Dirty syringes, used masks and gloves are amoung the waste streaming into the Cisadane River, in Indonesia's city of Tangerang.
Medical waste has been piling high since the first cases of coronavirus in the country.
Then in May, the walls of a landfill beside the river collapsed, sending tons of garbage cascading into the river, doubling the threat for those down stream; families who bathe and wash their clothes in the river.
It's triggering fears that the coronavirus could spread, as the country still struggles to contain it.
39-year-old Astri Dewiyani is trying to keep her children away from the water:
"I worry about the kids getting infected with COVID-19 when they swim here. I'm anxious. That's why I always forbid my children from swimming in the river."
Indonesia has the highest COVID-19 death toll in Southeast Asia, and like many countries, it's also got a huge increase in medical waste.
The ministry of health has admitted the country lacked treatment facilities and said it was trying to find a solution.
Ade Yunus, founder of Cisadane River Rubbish Bank is working with volunteers to organize a clean up.
"We are concerned about the sustainability of this river. We don't want it polluted with any waste, including industrial waste, which is dangerous. Especially during this pandemic."
The health ministry said that up to 1,500 tons of COVID-19 medical waste was produced across the country each day from March until June.