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The Faces Of Tuberculosis

Ukraine has the second-highest rate of tuberculosis (TB) in Europe after Russia. It records about 100 new cases per 100,000 people every year. Thirty Ukrainians die of the disease every day. The country also has alarming rates of new HIV infections.

Both problems are exacerbated by poor infection control in prisons and hospitals, primitive treatment for drug addicts, irregular access to TB medications, misdiagnosis, poor adherence to treatment programs, and a general lack of government concern.

Ukrainian photographer Maxim Dondyuk began photographing the faces of Ukraine’s TB epidemic over two years starting in December 2010. During a hospital visit in the eastern Donbas region, Dondyuk photographed a naked man, staring at the ceiling and dying of gastrointestinal tuberculosis. A week later, Dondyuk was with the man when he died. These are the stories of some of the other victims Dondyuk has met and photographed. (15 PHOTOS)
I met Hennadiy, 42, at the Kherson TB hospital in August 2011. He was diagnosed with multiple-drug-resistant tuberculosis (MDR TB) and HIV. He said he’d been suffering from TB for six years and had no idea how he got it. He’d been working on a fishing boat off Kamchatka in Russia’s Far East when his mother asked him to come home. But he couldn’t find a job and began drinking hard. I met Hennadiy’s mother at the hospital as well. She’d sold almost everything she owned in order to pay for his treatment and food. He died on October 12, 2011.
1 I met Hennadiy, 42, at the Kherson TB hospital in August 2011. He was diagnosed with multiple-drug-resistant tuberculosis (MDR TB) and HIV. He said he’d been suffering from TB for six years and had no idea how he got it. He’d been working on a fishing boat off Kamchatka in Russia’s Far East when his mother asked him to come home. But he couldn’t find a job and began drinking hard. I met Hennadiy’s mother at the hospital as well. She’d sold almost everything she owned in order to pay for his treatment and food. He died on October 12, 2011.
Konstantyn, 42, was a patient at the Kherson TB hospital in August 2011. He was diagnosed with MDR TB and HIV. Beaten by his father as a child, Konstantyn tried to commit suicide by shooting himself in the head. The bullet passed through his skull, leaving him blind in the right eye. After his recovery, he began using drugs. He was an addict for 25 years. He served a prison term for drug dealing and was able to get clean while doing his sentence. But he also was diagnosed with TB. For four months, he underwent hospital treatment. His mother brought him food and medicine every day. He died on August 24, 2011.
2 Konstantyn, 42, was a patient at the Kherson TB hospital in August 2011. He was diagnosed with MDR TB and HIV. Beaten by his father as a child, Konstantyn tried to commit suicide by shooting himself in the head. The bullet passed through his skull, leaving him blind in the right eye. After his recovery, he began using drugs. He was an addict for 25 years. He served a prison term for drug dealing and was able to get clean while doing his sentence. But he also was diagnosed with TB. For four months, he underwent hospital treatment. His mother brought him food and medicine every day. He died on August 24, 2011.
Vasyl was a 71-year-old TB patient at the TB dispensary in Novozburivka in August 2011. A doctor told me his bed had been carried out into the hospital courtyard because Vasyl couldn’t control his bladder. His speech was incoherent. He raves that he is at work. Relatives took his apartment from him and sent him to this state clinic. Once a month a woman comes and brings him a bag of food. When I asked, she flatly denied that she is related to Vasyl.
3 Vasyl was a 71-year-old TB patient at the TB dispensary in Novozburivka in August 2011. A doctor told me his bed had been carried out into the hospital courtyard because Vasyl couldn’t control his bladder. His speech was incoherent. He raves that he is at work. Relatives took his apartment from him and sent him to this state clinic. Once a month a woman comes and brings him a bag of food. When I asked, she flatly denied that she is related to Vasyl.
Mykola was a 54-year-old MDR TB patient at the Novotroisk TB hospital in July 2011. A former tractor driver, he’d spent three months taking care of a paralyzed neighbor who was dying of TB. Mykola contracted TB himself. He supports himself with a modest state pension. His two sons visit him from time to time.
4 Mykola was a 54-year-old MDR TB patient at the Novotroisk TB hospital in July 2011. A former tractor driver, he’d spent three months taking care of a paralyzed neighbor who was dying of TB. Mykola contracted TB himself. He supports himself with a modest state pension. His two sons visit him from time to time.
Hennadiy, 44, was a prisoner at Starozburivska Corrections Colony No. 7 in July 2011. He had been diagnosed with MDR TB and HIV. Hennadiy was formally a low-ranking member of Ukraine’s organized-crime subculture, but now he moans that there is no code of thieves anymore. His tattoo shows the Four Horsemen of the Apocalypse.
5 Hennadiy, 44, was a prisoner at Starozburivska Corrections Colony No. 7 in July 2011. He had been diagnosed with MDR TB and HIV. Hennadiy was formally a low-ranking member of Ukraine’s organized-crime subculture, but now he moans that there is no code of thieves anymore. His tattoo shows the Four Horsemen of the Apocalypse.
I met 52-year-old Svitlana in at the Feodosian TB hospital in July 2012. She was a doctor and did not know how she contracted TB. Svitlana had been in treatment for 10 months. She was afraid to tell her relatives and friends about her diagnosis because of widespread prejudice against people with the disease. She explained her long hospital stay by saying she was being treated for a tumor. A week after I met her, she was released from the hospital with a clean bill of health.
6 I met 52-year-old Svitlana in at the Feodosian TB hospital in July 2012. She was a doctor and did not know how she contracted TB. Svitlana had been in treatment for 10 months. She was afraid to tell her relatives and friends about her diagnosis because of widespread prejudice against people with the disease. She explained her long hospital stay by saying she was being treated for a tumor. A week after I met her, she was released from the hospital with a clean bill of health.
In July 2011, Vasyl was a 52-year-old serving a life term for murder at Kherson Corrections Colony #61. He has MDR TB. This is his third prison term. He spends much of his time caring for his cellmate, who was paralyzed following a stroke.
7 In July 2011, Vasyl was a 52-year-old serving a life term for murder at Kherson Corrections Colony #61. He has MDR TB. This is his third prison term. He spends much of his time caring for his cellmate, who was paralyzed following a stroke.
I met Oleksandr, 54, at the Novotroitsk TB dispensary on July 25, 2011. He was diagnosed with TB and mental illness. Hospital staff told me he had been severely beaten and had amnesia. They said his relatives had not been located and that he was anxious and aggressive. After his TB treatment, he will be sent to an asylum. Privately, he told me his name was Oleksandr Bukariv, that he was born in 1957, that he was a resident of Kherson, that he was married and had two children.
8 I met Oleksandr, 54, at the Novotroitsk TB dispensary on July 25, 2011. He was diagnosed with TB and mental illness. Hospital staff told me he had been severely beaten and had amnesia. They said his relatives had not been located and that he was anxious and aggressive. After his TB treatment, he will be sent to an asylum. Privately, he told me his name was Oleksandr Bukariv, that he was born in 1957, that he was a resident of Kherson, that he was married and had two children.
I met Valeriy, 41, in Kherson in July 2011. He had been diagnosed with TB, which he contracted while harvesting potatoes. After initial treatment failed to help, one of his lungs was removed. Valeriy spent a month on morphine and then began taking synthetic drugs. Two years later, his wife sold their apartment, took their children, and moved to Russia. He was able to beat his addiction by tying himself to his bed through his withdrawal. When I met him, he was a seasonal construction worker and lived in the basement of the house where he grew up. Other building residents gave him most of his furniture; the rest he found in garbage dumps. Valeriy was planning to install a shower, buy a refrigerator, and have his teeth fixed.
9 I met Valeriy, 41, in Kherson in July 2011. He had been diagnosed with TB, which he contracted while harvesting potatoes. After initial treatment failed to help, one of his lungs was removed. Valeriy spent a month on morphine and then began taking synthetic drugs. Two years later, his wife sold their apartment, took their children, and moved to Russia. He was able to beat his addiction by tying himself to his bed through his withdrawal. When I met him, he was a seasonal construction worker and lived in the basement of the house where he grew up. Other building residents gave him most of his furniture; the rest he found in garbage dumps. Valeriy was planning to install a shower, buy a refrigerator, and have his teeth fixed.
In August 2011, Mykola was a 66-year-old TB patient at the Novozburivsky TB dispensary.  A former combine driver in Kazakhstan, Mykola has no relatives. He lived in a nursing home until he was diagnosed with TB and sent to the dispensary. All of his belongings and documents disappeared soon after. He had not been able to receive his pension. He was undergoing a second course of treatment. Mykola told me the nursing home was as bad as a concentration camp and that he was afraid of being sent back.
10 In August 2011, Mykola was a 66-year-old TB patient at the Novozburivsky TB dispensary.  A former combine driver in Kazakhstan, Mykola has no relatives. He lived in a nursing home until he was diagnosed with TB and sent to the dispensary. All of his belongings and documents disappeared soon after. He had not been able to receive his pension. He was undergoing a second course of treatment. Mykola told me the nursing home was as bad as a concentration camp and that he was afraid of being sent back.
Mykhaylo was a 63-year-old MDR TB patient at the Kherson TB hospital in July 2011. He was a retired bricklayer. Doctors discovered his TB while he was in the hospital for stomach surgery. He had been treating his disease off and on since 1983. He said his condition gets much worse every autumn. In Soviet times, he said, the hospital food was pretty good, but since then he had to buy food himself. Four years earlier, his wife died, and Mykhaylo had a stroke. He was walking with a cane and had trouble speaking. His son brought him food and medicine.
11 Mykhaylo was a 63-year-old MDR TB patient at the Kherson TB hospital in July 2011. He was a retired bricklayer. Doctors discovered his TB while he was in the hospital for stomach surgery. He had been treating his disease off and on since 1983. He said his condition gets much worse every autumn. In Soviet times, he said, the hospital food was pretty good, but since then he had to buy food himself. Four years earlier, his wife died, and Mykhaylo had a stroke. He was walking with a cane and had trouble speaking. His son brought him food and medicine.
I met Vasyl, 60, in Kherson in August 2011. He had TB. Born in Belarus, he had a graduate degree in philosophy from a Moscow university. After finishing his education, he was sent to Kherson, where he wrote a dissertation entitled “The Contradictions of Socialism.” After the collapse of the Soviet Union, his research was irrelevant and he was laid off. His left leg was amputated because of a vascular condition. He was living in a dormitory-style room with no running water. He was carrying water in buckets each day to his second-floor room. He did not know how he contracted TB.
12 I met Vasyl, 60, in Kherson in August 2011. He had TB. Born in Belarus, he had a graduate degree in philosophy from a Moscow university. After finishing his education, he was sent to Kherson, where he wrote a dissertation entitled “The Contradictions of Socialism.” After the collapse of the Soviet Union, his research was irrelevant and he was laid off. His left leg was amputated because of a vascular condition. He was living in a dormitory-style room with no running water. He was carrying water in buckets each day to his second-floor room. He did not know how he contracted TB.
In July 2011, Viktor was a 36-year-old MDR TB and HIV patient at the Kherson TB hospital. He said he’d worked in a plastics factory. A year earlier, while being treated for pneumonia, he was diagnosed with MDR TB. He was treated for seven months and released. Soon after, he was readmitted for more treatment. Viktor died on September 7, 2011, leaving behind a wife and a 14-year-old son.
13 In July 2011, Viktor was a 36-year-old MDR TB and HIV patient at the Kherson TB hospital. He said he’d worked in a plastics factory. A year earlier, while being treated for pneumonia, he was diagnosed with MDR TB. He was treated for seven months and released. Soon after, he was readmitted for more treatment. Viktor died on September 7, 2011, leaving behind a wife and a 14-year-old son.
In January 2011, Oleksiy was a MDR TB patient at the Dzerzhynsky TB hospital. He formerly drove a bulldozer at a mine. His wife had already died while undergoing her second course of TB treatment at the same hospital. Oleksiy’s daughter was living in his apartment with an ex-convict. She took his pension each month, saying she needed it to support Oleksiy’s grandson.
14 In January 2011, Oleksiy was a MDR TB patient at the Dzerzhynsky TB hospital. He formerly drove a bulldozer at a mine. His wife had already died while undergoing her second course of TB treatment at the same hospital. Oleksiy’s daughter was living in his apartment with an ex-convict. She took his pension each month, saying she needed it to support Oleksiy’s grandson.
I met Natalia, 37, in the TB section of a Kherson detention facility in August 2011. She had been diagnosed with MDR TB and HIV. “I had a great, loving family,” she told me. “I was my daddy’s little girl.” But her father drowned in a swimming accident at the age of 42. Natalia gave up her education as a musician and began selling drugs in order to send her younger sister to college. Soon, she was taking drugs herself, which is how she contracted HIV and, later, TB. Natalia died on August 16, 2011. Her younger sister is married and living in Moscow with her husband and daughter.
15 I met Natalia, 37, in the TB section of a Kherson detention facility in August 2011. She had been diagnosed with MDR TB and HIV. “I had a great, loving family,” she told me. “I was my daddy’s little girl.” But her father drowned in a swimming accident at the age of 42. Natalia gave up her education as a musician and began selling drugs in order to send her younger sister to college. Soon, she was taking drugs herself, which is how she contracted HIV and, later, TB. Natalia died on August 16, 2011. Her younger sister is married and living in Moscow with her husband and daughter.
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