Cambodia's growing demand for recyclables -- from bottles and cans to cardboard -- has seen a sharp rise in the number of child scavengers trawling through the capital's waste heaps, many of them press-ganged into what advocates say is one of the world's most hazardous forms of labour.
In 2006, around 4,000 children were working on Phnom Penh's streets, according to Chan Haranvadey, an official with the Social Affairs Ministry.
That number is estimated to have spiraled to between 10,000 and 20,000, though the number dips during the planting season in May and June, when many children return to family farms, non-governmental organisations say.
In March Doctor Tuy Puthea was finishing his rounds behind Phnom Penh's Olympic Stadium, inspecting a wound on the neck of a young boy, one of a dozen children .
His 10-year-old patient, wearing only ragged shorts and a t-shirt, was just one among thousands of youngsters scraping out an existence scavenging waste on the streets of the Cambodian capital.
"These child scavengers are the most vulnerable," said Tuy Puthea, who works with the NGO Mith Samlanh, which helps homeless children.
"They use neither gloves nor shoes, they inhale toxic fumes, eat out of garbage bins," he said, listing ailments he sees every day, from headaches and infected wounds to diarrhoea and hacking coughs.
Across Cambodia an estimated 1.5 million children under 14 are forced to work, child advocacy groups say. They says that while most labour on family farms, up to 250,000 work in hazardous conditions at such pursuits as begging, waste scavenging, factory work or mining.
In Phnom Penh, where an economic boom has also fueled the trash trade, some 70 percent of scavengers are children, according to Mith Samlanh and another child advocacy group, For the Smile of a Child (PSE).
They can be seen day and night, sometimes alone or with their families, picking through piles of trash or begging for bottles and cans from customers at streetside restaurants.
-- Scavengers' lives defined by violence, degradation --
By foraging for plastic, glass, metal or cardboard, a child can make a dollar or two a day -- no small sum in a country where 35 percent of the population is mired in poverty.
But scavenging also places them in a rigid system of patronage, extortion and intimidation at the hands of local thugs acting as middlemen for large recycling outfits operating in Thailand or Vietnam.
These handlers, often pay lower than market value in exchange for protection or small tips to children who are sometimes only a few years older than the scavengers themselves.
It's a necessary arrangement in a world defined by violence and degradation.
"They are exposed to others problems -- violence, drug use, sexual harassment or trafficking," says Tuy Puthea, whose clinic treats about 30 children a day.
That number could drastically increase as plans to close Cambodia's largest dump get underway. Phnom Penh needs to find somewhere else for its garbage because the current dump is almost full, say city officials.
Only a few short kilometres (miles) from Phnom Penh's burgeoning downtown, at the end of a dirt lane crowded with garbage trucks, is the Stung Meanchey tip, a vast horizon of trash.
Here hundreds of scavengers, many of them children, wander through the smoldering squalor, their clothing stiff with grime and faces tightly wrapped with scarves against the stinging, ever-present smoke.
But without the dump, they will be forced into the streets, swelling the ranks of those already prowling Phnom Penh's litter piles but also taking them further from the reach of the groups most actively trying to help them.
"Closing the dump is a good thing -- this should not be so close to the city," said Pin Sarapitch, director of the programmes at PSE, which for 12 years has operated on the fringes of Stung Meanchey, providing education or vocational training for more than 5,000 children.
"The closure should be followed by more social intervention from the state. The government cannot close the dump and leave these families without a place to live or work," Pin Sarapitch said.
"Where will they go, and how will we be able to our work with them if they cannot be found," he added.