Finding a good way to die
21 February, 2021 06:55 AM IST | Mumbai | mid-day.com | Meenakshi Shedde
How many of us can pull a life-giving plug on a loved one and watch him or her die? Many of us are asked to take that tough decision. Mostly, we cannot, and leave it to doctors to decide—it takes away the burden of our guilt. Farida Pacha’s documentary film Watch Over Me (92 minutes), is a most deeply moving account of a palliative care team in New Delhi, that visits the homes of terminally ill cancer patients, and tenderly holds the hands of dying patients and helps them cross peacefully to the other world. They primarily help manage symptoms such as pain, psycho-social distress, and grief. In helping terminally ill patients, as well as their families, come to terms with the inevitability of death, the film becomes tremendously life affirming. You understand why such trained care teams are angels of mercy, and why we desperately need many more of them. This film is all the more relevant in the time of COVID-19, when millions worldwide have come closer to death.
“In the end, being there is all that matters,” is the tag-line of the film. Maniamma R, Sini Kuriakose and Dr Reena Sharma are a wonderful team of counsellor, nurse and doctor, working for the NGO CanSupport, a palliative care organisation in Delhi. They do regular home visits, providing medical and emotional support to the patients and families, here Meherchand, Munni Devi and Hanif. They ease the grief of families when loved ones quietly become photo frames on the wall.
The documentary, a Switzerland-Germany-India co-production, is in black and white, and in Hindi and Malayalam. The film screened at the Solothurn Film Festival, Switzerland, and will play at the Berlin Critics’ Week next month. It was officially selected at the Mumbai Film Festival’s India Gold in 2020, though the festival did not take place because of COVID-19.
Mumbai-born, Milan-based Farida Pacha, who studied filmmaking in the US, is an accomplished documentary filmmaker. Her previous work includes the wonderful My Name is Salt (on workers who extract salt from the Rann of Kutch desert, Gujarati, 2013), The Women in Blue Berets (on an Indian, all-women police contingent of the UN peacekeeping operations in Liberia, West Africa, English, 2012), and The Seedkeepers (on Dalit women’s collectives practising sustainable farming in Andhra Pradesh, Telugu, 2005).
Watch Over Me also helps you understand the meaning of life—of existence itself—differently. Can the patient whisper to you? Can he swallow a spoon of water? Can she get sleep? Such are the minutiae that mean everything at the border of life and death, when there is little to do but wait. In India, we avoid uttering the C-word (cancer) or D-word (death) before the patient. Dr Sharma tells Meherchand with quiet firmness, that he has cancer, and not long to live, but they will care for him at home, so he is more comfortable. Later, the son gratefully tells the doctor, “Papa had been restless until you told him. After that he was very calm.” When a daughter begs for her mother’s life to be prolonged, she is advised, “She will live maximum a week longer, but that’s just for you, not for her; it’s only agony for her body.” Very few are lucky: Hanif recovers well, and even goes back to work. In most cases, the families are grateful for the team’s intervention: “She went easily, without pain… ahsan hi hai (we are grateful).”
Pacha’s direction is absolutely assured and unobtrusive.
Lutz Konermann’s cinematography is discreetly intimate, by the side of the dying and the medic team, witnessing heart-breaking decisions. As a black-and-white film, it pares all distractions and focuses on essentials. Pacha’s screenplay and Katharina Fiedler’s editing are spare and effective. Pratik Biswas’ location sound is superb, and composers Dürbeck and Dohmen gently, musically hold our hands too. The film is produced by Leafbird Film, Ventana-Film and Video Without Borders.
Don’t miss this film whenever it’s released. Jana toh hai, as a character says: go we must.
Meenakshi Shedde is India and South Asia Delegate to the Berlin International Film Festival, National Award-winning critic, curator to festivals worldwide and journalist.
Reach her at firstname.lastname@example.org
Moving, humane look at illness, death and the process of grief
03 March, 2021 00:57 AM IST | Mumbai | cinestaan.com | Sonal Pandya
The documentary Watch Over Me by Farida Pacha is an important look into medical care for terminally ill patients at home in India. It is held together by the work of three women — nurse Sini Kuriakose, counsellor Maniamma R and Dr Reena Sharma. These women tirelessly visit their terminally ill patients in the city of Delhi and offer them comfort, care and respect.
The majority of the patients are terminally ill and often don’t have time left. Watch Over Me, written and directed by Farida Pacha, follows the trio of health-care workers as they tend to their patients — Meherchand, Munni Devi, and Hanif. With each visit, we learn more about their families and the way the women have to alter the care according to the situation. All the patients are a shell for their former selves — one can barely put together the words, while Hanif, who has arrived here from West Bengal, is often breathless due to the effects of the cancer on his body and the medication he is under. Most of the patients can’t afford the care or the medicine, so the NGO the women work for, CanSupport, helps them and their families get the support they need.
The 92 minute documentary ends with an appalling statistic, that only 1% of six million patients in the country have access to palliative care. Watch Over Me makes a strong case for the need for palliative care, and the reformation of health care in India. Patients and their families, at the latter stages of their lives, should not be battling paperwork to avail of a medicine that can ease their pain, maybe even prolong their lives. The coronavirus pandemic exposed the state of health care even in most so-called first world countries, what to speak of the Indian system. There is a long way to go to fix the many problems we still face.
Pacha’s documentary, in Hindi and Malayalam, captures the constant state of grief these families live in. While unbridled grief can be hard to witness at times, here, it is not intrusive. The documentary focuses on the subjects but is respectful of their journeys. In fact, it helps them cope and understand what they are up against. Like the patients, even the family members have their own pain to process. Sometimes, the family wants them to live a little just to assuage their feelings and guilt. Gently, the counsellor or the doctor pushes them to think of the patient first.
Shot in black and white by cinematographer Lutz Konermann, the documentary often captures moments of stillness — when the subjects are lost in their own thoughts, or in the case of the patients, their pain. Editor Katharina Fiedler also intersperses the film with shots of the city going about its business, unaware of the pain these families are going through.
It is a difficult, draining occupation of taking care of terminally ill patients and it takes a toll on the women as well, especially Sini and Maniamma, who sometimes see eight patients a day. Watch Over Me deals with heavy matters, but humanity is always at the centre of it. The feature aims to show how compassion and proper care can lead to dignity and peace at death for those suffering from terminal illnesses.
Berlin Critics Week 2021: Two Docs and a Dream
MARCH 9, 2021 / filminquiry.com / SOHAM GADRE
Death, always a ripe subject for cinema, is something that is incompatible with the way we have built society. Financially, emotionally, and socially, death is considered an inconvenience. It is something that is not at the whims of our need for control and comfort at every turn. Especially in the developed world, death is foreign to us, and thus, requires deep emotional excavation to come to terms with. The subjects of Farida Pacha’s documentary Watch Over Me have one of the most emotionally difficult jobs in the world. Based in India, three women of a palliative care team assist a number of families dealing with one of their members suffering from a terminal illness. (…)
There is always a moral discussion necessary to be had in documentary cinema where the most vulnerable and aching moments of human life and connection are on display for the world to see. (…) On the other hand, Watch Over Me manages to be an introspective and empathetic portrayal of death, offering the valiant efforts of the trio of palliative care nurses as a blessing but also brings into question the deeper psychological and economic issues of the ‘death industry’. (…) One of the subjects, Hanif, and many like him from poor backgrounds can’t afford the treatment to fully recover from their illnesses. We also get a glimpse of the bureaucratic and logistic preparations required for death – shuffling papers, signing documents, etc. It’s all very mechanical and coldly pragmatic work for something that has such a tidal wave of an emotional effect.
While the heart of the movie lies in the love and warmth of family recovery, its soul asks the tough question: Is the society we have built compatible with our frail mortality?
Film Text: Watch Over Me
FEBRUARY 28, 2021 / wochederkritik.de / Bessie Rubinstein
Farida Pacha’s second feature-length documentary, Watch Over Me, closes with a title card bearing information that can be felt throughout the film: only one percent of seriously ill Indians have access to palliative care. The two, overworked caregivers whom Pacha follows, Mani and Sini, are introduced through opening shots of the women making their way to a patient’s home. This man, dying of cancer, is the first of three patients, all with children, whose stories Pacha intercuts. There is no coworker chit-chat between Mani and Sini in their vehicle at the film’s start. They don’t speak to each other, but look ahead. Their expressions are like a rorschach test for the viewer’s feelings about life’s end; a fearful viewer would call their faces solemn, while a more comfortable viewer could detect calmness and preparation.
Pacha shot Watch Over Me in black and white, unlike her other films. The choice forwards this documentary’s affective message: like shades of gray, every patient’s fight against their declining body brings the same emotions, and yet each clinical episode is different in the way that the fear and pain manifest in the patient and their family. Mani and Sini don’t meet the patient inside. Instead, Pacha shoots them greeting his son as they exit the car in a shot which reminds us of the emotional labor, and the triaging of knowledge, that frames each encounter with somebody facing potential death. The patient’s son tells Mani and Sini that his parents don’t know how far his father’s carcinogenic cells have spread—Mani’s easily forthcoming, measured response, that they’ll “keep it in mind,” conveys a sliver of what must be a considerable background in this field of care. Such a steady response to this request—to hide the fact that a man is at death’s threshold from himself and his life partner—speaks more to Mani’s experience addressing life-threatening illness than an overview of her career could.
The air of surrender Mani and Sini take on with their patients, and the shots Pacha inserts throughout—cars speeding through Delhi from behind a smudged windshield, clotheslines and wires swinging in open air—also suggest the mundanity of pathology, of mortality, while bringing up questions of direction and pace. Restless streets become insignificant when contrasted by the minute lateral movements Hanif, another cancerous patient, must make to breathe on his own. Or when a barely conscious mother’s slight turn onto her side can spare her yet more pain. Pacha hones in on gesture and breath, at times getting so close with her camera to the ill subject, their variably swelling and hardening bodies, that the scene becomes almost unbearable. Yet Mani and Sini do not blanch at symptoms in person, nor do the patients’ families. Instead they lean closer; gesture and breath is the only language of the dying.
And so Pacha must get closer, too. Far from being invasive, a pan to Hanif’s engorged stomach, its rise and fall, communicates his struggle to breath so that he doesn’t have to expend precious energy explaining it. In this way, Pacha’s economical filmmaking is vital. Mani and Sini, too, carry attitudes prioritizing conservation of emotional energy. “No matter what problems come up, we will have to face them,” says Mani in response to families who wish for improbable improvement for their loved ones, or for a few more days, or for final words that the sick person doesn’t have the ability to speak. Just as palliative care may need to prioritize comfort over treatment, caregivers and families might choose peace over honesty. Most in India, as evidenced by the families’ grateful deference to Mani and Sini, receive neither comfort nor treatment. “If you already know you’re going to die,” reflects Hanif (who lives), “then you feel that it can happen at any time.” Through both Pacha’s filmmaking and the caretaking practices she studies, Watch Over Me asks us to accept, even calmly embrace, the realities of what will come.
Documentary Review: Watch Over Me
“Watch Over Me” is a very important documentary that highlights a side of life most people do not want to acknowledge even.
Dealing with the terminally ill is a rather hard subject, which, very rarely, cinema touches upon, with Wang Bing’s “Mrs Fang” being one of the few works to do so. Farida Pacha dares to, however, by focusing on a team of three women, a doctor, a nurse, and a counselor (Maniamma R., Sini Kuriakose, Dr. Reena Sharma) who form a palliative care team in New Delhi, as they provide support and care to terminally ill patients and their families on a daily basis.
Their job is rather hard, as it includes educating the families about the medical care they have to give themselves to the patients, filling paperwork for them to receive medicine, which frequently does not go through, hear both the relatives’ and the patients’ occasionally desperate plights, while, unfortunately, watching them die little by little, on most of the cases. Through all these, however, the importance of their heroic efforts comes to the fore, as the services they provide, and also the patience, care and attention to all of their patients is indispensable for everyone involved. Furthermore, as they also have to clash occasionally with unwilling patients or relatives who feel guilt for obliging to the will of the ill not to go to the hospital, along with a government that is not able (or willing) to offer help to these people, their task is elevated to herculean proportions.
A realistically dramatic essence permeates Farida Pacha’s approach, with the highly contrasted monochrome actually suiting the aesthetics of the film to perfection, and DP Lutz Konermann camera intensifying all the context by getting really close to the patients, although not to a point that becomes obtrusive. This approach also highlights that the director has truly gained the trust of the group and the patients, a feat that seems necessary for the approach implemented here.
The feelings of fear, grief, doubt, guilt and pain are emitted from almost every scene. At the same time, however, there is also laughter, smiles, and occasional moments of happiness, with the documentary also mentioning that one of the patients is actually a success story, even though his case is a drop in the ocean. These moments, provide some much-needed relief from all the pain presented on screen, also highlighting that not everything is completely bleak, at least not all the time. Katharina Fiedler’s editing is excellent in that regard, as much as on the overall pace of the movie, which allows the various scenes to present the whole issue with much detail, without lingering intensely however, to each sequence.
Pacha does not dwell on the personal information of her “protagonists”, an approach that allows her to avoid the reef of the poverty porn, and also to focus on the issue as a whole rather than individual cases. At the same time, however, a little more information about the background and the reasoning of the members of the team, for doing such a hard labor, would also be welcomed.
“Watch Over Me” is a very important documentary that highlights a side of life most people do not want to acknowledge even. At the same time, it is also artful in its production values, resulting in a movie that is definitely worth watching.
In documentary on end-life cancer patients, despair, courage, grace – and angels
Farida Pacha’s ‘Watch Over Me’ follows the stellar work of team members of a palliative care group.
Farida Pacha’s new documentary Watch Over Me is often hard to watch. Was it just as hard to make? The Milan-based filmmaker spent close to two years following members of CanSupport, a non-profit in Delhi that works with cancer patients for free. Pacha eventually picked three case studies that were attended to by a doctor, a counsellor and a nurse.
The deeply empathetic and illuminating documentary has been shot in black and white by Lutz Konermann. The use of monochrome is one of many stylistic choices Pacha made in tackling a difficult, emotionally wrenching subject. Meherchand, Munni Devi and Hanif are all seriously ill. It falls upon the angels of the title, Maniamma R, Sini Kuriakose and Reena Sharma, to watch over them as they confront possible death, prepare their families for the inevitable, and offer advice on medication and any measures that alleviate their suffering.
Watch Over Me will be screened at the Indian Film Festival of Los Angeles (May 20-27). The 49-year-old director of the award-winning My Name is Salt, about salt workers in Kutch, and The Women in Blue Berets, about soldiers with a United Nations peacekeeping unit in civil war-riven Liberia, spoke to Scroll.in about the inspiration behind her new film and the challenges of handling a tricky subject.
Did ‘Watch Over Me’ emerge from a personal space?
The film has struck a chord with a certain age group of people who have had this experience or are going through it. I too had gone through something similar. I spent six years after film school caring for my mother, who had Parkinson’s, and my father, who was a heart patient. I saw them degenerate from one day to the next. I never imagined having to make a film on this. I was researching a documentary on rural health in India, but it somehow didn’t work out. Over the course of my research, I read about CanSupport. I met the founder, Harmala Gupta. She understood what I wanted to do and said I should give her a written proposal. We started shooting in October 2017.
What guided you in picking the case studies we see in the film?
We were following a few patients. I have used only a fraction of what we shot. We selected these three during the edit. Among the qualities we were looking for was how comfortable they were with us. The team too wasn’t bothered about being filmed, they went ahead and did what they had to do. I was also looking for people who could listen to what the patients had to say. For instance, the story of Hanif is also about the bureaucratic hurdles that need to be crossed in order for him to get the medicine on which his life depends.
How did you go about filming delicate situations – terminally ill patients surrounded by anxious family members?
We had a lot of discussions about the filming. We went in only after we had obtained the consent of the families. Many families refused, while others said they didn’t want to continue after we had met them a couple of times.
We filmed from the time we entered. The documentary is a testament to how generous people can be. I wonder, would I be comfortable with my parents being filmed? They might be fine with it, but maybe I would have a problem.
It must have been emotionally hard to sit in on the counselling sessions, watch patients struggle to breathe and communicate and hold on to hope.
This is the hardest film I have ever worked on. It has been wrenching. As a documentary filmmaker, you think you are prepared for it, but you are not. It was very hard to see such sick people every day. One had to constantly confront the fact that you are mortal. It took a psychological toll on us, and then it took a toll on the sound recordist and the editor too.
I won’t ever forget this experience. It was also very rewarding and very much enriched my life. You see the humanity of people at such close quarters. You see so much care and love.
Why did you choose to make ‘Watch Over Me’ in black and white?
It would not have worked in colour. It would have been too distracting to have your eye wander to a blanket with brown flowers or a purple curtain. Your attention would have been drawn to patterns that were not important. Black and white is able to draw you into the core of the film.
What discussions did you have with cinematographer Lutz Konermann about framing the characters and shooting them in their homes?
There were three constellations – the palliative care team members, the patients and their families. There was a lot of talking happening across and between. We thought we would have a two-camera set-up, but it looked horrible.
I figured that it wasn’t about covering the situation. Even in My Name is Salt, we worked with a basic Sony camera. In this case too, we didn’t want to have to change lenses in the middle of a shot. We knew we wouldn’t have much time.
In any case, when you are going into an atmosphere where there is so much distress and tension, you don’t have the time to set up lights and stuff. We worked with available light or a very basic light. There were three crew members, including the sound recordist.
How did the family members react to your presence?
The funny thing is that you are not inconspicuous, and that isn’t even the point. Even in such situations, people accept you for what you are doing. It’s a mystery how it happens. People don’t bother you once they have let you in.
We had a quiet presence. But there was no notion here about being a fly on a wall. Lutz was moving all the time, for instance. Sometimes, we would be flat up against a wall, or sometimes move around the bed. In a one-camera set-up, you want to cover everything. We wanted a sense of people talking and listening.
Although we spent equal amounts of time with the CanSupport team members, we don’t learn much about their backstories.
The choice was to stick to their working lives. We would meet them at their office, set out with them, and then part ways. We didn’t want to go home with them – where would the film go after that? You would have a million other questions.
I didn’t want to get into their private lives. It’s clear that they love what they do. That way, you get a sense of the people too. I never filmed the patients separately either, you see them only in the presence of the team.
The film is a classic observational documentary. I don’t work with people I can see are performative just because it looks good. Whenever I have tried to engineer anything for any film, you can see in the footage that it isn’t authentic.
Has the documentary been shown to the families of the patients?
I thought I would come to India and show them the film and then the coronavirus pandemic broke out. I didn’t just want to send the families a link to a screener. I would like to be there for the screening.