Out of darkness: A photo story
Fighting hepatitis C in Ukraine
Millions of people in Ukraine continue to suffer silently through the pain of hepatitis C. Around five percent of the population live with the disease, many of whom remain untreated due to a historical lack of access to affordable treatment and diagnosis.
In Ukraine, MSF began offering hepatitis C treatment in people who are co-infected with HIV in the Mykolaiv region, in the south of the country, in 2017. People who formerly injected drugs or are on opioid substitution therapy and healthcare workers infected with hepatitis C also receive treatment.
Ukrainian photographer Aleksandr Glyadyelov spent several weeks in Mykolaiv with people living with hepatitis C, exploring their stories and the daily burden, suffering and hope of those affected by the disease.
Follow the MSF Exposure story and some of the stories from the project.
Photograph by Alexsandr Glyadyelov
Ihor Skalko, 53, is a lawyer living in Ukraine. He was diagnosed with hepatitis C 11 years ago. “I do not know when I got infected with hepatitis C. I got tested out of curiosity. After testing positive in 2007, I immediately tried to forget about it. Because I knew that there was no access to treatment in Ukraine.”
Photograph by Alexsandr Glyadyelov
Ihor and his wife Oleksandra.
Photograph by Alexsandr Glyadyelov
Since 2005, Ihor has been working as a lawyer for Time of Life, a charitable organisation which specialises in supporting people living with HIV.
Photograph by Alexsandr Glyadyelov
Ihor shops at the market.
Photograph by Alexsandr Glyadyelov
Ihor, as a lawyer of Time of Life, reviews the case of Angela who had not been provided with medical care in a penalty facility and had her leg amputated as a result.
Photograph by Alexsandr Glyadyelov
Ihor takes his hepatitis C medication.
Photograph by Alexsandr Glyadyelov
Ihor sees a tuberculosis doctor.
Photograph by Alexsandr Glyadyelov
Ihor reviews the case of Angela.
Photograph by Alexsandr Glyadyelov
Ihor at his home.
Photograph by Alexsandr Glyadyelov
Ihor and his wife Oleksandra cook borsch at home.
Photograph by Alexsandr Glyadyelov
Ihor at his home.
Photograph by Alexsandr Glyadyelov
Kostiantyn Dymynchuk, 47, graduated from college and was trained as a metal worker and an operator of multiple types of equipment. However, his life took a different path. He started using drugs and then went to prison. Here, together with his colleague, he explains to people who were recently released from prison the optimal ways are to be admitted into a rehabilitation center.
Photograph by Alexsandr Glyadyelov
Kostiantyn in church Primireniye s Bogom (Reconciliation with God).
He preaches in penal facilities and works in construction, mounting plastic insulating glass units. He has three grandchildren.
Photograph by Alexsandr Glyadyelov
Kostiantyn thinks he contracted hepatitis C in 1996. He was formally diagnosed in 2008. Since then he started to seriously look after his health.
Photograph by Alexsandr Glyadyelov
Iryna Parakhonko is a 52-years-old nurse who graduated from the Kyiv medical post-secondary school. She found out she was infected with hepatitis C in 1999.
Photograph by Alexsandr Glyadyelov
Since 2003 Iryna has been the president of Time of Life which specialises in supporting people living with HIV. Since 2005, she has been a member of the regional and city coordination councils tackling HIV/AIDS in Mykolaiv.
Photograph by Alexsandr Glyadyelov
Iryna and her daughter Rita.
Photograph by Alexsandr Glyadyelov
Iryna at home after taking her hepatitis C medication.
Photograph by Alexsandr Glyadyelov
Andrii Konovalov found out that he was HIV-positive when he was 24. For the next 10 years Andrii was ready to die at any moment. A meeting with an MSF social worker in 1999 radically changed his attitude towards his life. Back then, MSF was running a medical and social support programme for people living with HIV/AIDS in the Mykolaiv region.
Photograph by Alexsandr Glyadyelov
Andrii received treatment for hepatitis C in a free treatment programme in 2015. However, the treatment was very difficult because of the side-effects. Now he uses his experience of battling the disease to help other patients in the MSF programme, where he has been working as a peer educator since October 2017.
Photograph by Alexsandr Glyadyelov
“The MSF programme uses new drugs which do not have such severe side-effects. Patients can tolerate this treatment much better. But they still need support and I do my best as a peer educator to provide it. I can tell that people trust me and I see how important it is to support a person during the tough times in life,” Andrii says.
Photograph by Alexsandr Glyadyelov
“Living with HIV, I didn’t pay any attention to the problem of hepatitis C. It was only after the death of my cousin from liver fibrosis that I became interested and did some research on the development of hepatitis C in the body," says Andrii.
Photograph by Alexsandr Glyadyelov
Andrii in MSF's Patient Support, Education & Counselling (PSEC) room.
Photograph by Alexsandr Glyadyelov
Andrii Konovalov at work.
Photograph by Alexsandr Glyadyelov
Andrii takes a viral load test.
Photograph by Alexsandr Glyadyelov
Olena Melnikova, 42, has been acting-director at the Mykolaiv department of the Ukrainian charitable organisation, All-Ukrainian network of people living with HIV, since its foundation in 2003.
Photograph by Alexsandr Glyadyelov
Olena and her boyfriend Aleksandr.
Photograph by Alexsandr Glyadyelov
Olena speaks with an MSF peer educator outside of MSF's clinic in Mykolaiv.
Photograph by Alexsandr Glyadyelov
Olena was diagnosed with hepatitis C in 2007. She had been living with HIV since 1999.
Photograph by Alexsandr Glyadyelov
Olena in the Mykolaiv branch office of charitable organisation, 'All-Ukrainian network of people living with HIV’.
Photograph by Alexsandr Glyadyelov
“When the first free programmes of hepatitis C started, it was very difficult to get selected. What scared people away was the difficulty of the treatment with all its terrible side-effects. Diagnostics of hepatitis C are another issue as there are no rapid tests available. Diagnostics are very expensive, not everyone can afford them,” says Olena.
Photograph by Alexsandr Glyadyelov
Olena has a meeting with her colleague from a non-governmental organisation.
Photograph by Alexsandr Glyadyelov
Olena in a session with a MSF peer educator in the Patient Support, Education, Counselling (PSEC) room.
Photograph by Alexsandr Glyadyelov
Olena in the Mykolaiv branch office of charitable organisation ‘All-Ukrainian charitable organisation All-Ukrainian network of people living with HIV’.
Photograph by Alexsandr Glyadyelov
MSF peer educators talk with Olena.
Photograph by Alexsandr Glyadyelov
Olena receives hepatitis C medications.
Photograph by Alexsandr Glyadyelov
Viktoriya Kuznetsova, 45, has been a social worker for ‘Time of Life' (a charitable organisation which specialises in supporting people living with HIV) since 2014. Viktoriya has previously used drugs and served time in prison. Her HIV status was confirmed in 1996 and she was diagnosed with hepatitis C in 2001.
Photograph by Alexsandr Glyadyelov
Viktoriya started evening classes to prepare for national tests, as she wanted to go to university and get a degree. She also had a full-time job. Since last year she worked hard in her studies and managed to pass the national tests.
Photograph by Alexsandr Glyadyelov
Viktoriya, as social worker for 'Time of Life', holds a consultation with a patient who is beginning treatment with antiretrovirals.
Photograph by Alexsandr Glyadyelov
Viktoriya at her workplace.
