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The disturbed man shuffled as the metal door swung open, his eyes wild with fear. He quickly patted the lump under his filthy brown blanket to make sure whatever it was he held precious was safe.
Nearby, another mental patient banged angrily on the steel gate of his tiny cell, a dark closet barely wide enough to lie down in and daubed with scrawled messages to Jesus. This month's earthquake has deepened Haiti's mental scars.
The Haitian government's Mars and Kline Psychiatric Centre was founded in 1958, which might just be when its wards received their last coat of paint, and was in a desperate situation even before the January 12 catastrophe.
Now, many of its patients have gone off to fend for themselves and its courtyard has become a makeshift refugee camp for local families left homeless by the quake and for a handful of wandering mental patients.
Flow of traumatised people
None of the international aid that has begun to flow into Port-au-Prince had yet made it to the hospital Tuesday, and staff fear a new flow of traumatised people seeking care after seeing their lives turned upside down.
"After the quake, a lot of people came to see us," said clinic coordinator Vincent Jean-Wihelde, as he showed a reporter around the decripit facility.
He and his colleagues expect a surge in cases of mental illness following the traumatic quake, which leveled much of the surrounding downtown district and may have killed more than 150,000 people in the capital alone.
"It was like waves on the ocean," he recalled. "Houses were collapsing around us. Everyone was terrified. Cars were smashed. It was catastrophic."
Hospital in poor state
Looking around the hospital it is hard to believe people will find much comfort here. The halls are gloomy - there is no electricity in Port au Prince - and the unpainted concrete floor is scattered with dust and debris.
Someone has voided their bowels on the floor of the eerily silent women's wing, and in the treatment room a few sachets of red pills lie scattered amid paperwork and empty dispensing cups.
Nearby a rusting metal chair is bolted to the floor.
The remaining nine male patients live around an open courtyard in a series of small, shared rooms. Some of their metal bunks have blankets but that is the only concession to comfort.
One man lies crumpled against a bare wall, sleeping so deeply that his inert form recalls the corpses that until recently dotted the streets outside.
Another, the man on the blanket, is naked under his shirt, taking more care to protect whatever treasure lies under his bedding than he does his dignity.
Three of the patients are deemed aggressive and are detained in tiny, black-walled cells. Someone has scrawled, high on the wall, in a mixture of French and English: "Ruelle Death Row".
No treatment
No therapies were under way as AFP visited, but in less difficult times patients have been encouraged to draw childlike pictures of rabbits and cartoon characters and these are stuck to the wall at head height in the corridors.
"This is a completely exceptional situation," said Jean-Wihelde, "but our problems began long before the earthquake.
"The house was designed for 36 boys and 11 women, but people kept coming, and we had 150 people," he explained, adding that at any one time 500 outpatients would also visit for consultations and medication.
"Behavioural difficulties, hallucinations, cocaine addiction, people with psychological disorders, things like that," he said.
"They were terrified in the quake. They are mentally unwell, and this made it worse."
Shock wave
Almost all of those staying in the hospital have melted back into the crowds of destitute living rough in the streets since the quake, but staff expect more to come as the shock works its way through the population.
And, aside from the disturbed, ordinary families are now bivouaced on the grounds. Sleeping on the grass and in the carpark.
Cooking meagre meals.
One woman nursed a tiny baby of less than six months, dressed oddly in a small, bright-red Father Christmas costume, complete with fake fur trim.
"We need tents, medicine, matresses, food and water," said Jean-Wihelde. As he spoke, behind him, two security guards handcuffed a grinning woman to a bannister rail, leaving her to giggle and dance alone. - (Sapa, January 2010)
