Viskhan Siriyev has not walked or talked since a bomb hit his house at the start of the Chechen war ten years ago. He is 16, but looks like a terrified and skinny eight-year-old.

“He can’t speak. He understands what you say but can’t really move,” said his 25-year-old brother Ruslan, standing in a room shared by five members of his family.

Viskhan rolled his huge eyes at the wall and hid behind his thin arms, distressed by a stranger’s visit to the hostel occupied by Chechens whose houses have been destroyed by the bombing.

Doctors say such mental damage to children threatens to bring catastrophe to Chechen society.

It affects hundreds of thousands of children and could have a greater long-term effect than the war’s physical injuries.

Sultan Alimkhadzhiyev, head doctor at the Republican Children’s Hospital outside the Chechen capital, Grozny, compared the children’s trauma to that suffered by the young hostages held at Beslan, where 330 people - half of them children - died at a school siege last year.

“I was glad to see the help that the children of Beslan received. But our children have been suffering for 10 years not two days ... The kind of problems the children in Beslan had, we have across the whole republic,” he said.

“Almost all of the children, probably 80 percent, have psychological trauma. They have seen death, explosions. That’s about 300,000 children.”

HEAVY COATS

His hospital does not have the resources needed to treat such numbers.

On a recent visit, patients and doctors wrapped themselves in heavy coats while a single open gas flare provided the only heat on the ground floor.

Many parents have even taken their children home - where the young patients go untreated - to keep them warm.

And the war’s effects have not been confined to children. Doctors at city hospital No. 9 in Grozny’s shattered centre, said people like Zelimkhan Ediyev were being injured by bullets and bombs almost every day.

Ediyev said he was shot as he walked with friends through Grozny at night. He will be in hospital for a month.

“It was around nine at night and I was with five or six friends. I do not know who shot me, it just happened,” he said, a bullet-sized bloodstain on his bandaged thigh marking where he was hit.

The 19-year-old was lucky not to join the tens of thousands of civilians killed in the decade-long separatist war, but doctors said his wound would be easier to treat than less visible damage caused by years of poor food and water.

“There are stomach problems, people have not had enough food or have eaten bad food. They get stomach ulcers as a result. And then that has complications,” said doctor Rozambek Nashkhoyev.

“Then there are gynaecological problems that come about through stress. The psychological situation is bad, you understand.”

Alimkhadzhiyev said the weakness of new-born children and mothers was threatening a population collapse.

“Every fourth or fifth child has a problem ... 75 percent of children that die, die before they are a month old,” he said.

“We have infant mortality higher than anywhere in the former Soviet Union. They are born weak because their mothers are already ill.”

He said official figures massively underestimated infant mortality, which could be as high as 50 per 1,000 - more than double that of the rest of Russia and tens times higher than a Western nation like Britain.

CULTURAL COLLAPSE

Illness coupled with a decline in education standards could destroy Chechen culture and society as Alimkhadzhiyev knew it, he said.

“I can remember when four-year-olds spoke Russian better than a child from Moscow. And now you get university students who don’t even speak it,” he said.

“If you go to the cemetery now, you will see more small graves than big ones. The situation is scary,” he added.

“We need help, equipment, medicine. Even equipment people throw away would be dear to us. We need the help today, if we get it in five years it will be too late,” he said.