Among the many ruins in Kosovo, few sights are more pitiful than the aimless shuffling of residents at a Dickensian facility here that is supposed to be a mental hospital.

There are 350 patients, a majority of them Serbs, at the Stimlje mental institution in central Kosovo, 18 miles south of Pristina, the provincial capital. On June 14, two days after NATO peacekeepers entered the Serbian province, the entire Serbian staff, including doctors, fled north -- leaving all the patients behind.

"The Serbs left us, abandoned us," said Svetlana Persic, a 40-year-old woman from the Serbian town of Loznica. "Thank God for the Albanians -- they fed us, they helped us."

As Persic talked, it became clear she had been abandoned long before June 14. Paralysis on the right side of her body has immobilized her arm and made it difficult to walk, but she does not seem to be mentally ill. She has lived here for 20 years, since her family tired of caring for her, she said.

The institution, built immediately after World War II, is a human dumping ground -- for the mentally and physically impaired, for juvenile delinquents and for children who had the misfortune to be born to patients.

Many patients have severe mental disabilities, ranging from profound retardation to schizophrenia. Some wander the halls for hours, dressed in rags, mumbling to themselves, squawking at demons or staring blankly. There are no organized activities for them, and interaction with staff members seems limited to meal times or when physical restraint is necessary.

At the same time, a number of the patients, including some very young children, seem afflicted with the sort of mild mental retardation that would not prevent them from leading self-sufficient, productive lives if they had a proper social or family support.

"I'd like to go home," said Stevo Bobic, 42, speaking English, who appeared to have a nervous disorder and was left here by his brother four years ago. "I don't deserve to be here."

"My brain is very healthy," said Milovan Radu, a swaggering 15-year-old from Vojvodina, a province in northern Serbia, who has lived here for six years. He said he was brought here by police after being falsely accused of killing his grandmother. "I have no problems with my head," he said.

It was impossible to discuss diagnoses or the severity of patients' problems with the nursing staff, because many of them do not even know the patients' names, let alone their medical histories. Saddest of all amid the general neglect are the dozens of children and teenagers who wander throughout the bleak facility.

Sanella is 4 or 5 years old. The nurses who care for her are unsure of her age and last name. They said she was born to a patient and has never been outside the hospital's rusting gates.

She draws quietly in a stranger's notebook, then sits serenely on a visitor's lap as if a little affection were an opiate. Nearby, a woman, her legs hideously swollen and scarred by sores, comes through a door on her hands and knees, talking to herself. Sanella says nothing. She does not talk.

Sadik Musliu, an ethnic Albanian social worker who has worked at the institution for 15 years, said Sanella was born with very mild retardation and that in four years, with no educational stimulus, she has not developed at all. "She was almost normal," he said. "She has gone backward here."

Musliu said that at least four or five children in the facility, all of them orphans, have IQs above the level that defines mental retardation. It was their fate, he said, to have been born in a place where they have not had a chance to receive an education or develop socially, so that now they actually seem mentally ill.

When the 50 or so Serbian staff members fled on June 14, Musliu said, they left the gates open and yelled back at their patients to run away because ethnic Albanian "terrorists" were coming to kill them. The seven ethnic Albanian staff members, including janitors, hustled the patients back inside. Fifteen fled, however, and are presumed to be wandering somewhere in Kosovo.

In the past week, 40 more ethnic Albanians employees -- including some who went into hiding as the Serb-led Belgrade government sought to purge Kosovo of its ethnic Albanian majority -- have come back to work. But the institution is still without a psychiatrist or a director. An international humanitarian organization visited last week, nurses said, but they could not recall its name and did not know what help had been requested or offered.

Still, Musliu hopes the arrival of foreigners in Kosovo will eventually improve care at the facility. "It would be nice to have European standards, new doctors," he said -- "maybe even a separate facility for the children."

CAPTION: Sanella, aged 4 or 5, was "almost normal" when she was born to a Stimlje patient but "has gone backward." She has never been outside the hospital and does not speak.

CAPTION: Nurse Esma Fasliu, a Bosnian, tries to feed a disturbed boy at the Stimlje mental institution. He is one of 350 patients abandoned on June 14 when fearful Serbian staff members fled the hospital, leaving the gates open.

CAPTION: Unsupervised patients at Kosovo's Stimlje psychiatric faciliity roam the buildings and grounds at will following the flight of all its Serbian physicians, nurses and support personnel, leaving only five nurses to care for 350 people.