PORT-AU-PRINCE, Haiti - The battered bodies may be mending, but the minds still struggle.

As many as one in five Haiti earthquake victims have suffered trauma so great with the multiple shock of lost homes, jobs and loved ones that they won't be able to cope without professional help, doctors say.

"It's not about immediate psychological counseling," said Dr Lynne Jones, a senior medical adviser for the International Medical Corps.

"It's about assisting mourning. People cannot recover if their social needs are not met."

Jones, a veteran of natural disasters and wars from Bosnia to Indonesia, is teaching front-line doctors how to identify "disabling fear" and, quite literally, hold people's hands and listen.

Hugo Emmanuel is one of the untold thousands who doctors say have lost the ability to cope.

"Stay away! I don't want you to touch me," he barks at an American nurse who only wants to wash his shattered lower leg.

Spindly limbs

Emmanuel, 49, is an educated man of spindly limbs but voluble spirit who lies on a mattress on the floor of the kitchenette in the Espoir Hospital in the capital's eastern hills.

He tore the cast off his leg last week. For days after he arrived two weeks ago, he only let the hospital director feed him; he claimed everyone else was trying to poison him.

Emmanuel, who lies in his underwear beneath a white sheet and towel, is at least getting personal attention. Most of those diagnosed with severe trauma are treated as outpatients because there is no room for them in the country's 91 functioning hospitals. (AP)