The lake and the 30 million people who depend on it in Kenya, Tanzania and Uganda face an uncertain future as the contaminants abet myriad diseases and cut fish catches as water levels fall for various reasons, officials say.

"In terms of water quality and quantity, the situation is bad and worsening," said Ladisy Chengula, a natural resources management specialist for the World Bank. "We don't know where it will end up".

Last week, the presidents of Kenya, Tanzania and Uganda issued a joint call for action to reverse the trend but that will first require an indeterminate amount of study.

In the meantime, on this beach in Kisumu, Kenya's third-largest city, no fewer than 500 vehicles a day are soaped up and scrubbed down by some 300 car washers, the effluent all draining into the lake despite a ban on such activity.

"I know that I'm polluting the lake but I have no alternative job," says Patrick Otieno, who for the past three years has washed cars here, earning daily wages of about 300 Kenyan shillings (4.25 dollars, 3.50 euros).

"I have to eat at the end of the day," the 29-year-old says, thankful for having a job in a region where the unemployment rate hovers at 30 percent.

Otieno, his car-washing colleagues and others who work on the beach number about 1,000 -- and they toil all day in an area with just a single public pay toilet.

"People are using alternative bush places," says Erick Muok of the Kenyan Medical Research Institute (KEMRI) that has monitored the growing health hazards posed by both human waste and other pollutants.

"One hundred percent of the car washers are schistosomiasis infected," says KEMRI's Diana Karanja. "It's very rare to find somebody in good health among the people dealing with the lake. Most of the residents are sick."

Schistosomiasis, bilharzia, cholera, pneumonia, diarrhea and skin diseases are among the water-borne or abetted illnesses that afflict Lake Victoria residents with increasing frequency, health officials say.

And the human excrement expelled into the lake from the Kisumu car washers is by far one of the least of the pollutants.

"Millions of liters of untreated sewage sludge flow into the lake every day from major urban centers along the lake shore," the UN Environment Programme (UNEP) said of Victoria in its 2006 assessment of east Africa's lakes.

This contamination, coupled with chemical and fertilizer run-off from lakeside industry and agriculture, has had a devastating effect, contributing to a disturbing rise in anoxia, lack of oxygen, in the lake water, it said.

"Nearly half of the lake floor currently experiences prolonged anoxia for several months of the year, compared to the 1960s when anoxia was localised and sporadic," UNEP said.

"The sanitation is becoming alarming," says Daniel Olago, a geology lecturer at the University of Nairobi who was a co-author of the UNEP report and has called for hefty increases in fines for polluters.

"Another major problem is the amount of sediment going into the lake because of deforestation from people who need firewood," he said.

Over the past four years, the water level of Lake Victoria has ebbed by 1.5 meters (five feet), bringing it to only 17 centimeters (6.7 inches) above the lowest-recorded level in 1923.

Some researchers have accused Uganda of diverting water from the rivers and streams that feed Victoria for hyrdroelectricity but many say blame for the lake's poor health is due to a variety of factors, including poverty.

KEMRI's Karanja believes the decline is the result of the vicious cycle, saying the more people need the lake to survive the less they will respect the precious and fragile nature of its resources.

"We need an improved economy for rural areas," she said. "Tackling poverty issues will make things better."

"This situation has to be reversed or else we will reach a critical point when the lake is no longer useful. It's an urgent situation."

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