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The tuberculosis (TB) epidemic in Ukraine is among the most severe in the European region, with nearly 700,000 people infected.
All photos © Aleksander Glyadyelov
Médecins Sans Frontières/Doctors Without Borders (MSF) provides treatment to prisoners and ex-prisoners in the Donetsk region in eastern Ukraine in order to help tackle the growing epidemic of drug-resistant TB (DR-TB), which is a particular problem in overcrowded prison environments.
MSF provides treatment to around 230 prisoners in Colony 3 (a special prison hospital for inmates with TB), in pre-trial detention centres, and in the civil sector.
When Vladimir wasn’t feeling too ill from DR-TB, he would spend time refurbishing his cell in Colony 3. “Nobody has a room like me, nobody has it better,” he says. He looks forward to meeting his grandchildren, as he is close to completing his four-year prison sentence.
MSF has renovated the Colony 3 laboratory and introduced infection control measures to reduce the risk of transmission of drug-resistant TB. MSF has also introduced a special machine called GeneXpert which makes it easier and faster to detect drug-resistant forms of TB.
Up until now, Igor has been sharing a cell in Colony 3 with 14 other people infected with TB. Once he is released, he will be referred to the Mariupol TB hospital where he will continue his treatment. “I am praying for all who are staying here in Colony 3,” he says, clutching a bible.
A prisoner and his wife enjoying a rare moment together in the hotel suite inside the Colony 3 prison grounds. Inmates who have been taking their treatment properly, and are not infectious anymore, are allowed to rent the suite every three months to spend time with family members. The suite is equipped with a bedroom, TV room, kitchen and bathroom.
A serious challenge is to ensure that patients continue taking their treatment until they are cured. Heavy side effects from the DR-TB drugs is one reason why many patients struggle to complete treatment. Here, a nurse is trying to explain to a DR- TB patient about the importance of him continuing to take his daily dose of medication. He is about to be released from prison on medical grounds, as he has a heart problem and is very ill.
In the industrial zone of Colony 3 some prisoners carry out work such as production of construction materials, woodcarving, sewing, painting and making religious shrines. This man is carving a box with an illustration of an old ship.
The Head of Colony 3, Valeriy Chigrinets, has worked for 25 years in the prison system. He says that there is progress made in the fight against TB, but he also admits that more work is needed in detecting the microbacteria, addressing drug-resistant TB and making sure that patients complete their treatment.
DR-TB patient Vladimir arriving and registering at the Donetsk TB hospital after having served a four-year prison sentence in the Colony 3 TB prison. His lungs are in poor condition and he may require surgery. But he is in good spirits and grateful that he is still alive. He says he is determined to complete his treatment, despite having experienced some very painful side effects from the TB drugs he has been taking for over a year now.
Since June 2012 MSF has provided treatment to prisoners and ex-prisoners in the Donetsk region in eastern Ukraine, in order to help tackle the growing epidemic of drug-resistant TB (DR-TB). MSF provides treatment to around 230 prisoners in Colony 3 (a special prison hospital for inmates with TB) and in three pre-trial detention centers.
Once patients are released from prison, MSF offers continued treatment until they are cured. In addition, MSF provides antiretroviral treatment to patients that are co-infected with HIV. Activities are carried out in collaboration with prison authorities and the Ukrainian Ministry of Health.