Families have started rationing water in and around Yemen's Taiz city, where renewed fighting has disrupted fuel supplies and access to water systems serving 3 million people, aid groups and UN agencies said.
Meanwhile, mounting piles of garbage along major roads are raising fears of disease outbreaks in the city, Yemen's third-largest.
Fighting between the Saudi-backed government and the Iran-backed Houthis since September has cut key supply routes, including the Taiz-Aden corridor, worsening shortages of water, food and fuel in and around the city.
The lack of fuel is hampering the operation of water pumps and hospitals, while disruption to waste collection has left garbage piled along roads of the city, a stronghold of anti-Houthi forces which is now under siege by the Houthis.
The Taiz governorate hosts nearly half of the 250,000 people displaced by the latest escalation, aid groups said.
"The state of the garbage in the city is very wretched, and the build-up is terrible, like nothing before,” Taiz resident Abdelbari al-Qadi told Reuters.
Sanitation worker Ali Ahmed said authorities could no longer go to the main dumping site because of clashes, and they were forced to burn it in the streets.
'Extremely dangerous situation' for children, says relief official
Families are rationing drinking water as diesel shortages hobble pumping stations and sanitation systems, said Akhil Iyer, UNICEF's representative in Yemen.
"I get the water with difficulty. We wait in queues from the morning until our turn comes,” Alaa Khalil told Reuters while people queued to fill jerry cans in Taiz, where most residents depend on trucked water.
Access to the Al-Dhubab aquifer, a major source of trucked water for Taiz, has been restricted, while fuel disruptions have affected pumps, creating a severe water crisis, said Wathiq Aghbari, director general of the Local Water and Sanitation Authority in the governorate.
Water production in Taiz has fallen by about 50%, according to Save the Children.
“We find children in an extremely dangerous situation where they are not able to have their basic needs satisfied. They are not able to access sufficient food and water and healthcare,” said Rishana Haniffa, Save the Children's country director for Yemen.
Aid groups are exploring other sources, including a shallow aquifer west of the city. The cost of a water truck has tripled from about 23,000 Yemeni rials ($14.80) before the latest escalation to about 70,000 rials ($45), according to UNICEF.
CARE International says cash assistance is buying less food and water as prices rise.
“We feel the situation is really getting out of hand unless we able to negotiate access to have water tankers come in to the city,” said Iman Abdullahi, CARE Yemen country director.
Garbage build-up 'will cause diseases,' says health official
"The build-up of garbage is very harmful and will cause diseases, whether respiratory or otherwise," said Abdulrahman al-Sabri, director of Taiz Governorate's Health Office, adding that dengue fever and cholera cases were spreading.
Cholera cases have tripled since early September from 221 to 683 this month, while hospitals face medicine shortages and 12 facilities have fuel supplies sufficient for only about four days, the World Health Organization said.
A doctor who asked not to be named for security reasons said some families could not reach healthcare facilities because of fighting around the city.
The Danish Refugee Council said the impact of deteriorating water and sanitation conditions could spread beyond Taiz city. It pointed to overstretched resources in crowded displacement sites across the governorates of Taiz, Lahj, Abyan and Aden.
The spread of disease could also worsen hunger in Taiz governorate, UNICEF said. It has identified 52,000 acutely malnourished children in Taiz so far this year. Road closures have halted UNICEF's deliveries of a therapeutic food for severely malnourished children in Taiz.