"We're under severe psychological pressure. How long will we get bodies of men, women and children, severed limbs, severed heads?" said Sajida Nasreen, catching her breath on duty at the main hospital in the northwest city of Peshawar.

"A dead 11-year-old was brought in, drenched in blood but his shoes shining with polish. His father came, lifted the child onto his lap, kissed him and said: 'I sent you to school, not to die'.

"For the first time in my career, I wept bitterly," said the nurse, who at 53 thought she had seen everything until Al-Qaeda-linked attacks got worse and worse, killing 2,540 people in Pakistan over 29 months.

"Those responsible should see the situation in the hospital to understand what these blasts do," she added.

Lady Reading Hospital, or LRH as it is known among the 2.5 million residents of Peshawar, was founded in 1924 when Lord Reading was viceroy of India and is now one of Pakistan's largest teaching hospitals.

On a visit to the area, his wife fell off a horse and suffered an injury, only to find proper treatment was unavailable locally. In England, she collected donations from British philanthropists and set up a hospital that ultimately took her name.

But the romance of its beginnings has vanished under the carnage witnessed in Peshawar and the surrounding North West Frontier Province (NWFP) where Taliban bombings and military offensives have been concentrated.

"We have dealt with 49 blasts... 2,200 injured and 576 bodies in bombings," Doctor Ataullah Arif, surgeon in charge of the emergency ward, told AFP.

Tactics are changing. Bombings of crowded markets are beginning to maximise civilian casualties. Attacks on the army, police and paramilitary to avenge the government's alliance in the US-led "war on terror" are becoming more brazen.

"Victims are pouring in almost daily now. We start our day with prayers that may Allah spare us from tragedy," said Arif.

"We have been working under severe stress over the past two months. I can't explain the situation in words.

"Very often there are bodies and blood, as rows of stretchers start flowing amid shouts and screams," he said.

The 1,543 beds are woefully inadequate and the hospital is struggling to overcome dire shortages to build a 500-bed emergency ward.

"In an emergency, sometimes we put two wounded on one bed and people with lesser injuries are treated on the floor or in wheelchairs," said Arif.

There are fears that a suicide bomber could strike the hospital, a soft target. There are eight gates into the 30-acre (12-hectare) compound guarded by just seven policemen, Arif says.

"Our staff are constantly in danger. They are under severe threat from militants. We have received calls from militants, warning the staff 'you are treating those who are our target. We will not spare you.'"

LRH chief executive, Doctor Abdul Hameed Afridi, says shortage of space is so acute that the basement was converted into a mortuary last year.

"We face great difficulty in coping with the situation. We badly need funds, equipment and trained staff. In such a big hospital, we have just one CT scan machine and no MRI facility," said Afridi.

"We need life saving drugs. LRH bears the pressure not only from NWFP but from Afghanistan. When there is a big disaster in Afghanistan casualties are also sent to Peshawar," he said.

Aged 25, Bibi Zakia is one of LRH's younger nurses but has grown old quickly in the face of horror.

"It is a human crisis. It's a huge burden. We have to treat not only the victims, but also take care of their relatives," she said.

"We are tired but I'm proud to be a nurse and I think I'm better than millions of others because I'm serving humanity."

But even hardened nurses sometimes find it difficult to cope with the magnitude of the suffering.

One particular occasion was a car bomb on October 28 that killed 118 people in Peshawar's Meena market, frequented by women and children, in the deadliest militant attack in Pakistan for two years.

"I remember two charred bodies of children. They looked like roast chickens. It was horrible. I couldn't control myself. Pain and anguish filled my body and I screamed and I shouted: what was their crime?"

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