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World's Cruelty and Pain, Seen in an Unblinking Lens

If this were a perfect world, everybody would see the photographer James Nachtwey's astonishing shows at the United Nations and at 401 Projects in the West Village.

Sadly, as Mr. Nachtwey knows, this isn't a perfect world, a point he brings home in the work shown here. "Inferno," the title of a 1999 book of the photographs he shot in Kosovo, Rwanda and other hellholes, aptly describes the horror in these two exhibitions.

For years, in Time magazine and elsewhere, he has demonstrated the good uses to which art can be put. Since 2000, he has crisscrossed Southeast Asia and Africa, documenting the resurgence of tuberculosis related to the global AIDS epidemic. (The show at the Visitors Center at the United Nations was timed to coincide with World TB Day last Saturday.) He has also photographed the war wounded in Iraq, where he himself was injured by a grenade a few years ago, and traveled with Medevac units to field hospitals and emergency rooms.

The series of Iraq pictures, some of which were first published in National Geographic, are called "The Sacrifice." The title refers to the medics and physicians who treat everyone, including wounded insurgents. The insurgents are given goggles so they can't see and later seek out to kill the Iraqi translators helping the medics, for which reason Mr. Nachtwey doesn't photograph translators. He does photograph an Iraqi child mangled in a suicide attack: the boy is screaming beneath his oxygen mask.

The title also refers to American soldiers whose work daily forces them to play Russian roulette with roadside bombs, soldiers regularly sacrificed in the war. Mr. Nachtwey devised a collage of photos (grainy, black-and-white, shot under the fluorescent glare of military trauma centers) suggesting the choreographed chaos in which American doctors tend to failing patients. The last of the pictures, a mordant coda, shows a dead soldier on a gurney under a blanket, a chaplain's arm reaching into the frame and holding up a dog tag.

It matters not a little that Mr. Nachtwey is such an artful composer of images, that his work, although almost too painful to look at, is so graphic and eloquent. He snaps a picture just at the moment that the arms of rushing, dodging medics trading scalpels and scissors form a perfect zigzag of thrusting lines ending with a nurse pressing a fist into a patient's head wound - the punctum of the image, to borrow Roland Barthes's term. The nurse's gesture has a strangeness that carries something of the quality of grace.

He finds the same encapsulating detail, concentrated by simple geometry, in a photograph of two doctors. (You just see their arms.) They're gingerly examining the spine of a rail-thin woman with AIDS; she is sitting on the floor and facing away from Mr. Nachtwey so that only her bare left foot, leathered, turned toward the camera, reveals her advanced age. One of the doctors presses his index finger into her back - another memorable motion, subtly conveying care and dignified by the stately, condensed order of the picture.

Beauty is a vexed matter in scenes of suffering, cruelty and death. The difference between exploitation and public service comes down to whether the subject of the image aids the ego of the photographer more than the other way around. The two are not mutually exclusive.

Along with bravery and perseverance, Mr. Nachtwey's pictorial virtue makes him a model war photographer. He doesn't mix up his priorities. His goal is to bear witness, because somebody must, and his pictures, devised to infuriate and move people to action, are finally about us, and our concern or lack of it, at least as much they are about him and his obvious talents.

He finds heroes in the most woebegone spots. These are the soldiers and the doctors and the aid workers, but also the wives, mothers, children and priests who try to ease the pain of the afflicted.

In Thailand, north of Bangkok, he came across an American priest named Michael Bassano who spends endless days with the most desperate of AIDS patients, massaging their feet, changing their diapers, helping them die. Their flesh clings like cellophane to their bones, and their eyes roll up in their heads. In one photograph Father Bassano's arm just barely extends into the lower right corner of the frame, clasping the tiny wrist of a young woman named Lek. She stares doe-eyed back at him, as if from the grave.

And I hardly know what to say about three remarkable photographs of an orphaned 12-year-old Cambodian peasant named Va Ling. Barefoot, he leads a small procession down a dirt road, clutching to his chest the wedding photo of his dead 33-year-old mother, Am Nita.

Elsewhere, she is a flesh-draped skeleton on a bier, utterly unrecognizable; his head shaved, Va Ling closes her eyes for her, a gesture in which you see him grow up all at once. In the third picture, he stands before her funeral pyre, engulfed in smoke, wearing a loose white sash, a swatch of rough black cloth pinned at his shoulder. He is lost in thought.

Beside that photograph at the United Nations is a vitrine displaying the medicine that, at modest cost (about $20 per patient per month), could eradicate tuberculosis if the drugs were properly distributed and taken; but they aren't, because of corruption, politics and ignorance. With the pictures, the message is devastating.

Mr. Nachtwey's work about the war wounded in Iraq is no less haunted. Finding the most human detail amid chaos, he photographs an unconscious soldier on the operating table at the instant his wedding band is removed from his hand. He photographs Brian Price, an Army sergeant wounded by an improvised explosive device in Ramadi, wincing on a gurney, the camera focused on the name of the soldier's four-month-old daughter, Ashlynn Jaide, tattooed in script over his heart.

In a separate image a nurse lifts and turns the limp Sergeant Price over. His back has several small holes. The scene is like a Pietà. You read in the nurse's fallen face the sudden realization that the soldier's spine has been severed.

And at a military hospital in Germany, Mr. Nachtwey found Pvt. Andrew Bouwma in a coma, watched over by his stunned parents. His mother, Kandi, smiling in her University of Wisconsin sweatshirt, gently caresses his hair. His father, Jim, sunglasses perched on his head, rubs one eye and leans with his other hand on the railing of the bed for support. A chaplain's hand, extending into the picture, touches Andrew's shoulder. They're praying. It's frozen drama, like a Jeff Wall staging, but true. Breathing through a respirator, eyes shut, Private Bouwma looks heartbreakingly young.

Is this how these men would wish to be remembered? Are the pictures an invasion of privacy?

That was the Bush administration's excuse for prohibiting photographs of returning coffins. But then there's the argument made at the opening of the show at 401 by a ex-marine who lost his right arm in Iraq. (He was among a number of veterans who stopped by the gallery, a nonprofit space devoted to this sort of exceptional photographic projects, to pay tribute to Mr. Nachtwey.) The marine said he thought these pictures should be on billboards in Times Square so that everybody would know what's really happening over there, and nobody could miss seeing them.

Wouldn't that be something? Public art of real consequence and quality for a change, bringing home a war that the whole country is conducting but that only the small percentage of families in the volunteer military experience firsthand. There would be no chance to turn the page or flip the channel or skip the exhibition.

If the AIDS pictures were blown up onto billboards too, there would be no sanctuary from images like the one of the black stick-figure man in a white-walled hospital in Zimbabwe, struggling alone down a narrow, bending corridor to a shower for lack of a doctor's or nurse's help.

Nor would there be any way to avoid the photograph of Derek McGinnis, an amputee from Iraq, on Pismo Beach in California, under a leaden sky, leaning over, his head obscured behind his surfboard, so that man, prosthesis, surfboard and fin make a perfect right angle. It's an amazing image. He's a modern-day Discobolus.

That's a redemptive sight, celebrating a brave soldier who survived the inferno and made the best out of what he had left. We would prefer not to see him, perhaps, but Mr. Nachtwey calls us out in our discomfort and neglect.

The least we should do is not look away.

"The Sacrifice" runs through April 24 at 401 Projects, 401 West Street, at Charles Street, West Village, (212) 633-6202. "World Free of TB" runs through April 27 in the visitors' lobby of the United Nations, First Avenue at 46th Street, Manhattan, (212) 963-0089. (Closed on April 6.)