MARCH 2013 BACK ISSUE by Maxim Dondyuk In 1995, the World Health Organization declared a tuberculosis epidemic in Ukraine. Over the past 16 years, the situation has deteriorated even further. Each day TB takes lives of 30 people; annually, about 10,000 people. In December 2010, I went to the Donbass region of Ukraine. I was greatly affected by what I saw on the first day. 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 could not move or talk; his body was like a skeleton covered with skin. He clutched a cross to his chest and prayed. Afterwards I met his wife and she told me how he had walked around the house with a torn stomach and his intestines dragging across the floor, because the ambulance had refused to transfer him to a hospital. They had been forced to call a taxi. After a while, I realized that this was happening all over the country and that the epidemic of tuberculosis was a national problem. Many prisons release pardoned convicts with serious health conditions, so as not to ruin their mortality figures. Two-thirds of former prisoners dissolve into the general population without medical supervision. Hospitals are in a terrible condition and all phthisiology rests with doctors for whom retirement is long overdue. Patients with drug-resistant TB have to use public transport to receive medical supplies and food and those without money just die in their beds. In the midst of the current political wars in Ukraine, the Ukrainian people are indifferent to the problem of tuberculosis. X-ray films are being processed by old method due to a lack of modern equipment. X-ray room, Zhdanovskaya correctional colony № 3, 03 February 2011. Children's TB Hospital Tsyurupynsk, 2011. Doctors monitor a prisoner during fluorography. X-ray room, Zhdanovskaya correctional colony № 3, 03 February 2011. Isolation ward in TB department. Donetsky investigatory isolation ward, February 02, 2011. Treatment room. Starozburevskaya correctional colony № 7, July 26th, 2011. Children's TB Hospital Tsyurupynsk, 2011. Andrew and Ina are patients of Enakievsky TB dispensary. Diagnosis: multi-resistant form of tuberculosis. December 22, 2010.  They got acquainted in the dispensary during their treatment. They call each other husband and wife, even though they are not. He has been liberated from prison where he caught his TB. While he was in prison, his mother died, his house was robbed and everything was stolen, including his identification documents. Since he has no home, he cannot get an official residential registration, and Andrew and Ina cannot register their marriage. They see each other during the daytime and sleep in different wards atnight. They hope to register their marriage and to have a family one day. Michael, 63 years old. Diagnosis: multidrug-resistant tuberculosis. Kherson TB hospital, July 19th, 2011. Worked as a bricklayer on a construction site. After surgery on the stomach, he went for a check up with his doctor, who found spots in the lungs.  He was sent immediately to a TB clinic. He has been being treated since 1983. Distribution of medication. Zdanovsky penal colony №3. February 03, 2011. Alexander, 54 years old, mentally sick. Diagnosis: tuberculosis. Novotroitsk TB dispensary, July 25, 2011. The medical staff told me that he was found severely beaten and had lost his memory.  They could not find his relatives. He is anxious and aggressive. When his TB treatment is over, he will be sent to an asylum. The patient’s story: My name is Bukarev Alexander Michailovitch. I was born in 1957 and I now live in Cherson. I am married and have two children. Sergey, 40 years. Diagnosis: multi-resistant form of tuberculosis. Novozburievsk TB dispensary, August 16, 2011. The doctor’s story: He has chronic tuberculosis and needs an operation. He does not wish to undergo an operation, because he gives all his money to his four children. He has been treated in dispensary for three years and does not want to go home. Anatoly Pavlovitch Mandrykin (on the right), 75 years old. Diagnosis: tuberculosis. Novozburievsk TB dispensary, August 16, 2011. Patient’s story: He graduated from Kharkov Military Officers School with honors degree. After, he served in the Navy aviation regiment in Stargrad, was a pilot of supersonic fighter aircraft MIG-19. After three years of service during a regular medical check-up spots in lungs were found. He underwent a medical review board. After that he entered the Institute of Journalism. He worked as a journalist in the newspaper Zarya in Volgograd area. He wanted to publish his books. Copies of his books were kept in the Council of writers in Rostov-on-the-Don. After the breakup of the Soviet Union his manuscripts disappeared. Nikolay, 66 years old. Diagnosis: tuberculosis. Novozburevsky TB Dispensary, August 16th, 2011. Nikolay used to work as a combiner in Kazakhstan. He has no relatives and no children. He used to live in a nursing home and was diagnosed with TB during a medical examination. Nikolay. Mother and the close friends of Gena at his his funeral. October 14th, 2011.  Diagnosis: multidrug-resistant TB and HIV positive. Died October 12th, 2011. I met Gena in a hospital courtyard, sitting on a bench. He told me that he had had TB for six years. A cemetery near Novozboryevsk Tuberculous dispensary where patients who died from TB are buried. Hersonskaya area, Novaya Zbourievka, August 17, 2011. The TB dispensary frequently has to bury the dead. There is no money for coffins and monuments. The patients capable of holding a shovel dig the graves.
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