Views & Reviews Review of the week

Seeing is believing

BMJ 2007; 334 doi: (Published 05 April 2007) Cite this as: BMJ 2007;334:749
  1. Khalid Ali, senior lecturer in geriatrics, Brighton and Sussex Medical School
  1. Khalid.ali{at}

    A human rights film festival in London showcased several films that document abuses from a patient's perspective. Khalid Ali reports.

    This year's Human Rights Watch Film Festival, which has just finished in London and moves to New York in June, showcases several films that document the discrimination faced in certain societies by people who are ill, or who have suffered physical attack, and are in medical need.

    The festival, set up by the organisation Human Rights Watch to publicise the stories of activists and survivors of human rights abuses around the world, includes 22 films from 20 countries this year.

    Rosita, a joint US and Central American documentary, tells the story of 9 year old Rosa, a Nicaraguan girl who became headline news in 2003 when she was raped and fell pregnant. Her parents, who were working in Costa Rica as coffee pickers at the time of the attack, fight for Rosa to obtain a rarely granted “therapeutic” abortion. The story is told through media footage and the words of Rosa's parents, doctors, lawyers, and priests. As the media and the government publicise Rosa's story, the girl is imprisoned in “hospital” to be cared for. The Catholic Church uses her tragedy to criminalise abortion and manipulates the local hospital doctors into claiming that the pregnancy is not harmful and that it should be allowed to full term. Horrifyingly, the doctors are not even allowed to treat her sexually transmitted disease, contracted through the rape, for fear of inducing abortion.

    After the intervention of local human rights activists, Rosa is secretly taken back to Nicaragua for a clandestine abortion. The reaction of the church is to excommunicate the whole family and the anonymous doctors who performed the abortion. The film is a timely protest against the current legislation in Nicaragua. In October 2006 a new law enforced by the government banned all forms of abortion, including therapeutic ones, even when the mother's life is in danger. Women and doctors face a jail sentence of up to 10 years. The repercussions of this unjust law were seen in November 2006 when a young woman was left to die from vaginal bleeding (BMJ 2006;333:1037 doi: 10.1136/bmj.39035.344387.DB). Doctors were unable to treat her for fear of breaking the law and facing imprisonment. This could be just the beginning of a big massacre of young poor women who are denied lawful abortion by doctors unable to practise their profession.

    A second film, this time from the Democratic Republic of Congo, has a similar bleak opening. Lumo follows the story of a 20 year old woman who is brutally raped by the militias and is left with a fistula. Rejected by her family and fiancé and made a subject of mockery in her village because of her incontinence, Lumo finds her way to the one place that can offer solace, a hospital that helps rape survivors. The hospital, run by the charity Heal Africa and managed by a group of female counsellors, “the Mamas,” offers free surgery and rehabilitation to fistula patients. As Lumo and her friends recover from surgery, they share their fears of multiple operations, as well as their hope of being cured. They all dream of going back to the outside world and living a normal life with their own families again. After two years and five operations, Lumo leaves the hospital physically cured but emotionally scarred. The film ends with a big march denouncing violence against women and a warning that the violence may still continue.

    We'll never meet childhood again (UK 2007) is a documentary which considers the difficult lives of children with HIV. A large proportion of HIV positive children in Europe live in Romania, where they are likely to be abandoned in hospitals. The documentary focuses on a group of children who live in one of the homes set up by the British charity Health Aid UK and is made up of interviews conducted between 1986 and 1996. HIV is still widely perceived as a social stigma and a terminal illness in eastern Europe. Some of the children featured are abused by their playmates and called the “the ugly ones, the AIDS ones.” School headteachers refuse the children's right to education in public schools. Along with its positive message of support and solidarity with HIV positive children, the film acts as an educational tool, dismissing false beliefs about modes of transmission of the virus. Moreover it explores the children's psychological problems as they grow up and start thinking about having their own families. A note of harsh reality intrudes as the foster parents struggle with the death of some children who developed AIDS. On a more optimistic note, the foster parents develop coping mechanisms through religion and the belief that they are indispensable to these children. The strong bond that eventually develops between them shows the human side of the caring profession.

    The message from these powerful films is that healthcare professionals need to consider human suffering and discrimination in all its forms all over the world. Our duties and responsibilities are far beyond just dispensing medications. As we endeavour to heal patients' ailments, we should also strive to fight ignorance, spread education, and champion human rights. Then and only then can we call ourselves human doctors.

    This could be just the beginning of a big massacre of young poor women who are denied lawful abortion by doctors unable to practise their profession


    • We'll never meet childhood again

    • UK 2007

    • Rating: ***


    • US/Nicaragua/Costa Rica 2005

    • Rating: ***


      Democratic Republic of Congo/US 2006

      Rating: ***

      The 11th International “Human Rights Watch” Film Festival

      London, 21-30 March 2007

      New York, 14-28 June 2007

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