All photos © Misha Friedman

Misha Friedman has been photographing humanitarian crises around the world, with a recent focus on documenting the tuberculosis epidemic in the former Soviet Union. The number of patients with non-treatable forms–called XDR or extensively drug-resistant TB–is growing steadily in that part of the world because of lack of treatment and education. “[Those] who become sick are stigmatized, relatives turn away, neighbors stop speaking,” Friedman explains. “They spend months in prison-like clinics, where equipment is outdated and medical and nursing staff are just as poor as their patients. Many leave without finishing their treatment only to return over and over again.” These images were taken during several trips to hospitals in Ukraine, Uzbekistan and Russia.  Friedman says it was emotionally draining to witness the suffering and inadequate treatment, then leave the hospitals and see how governments spend so lavishly on other things, such as a sports stadium or a new limousine for the local public health official. Friedman has collaborated on the project with NGOs including Doctors Without Borders, World Health Organization, and the Institute of Modern Russia. His goal is to draw attention to the TB epidemic, which is now killing thousands of people–and not just in the  developing world.

Above: A 37-year old patient outside the palliative ward for terminally ill showing his lunch – that’s the only food he can afford on his pension.

A 19-year old patient has just been diagnosed with XDR-TB – the form of tuberculosis that is resistant to all available medication. The doctors just found out he can not be treated. The patient’s mother has died of TB and his brother is also sick with a drug resistant form of the bacteria. He however responds to some of the medication and is recovering. Nukus, Uzbekistan.

MSF psychologist conducting a meditation session for MDR-TB patients in a Nukus TB hospital. Uzbekistan.

Destroyed and abandoned factory. Grozny, Chechnya Russia.

Doctor checks Andrei for signs of life and finds none. A drug user for many years, he died at the age 46 from HIV-associated drug-related tuberculosis. He had checked himself into the hospital three days earlier.

Empty hospital bed in Nazran, Ingushetia Russia.

Laundry worker next to her washing mashine – she says its as old as she is. As far as she knows, its been in the tuberculosis clinic since 1984. Donetsk, Ukraine.

Diana has advanced MDR-TB. She is too frail to play table tennis, as are most of her fellow patients at the hospital. Nukus, Uzbekistan.

A hospital room for five male mdr-tb patients in Nukus TB hospital. Uzbekistan.

Kolya, 31, who is living with HIV, contracted tuberculosis in prison. Mariupol, Ukraine.