Living in Emergency (review)

If one of the roles of documentary filmmaking is, as Michael Rabiger asserts, to bear witness to the times we live in, then this gripping documentary is rather more successful than it sets out to be. Depicting the challenges and frustrations of four doctors working for Doctors Without Borders (MSF), it also offers a chilling vision of what lays beyond the work that they do – they are like the little boy with his finger in a dyke, holding back a tide of human suffering and despair – one patient at a time. In the face of overwhelming odds, these physicians have to retreat to the moment, to what they can do in the here and now.

The film opens with a montage of images of war, disaster and chaos. The point is made that the main task of MSF is to provide emergency medical care to nations in distress. A series of clips highlights the challenges of working in a situation where the demand is infinite, the resources limited, and the choices tough. In some areas, MSF physicians are the first to work in an area for several decades. This introduction serves to contextualize the challenges faced by the four doctors who are the main focus of the film: a dynamic Head of Mission from Italy, and Australian doctor on his last mission before retiring from MSF, and two doctors (from the USA and Australia) who are on their first missions for MSF. By focusing on these four, the film succeeds in offering viewers an insight into the motivations and frustrations of doctors at different stages of their MSF experience. Viewers are given an intimate glimpse of the inner workings of emergency rooms in Liberia and the Democratic Republic of the Congo (DRC). The cases that the doctors deal with are, in the words of one of them, “humanly abnormal and bizarre.” The bodies of these patients are inscribed with their histories, and the film is uncompromising in revealing the physical results of years of social disruption and isolation from mainstream medicine.

The film raises important questions about the work of MSF, through both its visual narratives and interviews with doctors in the field. The challenge of making seemingly impossible choices; the inevitable compromises in the standard of care which are so difficult for “a young bourgeois from a wealthy country” to accept; the heavy toll of watching people die when they could have been saved under different circumstances – all these are unflinchingly explored. The personal lives of doctors and the inevitable conflicts, frustrations and despair of trying to make a small contribution in an impossible situation are revealed in the interwoven stories of the four doctors.

By focusing on the stories behind the generally held perceptions of the MSF, the filmmaker has succeeded in demystifying the workings of the organization. One of the aims of the film is to provide an accurate picture of the work in the field to the many doctors from all over the world who apply to join every year. The fact that many doctors on their first missions choose not to sign up again, is emphasized. Of our four protagonists, only two will return to the field after this tour of duty: the Australian veteran retires after years “running on empty,” and one of the first-timers also opts out, despite intense on-camera encouragement. When the MSF free hospital in Monrovia is closed down, the Head of Mission explores her feelings of despair and frustration at not being able to respond to a human disaster appropriately due to institutional restraints. “When you come across a car crash, you stop and help,” she states. “Liberia is one big car crash.” She is recalled to the Head Office in Paris, to be deployed in another emergency zone, serving as a stark reminder that the organization cannot help everybody. A more human and optimistic view is articulated by the American first-timer who continues working with MSF: While you cannot solve all the world’s problems, you can...