Brent Stirton/Getty Images

I went to Ukraine to work on HIV issues because, at the time, it was experiencing the fastest acceleration of HIV infection in the world. I had very little time on this trip, it’s an expensive place to work and I was covering the worst elements of the HIV crisis in a 14-day sprint across the country. After a whirlwind tour across half Ukraine, a horror show of disease, ignorance and neglect, I came eventually to Donetsk, a bleak industrial ruin of a town.

Industry has collapsed since the fall of communism and the majority of the population live in the abject poverty of prolonged unemployment, men and women living each day under a cloud of impotent fatalism. There is very little possibility of improved circumstances and people know that. They looked at me with a mixture of resignation and contempt, as well as a rare opportunity for cash made manifest.

Shortly after arriving I made my way to a particularly bleak neighborhood where I had arranged to meet the guide I had been negotiating with - a former addict and pimp now on a wavering path to reform. After a nervous introduction he led me to a doorway on the lower level of a grimy red-brick apartment building and knocked on the first door. After an age the door opened and a sickly young woman lurched out and stared at us. She stared for a full minute before reacting to my guide. Obviously wasted, it took her a while to realize she was looking at someone she knew. Meanwhile, the smell of the apartment wafted up behind her and reached out to me. It had the sickly sweet smell of unwashed, decaying humanity. After a protracted, incoherent negotiation on the doorstep, the woman led us into the apartment. It was dark and gloomy, with no sense of order or sanitation, or any attempt to keep things clean. In the darkened front room, two women were gathered around a weak bulb. The women acknowledged me briefly. Once my guide reminded them of why I was there, they nodded and went back to their task.

One of the women was standing with one leg on top of a small table, another woman sitting below her was trying gamely to find a vein in the leg into which she could plunge the syringe she was holding in her mouth. The thing is, the leg didn’t look human. It was swollen to twice the size of the other leg and had a band of decaying infection right around it, literally eating away the remaining flesh. On the top part of the leg, you could see recent evidence of minor surgery; with a fresh-looking band of exposed flesh so precisely cut it had to have been the work of a medical professional. You could smell the leg. Its owner was wearing a dressing gown with dolphins in its design. Everytime the needle probed the exposed wounds, the dolphins shuddered as the woman winced in pain. Looking down at the thin trickle of new blood from the failed needle marks, the woman in the gown urged the syringe bearer to look higher in the wound, to find a fresh vein. Despite the obvious pain of probing the infected leg with a needle, the woman’s overwhelming desire for her shot was paramount and she coaxed the other woman in quiet Russian as if speaking to a pet.

Eventually the needle slid into a surviving vein at the top of the wound and a smile spread across the strained face of the woman in the dolphin gown. She looked up, as if seeing me for the first time, reached across and offered me her hand as the other woman withdrew the needle and prepared her own shot with the same syringe.

“My name is Tatjana,” said the leg owner. She used both hands to lift her diseased leg to the floor, sat down and shot up the other woman with the same syringe and needle.

“We are all HIV+ in this apartment, so why should we worry about needles?” Tatjana told this to my guide when he pointed out the dangers of sharing a syringe. By this time, two more women had appeared, one with a hand equivalent of Tatjana’s diseased leg. They told me six of them usually live in the apartment, all are HIV+, all sex-workers, all injecting drug users.

It felt like swimming in a lake of hopelessness, talking to those women, all of them in a state of decay. Three of them started getting dressed in their work clothes, tight-fitting leggings and long sleeve shirts, all carefully placed to hide the horror-show eating away at their bodies. They were getting ready to go to the highway, where they would sell themselves for an average of $5 to the truckers and motorists who could afford them and didn’t mind how far gone they were.

Just then a dirty, bare-foot young boy came into the room. He was about 11 years old and he came up to Tatjana and whispered in her ear. She reached into her pocket and gave him some small change. He slipped out of the room and was back soon with some bread. He made some tea in the filthy kitchen and sat down and ate his lunch while he watched the remaining women shoot up. He was Tatjana’s son and he was the only child living in the apartment with six women. He did not go to school and spent most of his time running wild, returning to the apartment to eat and sleep.

After a short time I asked if I could take a picture of him with his mother. He was shy but agreed and they sat down on her filthy mattress and posed awkwardly, not knowing where to look. Tatjana was not affectionate with him, she leaned away, looking across the bed at her son, her leg bleeding a thin stream all the while. After an initial shyness, he leaned forward, put his head in his hands and looked at the camera. That’s when I took this shot. That kid was so tough, so old before his time. He knew that his future was limited even before it had begun. As soon as I shot this frame he stood up and walked out of the apartment.

Tatjana died a month after this image was taken. The last I heard, the boy was still living in the apartment. What his future holds, I can only speculate. It looks bleak, as it does for every other victim of HIV in the Ukraine at this time.

This entry was posted on Thursday, November 29th, 2007 at 5:13 pm and is filed under World AIDS Day, Pictures, photojournalism, AIDS/HIV, Ukraine. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.