Stephen Ginn: Living in emergency

Stephen GinnThe RSM’s Global health and human rights film club launched on 8 September 2011 with a screening of director Mark Hopkins’ Living in Emergency.

Filmed in the war zones of Liberia and Congo it follows four volunteer doctors providing emergency care under the aegis of Médecins Sans Frontières (MSF). The film’s urgent title is borne out by its content. The doctors work in chaotic overcrowded clinics, there is limited diagnostic equipment, and often they have sole responsibility for the lives of all the patients they treat. 

The stress of this situation runs through every frame and every line of dialogue. “The demand is pretty much infinite,” says Dr Christopher Brasher. “It’s just a matter of choosing what you can do.” The film shows that the inadequacy of what MSF’s doctors can offer is in direct contrast to the enormity of the task with which they are faced.

Brasher, a veteran of several conflicts, wants out but wonders where he should now call home. American surgeon Tom Krueger works in Monrovia’s only emergency hospital and is on his first assignment, having grown disillusioned with the contribution he could make at home. He appears to cope the best, but struggles to live with his inevitable mistakes.

Davinder Gill, 26 years old and working in remote bush, is overwhelmed and exhausted by his responsibilities. His irascibility makes him the most compelling character, his frustrations leaving him unguarded in front of the camera. Perhaps inevitably Chiara Lepora, the head of the Liberia mission, compares him to Conrad’s Kurtz, driven mad by the insanity that surrounds him. Like the majority of MSF doctors who never make it beyond one 9 month mission, Gill is unlikely to volunteer for a second time.

When conflicts end, healthcare needs remain and the film sensitively shows how difficult it is to leave. Also here are the gore, personal conflicts, and difficult compromises that day to day MSF work entails. This is no recruitment film for MSF, but a forceful character study of people close to their emotional limit.

It’s a shame that it couldn’t have gone a bit deeper, as its subjects’ back stories remain untouched. A more serious omission is the total lack of any local viewpoint on MSF interventions or volunteers. Without this, their suffering becomes a mere backdrop for the disillusionment of Western idealists.

Stephen Ginn is the BMJ editorial registrar.

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