It is a too-common condition at Charity Hospital, the only charity hospital in New Orleans, as the strain of living in a city still shattered by Hurricane Katrina wears away at the strength and spirit of those working to rebuild their lives a year after the storm.

Some are pushed over the edge by a long-awaited insurance settlement which fails to cover the cost of home repairs. Some have lost their apartments to rising rents or have been kicked off the couches they had been camping on. For others, it is the memories of everything -- and everyone -- that was lost.

"The people are sad and they're stressed," Pellagalle told AFP recently while taking a break at work.

Suicide is not the only stress-related injury. There has been a sharp increase in domestic violence and abuse of drugs and alcohol. People come in with cuts and missing fingers from home repairs gone wrong. And patients wait for hours to get help with stomach problems and headaches.

"You wonder if it doesn't come just from wanting someone to talk to or care for them," Pellagalle said as her eyes misted over.

Pellagalle's kind face and gentle demeanor are sure to help. But she and her colleagues are overworking and scrambling to make do with extremely limited resources.

The CAT scan equipment is in a semi-trailer parked in the alley. The pharmacy is not fully stocked. And trauma patients and those requiring more than 24 hours of observation have to be transferred to for-profit hospitals where they face hefty bills they cannot afford to pay.

"We do what we can. That's all we're capable of," Pellagalle said, though it was clear she wants to do more.

Charity is the second-oldest public hospital in the country, founded in 1736 to provide care to the city's poor. The 1930s-era building is a local landmark and there was strong protest against the decision to replace it with a new, state-of-the-art facility expected to open in November.

The hospital has seen too much change, said Pellagalle.

Two thirds of the hospital system's employees were laid off following the storm, including some of those who struggled to keep patients alive in the darkness as temperatures soared and the water and power stopped working.

The emergency room staff was brought back soon after the hospital was evacuated to work in tents set up in a parking lot. Then Charity moved to tents set up in the Convention Center. Then the tents were moved into the old Lord and Taylor's upscale department store in a mall next to the Superdome.

In May the tents were replaced with office dividers which created more room for staff and more privacy for patients, but the mirrored columns and faux marble walkways are sharp reminders of the still-temporary nature of the facility.

The new facility will allow the hospital to rehire about 1,100 of the employees laid off after Katrina, although staff levels will still be half of what they were before the storm.

That will pose a problem for the community at large.

"Our overall population is down but the need for assistance has risen," hospital spokeswoman Marcia Kavanaugh said, explaining that thousands of people who lost their jobs in the storm also lost their health insurance.

Right now, Charity's 725 employees are seeing about 4,500 patients a month compared with 6,000 a month when the system's hospitals had nearly 4,000 employees. Patients often wait 10 or 12 hours to be seen.

The staff is overworked and exhausted from dealing with their own problems, like gutting out flooded homes and dealing with the bureaucratic nightmare of insurance companies and government agencies.

"You see what's really important when you have to throw everything you own out on the corner," Pellagalle said. "Thank goodness we're here to help people. The people are coming back and they're sick."

Katrina swept ashore in the early morning of August 29, killing more than 1,300 people and flooding 80 percent of New Orleans.

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