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Asuncion, Paraguay, 2005. The oldest, most run-down of the wards at the Neuro-Psychiatric Hospital houses the chronically ill.

Asuncion, Paraguay, 2004. Screaming and pulling at the bars, this woman has repeatedly attempted to escape from the Neuro-Psychiatric Hospital.

Asuncion, Paraguay, 2005. Among the patients in the acute ward of the Neuro-Psychiatric Hospital is a woman who murdered her husband, and another who plucked out a patient's eye.

Asuncion, Paraguay, 2005. Built as a paupers' home, the Neuro-Psychiatric Hospital now holds 460 patients. This is the oldest, most rundown ward for chronic patients.

Asuncion, Paraguay, 2003. Said to have been addicted to drugs, a patient peers out a window at the Neuro-Psychiatric Hospital.

Asuncion, Paraguay, 2004. The forty-six residents of Sala 2 at the Neuro-Psychiatric Hospital pull their mattresses into the courtyard, so that their sleeping rooms can be hosed down.

Asuncion, Paraguay, 2004. A longtime patient at the Neuro-Psychiatric Hospital hopes to adopt a puppy that had wandered into the yard.

Asuncion, Paraguay, 2003. While a majority of patients live heavily medicated, solitary lives, a few patients at the Neuro-Psychiatric Hospital form relationships and attempt to care for one another. These patients have gathered in one of the outdoor…

Asuncion, Paraguay, 2003. There are forty female patients confined in the acute pavilion at the Neuro-Psychiatric Hospital.

Asuncion, Paraguay, 2005. A woman whose left eye was gouged out by another patient who was permitted to remain on the ward of the Neuro-Psychiatric Hospital.