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“Living in Emergency quickly takes on an emotional / dangerous / enraging quality that rivals only The Cove in its scope and complexity, and completely blows it out of the water with its topic and tone… By allowing filmmakers in for the first time, MSF has given director Mark Hopkins the opportunity to create both a calling card for the work that Doctors Without Borders does, and a cautionary tale about what it means to really help in a world that is teeming with outstretched hands.”

—LAist, November 29, 2009

Summary

For the first time ever, MSF gave a documentary crew uncensored access to its field operations. Set in war-torn Congo and post-conflict Liberia, “Living in Emergency” interweaves the stories of four doctors as they struggle to provide emergency medical care under extreme conditions. Two volunteers are new recruits: a 26-year-old Australian doctor stranded in a remote bush clinic and an American surgeon from Tennessee trying to cope under the load of emergency cases in a shattered capital city.

Two others are experienced field hands: a dynamic head of mission, valiantly trying to keep morale high and tensions under control, and an exhausted veteran, who has seen too much horror and wants out. Amid the chaos, each doctor must find their own way to face the challenges of the work, the tough choices, and the limits of their idealism.

2010 Oscar Consideration

The Academy of Motion Picture Arts and Sciences announced that "Living in Emergency: Stories of Doctors Without Borders" was shortlisted as one of 15 films in the Documentary Feature category for the 82nd Academy Awards®.

MSF Projects

"Living in Emergency" saw MSF doctors in post-conflict Liberia and war-torn northeastern Democratic Republic of Congo. Following are summaries of the contexts featured in the documentary and information on recent MSF activities.

Liberia

MSF has worked in Liberia since 1990. A 14-year civil war ended there in 2003, but many Liberians still live in crushing poverty, and the health sector cannot provide adequate care. Women and children are particularly vulnerable.

In “Living in Emergency,” MSF Head of Mission in Liberia Dr. Chiara Lepore announces the hand-over of MSF’s project in Mamba Point Hospital in the capital, Monrovia, to the Liberian Ministry of Health. Starting in 2006, as the country began moving towards greater stability, MSF handed over several of its projects, most to the health authorities. Also in the documentary, Dr. Tom Krueger performed surgeries in Mamba Point Hospital and Dr. Davinder Gill was in charge of the MSF clinic in Foya, a remote area in the northwest of the country.

Today, the incidence of sexual violence remains high in Liberia. In Benson Hospital in Monrovia, MSF provided medical and psychological care for victims of sexual violence, treating more than 880 rape survivors in 2008, before handing the project over to Think, a local NGO. MSF still provides technical and material support.

As of 2009, MSF continued to provide free access to health care in Island Hospital, a pediatric facility in Bushrod Island in Monvrovia. Care was focused particularly on mothers and children, including malnourished children with medical complications, as well as on integrating care for chronic diseases such as HIV/AIDS and tuberculosis (TB), and sexual violence. In 2008 MSF teams helped deliver more than 3,900 babies and total admissions exceeded 12,600. MSF also helped provide primary care in two centers run by the ministry of health in Clara Town and New Kru Town. Teams supported a range of services for mothers and children, such as antenatal and postnatal care, vaccinations, and prevention of mother-to-child transmission of HIV, as well as treatment for sexual violence. Together the centers provided more than 122,300 consultations in 2008.

In 2009, MSF was managing a health center in Saclepea in Nimba County, northeastern Liberia. Plans are under way for handing the project over to the ministry of health, but in 2008 the center conducted more than 3,000 outpatient consultations. More than 100 people took advantage of free anonymous tests for HIV. MSF is also collaborating at the center with the ministry of health, the center for Research and Field Epidemiology (Epicentre), and the Drugs for Neglected Diseases Initiative (DNDi) on a study aimed at making artemisinin-based combination therapy (ACT) available for malaria sufferers throughout Africa.

Approximately 80 people with Lassa hemorrhagic fever were admitted to Saclepea’s special hospital unit for treatment in 2008. The fever is deadly if not treated quickly with ribavirine, a costly medicine protected by a pharmaceutical monopoly. As part of its 2009 withdrawal from Saclepea, MSF was trying to ensure that ribavirine becomes affordable in Liberia. Teams are also lobbying health officials for continuity of care for HIV-positive patients after the withdrawal. It has now been agreed that HIV-positive patients will be able to receive treatment at Ganta hospital in northern Nimba County, and that screenings for HIV and TB will continue in Saclepea.

MSF is also lobbying for consistent implementation of free health care throughout the country.

• Read more about Liberia
• Report - Shattered Lives: Immediate medical care vital for sexual violence

Democratic Republic of Congo

The “Living in Emergency” crew filmed in Beni and Kayna, two towns in North Kivu Province, in northeastern Democratic Republic of Congo (DRC), an area that has been in conflict for years. MSF veteran Dr. Christopher Brasher was filmed at the MSF project in Kayna hospital in 2005.

Today, the violence in North and South Kivu provinces, and beyond, continues. Civilians were directly targeted in 2009 during violence between the DRC military and the Democratic Forces for the Liberation of Rwanda (FDLR) rebel group. Many were killed or injured, or became victims of sexual violence. Hundreds of thousands fled their homes attempting to escape the fighting.

In the Kivus, MSF carried out nearly 300,000 medical consultations in the first half of 2009, and treated 2,800 victims of sexual violence. The only international humanitarian organization performing surgery in North Kivu, in Rutshuru hospital, MSF performed an average of 12 emergency surgeries per day. During a mass vaccination campaign for measles in Masisi district in October, seven sites operated by MSF came under fire by the DRC military. Some 165,000 children were vaccinated, but the thousands of people gathered at the sites with their children had to flee the fighting.

At the end of 2008 into 2009, Ugandan rebel group the Lords Resistance Army (LRA) unleashed merciless brutality on civilians in Haut-Uélé and Bas-Uélé provinces, also in northeastern DRC, following military attacks by the Ugandan and Congolese armies. Villages were burned, people attacked with machetes and clubs, and children abducted.

People fled by the hundreds of thousands, with many crossing into camps in Uganda and in Southern Sudan, where existing MSF teams set up emergency medical care. In addition to performing surgical interventions on those wounded in the fighting, MSF teams in northeastern DRC also provide more than 9,000 medical consultations per month in hospitals and health centers; this includes obstetric care, treatment for malnourished children, and vaccinations—in the Dungu area of Haut-Uélé, MSF vaccinated 20,000 children against measles in August. About 16,000 displaced people received relief items from MSF between January and October. Teams also offer mental health services and run a program for children who were abducted by armed groups in Faradje, Haut-Uélé Province.

MSF Staff

The following MSF staff were featured in "Living in Emergency":

Dr. Christopher Brasher worked for nine consecutive years from 1996 to 2005 with MSF. He served as: an anesthetist in war-torn Burundi; head of mission for four projects in Angola; emergency coordinator during conflicts and epidemics in Sierra Leone, Mozambique, and Eritrea; and then as program manager responsible for activities in Armenia, Congo, Colombia, Georgia, Niger, Malawi, Sri Lanka, and the country of his first assignment, Burundi. Taking a break after nine years of field work with MSF, Dr. Brasher currently holds a fellowship in pediatric and obstetric anesthesia at the Hôpital Robert Debré in Paris. Along with his training in surgery and anesthesiology, Dr. Brasher also earned a diploma in tropical medicine from the London School of Hygiene & Tropical Medicine. He has contributed to multiple articles in the Lancet, Journal of Tropical Pediatrics, and Transactions of the Royal Society of Tropical Medicine and Hygiene.

Dr. Tom Krueger is an American surgeon who closed his private practice of 20 years in Springfield, Tennessee, in order to work in humanitarian crises with MSF. He was sent to post-conflict Liberia where he performed more surgeries in two months than he ever had in six months in a U.S. hospital. Since that first assignment, Dr. Krueger has worked in three other crisis zones. In Nigeria, he set up a trauma hospital. In Darfur, Sudan, he was chief of surgery in a hospital serving 120,000 displaced people. When the conflict in Sri Lanka reignited in 2007, Dr. Krueger left on a moment’s notice to treat the war injured. In the U.S., Dr. Krueger has returned to private practice at the Southern Hills Medical Center in Nashville, Tennessee.

Dr. Chiara Lepora is an Italian toxicologist from Alice Castello, who has been working with MSF for several years. Her most recent MSF missions were to Sudan and Somalia. She planned to start a post-doctoral fellowship at the National Institute of Health, the world's largest research hospital, in 2009.

Dr. Davinder Gill, an Australian doctor from Adelaide, was completing his studies in pediatrics in Australia in 2009. His assignment to Liberia was his first with MSF, and he has not been on any assignments since.

Filmmaker and Producer

Mark Hopkins, after graduating from high school in the UK, attended Georgetown University where he majored in Philosophy. During this time he spent eight months in Vietnam studying history and teaching English at the University of Hanoi. Mark’s film career began as an assistant to New York-based producer Scott Rudin, working on such films as: “The Truman Show,” “A Civil Action,” “Bringing Out The Dead,” “Angela’s Ashes,” “Sleepy Hollow,” “Wonder Boys,” and “Shaft.” He left to start an independent production company, with the aim of focusing on non-fiction storytelling. In 2001, Mark began working with documentary director George Butler, helping to develop and produce his films. The association began on the award-winning documentary “The Endurance: Shackleton’s Legendary Antarctic Expedition,” followed by “Roving Mars,” and included a series of shorts directed by Mark for Columbia Tristar Home Entertainment. He later went on to produce George Butler’s critically acclaimed film “Going Upriver: the Long War of John Kerry.” “Living in Emergency: Stories of Doctors Without Borders” is Mark’s feature length directorial debut.

Read more about those involved in the making of the film on IMDB.com