Sundance 2008 Interview: Patrick Reed (Triage: Dr. James Orbinski’s Humanitarian Dilemma)

[IONCINEMA.com is proud to feature the rookie and veteran filmmakers showcased and nurtured at the 2008 edition of the Sundance Film Festival. This is part of collection of emailer interviews conducted prior to the festival – we would like to thank the filmmakers for their time and the hardworking publicists for making this possible.]

Patrick Reed

When did you first hear of Dr. James Orbinski’s story, and why did you want to make it into a documentary?
I first met James in Rwanda in 2004. Peter Raymont and I were there making a film about the 1994 Rwandan genocide and General Romeo Dallaire’s return for the 10th anniversary commemoration.

Like Dallaire, James had been based in Rwanda during the genocide, as Head of Mission for MSF; and like Dallaire, the experience of witnessing genocide while the outside world turned a blind eye understandably haunted him.

Unlike Dallaire, though, Rwanda was just one of many humanitarian catastrophes that James had personally experienced: Somalia during the 1992 civil war and famine; Afghanistan; refugee crises in Zaire; Kosovo; among others. I was curious to know why he kept going back, what compelled him, and how he was able to deal with the fall-out without be consumed by either rage or despair.

I knew James by reputation, of course, as past President of MSF when they won the 1999 Nobel Peace Prize. But at the end of one long day of shooting, I spent a few hours with him, and Producer Peter Raymont, and Gerry Caplan, an International Affairs Analyst. James was an unusual mixture of someone who was at times guarded, and at other times intensely raw and aggressively honest. I immediately wanted to find out more about him, to understand him better.

On a more personal level, I couldn’t help feel both inspired and challenged by James. When he was MSF Head of Mission during the Rwandan genocide he was only 34 years old-the same age as I when we were in Rwanda making Shake Hands with the Devil. I kept wondering what would I have done if I were in his position. Would I have gone; would I have stayed; would I have been overwhelmed?

Is there a problem making a film about Africa through the eyes of an outsider, particularly a white outsider?
There’s always a danger making a film about Africa, for instance, through the eyes of a white guy, like James. If done crudely, it can play into the dangerous stereotype that Africans are passive victims, and somehow need saving from the heroic outsider-a kind of updated version of the old White-Man’s Burden.

Before filming, James and I talked a lot about this. He kept stressing that although he was the subject of the film, the film wasn’t really about him. He didn’t simply want it to be about retracing his steps, revisiting his past; it had to be about engaging with the present, meeting with locals, using his eyes as an entry point, helping share their stories with the rest of the world.

Yes, people may watch the film because of an initial interest in James, but they should leave with images and memories of people like Lesto in Somalia, or Emmanuel in Rwanda, people who James encounters in the film. It is their story as much as it is James’.

Your films, including this one, tell very important and upsetting stories. Why do you continue to enter war zones to tell these stories?
Yes, the stories are important and often upsetting, but we rarely enter war zones. I’m not a particularly brave person, and we avoid, or at least minimize, danger wherever possible-for that reason, among others, we didn’t film in Afghanistan, even though James had been based there with MSF in the past.

There are many important and essential filmmakers and journalists who cover conflicts, and such coverage is invaluable. However, there is a tendency for media outlets to leave once there is a “sexier” conflict somewhere else, or once it gets too dangerous, or conversely once things quiet down and the “drama” is over. That’s where we, as documentary filmmakers, come in.

Often the real story is the fall-out, the lingering conflict, the forgotten emergency, and this is what is rarely covered in mainstream media.

We did some filming in Goma, Democratic Republic of Congo, for instance, specifically because it’s largely off the media radar. Over 4 million people have been killed in the region over the last decade in what some commentators have called Africa’s First World War. Despite the horrific numbers and the unspeakable atrocities that have been committed there, the Western media largely ignores the area for a number of reasons-only showing up briefly when there’s a major cholera epidemic or a volcano, for instance, dramatic images, an easy story.

What we hope to do when filming in Congo, for instance, or Somalia, or even Rwanda is both to show what happens when the media cameras leave, and also to give a different picture of a place, ideally elevating the people from mere images of despair on the evening news, and actually giving them back their humanity, by hearing their stories, and including them as “characters” in our film.

What kind of preparations did you undergo before entering a former conflict zone?
Preparations are key. It’s absolutely essential that both your crew and your main character, in this case James, feel relatively secure. Before going on shoots there is a long process of gathering information from a variety of sources about the situation on the ground-using networks of journalist, humanitarian organizations, and locals. Always checking and cross-checking sources, and always making sure your information is as up-to-date as possible since the situations in places like Congo and Somalia, are extremely fluid, with power structures and security changing day-to-day.

Contacts are essential. Dropping the wrong name, or trusting the wrong person can mean the difference between life and death.

After months of preparation, it literally came down to a last minute decision before we decided to enter Somalia. There was active fighting in the country; the borders were officially closed; the people in the transitional government who were providing safe passage were in a constant state of flux, making it difficult to know who was really in power.

Ultimately, we did our risk assessment, and in this case followed James’ lead. He was comfortable, so we were comfortable. Many times in the past as a humanitarian doctor, James had been forced to make similar situations about entering a place during a time of crisis. He kept stressing the similarity between our own determination to go in and film, and his own assessments in the past.

We made a few final calls from the airport tarmac, were further reassured, then got on our charter plane and flew from Nairobi to Somalia.

What kinds of danger did you and the crew face?
The dangers were thankfully minimal. Rwanda is a relatively safe country for foreigners, and we have lots of good contacts there. James is remembered well due to his work there with MSF during the genocide. My crew who I’ve worked with many times before in Africa, John Westheuser and Ao Loo, had both been to Rwanda with me in the past, so there was a built-in comfort level.

Eastern Congo is a dangerous, volatile place, but we had good intelligence (both from MSF and through our fixer, Moses, who was from Goma) and were able to avoid or easily defuse most tense moments.

In Somalia, we limited ourselves to Baidoa, which was rather safe, at least relative to other places in Somalia. Plus we had a number of armed guards in our entourage, which is always comforting, assuming they’re friendly, which they were.

Most importantly, we were met in Baidoa by Lesto, a former MSF employee who was a personal friend of James’. Lesto had come down to Baidoa from Mogadishu to make sure we were well taken care of.

During his time with us in Baidoa, Lesto’s residence in Mogadishu had been bombed and many of the occupants killed. He jokingly said that he was supposed to keep us safe, but our presence actually saved his life. Somalia is a strange, challenging place.

How difficult was it for you and your crew to hear these peoples’ stories and visit some of these haunting locations?
You’re so caught up in the process of the filming that it’s possible to maintain some degree of distance even during the most difficult moments.

It often hits you at the end of the day, when you return to the hotel and put the gear down. Then you rely on your crew, your friends, to decompress. Thankfully, we all get along very well-John, Ao, James, and Steve Simon, our stills photographer-and knew that we could always lean on each other for support.

Ultimately, though, you have to keep it in perspective. You’re only visiting these places. You come from a position of extreme privilege and will be returning to your families and relatively comfortable existence in Toronto.

To hear the stories and spend time with genocide survivors in Rwanda, or rape victims in Congo, or Internally Displaced Persons in Somalia, is on the one hand difficult, but on the other hand it’s an incredible privilege. These people are sharing some of their most intimate details with you, and trust you to tell their story with honesty and dignity.

It’s a rare opportunity and a real responsibility, to be embraced rather than avoided.

Throughout the film, we see Dr. Orbinski working on his book, and hear various people speaking about the importance of his writing as a means to process and deal with the events he survived. How do you think this film fits into that process?
There is an excessive emphasis in Western culture on healing-whether physical or psychic-on overcoming and moving on. What’s fascinating about Dr. James Orbinski is he consciously struggles with the most painful memories and addresses the most difficult currently realities not to lessen his burden but to share it with others, compelling us to see the world in a different way. He lives honestly, with as little fear as possible, and invites others to do the same.

Writing the book and participating in the filmmaking was for James, I think, part of this process. It was not therapeutic in the colloquial sense of the word-that is, it wasn’t a way for him to get over it. But rather it was and is a way for him honour the past, engage with the present, and hopefully transform the future.

Please expand on the film’s title “Triage: The Dilemma of Dr. James Orbinski”.
The act of triage, particularly in a humanitarian crisis, is a gut-wrenching process. You have limited resources, and an overwhelming number of people who need treatment, forcing you to make split-second decisions about who gets treatment, in what order, often forcing you to directly or indirectly determine who will live, and who will die.

As James says in the film, he doesn’t have regrets about such decisions but he has complete outrage about the circumstances that created that situation where that kind of decision had to be made.

On a much smaller scale, story-telling (such as filmmaking; or in James’ case writing his memoir) demands a kind of Triage. To construct a coherent narrative, you are forced to make difficult decisions about what goes in to the story, and what stays out-or to extend the metaphor, what “lives” through the story, or what “dies.”

It’s a creative decision but it also becomes a personal one. For instance, one of the most difficult moments during the filmmaking was spending time with young rape victims in Goma, DRC. Their stories were heart-breaking, but just as heart-breaking is the fact that their voices are not heard, their stories are not known in the West.

Perhaps it’s a conceit on my part, but I still work with the illusion that stories matter, that documentaries matter, and told in the right way, seen by the right people, it can change the way people look at the world, and ideally affect change.

In the edit suite, we were forced to leave the rape victims out of the story. It was our little act of creative “triage.” Again, nothing like what humanitarian intervenors have to deal with, but a decision that leads to silence rather than life nonetheless.

Why did you make the film? What is your message to the audience?
I initially made the film because of a personal interest in James, and a hope that through his eyes the viewer could see into another world.

It’s not a “message” film in the tradition sense. It’s not neat and tidy. It’s rugged and unresolved, intentionally so. I’m hoping the audience is challenged to at least start asking different questions about the world.