Help on what went wrong here !

[kamboura]

Hi All,
I am looking for your help on this picture.. As you can see, it didn't come out anywhere near what I wanted. I can guess on some of the issues, but I wanted to get a few more opinions from you.

I am using "vintage" equipment. This picture was taken with a Sakar (probably maker of Vivitar lens), Macro Lens 75-200 f4.5, with 2X converter. Handheld at 1/500, don't remember the f-stop, probably the equivelant of f/6. Manual focus camera.

Other than the no flash issue, what else is wrong here? Is it out of focus, is the lens dirty, is there camera shake?, is the lens combo just too old or too cheap to get me a discent picture? Help please.