by photographer Gary Calton
2002 FiftyCrows PhotoFund Winner

In the late 1950s pharmaceutical drugs put an end to the threat of tuberculosis. However, in 1993, the World Health Organization (WHO) declared tuberculosis a global emergency.

The WHO has designated a number of areas in the world as TB hotspots. The region covered by the former Soviet Union is one of them. After the fall of the USSR in 1991, declining living standards coupled with inadequate preventative measures increased the number of people at risk of contracting TB in the region. In addition, inconsistent and incomplete TB treatment using black market drugs has led to the development of a large, multi-drug resistant tuberculosis (MDR-TB) population. The spread of this disease is particularly devastating in sanitariums and prisons where poor nutrition and overcrowding help to spread this airborne killer.

It is estimated that one inadequately treated TB patient can infect between 9 and 12 people. Add into this equation people’s migration and travel habits, and the dangers of MDR-TB become a very real, global problem. TB is now the number one health problem in the former Soviet Union. It kills more people than any other infectious disease in the world – more than malaria and AIDS combined. With this project, Calton will continue to visit the overcrowded Sizos, or pre-trial prisons, in Moscow. His goal is for this work to “act as a voice for those patients and prisoners who have developed MDR-TB and who are at this very moment experiencing a miserably condemned life, struggling with the realities of a slow death.”