Powerful images. Haunting... hard to believe they are just from this past year.

Powerful images! Nachtwey once again wakes the world.

Heartbreaking photographs. That's all I can say.

It is hard to believe that some of these are real people. As Americans we are so used to seeing well nourished (probably over-nourished) men and women, seeing these dying patients, it is shocking. Thank you.

there is nothing, but their eyes..

Black and White pictures are way better to get the "feeling" of the moment. Hope some day no one in the world has to suffer while others are just wasting resources. Thank you Boston.com.

Breathtaking.... Almost too much.

http://www.BJNArt.com

oh my gosh... this and the children's cancer photos are beyond words. they bring out so much emotion. truly great examples of how single pictures are worth more than words could ever explain. completely amazing! i love this site

A couple of days ago I said on another blog that I don't like James Nachtwey so much, but after watching this pictures I think I like him. :-)
I didn't like his movie so much.

e pensare che noi ci lamentiamo per molto meno. dovremmo vergogniarci!

I am such a fan of his work! One of the best photojournalists ever. Always inspiring. Always personal.

Very powerful

breathtakingly haunting!

I can not believe we live in the same world. These photographs are incredible powerful.

I work in medicine at a busy trauma hospital and see tragedy everyday.
Even as desensitized as I am, these pictures really hit you at the core. It's unpleasant, but real life ...

... maybe we don't have it so bad here in the U.S. ?

Wow. #14 is scary...

Makes you thankful for your health and healthcare system in the USA.

Truly haunting photographs.

nachtwey chooses to use his camera as a tool to educate others on the suffering in this world. he should continue to be highly commended for the work that he does. for those of you who aren't familiar with him, you should watch the documentary "the war photographer".

truly gripping photos. thanks for sharing.

on a picky side note, tuberculosis is misspelled once in the description - it appears as "tubercolisis", i believe.

Thank you for sharing these images!
Also, I would like to point out a typo in the 4th picture. It is 'Tambaram', not 'Tambaran'.

Powerful images, but will anyone pay attention? I'm a big fan of Nachtwey and particularly of his attempts to get news media to pay attention to important stories. But the truth is, more than at any other time in recent history, mainstream media have no interest in stories like this and most of the people watching, listening or reading, don't seem to mind.

Typos fixed, thanks all.

XDR-TB cases have already been reported in the USA. The fragility and exclusionary nature of our healthcare system here will be put to the test if a disease like this or others gets a firm foothold in the population.

The choice of black and white is interesting. Perhaps done for artistic purposes... however I think that colour photos may have brought more attention to the fact that that this isn't an issue of the past, but a pressing issue of today.

Full of so much sorrow and heartbreak - black and white is the perfect medium for this - it starkly highlights the despair and pain that comes across so many of these frames.

Absolutely moving....reminds me of how as humans we are all so fragile.

Unbelievable. Beautiful. Heartbreaking. Awful.

Oh my god, when I stumbled onto this, I was shocked with awe.

This is such a powerful photshoot, it really shows what's going on over there.

Shock and powerful image.
Thanks for your work, and your work definitely reminds us who may ignore this reality in dailylife.

Jim Nacthwey and Sebastiao Salgado define what is good photojournalism. I can't think of anyone who can match those two for sheer beauty of their work as they expose all sides of life.

I met Jim once, and he's one of the most humble people I've ever met in this business. Such an amazing eye, such true concern for his subjects. The definition of "The Concerned Photographer."

$700 Million to bail out the filthy rich in the U.S.... while images like this seem to go unoticed. The world is one messed up place my friends...

Wow.... my jaw was dropped literally the whoooole time i saw these pictures. The conditions of these people is just terrible and heartwrenching

Of course, it wouldn't take 700 Millions of US$ to cure all this (these) which make it so difficult to achieve! :(

Sad pictures... Its something wrong with the world nowadays...

Alex
http://www.recentnews.co.uk

700 b $ bailout bill? With only 1 b $ we could save all this people and thousands more. And no one f**king cares.

Sadly real

et pendant ce temps-là, M. ou Mme Dupont reçoivent deux ans de salaires en guise d'indemnité de départ alors que la banque qu'ils ont géré coule. Si on remettait ce monde à l'endroit ?

I cryed. It's a crisis of consciousness. Humanity has to be better than they have ever been before, not in terms of religious doctrine but in terms of ethics. There are enough resources to struggle and win the war against ignorance, poverty and all the unnecessary pain and suffering depicted in these pictures. Mankind mostly chooses for self rather than a choice for community. Those, who for whatever reason, have been given an opportunity to prosper in this world have betrayed that gift. They most often by promote their own agenda's-their own self interest rather than promote the potential for a better world. Mankind use their little position of power, provided by their abundance, to assure for themselves more abundance until they become sick with there own greed. Until enough people can raise consciousness to a new level, which may have a lot to do with being couragious enough to hold each other accountable, I don't see how we can achieve, what must be achieved, to survive.

Hi from Indonesian .

By chance I also the sufferer the TB that was undergoing medical treatment 6 months.

Pray for it is hoped I could recover !

thank's

sorry for my bad english,because i using software translator

What can we do to help?

Take a long look at the conditions that exist in #11. In that very city, mogul Mukesh Ambani is in the process of building his 27-story, 400,000 square foot "residence antilla". The construction costs are estimated to be nearly $2 billion US (http://www.forbes.com/2008/04/30/home-india-billion-forbeslife-cx_mw_0430realestate.html). He and his brother Anil are respectively listed as 5th and 6th wealthiest people in the world at a combined net worth of over $80 billion. The fact that this man lies in squalor in the shadow of this monstrous construction project is shameful.

Cases of this disease will be coming here thanks to our open borders immigration policies. The increase of TB cases in places like Milford, MA have been attributed to the influx of illegal immigrants who bypass whatever health screening is done through legal means of immigration. I am guessing that the strain of the disease here in the US is not the drug resistant variety but with time and continued tolerance of illegal immigration the resistant strain will no doubt make it.

Margie, wake up (#38). It's not our job to take care of the entire world, just our country. If you want to save the world then go for it, girl: but the rest of us are not signing on to your crusade.

Very touching images. Lets spread awareness about XDR-TB to help those people!

Very powerful photos. Eye-opening. The world has enough resources to help people with TB and with many other diseases. We should stop being so greedy that we eat up so much of the world's resources. Let's give up the latest gadget, the new fancy restaurant, the idea of a new car when the old one works fine and consumes less, the expensive and preservative-laden ready meals, the brand name jeans and put our money to better use. While we worry about Wall Street, ordinary people the world over are going through real crises.

My god, Unbelieveable!

It's nonsensical that people in such a condition as documented in the photos receive medical care in hospitals. Part of the reason the worldwide TB infection rate has risen is because of life-extending treatments for such patients.

Numerous epidemiology studies have shown that the best strategy to reduce overall infection rates of TB and AIDS in undeveloped populations is quarantine without life-extending medical care. Resources can then be devoted to halting the progression of the disease in early-stage patients.

It is so shameful that this country is spending billions to wage war in a wealthy country like Iraq and letting this disease rage on - what next? So graphic, so heartbreaking! This is why I support the "Doctors Without Borders" group. The USA isn't doing much - just preaching abstinence as a deterrent to HIV! I'm so disgusted!

James Nachtwey's work is just unbelievable, impossible. Those photographs are only be possible if he'd be invisible.

And we think we have it bad sometimes!

Bob B. and S. Murray, those are pretty cold statements. I assume that if someone in the street reached out their hand to you to help them up, you would, instead, recoil in disgust and walk the other way back to your warm house.

while the western worlds fight over billions of dollars, obesity and celebrity tabloids, the rest of the world is facing the horrors of preventable diseases.

sometimes my own culture disgusts me.

david
www.davidsmeaton.com

James Nachtwey is one of my favorite photographers of all times. Sadly enough such heavy subjects that he photographed and brought awareness to took a toll on him and possibily costed him his life.

For those interested in his work, rent or buy the documentary War Photographer. He was a brave soul.

Hey, S. Murry (#47), does that solution include your relatives?

Hey, Jeanne Benjamin (#54), that solution would indeed include my relatives if they were members of undeveloped populations and infected with TB or AIDS.

By the way, I'm an epidemiologist at a major research institute in Boston, so I suspect I know more about population-based health management than you do.

S. Murray (47): That is a truelly callous and short-sighted statement you have made. Your solution is to basically let the third world die? Or are you proposing death camps a-la WWII? First it'll be AIDS, then TB, then Cystic Fibrosis, then it'll be anyone who carries a gene that may cause these diseases in their offspring.
Maybe we should quarantine you?

XDR-TB developed from the mismanagement of multidrug-resistant TB (MDR-TB), often when first line treatment was not reliably continued. There is substantial funding of ongoing research into the disease, including the Bill and Melinda Gates foundation.

XDR-TB demonstrates the impact of misapplication of continued strong scientific advances in antibiotics. Many in the United States even demand antibiotics for the common cold as a sort of socially acceptable placebo... and future generations will continue to pay a price for this sham which remains accepted and enabled by the medical profession. Even today, I would guess that innovations like Zyvoxx are probably prescribed as much for celebrity status or physician arrogance as medical need.

Roman Catholic priests would be spending less time in AIDS hospices were the church to cease the theological, inhuman insistence on abstinence-only education throughout the world. TB is one of the most common infections of individuals with HIV/AIDS. This abstinence teaching policy by the Catholic church and the United States government continues to result in the needless deaths of millions.

Wow! A prayer for them is all we can really do at this point. I am a firm believer that the over use of antibiotics for common colds and viruses are a huge part of not having a cure for such dieases!

How fortunate we are to have the medical care that we do in the USA!!!!!!!!

Yaseen (#56), my statement may be callous, but it is certainly not "short-sighted." Quarantine and elimination of life-extending care for dying TB and AIDS patients minimizes infection rates in undeveloped populations, and reduces the likelihood of the emergence of drug-resistant strains. Multiple studies and models have concluded that this approach to population-based health management reduces the rate of infection in the long run.

This has absolutely nothing to do with eugenics, cystic fibrosis, or death camps. And clearly the people who pay me $100,000 a year to research infection dynamics in undeveloped populations don't believe that I should be quarantined.

#57: Stop perpetuating the lie. Neither the availability of condoms nor their widespread use DO NOT lead to fewer STD transmission rates. Stop with the subrosa racism, also, by suggesting that 'Third Worlders' cannot control their sexual impulses and be abstinent.

AIDS victims in 1987: Philippines 135 / Thailand 112

In 1991 the WHO predicted the Philippines would have 80,000 to 90,000 cases and Thailand 60,000 to 80,000 AIDS victims.

Thailand promoted the use of condoms in massive campaigns; the Philippines promoted 'Abstinence' and 'Be faithful'.

The prognosis of the WHO was wrong for both countries:

1999: Philippines 1,005 / Thailand 755,000 AIDS victims

(Source: British Medical Journal, Volume 328, April 10th 2004)

Now we are seeing some of those gains lost in the Philippines as condom use rises: http://www.lifesitenews.com/ldn/2006/feb/06020308.html

Here is another case:

The March 2004 article in the medical journal, 'Studies in Family Planning' published an article titled "Condom Promotion for AIDS Prevention in the Developing World: Is It Working?". The piece was a meta-review of the scientific literature on the question.

The results shocked condom advocates. In the article, researchers Sanny Chen and Norman Hearst noted that, "In many sub-Saharan African countries, high HIV transmission rates have continued despite high rates of condom use." In fact, they continued, "No clear examples have emerged yet of a country that has turned back a generalized epidemic primarily by means of condom distribution."

No surprise, then, that Botswana, Zimbabwe, Kenya, and South Africa — the nations with the highest levels of condom availability — continue to have the highest rates of HIV prevalence.

(Source: "The White House Initiative to Combat AIDS: Learning from Uganda," Joseph Loconte, Executive Summary Backgrounder)

And yet another case:

Uganda at one time had the highest rate of HIV/AIDS in the world. Starting in the mid to late 1980s, their government instituted a program to teach abstinence before marriage and fidelity to one's partner afterwards. They only reluctantly advised condoms for high risk groups (like prostitutes) whom they knew would not accept the other two approaches.

Billboards, radio announcements, print ads, and school programs all promoted the virtues of abstinence and fidelity to prevent HIV/AIDS.

The results were astonishing.

In 1991, the prevalence rate of HIV was 15%. By 2001, it had dropped to 5%. It was the biggest HIV infection reduction in world history.

Among pregnant women, the drop was even more dramatic (as reported by CNS News, January 13, 2003). In 1991, 21.2% of expecting mothers tested positive for HIV. By 2001, the number had plummeted to 6.2%. Compare this with the 2001 numbers from Kenya (15%), Zimbabwe (32%), and Botswana (38%). All three countries focus on condom distribution, and all three countries continue to see their rates rise.

But wait, the condom advocates object. The Ugandan "miracle" is simply the result of more widespread condom use.

Not so, says Dr. Edward C. Green, an anthropologist at the Harvard University School of Public Health. Dr. Green was a strong proponent of condom distribution to stem HIV/AIDS... that is, until the U.S. Agency for International Development (USAID) hired him to study the reasons behind the success in Uganda.

The results of his research left him little doubt. "Reduction in the number of sexual partners was probably the single most important behavioral change that resulted in prevalence decline," he noted. "Abstinence was probably the second most important change" (testimony before the Subcommittee on African Affairs, as reported by Joseph Loconte).

"It is a very indicting statement about the effectiveness of condoms," he told Citizen Magazine. "You cannot show that more condoms have led to less AIDS in Africa.... I look at the data and I see that what might be called a more liberal response to AIDS — more and more millions or billions of condoms — has simply not worked, especially in parts of the world with the highest infection rate, Africa and the Caribbean."

(Source: http://www.catholiceducation.org/articles/facts/fm0045.html )

The pictures can nearly bring one to tears. Some very sad and haunting images. Very powerful.

Go to XDRTB.org to take action against tuberculosis.
Then visit ACTION.org to learn more.

Incredible, Powerful, Gripping images...

I am not surprised by the images, but nice practise of art!

These photos surely remind us that we are mere mortals in spite of how technologically advanced we are. All the statements made, address a common theme of human behaviour. It may be a high risk sexual behaviour, it may be, not following social hygiene and so on. We need to be careful in phrasing strongly worded sentences. We all are capitalizing on problems and thinking that we are working towards a solution at the same time benefiting ourselves in solving those problems. By Capitalizing I don't mean just monetary benefits but also solace, deriving satisfaction in caring for fellow beings.But we need to realize that researchers would not be paid so much if there was nothing to research on, so Dr Murray should be grateful to undeveloped nations and infections...and yes if condoms are not as efficient as compared to limiting sexual partners why is so much spent on Condoms.

RESULTS (www.results.org) has been working on the issue of TB for the past 10 years. When we started the U.S. was putting $2 million into global TB. The Lantos-Hyde Act that was passed this summer authorizes $4 billion over the next 5 years to combat TB as part of U.S. efforts to combat AIDS, TB, Malaria. Drug resistant TB is moral issue and security issue. If we do not combat regular TB properly, it turns into MDR and XDR TB and will end up in our country. Join a local chapter of RESULTS and make sure your elected officials know what actions to take to avoid the human suffering represented in these photos and protect our own nation.

These are really thick photos.I have strange feeling in my chest.

"I have been a witness, and these pictures are

my testimony. The events I have recorded should

not be forgotten and must not be repeated."

-James Nachtwey

this make me so sad :[

To S.Murray (#55) While working with numbers and population - you might be right, but from the point of view of the person which works with REAL people in need - your way of thinking is the cowardly way to hide and/or be ashamed of doing nothing to change their situation. But once you are involved you may see that a dollar, resources and prescise calcutations have little to do with what human being can do, helping to a brother/sister. Stay in the office, wash your hands regularly, enjoy your life.
Natchwey's sharp eye does not help to see some "blinds" unfortunately...
Excellentwork, James Natchwey! Thanks for visiting Siberia!

I wish TV channels would be brave enough to show such images.

Lost for word's. How sad that the world has come to this.. Best in photographic work I've seen in a long time. I am a retired Photo person...

Skin on Skeletons... #5, #11
And to think TB is so trivial in the Western World.

thanks for posting, i wish there would be a wider coverage in the media.

Guido Steenkamp
http://www.guido-steenkamp.com

sitsit

To: Yaseen (#56):

Don't worry.
The Third World will effectively exterminate itself if it continues its unchecked population growth.
And if a pandemic does occur and millions of us are piling up in the streets, I'm afraid the suffering seen in these photos will only be looked back upon as avoidable scenes in The Great Human Folly.

My grandfather died at age 50 of TB in 1934, by the way - in enforced isolation and without modern drugs. Amazing - that system actually worked.

parce qu'on nous cache ce qu'il faut voir
tous aveugles & sourds...

if you guys are so touched by this..
then DO SOMETHING ABOUT IT.
not being mean, but seriously..
thank you for reading.

Hello,
For those of you who love James Natchwey as much as I do, check out a video interview of him with CEO of NEED Magazine.
http://www.needmagazine.com/video/NEED06_Dialogue_Video.html

The picture is very haunting and powerful. The look in his eyes says it all. I like is because it's so real it's almost frightening. I get many emotions from the photo. I feel angry because there is so much technology out there that people shouldn't have to go through this, sad because he looks hopeless. Natchwey captures the essence of the moment and I think he is the definition of a photojournalist.