Film Review: “Living in Emergency” — On the Ground with “Doctors without Borders”

by Gar Smith
Tuesday June 01, 2010 - 03:25:00 PM

The film on Doctors without Borders will be playing at the Rialto Elmwood in Berkeley and the Opera Plaza in San Francisco, opening on June 4. 

A warning: After seeing “Living in Emergency” — Mark Hopkins’ sweeping and intimate look inside the world of Médicine Sans Frontieres (“Doctors Without Borders”) — the first thing I did was write MSF a $100 check. You may feel similarly moved. 

MSF, a 40-year-old organization that supports 27,000 volunteers in more than 60 countries, won the 1999 Nobel Peace Prize for bringing comfort to the victims of war in some of the world’s most desolate and dangerous places. While most volunteers are local, around 10% of MSF volunteers are professional practitioners who hail from Europe, Asia and the Americas. This riveting 93-minute film follows four international volunteers as they deal with the challenges of trying to save lives in war-ravaged Congo and post-war Liberia. 

Filmed over the course of two years in Liberia, the Democratic Republic of Congo, Pakistan, Niger, Kenya, Canada, the US and the MSF headquarters in Paris, the film was intended, in the director’s words, to “explore the limits of idealism” by “immers[ing] people in the MSF experience.” One of the film’s most striking images is the sign outside Monrovia’s Mamba Point Hospital that reads: “Free Hospital Care.” While the US still debates universal health care, free life-saving surgeries are available in the capital city one of Africa’s poorest countries — thanks to the volunteers of MSF. 

Dr. Chris Brashiers — a charismatic original with a pierced eyebrow and mannerisms reminiscent of George Clooney and Mel Gibson — has seen a lot during his tours with MSF. On his latest return to Liberia, the camera captures his response as his car rolls down the streets of Monrovia: “It’s nice not seeing anyone with guns,” he marvels. Brashier, an Australian now based in France, describes his discovery that “sometimes when people are poor, they’re more human.” Having experienced several life-changing MSF tours, Brashier ow finds it difficult to live in a European city where people seem to be acting out shallow, fictional masquerades instead of living anything like a real existence. “Most people in the world have a difficult time getting through the day, the week, a year,” Brashier says. “I wouldn’t have known that. Now I know.” 

There are graphic moments that go far beyond anything you may have experienced on an episode of “ER.” Amputations. A child with a head horribly disfigured by a mysterious swelling. A man whose intestines have exploded from his belly moaning as an MSF doctor, working by the flashlight, slowly massages the errant organs back inside the man’s body. 

There are apocalyptic scenes of young Congolese men waving machetes and prancing down the street holding assault rifles like dancing partners as they pop off rounds. And there are the inevitable scenes of the aftermath — a father whose ear has been shorn off by the bullet that entered his head (the doctors save his life) and the frightened boy whose arm has been nearly ripped off by a bullet (he is bandaged and comforted; his arm saved). 

The doctors are committed, exhausted, resigned, sardonic and as riveting to watch as any A-list Hollywood actor. In a world of abiding stress and anguish, small affronts and petty squabbles can flare into resentment. Chiara Lepora, a beaming, hard-charging Italian doctor and Head of Mission flies into troublespots in an attempt to solve personal disputes and winds up burying her face in her hands as personal critiques erupt into accusations and insults. “Anger and frustration are part of the process,” she observes, but it’s useless to get mad at each other: “We need to get mad at war.”  

One prevailing problem is the angst of trying to do more with always limited resources. Lepora sums up the anger and frustration of Davindra Gill, a young doctor doing his first (and probably his last) MSF stint in Liberia. She compares Gill to Col. Kurtz in Joseph Conrad’s “Heart of Darkness” and concludes: “If you put a reasonable person in an unreasonable situation, becoming crazy is the most reasonable thing you can do.” 

Liberia is bad, Lepora says, but the West Point district of the capital, is “catastrophic” (a fact the camera crew confirms with stark, gritty imagery). Still, she confesses, “not to intervene would be a criminal mistake.” Becoming a MSF volunteer comes with the baggage of tough choices, the main one being that “you can’t help everyone.” Lepora, who initially seems the most indomitable spirit in the film, begins to crack and fray. Her always-smiling face is suddenly wracked by the tremors of suppressed emotion as she struggles to explain the “nonsense” of trying to leave the battlefronts and return to another life, still knowing that “there is something that needs to be done and you aren’t there to be doing it.” “The Congo is a car crash,” she says with a tearful smile. “And there are car crashes everywhere.” 

Some of the four doctors will go on to other tours. Some will quit after their first experience. One of those who will return is Tom Krueger, a surgeon from Tennessee who calls his volunteering “a selfish thing.” He explains his discovery that “fixing other people is a way of fixing myself. I can’t fix the world but I can find a broken person and put them back together. That’s something.” 

At the end of Lepora’s tour, the community gathers to say goodbye. One young man, noting MSF’s limitations, warns against depending on “expatriates” because they will always leave you: they never choose to stay. “But MSF is not about individuals,” he adds. “It is about everyone. The work will go on.”