Pisco residents walk through dust clouds between collapsed buildings, covering their mouths and noses with whatever they can find -- sweater sleeves, handkerchiefs or bare hands.
A few lucky ones wear masks distributed by health workers, but like many others they squint to protect their eyes from the dust.
The spread of dust is exacerbated by the incessant work of trucks removing rubble, kicking more dirt into the air.
Medical officials said Saturday that symptoms of respiratory infections have begun to emerge and could deteriorate into an epidemic if residents fail to take precautions.
But as two-thirds of Pisco was destroyed, many of its 130,000 residents have been sleeping in front of their broken homes on streets that keep accumulating dirt, exposing them to dusty air.
One mobile clinic from Lima's Solidaridad Hospital stationed at the town square treated 350 for respiratory ailments on Saturday alone.
Doctor Marina Deza said the majority of the patients have visited the clinic complaining about coughing, sneezing and itchy eyes.
While few have been suffered breathing problems, patients are being cautioned about overexposure "to prevent it from becoming an epidemic," Deza said. But the clinic was out of masks by the end of the day.
Bernice Hernandez, a 67-year-old retiree, walked out of the mobile clinic's blue bus carrying four antibiotic tablets in her hand, hoping they would sooth her chest pains.
She has been sleeping on San Martin Avenue in front of her home, which was shattered by the 8.0-magnitude earthquake that killed 500 people in Peru's southeastern coast, the majority in Pisco.
"We can't sleep. I don't even have a bed," she said. "We are getting sick with all this dust."
Health Minister Carlos Vallejos listed respiratory problems among the government's concerns for potential epidemics, along with the spread of diseases from dead bodies and diarrhea outbreaks.
Vallejos said 1,500 international and local medical workers have been deployed in the hard-hit areas of the country to prevent major epidemics from breaking out.
"The problem is not only that there are still unfound bodies, the problem is water," and how human waste is being disposed, he said.
Doctor Carlos Armando Orellana Salazar, manager of Hospital Peru, a mobile medical services organization, said on his side of Pisco's main square that consumption of dirty water has been a problem.
"What has emerged is diarrhea," he said.
Enrique Quiroz walked out of a mobile clinic with his wife Elvira holding their three-year-old daughter Alexandra wrapped in a blanket in his arms.
They have been sleeping on a small football field, eating whatever water food they could salvage from their home and mostly drinking water from a tank truck that passed by their camp.
"The water was a little dark," Elvira Quiroz, 21, said. "We still drank it."