the health risks.
"What we want is a healthy life for our children. It is difficult to live in a country in which every year new projects are started due to destruction. We hope that this time we can have some kind of peace," Abdullah Kubaissy, 43, from Sho'ola suburb of Baghdad, told IRIN.
ACCESS TO CLEAN WATER
Only 55 percent of Iraq's 22.5 million inhabitants had access to purified water directly after the war, according to officials at the Ministry of Water Resources.
Under former President Saddam Hussein's regime, Baghdad and surrounding governorates had 100 percent potable water. But southern Iraq suffered badly following the revolt against Saddam after the 1991 Gulf War, leaving less than 45 percent of its water system functioning. Some remote provinces were left with no water facilities after the revolt, according to local officials.
A year ago, 25 percent of the 177 water/sewage treatment plants studied were classified as poor, a UNICEF sanitation monitoring programme in 14 governorates found. Only 20 percent were found to be acceptable, the September 2003 study of central and southern Iraq said. More recent statistics are unavailable.
Agricultural areas that do not have access to main water pipes are also a priority, according to the Ministry of Water Resources. Agriculture in Iraq was largely forgotten by Saddam Hussein's regime. "Our aim is to reach the most remote places in Iraq, giving them the chance to have a better lifestyle, together with good support for rural workers," Al-Hassan said.
"It will take time but we believe that by August 2005, a good and new step of development concerning irrigation support in Iraq will be done," he added.
Some water development work has been completed. Huge water storage tanks have been built in many small, remote villages in Iraq. A US NGO, which prefers not to be named for security reasons, is scheduled to build 87 water purification units. Another 160 are to be finished by the end of this year. When completed, they will benefit more than 300 communities in areas around Babel, Kut, Muthana, Karbala and Nasiriyah in the south.
Some 11.8 million Iraqis are expected to benefit from USAID's new projects, according to its website. Village residents will learn how to repair and maintain their own water systems after they are built.
The situation seems to be much better in the northern governorates of Iraq where 85 percent of the water systems run at full capacity, according to local officials.
The Ministry of Public Works will also focus on projects in southern Iraq, where the quantity and quality of clean water is very low.
Years of neglect and post-war looting left many rural communities disconnected from mains water or sewerage lines. Many people have no access to potable water and suffer from health problems related to poor sewage disposal.
More than 140,000 people will benefit from a mechanical and electrical upgrade to water and sewerage facilities in the southern city of Najaf expected to be completed by the end of the year, Al-Hassan said. By mid-August 2005, more than 535,000 people in Najaf will have clean water and an operational sanitation system in their houses, he said.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions