Imagine yourself living in Guatamala with Crecencia, mother of seven, and her wonderful family. You're invited into her community, to break bread with them, to take part in their traditions and rituals. But Crecencia has late stage cervical cancer. She needs treatment that costs thousands of dollars. Money that could be used to pay for pap smears that will prevent hundreds of women from getting the disease in the first place. What do you do?
The is the story of Emmy-winning documentary filmmaker Rob Tinworth. Nine years ago, Rob married a physician and became interested in global health. He produced a series of short films that explored stigma in leprosy villages in China, maternal healthcare in a remote corner of Nepal, and child malnutrition in Guatemala. Everything he learned began to develop into The Life Equation.
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Through this interactive documentary he puts you in the driving seat. What information do you need to make a decision? Who are the people behind the statistics in global health? And how can we help them?
Be transported to a hospital in Nepal where you must decide how best to save the lives of so many young mothers that die in child birth. See how the number of people dying of different diseases doesn't give us the whole picture.
Ask yourself what you would do if you were faced with the dilemma on whether to help Crecencia or prevent dozens of women from developing cervical cancer.
Rob is invited into Crecencia's life and he brings the audience along with him so that we can experience his turmoil and dive deep into not just the data but these people's lives.
Here's an excerpt from Rob bringing Crecencia's world to life:
"In a clearing in the dense jungle of Guatemala, the cameraman and I film a Mayan ceremony in the ruins of the ancient Kaqchickel capital of Iximché. It’s an emotional swirl of chanting, smoke, and fire – a ritual of healing for Crecencia, who is fighting cervical cancer. As we’re considering stepping back to capture a wide shot of the proceedings, the daykeeper, a kind of Mayan shaman, turns to me and says, “In one minute, it will rain. You should cover your camera”. When a shaman tells you to cover up your kit, you cover up your kit. Sure enough, just as we finish pulling a tarp over our camera the heavens open, and rain starts bucketing down in sheets.
The daykeeper pulls a tarp over Crecencia and the fire, but the rain has come on so rapidly that the fire has gone out. Crecencia leans down and blows into the fading embers. The fire explodes back into life, and as the symbolism of this action sinks in, I curse my ill-preparedness and set off back to the jeep to retrieve the wet weather cover for the camera.
As I pick out the trail with my headlamp, I stumble upon an altar, the candle-wax remains of another ceremony melted across it. I pause, alone with my thoughts. I’ve been so focused on capturing the scene that this is the first time I’ve reflected on the intensity of what I’ve been covering. It hits me in an instant, and I’m surprised to find myself sobbing uncontrollably.
Crecencia is going to need a lot more than prayer to treat her cancer. An American-backed NGO is fronting up the cash for radiation therapy in the hope of buying her a few extra years. On paper, I thought this was a crazy idea - $10,000 goes a long way in Guatemala, and that money could be spent on other programmes instead: child malnutrition, diabetes, or pap smears – that money could prevent hundreds of women from developing cervical cancer in the first place!
But standing in the clearing in the torrential rain, after days of filming Crecencia and her family, I don’t care how many wheelbarrows of cash it takes. Of course Crecencia’s treatment should be financed.
Weeks later, dry and ensconced back in my edit suite in Boston, I come across Toby Ord and ‘Effective Altruism’. At websites like this one, I read about the central premise - that we should use data and mathematical formulas to analyse healthcare interventions, and then fund the most cost-effective. I’m reviewing chart after chart showing that some treatments can save thousands of times more lives than others.
It’s a compelling argument, and I’m sucked right in. Medicine should be cost-effective. Not only to improve healthcare in poverty-stricken corners of the world, but also to rein in spiraling health care costs where I’m living, here in the US.
But following this logic, it’s ethically unsound to spend large sums on cases with poor outlooks. It’s ethically unsound to fund Crecencia’s treatment.
I’m stuck with no good answers, convinced that everyone has a right to the best medicine can offer, and equally convinced that health care should be driven by data to maximise its impact.
The Life Equation is an attempt to come to grips with that struggle, to explore the two sides of the debate, to understand why I feel so strongly that they’re both right, and to find a way to somehow resolve that.
I want to go beyond the scathing rejection of health care rationing as ‘medicine by death panels’ and beyond the realpolitik dismissal of ‘idealistic, unrealistic’ doctors.
I want to transport the audience into that forest in that rain with the chants of the Mayan daykeeper drifting through the trees. I want to put a human story on the faceless data and see what happens...
How did you feel following Rob down the rabbit hole? What would you decide to do with the money this NGO has raised? What about the people we've not met, such as those that could benefit from pap smears to prevent cervical cancer?
When we're striving to do the most good it is important to remember all of the individuals that make up the statistics. These decisions are hard. But big data and effective altruism are tools that can help us make them, and documentaries like this are powerful reminders of why it is so important. We can't ignore these choices, we're making them even if we're not thinking about it. Every time you decide to donate to one charity you also decide not to give to another.
So please, if you do one thing today, just take the time to think about Crecencia and this dilemma. Explore the data for yourself in the interactive documentary and let us know in the comments how you'd decide.