ANAMNESIS
"Speak up for those who cannot speak for themselves"
Bible, Proverbs 31
I
Every hour 4 cases of tuberculosis are recorded.
Every day about 30 people die from the disease.
Each year TB kills over 10,000 people.
Statistics in Ukraine for 2012.
Public health systems of some economically unstable countries of the former Soviet Union are unable to provide independently reliable treatment for tuberculosis patients. Not fully recovered after the collapse of the Soviet Union, they suffered from poor funding, lack of training, and cumbersome bureaucracy. A source of pride and envy, a centralized system of TB control despaired along with the division of the Soviet Union. Multiple drug-resistant tuberculosis – is a very disturbing phenomenon and the scourge of the Healthcare Service of the former Soviet republics.
“We really thought in the past that we could overcome the TB. But now everything looks hopeless."
Valentina works as a phthisiatrician since 1980.
II
I started to investigate the problem of tuberculosis in Ukraine in December 2010. For that moment I knew nothing about it and had the same stereotypes as other people. The first region I went to was Donbas, Eastern Ukraine, and I was greatly influenced by what I saw. One of the first patients I photographed was suffering from gastrointestinal tuberculosis. He was lying naked on a hospital bed and staring at the ceiling. A week later, I was with him in the last hours of his life. He couldn’t move or talk, his body was like a skeleton covered with skin. He clutched a cross to his chest and prayed. Shortly thereafter, I met his wife and she told me how he walked around the house with a torn stomach and intestines dragging across the floor, and because the ambulance refused to transfer him to a hospital, she had to call a taxi.
"Every day in a bed you are begging to die quickly."
Nickolay, 1945. Diagnosis: TB. A combined driver in the past.
III
Children’s TB is a huge problem: over the past decade, the number of TB cases among children increased by three times. It has become a norm that kids become infected with persistent forms of TB. Such progress depends not only on a lack of attention to this issue by the state but also on the parents' indifference. Many of them believe that their child is fully protected naturally, and that vaccination can only hurt him or her. As a result, every year during medical checks, about 200000 under-aged children are identified with a latent form of TB.
“I’m not just telling you the story, it’s a heart's cry. I don’t want my grandson to live in a TB state!”
Svetlana, 1959. Diagnosis: TB. A nurse in the past.
IV
The map of Kherson city, where Kherson penal colony #61 is mapped. This is the only colony, where the highly dangerous criminals and life-sentenced prisoners with TB are sentenced. It’s located right in the center of the city and is surrounded by a promenade, a public park, and alleys where families with children rest. After asking people, it turned out that very few of them knew about such a colony right in the center of the city.
The prisons have practically become a breeding ground for TB disease in Ukraine. The incidence of TB in them is about 50 times higher than among the civilian population, and the mortality rate is 30 times higher. Many prisons, not to ruin their mortality figures, release seriously ill prisoners. As a consequence ex-convicts dissolve among the population without registering with the health-care authority.
“When I came to the hospital, all patients were 50-60 years old, but nowadays, more and more young arrive! It is very bitter, sad, and scary."
Emma works as a physiologist since 1978.
V
At the time of the shooting, 2010-2012, Ukraine had the highest burden of tuberculosis in the European Region, second only to Russia. Only 50 percent of TB patients were recovered. Each year 40 000 TB patients were registered officially for the first time, 10 000 of them died. Every hour 4 cases of tuberculosis were recorded and each hour one of such patients died. Hospitals were in terrible conditions. Medicine equipment was either out of date, either absent at all. The government did nothing to stop the problem, even if there was some help it came from volunteer organizations. Patients with drug-resistant tuberculosis had to use public transport to get medications and food. Those who had no money just died in their beds. Unfortunately, now the situation isn't getting better. People don’t guess that modern Auschwitz is nearby them. While politicians play politics, people die of tuberculosis in hospitals without drugs, adequate nutrition, and proper care. The epidemic of TB became one of the national problems.
“In a holiday time a lot of TB patients work in cafes, on the beaches, and no one controls this situation.”
A physiologist of TB hospital in Feodosiya, Crimea.
Nowadays there is a huge danger of TB expansion. The war on the East of Ukraine and annexation of the Crimea by Russia, increased the number of refugees from Crimea and Donbas, over 1,2 million people. Thousands of tuberculosis patients on the East were left without treatment, many prisoners were released and taken to the separatists’, pro-Russian army. Because of the lack of medical treatment, medicines, devastation, and poorness, the TB epidemic increases day by day in the East of Ukraine.