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A New Kind of Hospital Drama: Canadian Film Board Marries Media and Medicine

By Tamara Krinsky

From The Bicycle: Fighting AIDS with Community Medicine

A bicycling healthcare worker in Malawi delivering AIDS medicine...homeless pregnant women-turned-portrait photographers...ride-alongs with cops and psychiatric nurses...No, it's not a new reality show on Fox TV, but rather a description of the projects spawned by director Katerina Cizek as part of the Filmmaker-in-Residence Program, the latest innovative project from the National Film Board of Canada.

Several years ago, under the impetus of NFB English Program Director General Tom Perlmutter, the Film Board decided to reinvent its dormant Challenge for Change program from the 1960s. Originally conceived as a device by which underrepresented communities could be heard, Challenge for Change sent crews and 16mm equipment out to remote populations to teach people how to make films. The program was very much a reflection of the liberal, political spirit of the era. According to NFB Filmmaker-in-Residence Producer Gerry Flahive, Perlmutter felt that though technology has changed over the years, the need for community-based media-making has not. As a governmental agency with a defined public service role, the NFB was in a perfect position to revive the project in a new, updated form.

The resulting Filmmaker-in-Residence Program is a partnership with Toronto-based St. Michael's Hospital, one of the largest hospitals in Canada. St. Michael's runs the gamut from the practice of high-tech medicine to outreach programs with deep roots in the community. As a downtown hospital, St. Michael's defines its main constituency as homeless, disadvantaged and transient populations. The NFB has specifically partnered with the hospital's Inner City Health Unit for this project.

Flahive stresses the unique nature of the relationship between the NFB and the hospital. "We've inserted Katerina Cizek, who's a documentary filmmaker, as a Filmmaker-in-Residence at the hospital," he says. "It's not Kat making a film about St. Mike's or teaching doctors and nurses how to make videos. It's not a co-production with the hospital, and we're not the corporate video unit of the hospital or a free PR unit for them. We're marrying media and medicine and experimenting with how documentary media--and in this case that means video production, Web-based projects, still photography and text--can advance the same sort of social-change goals that the hospital has."

Cizek says that one of the biggest challenges in getting the program off the ground was simply getting the people at the hospital to understand the unconventional nature of the projects they wanted to create. The NFB was used to the standards and work processes of "regular" documentary filmmaking, as well as the often sensationalistic sensibilities of news crews. Says Cizek, "Often when I explained the kind of media that we were interested in making, people would come up with their own ideas. The original idea and the goal of any of the given projects that I've come to work on always came from the community. It then transformed and developed as we talked."

The resulting projects reflect the diversity that is St. Michael's. Cizek organized a photo-blogging workshop with the participants in Young Parents No Fixed Address, a program that works with young women who are pregnant or parenting and have had experience with homelessness. Originally conceived as a six-week project, the workshop is still thriving nine months later. The photos taken by the participants were featured in an exhibit entitled "I Was Here," which opened in Toronto City Hall and then toured around the city. As a result, the women met with the mayor of Toronto and later held a speak-out to which they invited young, homeless parents from across the city. At press time, the women were scheduled to meet again with the mayor in March to present their concerns and solutions in areas of housing, childcare, education, justice, shelters and more.

The Bicycle was shot on location in Malawi, where Cizek tagged along with a group of doctors from St. Michael's. Explains Flahive, "What does Malawi have to do with a Toronto inner city hospital? It's a film about an innovative way of dealing with HIV drug distribution in a country that has virtually no medical infrastructure. St. Michael's has a very progressive view of what ‘community health' means. To their mind, particularly in a city like Toronto, the ‘community' extends to Africa because Toronto has a huge African population. The hospital realized that they have people who are coming here from all over the world, and maybe there are some problems we can solve before they get here." The short doc has played in several film festivals and is currently available for download on the NFB Filmmaker-in-Residence website,

Additional projects that have emerged from the program are The Interventionists, a short vérité documentary about a psychiatric nurse and police team that responds to 911 calls that include psychiatric incidents. The goal of the program, and thus the film, is to help decriminalize mental health crises. Cizek is currently in production on a project with the hospital's suicide prevention unit. She'll be filming an intense 20-week group therapy program for people who have tried to commit suicide more than twice. Cizek and the hospital staff are hopeful that the film will help to keep future attendees from dropping out of the program because they'll be able to watch it before entering and get an idea of what they are going to experience.

Quite a few ethical issues have come up during the Filmmaker-in-Residence tenure, including matters of privacy and informed consent, and there are several parallel academic studies that are accompanying the project. Says Cizek, "At first, it seemed easier for the hospital to understand what we were doing if it was in an academic framework because then they could see that we'd taken care of ethics, consent and all those things. But as I got to know the process more, I realized that we have a lot to learn as documentary filmmakers about the academic process, and a lot to learn from the healthcare community about informed consent. What is confidentiality? What are the ethics of why we're doing projects? I found that very humbling and illuminating. We like to pride ourselves as documentary filmmakers that we care about ethics, but nothing compares to what I've learned in this process."

The Filmmaker-in-Residence partnership with St. Michael's is scheduled to conclude in December 2007, but both Flahive and Cizek are hoping it will continue, as well as become a prototype for other NFB offices around Canada.


Tamara Krinsky is associate editor of Documentary magazine.