For many people around the world affected by poverty or war, the simple act of washing their hands is a luxury. Several humanitarian aid organizations say that about 3 billion people cannot wash their hands at home and that communal gathering points for water distribution are places where the coronavirus can spread.

One group is concerned that global funds focus on possible vaccines and treatments and that they neglect prevention. In Zimbabwe, clean water is often stored more for daily tasks like washing dishes and flushing toilets than for washing hands.

The United Nations says that in the Arab region alone, about 74 million people do not have access to a basic hand-washing facility.

Violet Manuel, 72, joined dozens of people queuing for their daily ration in the densely populated city of Chitungwiza, Zimbabwe. “Social distance here?” Asked Manuel bitterly. She sighed with relief once she received her assigned 40 liters (10.5 gallons) but is concerned about the risk of contracting the coronavirus caused by COVID-19.

“I got the water, but I probably have the disease, too,” he told The Associated Press. And yet, his plans for water did not include washing hands, but “more important” tasks, such as washing dishes and flushing the toilet.

Such options highlight the difficulties in preventing the spread of the coronavirus in slums, camps and other crowded settlements around the world where clean water is scarce and survival is a daily struggle.

According to the WaterAid charity group, some 3 billion people – from indigenous communities in Brazil to war-torn villages in northern Yemen – have nowhere to wash their hands with soap and clean water in their homes. WaterAid fears that global funds will focus on creating vaccines and treatments without “any real commitment to prevention.”

The final link between the COVID-19 infection rate and access to water is not easy without further investigation, said Gregory Bulit, who works with the UNICEF water and sanitation team, “but what we know is that, without water, the risk increases. ”

Almost a decade of civil war has damaged much of Syria’s water infrastructure, and millions must resort to alternative measures. In the last rebel-controlled territory, Idlib, where the most recent military operations displaced nearly 1 million people, resources are severely depleted.

Idlib resident Yasser Aboud, the father of three, said he has doubled the amount of water he buys to keep his family clean amid fear of catching the virus. He and his wife lost their jobs and must cut spending on clothing and food to pay for it.

In Manaus, Brazil, 300 families in a poor indigenous community have water just three days a week, from a dirty well.

“Water is like gold around here,” said Neinha Reis, 27, the mother of two. To wash their hands, they depend on donations of disinfectant. Reis and most of the other residents have become ill with symptoms similar to those of COVID-19 in the past month.

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The Associated Press journalists Zeina Karam in Beirut, Maggie Michael in Cairo and Renato Brito in Manaus, Brazil, contributed to this report.