Looking at tourism-related brochures of Kargil, one can see a rugged landscape marked by serene snow-capped mountains, long-winding streams, blue skies and friendly people.

An ideal place for a quiet little vacation. The last thing one would associate this place with is psychiatric disorders.

But that is the hard reality of this area located in Ladakh district of Jammu and Kashmir, on the Line of Control between India and Pakistan.

In 1999, it was the scene of a minor war between the two countries. Since then, there has been no respite for the people.

Constant shelling, rushing out of homes to bomb-shelters, the sight of people killed by missiles has had an adverse impact on the inhabitants of the region.

Sleeplessness, sweating, heart palpitation, suicidal tendencies – not symptoms one would associate with people residing in a beautiful place like Kargil – are common.

Take the case of 45-year-old Sultan (name changed). An artillery shell from across the border fell on his neighbour's house last year killing all the inmates.

"He has never been the same since then," Dr Mushtaq Margoob, a leading psychiatrist in the Kashmir valley, told rediff.com.

Sultan experiences tremors, sleeplessness, sweating, heart palpitation and suicidal tendencies - all symptoms of Post-traumatic Stress Disorder (PTSD. "PTSD brings about structural changes in the brain, which affect our memory," Dr Margoob said.

Despite the doctor's efforts, Sultan is not showing any improvement. "The intensity of the symptoms is very high among Kargil patients."

And, Sultan is not the only one with such complaints.

"Since the Srinagar-Leh national highway remains closed for nearly six months because of snow, I often have to take desperate calls from my patients and counsel them on the phone or advise local doctors on how to manage such complaints," Dr Margoob told rediff.com.

The increasing number of patients from Kargil is only adding to the workload of the only hospital for psychiatric diseases in the valley, which too has seen a tremendous increase in psychiatrist disorders since militancy erupted in the late eighties.

According to Dr Margoob, only 775 patients visited the psychiatric hospital in 1985. The number increased to 1,762 in 1990, when militancy erupted. In 2001, 37,860 patients visited the hospital while in 2002, the number was 43,654. Up to July 2003, 36,000 persons had sought psychiatric help in the hospital, he said.

Psychiatrists attribute the phenomenal increase in mental aliments to killings, arrests, search operations, cross-border shelling and nocturnal crackdowns, which have become common in the valley in the last 13 years.

The hospital has only two specialists, including Dr Margoob, while the posts of two assistant professors, four lecturers and four registrars are lying vacant. The government intends to fill the posts, officials said.

To add to the problems, in 1995, the hospital was gutted in a fire. Only a part was later restored. Now it has two wards for male and one for female patients, which is woefully inadequate.

"There is total confusion inside. It is truly a madhouse," said Bashir Ahmad, who went to the hospital recently with his mother who complained of heart palpitation.

In 1999, then health minister Mian Altaf promised to build a new hospital, but nothing happened.

Government officials say they have plans to construct a new hospital, but no time frame is forthcoming.

Minister of State for Health and Medical Education Abdul Gaffar Sofi told rediff.com that the government is aware of the problem. "We have already begun repairs and renovation of the gutted hospital."

A Netherlands-based NGO - Doctors Without Borders - has joined the state government's efforts in renovating the hospital and has also been assisting the doctors in counseling patients. "This NGO has also constructed a recreation hall inside the hospital for patients," says a hospital official.

More reports from Jammu and Kashmir