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A TB patient at Tomsk Regional Clinical Tuberculosis Hospital, Building #3. Photograph and caption © James Nachtwey/VII.
“Tuberculosis is a disease of poverty and stress“.
Merrill Goozner, The Center for Science in the Public Interest.
“Sixty percent of all new cases of tuberculosis have resulted from the rapid growth of the post-Communist prison archipelago”.
Proceedings of the National Academy of Sciences. Aug. 26th, 2008
Tuberculosis (TB) was under relative control in the former USSR. Soviets had lifestyles, nourishment and conditions of living that kept disease at bay. When communism fell, so did a civil order in many areas. The phalanx of activity that filled the vacuum involved new systems, new relationships, new businesses and new criminal opportunities.
The prisons filled in a society that needed to organize itself before it could organize it’s transgressors. The prison population swelled to 1.1 million (it is now down to little over 700,000). Post-communist prisons held malnourished, crowded populations with weak immune systems; they have been described as ‘Tuberculosis incubators‘.
Correctional Treatment Unit #1, a TB prison colony in Tomsk, Siberia. TB patient/prisoner gets a chest x-ray. Treatment is supervised by Partners in Health in partnership with the government TB program. James Nachtwey/VII
TB is best treated with various labour intensive methods known under the umbrella-term Directly Observed Therapys (DOTs). Due to TB’s many different strains – each with different drug resistancies – case by case treatments differ according to patient reactions to drugs. At the least, a patient must be observed and his/her drug regime modified over a 6 month period. For Multi-Drug-Resistant Tuberculosis (MDR-TB) the treatment can take as long as two years. And, MDR-TB & XDR-TB are increasingly common among prison and civilian populations of Tomsk and other Siberian urban centers. Unfortunately, closely monitored drug regimes are improbable in over-stretched and poorly funded state systems.
It wasn’t always so dire. The former Soviet provided a regular supply of drugs to abate disease amongst its prison population, but those supplies were interrupted in the fall of Communism – sporadic and incomplete treatments gave rise to multiple resistant strains of tuberculosis. To compound this the side effects of drugs were enough to discourage patients, and rarely, if ever, did courses of treatment go with a prisoner into his community following release.
TB patients smoke cigarettes in the smoking room of Tomsk Regional Clinical Tuberculosis Hospital, Building #1. James Nachtwey/VII
James Nachtwey‘s mega-promoted TED prize crusade addresses the spread of Extremely Drug Resistant Tuberculosis (XDR-TB), its mutant forms and human tolls. This excellent Guardian article notes Nachtwey has photographed the epidemic worldwide, from Siberian prisons to Cambodian clinics.
A prisoner who was convicted of murder was moved from prison to the TB ward of Battambang Provincial Hospital, Battambang, Cambodia when he was diagnosed with TB. He is coinfected with AIDS. James Nachtwey
Nachtwey stands with Sebastião Salgado in the “super-photographer” stakes. They both make the ugly beautiful.
Both Nachtwey and Salgado have inspired others to action and both believe firmly in the power of photography to change existences … even in a time when such sentiment is derided as old-fashioned, false idealism.
But, despite the odds, Nachtwey has succeeded in forcing his work into the conscience of millions. For some his work is an inspiration for social justice; but for others his work is a sub-conscious default to guilt, despondency and powerlessness to help others less fortunate.
James Nachtwey puts human faces to global suffering. And we are outraged. Or we feel we should be outraged.
I think Nachtwey wants us to believe in ourselves as agents of change. Nachtwey deliberately chose Tuberculosis – because while the situation is critical, it is not terminal and TB is theoretically entirely curable. Beating TB on a global scale is dependent on the behaviours of individuals and their communities.
Correctional Treatment Unit #1, a TB prison colony in Tomsk, Siberia. A prisoner proves to a nurse that he has swallowed his daily oral TB medication. The prisoners receive treatment through metal bars in order to give security to the nurses. Treatment is supervised by Partners in Health in partnership with the government TB program. © James Nachtwey/VII.
Nachtwey’s work extended beyond the prison walls in Tomsk and went into the public clinics (some images included here show those facilities); TB is no respecter of human walls or demarcations. Regional, economic poverty will spike rates of TB.
A TB patient has excess fluid drained from his chest a Tomsk Regional Clinical Tuberculosis Hospital, Building #1. James Nachtwey/VII
The worst thing we could do here would be to think that TB is a disease of other nations and other peoples. In Pathologies of Power (2004), Paul Farmer wrote about the New York prison system’s huge Tuberculosis epidemic of the mid-nineties, “By some estimate, it cost $1 billion to bring under control”. The strains that arose in the NYDoC have been directly related to the resistant strains of the former Soviet Union. Tuberculosis is latent within one third of the world’s population. Tuberculosis needs only the conditions for its growth.
Paul Farmer, of Mountains Beyond Mountains fame has taken the lead on combating TB, as well as other infectious diseases, amongst the world’s poorest populations. He worked with Partners in Health partly funded by a Soros Grant to “develop demonstration tuberculosis control projects which could become a model for replication throughout Russia.”
A nurse prepares a daily injection for TB patients at Tomsk Regional Clinical Tuberculosis Hospital, Building #3. James Nachtwey/VII
Prison Photography blog has focused twice previously on photographers’ responses to the USSR and its aftermath – the Gulag and the new prisons that arose. While Anna Shteynshleyger and Yana Payusova are working with very different issues, regions and populations they – along with Nachtwey’s work – remind us of the severe problems facing parts of modern Russian society. Unfortunately, and certainly in the case of Tuberculosis, these problems exist in other nations also. Nachtwey focused on TB because it was not – despite being a global problem – on the radar of most people. That sounds like something I’d say about prisons and prisoners’ rights.
Correctional Treatment Unit #1, a TB prison colony in Tomsk, Siberia. A patient/prisoner receives a daily medical injection. The prisoners receive treatment through metal bars in order to give security to the nurses. Treatment is supervised by Partners in Health in partnership with the government TB program. James Nachtwey/VII
For more information on XDR-TB read the Action – Advocacy to Stop TB Internationally website, and the Center for Disease Control & Prevention website. For the most accessible and recent article, read Merrill Goozner’s 2008 Scientific American article about Russian Tuberculosis strains which also includes a audio segment with a clear explanation of the situation.
A TB patient/prisoner receives his daily oral medication at Correctional Treatment Unit #1, a TB prison colony in Tomsk, Siberia. © James Nachtwey/VII.
James Nachtwey built his reputation as a combat photographer.
He was always reluctant to be the focus of media attention but after 5 Capa Gold Medals for War Photography he couldn’t escape the curiosity of Christian Frei who made the extraordinary film War Photographer. Nachtwey comes across as an articulate, self-isolated journalist-force devoted to his craft and courteously distant to others; here is a clip.
Nachtwey has done interviews here, here and here. Read an interview about his 9/11 pictures, and associated videos on Digital Journalist. The images were published in TIME.
He worked in Rwanda for his book Inferno.
View his TED Prize acceptance speech and the consequent October 2008 launch of his XDR-TB project and Flickr pool.
“I’m not interested in the political side of it at all. I don’t deny it and know it filters into the work, but I’m just not approaching it from that perspective. I’m interested in exploring inner exile and profound beauty as redemptive and liberating. There is that famous Dostoyevsky quote that ‘Beauty will redeem the world.’”
Anna Shteynshleyger, in an email to Tim Davis. April 21st, 2005
Perm (Grasses), 2001. © Anna Shteynshleyger
Guggenheim time again. Seven photographers were recipients of the big one. All of them are preoccupied with the passage of time. Thomas Joshua Cooper studies waves for a long time; Osamu James Nakagawa studies waves crashing in to cliffs for a long time; Suzanne Opton records the melancholy of veteran soldiers (a subject that will likely last a long time); Cheryle St. Onge makes reference to her Grandmother’s times; and Byron Wolfe has “for nearly twenty years held a deep and abiding interest in ideas about time, change, and the personal relationships one makes with a place.” Brian Ulrich‘s relation to time is that he is the hardest working man in the business and operates like there’s no time left. (I admit, that one’s a step too far).
Prison Photography‘s interest in the Guggenheim Awards for 2009 is specifically with Anna Shteynshleyger.
Siberia is Shteynshleyger’s visual record of the topography of prison labour camp sites and works. Critics and public are likely to know her more accessible work done at the Port Authority of unextraordinary people on escalators unextraordinarily unaware. Port Authority is an ordinary project; I cannot give it much time. Or perhaps Shteynshleyger’s versatility pulling the viewer from Port Authority‘s whim to the import and nonchalance of Siberia is too big of a conversion to devote the belief in both.
Kolyma (Floor), 2002. © Anna Shteynshleyger
With steady assurance Siberia deals with time, as it deals with the site, as it deals with the intelligence of the viewer. Too often a photographer rushes to the physical clue – the visual pointer – to drive home the importance of the political statement he or she intends to make. Shteynshleyger is not interested in explanation. Without the title on the wall and without the catalogue essay her pictures are simply a competent, nay beautiful, collection of large-format colour prints. They are mostly landscapes and, in truth, landscapes that could be from any continent on earth.
Perm (Bush), 2001. © Anna Shteynshleyger
Tim Davis wrote an excellent piece on Shteynshleyger’s Siberia citing ‘paintings of absense’ from art historical cannon, one-off expressions of ‘the sublime’ by genre painters, and the philosophy of modern cinema auteurs. Davis deliberately talks about as many things other than Shteynshleyger’s work in an attempt to position and thus explain Shteynshleyger’s work. It is a fine, fine judgement call;
Anna’s photographs of Siberia, a territory as suffused with suffering as any place on the planet, do not “bear witness” to anything. They are not documents of anyone’s journey. They are not war monuments; they are not apologies. Though her camera is pointing in the direction of historical sites of unremembered trauma, her pictures are not records of the locations of past crimes. They do not reckon with the past. They sidestep the inevitable failure of the photograph to stand for historical events. They are oblique and difficult, refusing any Spielbergian urge to heal through reliving previous horrors.
Some might argue Davis is wrong. That what he identifies as a resourceful, no-label, psuedo-documentary response to massive ideological violence is in fact a confusion of approach on Shteynshleyger’s part. But they would be wrong. William Meyer wrote a critique of Siberia beginning with the observation that many artists and photographers have sifted and surveyed Nazi concentration camps, and frequently (on the shoulders of other artists) have produced resonant work. The audience for art reflecting the holocaust and concentration camp trauma is well versed in the visual vocabulary of such. For Meyer, the Gulag is in a different position;
How many agitate on behalf of its victims? There are few memorials, few markers, few museums, few tourists. Out of sight, out of mind. But Ms. Shteynshleyger wants to show us.
Shteynshleyger is a pioneer and she is showing us how we can understand horror and how we can understand that horror passes. To me, it seems her images are as private as old men and women who hold silent testimony to past events. Just because something is understood doesn’t mean it should be said, and just because something is said does not make it understood.
Untitled (Tires), 2002. © Anna Shteynshleyger
It isn’t that Shteynshleyger’s work is evasive; it just seems she wants a rigorously curious audience as opposed to a docile one. She is quoted as saying;
… be it a metaphysical or cultural concern, whether it’s a critique or a celebration, art remains a practice rooted deeply in the material world. We make likenesses of what we see and transform our world in a very tangible way. Any situation can reveal a reality not apparent at first examination.
If Dostoyevsky is right and beauty is to redeem the world, beauty must either be apolitical or the most beautiful consensus-sealing political position never reached. Politics, in the common understanding of the term, can be a brutish and rude affair. If there is a message to take away from Shteynshleyger’s work it is, perhaps, that we should search for beauty more rigorously and pay more attention to understated, and dare I say it, apolitical positions.
Untitled (Perm Clouds), 2002 © Anna Shteynshleyger
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Anna Shteynshleyger was born in Moscow, Russia in 1977. She came to the United States in 1992. Shteynshleyger received a BFA from the Maryland Institute College of Art (1999) and an MFA from Yale University (2001). In 2004 the Museum of Contemporary Art in Chicago mounted a solo exhibition of her Siberia pictures. In 2006, her (12×12 project) was exhibited at the Museum of Contemporary Art, Chicago and Art Basel Miami Beach at the Jacob Karpio gallery in Miami, FL. Other exhibitions have been mounted at Moti Hasson Gallery, NY; Murray Guy Gallery, NY; Lombard-Fried Fine Arts, NY; Artists Space, NY; Vedanta Gallery, Chicago; Thomas McCormick Gallery, Chicago; Zolla Lieberman Gallery, Chicago. Shteynshleyger’s work is in the permanent collections of the Museum of Contemporary Photography, Chicago; LaSalle Bank Photography Collection, Chicago; Yale University Libraries and the University of Maine Museum of Art. She is the recipient of an Illinois Art Council Finalist Award, Blair Dickinson Memorial Award and Guggenheim Fellowship. Shteynshleyger is currently an adjunct professor of photography at Columbia College Chicago and McHenry County College.
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