Ebola, malaria, cholera and HIV. Names which appear so distant, in time and space. Names which sometimes appear on the news or in brief articles. Malaria and tuberculosis: diseases which don’t concern us, associated with far-off Countries, poverty stricken and corrupt, with few hospitals and little interest for human life. Diseases which afflict Africa and Asia. Not us. We are the first world, where everything works well. We are rich, happy and above all, indifferent. We have too many holidays and too many, often useless, items to buy.
Then, suddenly, nature, or maybe some obscure sense of justice, puts us on a par with the others, those living so far away. The poor people. And so, we discover that we have too few hospitals as well, we don’t have vaccines, and people die alone, just like they lived. No reflections. No thoughts on the idea that all men are equal.
In 2018, 228 million cases of malaria were registered. The number of deaths? Over 405,000, of which 67% were children under the age of five. Not many know that malaria is the primary cause of infant deaths. Malaria is transmitted by infected female mosquitoes feeding off blood. They come out at dusk and during the night. The disease’s symptoms are fever, pain, vomit, convulsions and coma. 90% of cases are registered in Africa. It has taken over 30 years of research to find a vaccine, which however is not giving great results. The attempt to use insecticides to stop mosquitoes propagating has merely increased the parasites’ resistance. In 2019, Burundi counted almost 8,500 cases out of a population of 12 million.
In Italy, the disease was endemic in many regions until 1950. It is a memory of the past, of a battle which endured nearly 50 years. I documented malaria in Congo, in Kindu, where on 12 November 1961 a group of Italians belonging to a UN mission were murdered. A local elderly man remembered the incident and told me they thought the men were Tshombe mercenaries. He said he was sorry. In Kindu, enormous Russian aviation vehicles land and take off. The drunk pilots load and unload giant cases before disappearing into the skies.
In 2017 there were an estimated 10 million cases of tuberculosis (TB) in the world causing over 1.7 million deaths. One million children were sick with the illness, 230,000 of them died. Every hour in Europe 30 people are diagnosed with the disease and in Italy there are approximately 4,000 cases.
In the last century it was considered a stigma. In actual fact, TB, or Koch’s bacillus, is the poverty disease par excellence, breaking out in places with poor sanitary conditions and a lack of diagnostic equipment and treatment. TB is one of the world’s major causes of death and is transmitted via the oral cavity and/or saliva droplets. Patients are forced to live months of isolation in sanatoriums, as I documented in Uzbekistan. Places of boredom and solitude. The hours never going by, and the memory of one’s loved ones hanging framed in a photograph.
Also known as “the subtle evil”, Giovanni Verga wrote about malaria in one of his short stories contained in “Novelle Rusticane”, as di Tomas Mann in “The Magic Mountain”. It has also been glorified in operas: Manon, La Traviata, La Boheme. Chopin died of malaria at just 39. The disease has been propagating for 2500 years.
It is estimated there are 38 million people in the word living with the HIV virus. Of these 1.7 million are children. In 2018, 770,000 victims were registered. While the virus exploded in the 1980s the disease already existed, but its symptoms were confused with other syndromes. The fact that it manifested itself in homosexuals and people making use of heroin meant that some saw it as a divine punishment. Others went even further, suggesting that it had originated in a secret laboratory which had lost control of it. Initially a deadly disease, HIV was considered a pandemic, and while in 1986 a combination of medicines which stopped it was discovered, contagion still cannot be prevented.
The death of famous people, the first of whom was Rock Hudson, followed by Freddie Mercury and Isaac Asimov and others, brought the virus’s danger to the forefront and stimulated research. Currently a vaccine does not exist, although it would be helpful. The misconception that one can recover from HIV continues to cause contagions throughout the world. The most dramatic situation can be found in Africa: Kenya, Nigeria, South Africa and Tanzania are the worst hit countries. The cause of this? Social inequality, abandonment, ignorance and exploitation. Nigeria is one of the richest countries in terms of oil production, yet it is also one of the poorest countries in the world.
Transmission of the virus from mother to child has caused the number of orphans here to increase to 15 million, 90% of the world’s total. Following the fall of the Berlin wall, the virus spread to Russia and in 2018 the number of infected reached the dramatic total of 1.2 million people, prevalently young people.
In Europe infection has continued to increase: the idea that it is possible to recover, the absence of rapid diagnosis and the media’s and governments’ indifference have generated a false sense of security which then develops into carelessness. In Uganda I saw how people die, how devastating the disease is and the ferociousness with which it attacks, especially women and children. On that occasion, for the first time, I thought how useless my job was and how little my photographs could do to help.
I understand that my journey into the diseases of others will never end. Humanity, like Sisyphus, will continue to roll the boulder to the top of the mountain, only for the boulder to roll back down again. I have visited places where people’s expectations are not a holiday, a beach, or going out for drinks and dinner. Their expectations are solidarity, justice and a redistribution of resources.