A small child clings limpet-like to me as I sit on the steps of the Stimlje institute. She's about six years old and seems to be dressed in neat clean clothes. But as I pick her up it becomes all too apparent that young Sanella is in bad need of a wash.

She is an apt metaphor for the entire institute. Set in large grounds - lightly wooded - with a sweeping driveway up to an imposing facade, this hospital appears largely to have escaped the ravages of the war.

And indeed during the conflict itself, the worst it appeared to suffer was regular visits from the military police intent on using the balconies as sniper points to terrorise neighbouring villages.

Human degradation

But what greeted the Norwegian Red Cross on the inside when they arrived after the Nato liberation were scenes of severe human degradation.

Like the patient population, most of Stimlje's staff were also Serb and as the capitulation of Serbia drew near, they deserted their charges.

The remaining Albanians did what they could but some patients had to be locked in their rooms, others actually tied to their beds. The heating, the water supply, the electricity - all had failed and the sanitation was non-existent.

The Serb staff had flung open the gates encouraging the residents to leave - telling vulnerable and largely non-comprehending people that they were about to be killed by Albanian terrorists.

A Noah's ark of disability

The Red Cross has improved matters at Stimlje no end, but this makes its real problems all the more obvious.

For Stimlje cannot decide what it is. Like a Noah's ark of disability, everything is here. Serious psychotic illness, physical disability, delinquency, deafness, cerebral palsy - you name it, they've got one.

Some like little Sanella have no disability at all. Her mother came here 10 years ago suffering from mental illness. Sanella is the product, staff think, of a liaison with a local villager.

During our entire visit, I never saw Sanella's mother once - explaining, I suppose, why she was so desperate for a little love and attention - even if it came from a complete stranger.

Abandoned

Serb staff deserted their charges

Sanella is not alone. Her best friend Ivana has nothing wrong with her. No one knows when her relatives last came and if they'll ever come again. But Sanella and Ivana at least have time on their side.

Stevo Bobic, a man in his late 60s with an uncontrollable shake, has been waiting for four years for his brother to come and collect him.

Ten years in a Serbian jail for killing his wife, he's simply been abandoned. Gentle and calm, his hope is undimmed that soon he will be out.

Waiting in hope

It is of course true that psychiatric illness and physical disability resonate in very different ways between cultures, geographies and ages - and judging according to one's own lights is a dangerous business - but this kind of relativism can only go so far when it comes to Stimlje.

For what makes urgent reform here absolutely necessary is not just the conditions in which the residents have to live or even the terrible experiences they've gone through, but the mere fact that the hospital represents a large pool of human potential which is currently being wasted.

The staff here do what they can to their best ability, but unless the international organisations which have taken an interest in Stimlje decide to be bold and persuade the local authorities that disability does not have to mean a lifetime of inactivity, then they will have failed the 309 patients who have now been given such hope.