KUWAIT CITY -- With Iraqi hospitals full of wounded and water shortages made evident by people in southern Iraq drinking from drainage ditches, humanitarian aid workers are warning that the worst for civilians could be yet to come.
Hundreds of thousands of gallons of water are needed in the south of Iraq, from the port city of Umm Qasr, where water is beginning to trickle in, to the chaotic city of Basra, where it is not. If the electricity needed for purifying water in the north remains cut, the problems for people in Baghdad and its environs could become even more severe.
Medical supplies are desperately needed throughout the country, aid workers said yesterday, and Iraqi doctors and nurses have worked to exhaustion because of the number of severely wounded civilians combined with sharply depleted staff. Also, humanitarian deliveries of food might be necessary on a scale never before seen.
The programs to address all these needs are in place. The problem is that the continued fighting, in virtually every part of Iraq, has left aid workers lining the country's borders but frustrated at their inability to transport their goods.
"The clock is ticking, and if time runs out, we will have a huge problem like you have never seen before," said Marc Vergara, a UNICEF worker who has been trying to get water into Iraq. "We can't get too far in because it's too dangerous for our workers. And when we can't get in, it's dangerous for the civilians."
Since Sunday, UNICEF has been able to get water tankers into Umm Qasr, Safwan, Zubayr and a southern suburb of Basra. But the supply has not come close to meeting the demand, Vergara said. With people drinking water from any source they can find, health workers are concerned about outbreaks of dysentery and cholera in a population already largely malnourished. "What we're doing is symbolic," Vergara said. "It does not come close to meeting the need."
Water lines running from treatment plants in Basra have been damaged in the war, and they ran at only about 60 percent capacity before the hostilities. British military officials say that the treatment plants were further damaged during fighting, and that even water running into Basra -- a city of nearly 2 million people -- has been cut to about half the normal flow.
A water line from Kuwait into Umm Qasr was opened this month, but it also falls short of the need, and some of that water has been hijacked by bandits who sell it on the black market, meaning that the most desperate people -- the weak and the poor -- are doing without.
Before the war, aid organizations hoped to get water, medical supplies and food -- in that order of priority -- quickly into southern Iraq, where they saw the need was already great. When Saddam Hussein was not brutalizing Shiite Muslims in the south, he was neglecting them, and virtually everybody in the region relied on United Nations food programs to survive.
When U.S. troops traveled north to Baghdad, before clearing out resistance in Umm Qasr and other southern cities, the civilian populations left behind faced great needs with no safe way for the aid organizations -- nongovernmental organizations, or NGOs, as they are known -- to deliver the supplies.
"The longer this goes on, the more hunger, the more sickness, the more deaths there will be," said Nicole Amoroso, spokeswoman for Save the Children, which this week began sending investigators into Umm Qasr to assess the needs there. "We're a long ways from getting into Basra, let alone Baghdad."
They do not want to enter cities with armed military escorts because they feel that if they are perceived as being aligned with any fighting force in any conflict, it could put them in danger in that operation and any others in the future.
The World Food Program has 32,000 tons of wheat, flour, rice, vegetable oil, baby formula and other supplies sitting in warehouses in Jordan, Turkey, Syria, Iran and Kuwait. Another 400,000 tons are scheduled to arrive next month, according to the organization's spokeswoman, Antonia Paradela.
"Right now, people have food in their stomach but nothing that you would call a rich diet," she said. "Soon they will have no food at all, and when that happens, the problems will be massive. It will be the biggest food distribution in history, and we have been able to do very little work."
The food program has begun assessments on need in Umm Qasr but nowhere else. Safwan is considered too dangerous but might be safe enough soon. Basra is out of the question, she said, with fighting continuing in some areas, and wild looting occurring almost everywhere.
Medical supplies were stockpiled in warehouses around Iraq in preparation for the war, but they, too, are dwindling, said Tamara Al-Rifai, a spokeswoman for the International Committee of the Red Cross. Water is needed as much as medicine, and blankets are in low supply because so many have been adapted for use as body bags.
The Red Cross said that hospitals are packed with civilians, and that the ability to treat them has been hampered not only by a shortage of supplies but also by power outages. At Baghdad's Al-Kindi hospital Monday, the organization said it counted 10 new patients arriving during each of the morning hours with generators supplying electricity. At the Medical City hospital, the Red Cross said that water and electricity are out, and that only six of 27 operating areas were usable.
"The situation is very, very difficult," said Al-Rifai. "More people are going to die who could be saved if there was adequate treatment available. The question is how many. That will depend on how long the war lasts."