Photographer Misha Friedman photographs the effort to battle an epidemic.
Fueled by rising rates of HIV and a health system crippled by years of political, economic and social transition, tuberculosis in the Ukraine has proven extremely difficult to eradicate. Whereas TB rates in most regions of the world has stabilized or declined, it has continued to spread in the Ukraine, which accounts for 11% of all cases in Eastern Europe. In recent years a number of NGOs, including the World Health Organization, have taken up the fight to contain the epidemic.
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A female TB patient is x-rayed at a clinic in Mariupol.Misha Friedman—WHOAt a mobile facility organized by Amicus, an NGO offering comprehensive care for people living with HIV/AIDS, patients can exchange needles and get blood tests. A high rate of HIV/AIDS has also contributed to the spread of TB in the Ukraine, as the compromised immune systems of HIV patients make them susceptible to the disease's predatory ways. Misha Friedman—WHO Amicus says that it collects ten bottles like this per day on average from intravenous drug users, in exchange for clean needles, condoms, and wet-wipes.Misha Friedman—WHO An HIV-positive woman injects herself with a heroin mix. The easy availibility of injectable drugs in the Ukraine has fueled the spread of the disease.Misha Friedman—WHO Kolya, a 31-year-old TB and HIV patient, lays in bed at a clinic in Mariupol.Misha Friedman—WHO A metal basin in a processing lab in Donetsk lists names and blood types of TB and HIV-positive patients. Misha Friedman—WHOA doctor prepares a TB patient for an x-ray at a Donetsk clinic.Misha Friedman—WHO Vladimir, left, a recovered TB patient, and his wife Tatiana, play with their son David. Both were intravenous drug users and are HIV positive. They met at a summer retreat for people affected by HIV, and together now help others to quit using drugs through counseling and outreach work.Misha Friedman—WHO Tuberculosis also has taken root in Ukrainian prisons, where cramped quarters and poor conditions contribute to its spread. This ex-convict, now blind, suffers from extra-drug resistant TB (XDR-TB), a strain of the disease that resists most treatments. He spends most of his days lying in bed at a clinic in Donetsk. Misha Friedman—WHO A doctor lays his hand over a 46-year-old HIV positive patient with MDR-TB who had checked himself into the clinic three days earlier for treatment. The doctor was looking for signs of life, but found none.
Misha Friedman—WHO In an effort to improve overall care in the Ukraine, the World Health Organization has launched The Stop TB Strategy, with the goal of dramatically reducing the reach of TB by 2015. Misha Friedman—WHO
