Thousands of people affected by the devastating earthquakes in Venezuela last month are increasingly facing challenges accessing clean water as well as sanitation and hygiene services.

Families in the hardest-hit state, La Guaira, have taken to the beach to shower and relieve themselves, with excrement now dotting parts of the once-crowded Caribbean beaches. Others are using the little water that did not spill from their home storage tanks to do dishes and clean themselves. Many are living in temporary shelters or outdoors after 190 buildings collapsed and 856 others were damaged, according to Venezuelan officials, in the back-to-back earthquakes on June 24 that killed 3,685 people.

“We always have water in the tank — water reserved — but with the earthquake, most of the tanks in the houses broke,” Juliani Herrera, 20, said of the large blue plastic tanks that many Venezuelan families use to store water on days when the state-owned utility services the areas. “Now, we have to wait to see if a tanker comes and fills buckets.”