PORT-AU-PRINCE, Haiti -- It was the end of the day and the water was almost gone. The six faucets at this public trough were dry. Still, Noel Zilice sat pouring what was left from bucket, to pan, to bowl. With her dirty rag, she washed her dishes. When she was done, she dipped her hands into the dirty water and wiped her son's face. Next she poured the water onto her feet and legs.

Three times a day, Zilice, 37, leaves her youngest children at her house on top of a crumbled hill in a neighborhood called Nan Siko Pwolonje to descend into the belly of the slum to fetch water from spigots at a government water site.

And three times a day, she fills a five-gallon tub, balances it on her head and walks steadily and gracefully back up to her one-room house, careful not to spill a drop. The water may not be safe to drink, but it is precious.

She said she has no alternative to drinking tainted water, which kills thousands of people in Haiti every year. This is her test for the daily water: "If it is clean, nothing will happen. When the water is not clean, my children get diarrhea."

It is a risk that millions of Haitians must take each day. Although there has been a public campaign to teach people how to drop a small quantity of bleach into their buckets to purify the water by chlorinating it, no one has been able to instruct families on what to do if they have no money to buy the bleach. So some Haitians decide on their own. "Sometimes," Zilice said, "I use lemon."

"When we see the doctor, the doctor will say, 'Take precautions for the water. Put Clorox so you can drink it,' " she said. But when there is no bleach, she said her children sometimes become sick with fever. That is when she boils the water if she can. Boiling water is a luxury for the rich. "I don't always have money to buy charcoal or gas to boil the water," she said. "I know it is a risk but I have no choice."

Clean water is only one of the life-threatening problems facing Haiti, the poorest country in the Western Hemisphere, where the life expectancy is 51 years and 80 percent of people live below the poverty line. Sixty percent of Haiti's 8 million people do not have safe drinking water, according to the government statistics, and most do not have access to basic medical care. Dirty water, which can cause skin ailments, dysentery and lead to dehydration, is everywhere. The child mortality rate is about 110 per 1,000, more than 13 times the U.S. rate, and more than 10 percent of infant deaths are attributed to dehydration, according to government statistics. More than 90 percent of the people here are illiterate, according to government officials. Most Haitians live in a cesspool of poverty.

There is a rumbling political crisis in Haiti between President Jean-Bertrand Aristide and those calling for his ouster. Aristide, a former priest in the slums, was voted into office in 1990 after decades of dictatorial rule by the Duvalier family, whose corrupt government allowed the advance of poverty and the progressive collapse of Haiti's infrastructure.

Aristide was deposed by a military coup in 1991, and was escorted back to Haiti by the U.S. military in 1994. But since being reelected president in 2000, he has been unable to raise living conditions. He does not have the support of the Bush administration, which accuses him of corruption and a lack of commitment to democracy.

According to a U.N. report, Haiti's social and economic conditions deteriorated severely after the 1991 coup. "Sanitation conditions have reached a deplorable state," the report said. "Gathering and disposal of solid waste is very erratic, particularly in Port-au-Prince and Cap-Haitien."

Some Haitians and human rights groups have said that a U.S.-led freeze on international loans to Aristide's government has hurt the country's already fragile infrastructure. A delayed package of $500 million in international loans to Haiti included a package aimed at improving health care, education, transportation and clean water. As a result of the delayed aid, "Haitians' access to potable water has decreased significantly, particularly in Port-au-Prince," said a recent report by the Haiti Action Committee, a nonprofit advocacy group. "Infectious diseases are on the rise, as the diminished public health care system struggles to respond. Blocking humanitarian aide in this manner has clearly been a crime against the people of Haiti."

In rural areas, only 25 percent of Haitians have access to clean water, said Leslie Voltaire, government minister of Haitians living abroad. "They go and walk two or three kilometers for a fountain," Voltaire said. "Sometimes you see small children go at 5 in the morning to get water before classes. If they do not walk for clean water, they die."

In another Port-au-Prince slum, Wilbert Jhon walked down a steep hill made even more slippery by loose gravel. The local public water hole was at the bottom of the slope, close to a river. On this afternoon, 200 people were bathing, washing clothes and filling buckets. "The water situation is so bad, some time people have to fight here because it is so crowded. After a certain time, the water stops," said Jhon, 17. He said he didn't know whether the water was clean, but drank it anyway. "This is the only source of water my family has," he said.

Elmina Timet, 18, was doing her best to bathe even though she was surrounded by strangers. She used a black cup as she poured water on her legs and ankles, and with soap, scrubbed herself beneath her clothes. She said she had been there for nine hours, since 7 a.m. She washed clothes for her mother, brother and three sisters, bathed after that and then prepared to carry water home. "It is not easy," she said. "The water is too far from my house," an hour's walk each way.

At the water company in downtown Port-au-Prince, the office was busy as people with crumpled gourdes -- the Haitian currency -- waited in line to pay taxes, but there was no one available to explain why the city has inadequate public sewage collection and treatment and why the main water sources are contaminated.

At the general hospital downtown, which has been virtually shut down since doctors were ordered by the opposition to go on strike two months ago, men were lying alone in empty corridors and blood was splattered on the walls and floors. A doctor who had slipped in to treat patients with nowhere else to go, said the lack of safe water makes matters worse and that typhoid is on the rise.

"They get internal parasites from drinking dirty water," the doctor said, not giving his name for fear he would be killed by government opponents for defying the strike.

"They get every parasite you can get through the water," the doctor added. "There is also an education problem. People should know not to build latrines close to the water source. The typhoid bacteria can infect the water supply from outdoor latrines."

But touring Port-au-Prince's poorest neighborhoods, it was evident that many people have little ability to deal with the basics of hygiene. Lionel Elie, a local resident, looked out over the hills of Haiti, where peasants have built their houses. He points to the rivets in between. "The toilet water runs downhill," he said.

"The good water runs down the hill. The bad water makes the good water bad," Elie said. "There are two waters, the bad runs into the good."

After she finished her chores at the watering place, Zilice crossed the street to buy a small bag of rice and beans to feed her children. She then fetched her dishes, put the water tub on her head and climbed the hill. Along the way, she saw a rooster tied with a string, old refrigerators turned on their sides and boys playing soccer with a plastic ball.

She kept walking, near where pigs and goats stood in a ravine, and water mixed with trash and human waste.

Her back was hurting and her neck swayed a bit, but she did not stop.

"I'm not tired," she said, licking her parched lips. "I go through this every day."

Along the narrow, crooked path was a faded sign in Creole that read FANM BEZWEN TI GOUT DLO POU CHANGE LAVI -- Women need a little bit of water so life can change. The saying advertised a clean water project, including six fountains to be built in Zilice's neighborhood between April 2003 and January 2004. But the deadline had passed and there was still no clean water closer to home.

She passed tiny stores lit by candles and children tugging at a drainpipe. She did not stop to catch her breath as she proceeded up the crumbling stone steps. The sweat dripped from beneath the rag cushioning the water tub. After a 28-minute walk, she arrived at her house, which had no doors, and where maroon curtains might shield some of the night air, but were no protection from thieves. Her six youngest children -- she has eight in all -- gathered around her. Two had no clothes.

Zilice borrowed 500 gourdes, less than $20, from a loan shark to pay someone to dig a hole for a toilet. She said some people came to the house not long ago asking for money, promising to bring water closer. "They said, 'Give me 10 or 20 gourdes,' " Zilice said. She gave them 14 gourdes, less than 50 cents, but she said she hadn't heard anything more. "The people lived in the neighborhood but they disappeared."

She tried to nurse her 5-month-old baby, who wore a dress but no diaper. She shook her chest to release the milk. But the milk would not come. The baby was thirsty.

Evening was approaching. A wall separated her house from the room of the family next door. Sounds spilled from underneath the tin roof. Next door a child was getting a beating. On a table by the door sat a brown bucket of water preserved for her children to drink until morning.

© 2004 The Washington Post Company. Reprinted from The Washington Post of February 10, 2004.