MOSCOW -- Nikita, a 33-year-old former television sports commentator dying of tuberculosis, seeks consolation in the upward mobility of his disease.
"Five years ago, when I was diagnosed, most of my fellow patients were homeless people, old bums and ex-prisoners," he whispered from his one faltering lung. "But now there are a lot of younger, better educated people like me. There is even an infected doctor here."According to research released in Moscow Wednesday by three international health organizations -- Medecins sans Frontieres, Merlin and Public Health Research Institute International -- one in seven Russians will be infected with TB by 2010, unless the epidemic is arrested.
As Russia's 20th century medical progress is reversed by its rapid economic degeneration, the medical scourge of 19th century Europe is making a terrifying comeback in a dangerous drug-resistant form.
The antiquated penal system is the main reason for the epidemic. Ten percent of Russia's 1 million-prison population are infected with TB. A third have developed multi-drug resistant TB (MDR TB), which is harder to treat.
"Our cramped and dirty prisons are perfect TB incubators," said Dr Anton Zarbuyev, deputy head of the anti-TB unit in Ulan Ude, southern Siberia, which has one of the highest rates of infection.
"Infected patients are not diagnosed quickly. Even when they are, they are not always isolated from their fellow prisoners, so the disease spreads rapidly. This is a public health disaster we are failing to control."
When they leave prison -- either at the end of their sentences or on compassionate grounds if they are dying -- they spread TB to the general population. The average TB sufferer infects 20 people a year.
Zarbuyev's wards are a vision of hell, faces frozen in pain as patients retch blood. Funds have run out and he cannot buy basics such as syringes or aspirin, let alone more sophisticated drugs.
Scripps Howard News Service