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Mark N. Hopkins

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Living in Emergency

Posted: 05/10/10 11:17 PM ET

Everyone thinks of making their film as an epic saga. Directors tell me horror stories of actors refusing to leave their trailer, starlets AWOL with 'nervous exhaustion'. I wonder if they think I'm lying when I talk about being stranded in war zones, dragged out of cars by machine gun, or capturing a French doctor's panic when short of supplies, he's forced to drill a dying man's skull with the wrong equipment. Then watching the doctor in a militia drinking hole break out the beers in celebration, as he finds out the old man recovered. And that's before the real sticky moments as a director -- trying to persuade people that you weren't about to hit them with another pious do-gooder film, because yours is... well, it's about Doctors Without Borders.

'We've said no to everyone else, why say yes to you?'

When I set out to make the film, it never occurred to me Doctors Without Borders would be anything less than delighted at my interest. I tried not to let it show on my face when they told me, very politely, I was the 26th filmmaker to have this bright idea. And as for being embedded with them, I was politely shown the door.

I wouldn't back down. Nor would they. The average Frenchman likes a lively debate, let alone the great intellectual renegades that have reshaped the face of humanitarian action. Several dozen bottles of wine later, after they'd put me through a test shoot in the Sahara (complete with bouts of severe dehydration), they granted us access. Unsure by now quite what we'd signed up for, we were off to the Congo with a bewildered crew and Chris Brasher MD, a punk rock doctor with a pierced face as our guide.

'You can't be told what the field is; you have to see it for yourself.'

Our first night in the Congo, we flew a rattling plane (that crashed 10 days later), filmed on no sleep, paid local thugs for a 'film permit', got back for curfew as armed militia circled the town, were given a security update containing the phrase 'forced evacuation', and then the drinking really began.

Having spent time growing up in Kenya, I felt I'd be somewhat immune to African culture shock. I was wrong. As we were beginning to grasp, we'd entered a sort of different dimension -- this was so much more intense, more fascinating, more fun, and more tragic -- all at the same time - than any of us could have imagined. Patients arriving in wheelbarrows, 'bushmeat' for lunch, a man with no scrotum seeking help, a UN general inviting you to tea, a rebel leader the same, all in a dizzying few hours.

The film's structure remained the same; several characters combining to form one story arc until the viewer gets a sense of what life is like in the field -- the thrilling/harrowing intensity of life on the medical front lines. A life committed to the principle of doing a thing for the thing itself.

We followed the doctors to Liberia, Pakistan, Malawi, Paris, Liberia again, Kenya, etc., taking helicopters with patients in one place, dancing on car roofs in another. 500 hours of footage later, so tired a day in Doha airport failed to register, we headed back to New York. Now all we had to do was to try and encapsulate this indescribable experience. Months of editing later, we arrived at our first rough cut.

'Where's the hope?'

Early rough-cut screenings were not a success. Having come for a Doctors Without Borders film, our poor test audience were expecting a hug-it-out 'message moment'. Trouble is, Hollywood messages don't fit the world of front line emergency medicine. Instead, life-affirmation comes from something unspoken but more powerful -- the decision to leave one's life path, the safety of home, for the genuinely dangerous, $14-a-day, psychological and physical minefield.


The 'moments' the film does show, are the times where these doctors realize what they do best. Their practice of medicine, which is reaching people who often don't expect help, let alone treatment. Two billion people do not have access to a doctor. So the doctors practice for it's own sake -- the patient in front of them. Hope in the typical "cause" film sense, would ring false. After watching the test screenings, we knew we had to do a better job of condensing the essence of that experience.

Because the film, and the environments it depicts, are not without hope. They're a reflection of the real world, beyond the one in which you can buy a movie ticket to see this film. It's our expectations of easy hope that don't match the front lines.

So back into the cutting room we went. This time, we focused on the life-force driving these doctors. The work hard, play hard, in the face of insurmountable need; the soldiering on. More rough cuts, more months, more screenings, until finally, one day, we were done. What shone from these doctors, as they channeled Florence Nightingale and Keith Richards was most of all, their commitment. In its own way, hopeful.

Living in Emergency: Stories of Doctors without Borders opens nationwide in select cities June 4th.