Clutching a weathered Iraqi vaccination card and her 2-year-old daughter, Zeinab Hasseb took a step Sunday toward preparing her family for war.
The head-scarved mother set Fatima Karim on a table in the grimy hallway of a health center in one of Baghdad's poorest areas, and watched as Fatima took part in a drive to immunize children against measles and polio.
"We will be exposed to the threats of war - maybe some chemicals or other lethal weapons," says Ms. Hasseb, a mother of five. "I worry about the health of the children, and want them to be as strong as possible."
UN and other relief agencies here are racing to prepare for a possible US-led war against the regime of Saddam Hussein. From thinking through water and sanitation issues to food and health supplies, aid workers are shifting to a war footing - even as UN foreign staff have been cut by more than half and some small private groups have left altogether.
"The critical message here is that we need until the end of March - we need time to save lives," says Carel de Rooy, the Iraq representative for UNICEF.
On Monday, a weeklong, door-to-door drive to vaccinate every Iraqi child against polio was launched. Shots against measles, often the most lethal wartime problem for children, are now being urgently stepped up.
The International Committee of the Red Cross (ICRC), one of the few non-UN relief agencies working in Iraq, yesterday began packaging water in 1 million one-quart plastic pouches for distribution to hospitals, in case all other water systems break down.
"It will help the people in hospitals, but not millions of others," says ICRC Baghdad spokesman Roland Huguenin-Benjamin. "The needs may be vast, beyond the scope of any organization."
Like the UN, the ICRC has built warehouses close to the Iraq border in neighboring Iran, Jordan, and Kuwait and struck deals with trucking companies to ensure immediate delivery of goods. The ICRC has also brought in kits to handle first aid, trauma surgery, and postoperation treatment for an initial 7,000 war casualties.
After two wars and 12 years of sanctions, Iraqis already live on the edge. One-quarter of children are chronically malnourished, and one in eight Iraqi children dies before its fifth birthday, according to UNICEF.
High-protein biscuits have not been delivered to pediatric centers for more than two years - a casualty of bureaucratic issues of the oil-for-food program - and therapeutic milk has not been issued for nearly four years.
The worst-case risks of war for Iraq's civilian population were spelled out in a UN report leaked last December. It warned that Iraqis in "immediate need" would number 5.4 million, and stated that as many as 500,000 could require treatment for injuries.
While Pentagon planners promise few civilian casualties and appear to be counting on a swift war, if one comes, the New York-based group Human Rights Watch warned last week that "if central services are disrupted in Iraq, the effects on civilians will be very swift and very severe."
Some relief workers here privately point out the chasm they see between cash for humanitarian needs - the UN has $30 million, by one count, to help fortify 23 million people - and the price tag for a war that some estimates put at more than $100 billion.
"To me it's quite obscene, it's almost scandalous that the humanitarian effort has only a fraction of a fraction of what this war will cost," says a veteran European relief worker here.
Relief workers have had more than half a year to prepare. The ICRC has reinforced windows by covering them with translucent plastic sheeting. But no organization says it has taken any precautions against the type of high-power microwave weapon that US war planners may use in the first moments of the war to zap Iraq's command-and-control capabilities. Collateral damage may include all computers, communication, and electricity grids within a certain range of a target - an event that relief chiefs here say would devastate their work.
Many UN groups have trained local Iraqi staff, many of whom have worked with the UN for years, to liaise with Iraqi health and welfare officials. UNICEF is now "very, very comfortable" that work will continue if foreigners are pulled out, says de Rooy.
During the 1991 Gulf War, a 42-day bombing campaign and ground war shut all systems shut down, packing water mains with sewage.
Now, Iraqi officials intend to ensure food distribution and a supply of clean water. The aim is to provide 10 percent of current water levels no matter what happens. One method will use UN water pump and filter units that can turn foul Tigris River water into drinking water.
Advance food distributions since last summer mean that most households have a six-week buffer - a supply that might prevent people from fleeing.
"If war comes and it takes more than six weeks, there will be pockets of famine and the impact on children will be devastating," says de Rooy. "It's why we want children to be as nourished as possible now."