Very strong message. The cold bars and weathered hands add to the feeling of years of sadness. Would have liked it to have been a bit sharper, to really get the texture on those hands out.
Wow.
Those hands look scarily human, which gives this photo a whole new level of effectiveness. Think the tight crop is a good idea as it forces you to confront it. Shame it's not a little more in focus.
Still very thought provoking.