Shedding light on unseen wounds

Published on 01/08/2023

Martin Vogt is not a trained medical doctor. But when the 40-year-old pharmaceutical scientist from Novartis takes his camera, he handles it like a surgeon’s scalpel to understand the inner workings of some of the world’s most precarious healthcare systems.

“I want to go beyond the naked facts and figures and understand the personal struggles healthcare specialists have in a challenging social environment,” Vogt says. “Ever since my studies as a chemist, I was always drawn to medicine and science, and my passion for photography leads me there too, almost naturally.”

Vogt started photography as a hobby a few years back, but quickly moved beyond the amateur stage, winning prizes and public recognition for his work, which often takes him to distant, sometimes remote places, where he likes to focus his lens on doctors, patients and healthcare workers.

In 2017, he traveled to Zambia and in the same year went on a longer trip to Mongolia to document the hospital and healthcare stations in these countries, which are both suffering from financial stress, weak infrastructure and a dearth of healthcare specialists (see also live magazine 2/2019).

His camera is essential for his travels. His most important asset, though, is his willingness to engage and empathize with people and get to know his models more intimately. He loves to take all the time necessary to connect with locals and gain their trust to accompany them in their most private moments.

For his 2019 trip to Georgia, where he visited a series of hospitals and clinics in the capital Tbilisi, among other places, he conducted several hours-long interviews with doctors, nurses and clinic staff to move beyond the mere surface reality and capture the genius loci of the place.

Georgia, which borders the Black Sea to the West, the Russian Federation to the North and East, and Turkey and Armenia to the South, has gone through a turbulent period over the past 30 years, marred by civil war and armed conflict with Russia, its former partner in the Soviet Union.

The protracted period of unrest culminated in 2008, during the short but intensive Russo-Georgian war that was fought over the control of two separatist regions. Since that time, the political situation has stabilized somewhat and the economy has improved.

However, the jobless rate is still at a staggering 12 percent and the country’s healthcare system, which went through difficult times too, is still off its goal to provide universal healthcare for the country’s roughly 3.7 million citizens.

Aware of the war-torn past and the economic hardship, Vogt expected grim vistas of disillusionment when he arrived in Georgia in February 2019. “Honestly, I imagined taking pictures of the remains of Soviet-era healthcare buildings. However, what I found was a healthcare system that, on the surface at least, looked very much like our own. Only when I started to talk to the people and learned more about their history did I actually see the underlying challenges,” says Martin Vogt.

Among the places Martin Vogt visited was the Rustavi Mental Health Center in Tbilisi as well as half a dozen doctors in regional hospitals and universities. He also talked to several leading industry figures, including Grigori Pirtskhalaishvili, who, among other things, works as a consultant for Novartis Social Business and helped Vogt navigate the Georgian healthcare landscape and establish contacts on the ground. Another important door opener was Michael Kangas, director for regional partnerships at the Novartis Institutes for BioMedical Research.

While all of his meetings left a mark on Vogt, one very intimate encounter was with Dr. Guga Kashibaze, a plastic surgeon and Head of the Burn Center at the Simon Khechinashvili University Hospital in Tbilisi, as well as his mentor, 90-year-old Prof. Besik Iashvili.

“Guga Kashibaze was a very impressive figure,” Martin Vogt recalls. “His stern and fixed expression, his idiosyncratic moustache that made him look almost like a hipster, were the outward marks of an extraordinary man intent on helping people.”

Martin Vogt was able to document Kashibaze’s work in the surgery ward, where he treated a girl with severe burns. After the intervention, Martin and Guga sat together to talk about the surgeon’s professional experience, the challenges of his daily work and the shadows of the war that still haunt him at times.

“In the 1990s, when I was pursuing my career in medicine,” Kashibaze said, “Georgia was in a very difficult position. The Soviet Empire had collapsed. Instead of a bright, free future, the country fell into crisis mode, leaving many people without a job and without hope. Many friends of my generation have not survived this time. Personally, I found strength in medicine.”

Kashibaze’s will to help others kept him sane during the wild transition years. It also partly prompted his decision to specialize in surgery for burn victims in the mid-1990s, joining the team of Besik Iashvili.

Iashvili, who is often described as the father of combustiology in Georgia, had studied in Moscow and later came back to Tbilisi to set up the Burn Center, which he expanded and modernized with the help of foreign sponsors. His move was timely. By the early 1990s, the country had sunk into one of its darkest periods. Violence was rife and led to a rise in the number of burn victims.

Although Iashvili has stopped performing surgeries due to his advanced age, he often visits the Burn Center. He also arrived on the day Martin Vogt held his interview with Kashibaze. When he joined the two, Iashvili told Vogt about the institute’s past and the difficult transition years, when the hospital had to be heated with firewood.

He was also full of praise for Kashibaze. “Guga grew up in front of my eyes to become a great professional, the best of his generation,” Iashvili said, adding that he likes to exchange views with Guga regularly and learn about new treatment methods that can improve outcomes at the Burn Center.

Guga, who blushed at the solemn praise, remained quiet, all the while keeping his concentrated demeanor that reflected the huge physical and psychological strain after the long operation. Vogt wondered how he coped with the stress. “One way to regain my balance is mountaineering,” Guga Kashibaze said. “I love sports that give you adrenaline kicks. I love to climb steep and craggy hills, but am also fond of paragliding. But at the same time, I have a very meditative side. I like to paint and am a big fan of graphic design,” he said.

As the interview neared its end, Martin Vogt asked whether Guga would now go back to his office to calm down a little bit. “I have no office. My office is the operation room,” he replied.

After the week-long trip, Martin Vogt needed months to peruse the material and select the most powerful pictures and stories, a process that is still ongoing.

One episode, however, immediately stood out from all the rest: It was Guga Kashibaze’s account about the Russo-Georgian war, when he had to treat not only his Georgian compatriots but also two Russian pilots who had been downed during the conflict and had suffered severe burns when their planes crashed.

“It was a difficult moment, of course,” Guga Kashibaze said. “But during the entire surgery I never had any second thoughts about my duty. In the operation room, the pilots were patients in pain who needed my help and undivided attention, even if their attacks could have killed me and my family.”

Martin Vogt was deeply impressed. But such are the stories of war and the private moments of heroism, which rarely make headlines and all too often remain buried under the crushing data of any armed conflict.

To find such personal stories and to document them is important. They not only deepen our understanding of our complex world, but can also offer a form of healing by exposing hidden wounds.

To know about people such as Guga Kashibaze through the pictures of Martin Vogt is to feel connected to a world where the forces of science and reason reign supreme and healing is always a possibility, irrespective of the hardship and tragedy.