Tanzania Final

9 06 2011

“It’s a dead body; it’s worth waiting for.”

Documentary is not journalism. It can have journalistic aspects, but documentaries are films first: art pieces crafted by filmmakers who sometimes have little to no journalistic training. There’s a big distinction between the two fields. Journalism, in theory, is a profession grounded in a service to the citizenry so it can be as informed as possible. Film has an obsession with beauty, more concerned with moving people, capturing emotion and giving the abstract ideas a firmer footing. Sometimes, documentaries are just commercials in disguise. In my experience, they’re usually bits and pieces of all three and when done well, they are a fine marriage of the best parts.

And there is tremendous potential for contradictory behavior. For instance, your work may be to advocate human rights, but composing a shot might involve offending someone’s culture or customs. You try sometimes to be as courteous and sensitive as possible, but sometimes the demands of your work can lead you into a gray area, or a situation that is downright insulting. It’s rarely intentional, but it does happen.

If you take a long time to set up a shot with the virtuous intention of creating a visual masterpiece, you might lose the moment or, in our case, someone might take it away from you.


The doctor maintained (to my ignorance) a passionate but otherwise innocuous conversation in Swahili on his cell phone. It wasn’t until I heard “documentary” that I knew the hospital would soon shut us down.

The elder man had passed away at seven in the morning and was being kept in the ward until the mortician arrived. The plan was to film a nurse covering his face with a sheet. It is their country, their customs, and clearly their right to pull the plug. Which they ultimately did. But the DP, in his eyes doing his job, had already filmed the body. And before any official had the chance to demand the footage, the media card was out of the building and safely stowed away in one of the vehicles.

Muhimbili Medical Centre has been called the best hospital in Tanzania. We spent a couple hours getting portraits of the wards. Fifteen people to a room. It’s a model for the use of needles, syringes, and IVs. But it’s not a place you’d want to spend the night. A young man with an enlargement disorder called out, “Merci, merci,” over and over. His lower body covered with a sheet, presumably because his own clothes would not fit anymore. His legs, swollen and lumpy, hung heavily off the side of the bed. There are no gowns for patients, but there seem to be plenty of doctors and nurses, at least when we are around.


We are doing circles in downtown Dar es Salaam, trying to find a decent restaurant to have our last meal in Tanzania. But after the hospital, my appetite isn’t charging too hard. Our host, still reeling from the meal with the health minister the night before, says he’s eating at a popular fast food court. The director and DP refuse because the selection is inauthentic and of terrible quality. The youngest of our crew befriends a young man on the corner over a cigarette. He’s a refugee from Rwanda, a Hutu, and he knows of a great place down the street. So the four of them take off.

I later join them. Sitting down, I catch the Hutu man in mid-story. He says his parents died in a church massacre in 1994, where the parishioners were locked in, shot, and burned. Still a boy at the time, he had been able to escape away to Tanzania. He casually mentions that two days ago his sister died from poisoned water. He’s all alone now. In two more days is the funeral and he has a 2000 km bus ride ahead of him. But he’s cool as can be. He refuses to order any food. We insist.

He gives thanks to the US, because they bring mosquito nets, baby formula, milk, grain. He still lives in a refugee camp. After 18 years, many Rwandans haven’t gone back because they have no where to live, no job.


It’s a bit of a guessing game, picking and choosing what to shoot whenever you’re in a new country, truly foreign, without any scouting whatsoever. For instance, just picking a nearby village, driving to it, and shooting an interview first thing in the morning, in our minds, should have taken no more than a couple hours. In reality, it took us three hours just to find the spot, and another three to make sure everyone was paid off so that we could shoot it. We were scheduled to arrive at our second location at 10 am, but we didn’t actually get there until 5 pm.

But sometimes a guess pans out, as in the case of the school today. We got there just before the kids were let out. The administrator would not let us shoot on the school grounds, so we waited right outside the walls. And the pay off came in hundreds of boisterous bodies, dressed in uniform blue bottoms and white shirts. We caused quite a commotion. But our sponsor had the idea of having two girls sing the national anthem of Tanzania for camera, and then a whole group of children joined in. It’s a beautiful example of him interacting with the people whom he works so hard to help. Minimal planning went into it, but it will play an important part in the film.


And now a few words about the man who made this trip possible:

Marc Koska is a self-made, self-educated social entrepreneur. Decades ago he came up with an idea and designed a self-disabling syringe with the goal of helping curb the spread of infectious disease through needle reuse. With his company SafePoint Trust, his Star Syringe system, and Life Saver initiative, he has made it his life’s work getting governments to endorse the philosophy and practice of safe injection. Due to distribution difficulties and economics, he still has far to go, but in our week with him he had many victories. This story has so many parts, there is so much going on, that one week of filming was not nearly enough to do it justice. For more information, check out:







Tanzania Day 5

7 06 2011

Ludacris is the unofficial face of every barber shop in Tanzania. They use either some really cheesy picture of him with a fade going on, or else it’s a drawing. Sometimes you see Tupac, but almost always it’s Ludacris (and…so it is). I’m curious to know whether he knows. “The country must have a blanket license,” squawked my producer.

As we drive through the countryside, looking for one particular village, we pass all kinds of people going about their business, children in uniforms walking to or from school, men with buckets washing motorcycles. The red, green, and yellow of roadside markets stream by at 50 km/hr. Women in sandals walk along the shoulder, preoccupied, the sun glistening off their dark shoulders. And it occurs to me that I have fallen in love with East Africa.

Then one of us sees a poster of Osama bin Laden, and the car falls silent. When a massive cement factory appears on a hilltop, it gives us cause for conversation.

We find the village we’re looking for, and begin setting up for an interview at a busy crossroads in the foothills. I call the location a “soundstage”, not because it’s a professional and controlled filming environment with craft service tables and air conditioning, but because there are about a million sounds to drive me crazy. In descending order of frequency there were: motorcycles (which act as cabs), busses, heavy trucks, SUVs and airplanes.

After the interview cant find out driver. We find him asleep in the car, and we start back down out of the hills and south towards Dar. On the way, he makes an unexpected stop to run into a pharmacy. It turns out he has malaria.

That night we are joined at a chinese dinner by none other than the deputy minister of health of Tanzania. Ma’am’s is not partial to fish, but loves noodles. And she is 100% behind auto-disabling syringes. She provides us with a letter granting us access and permission to shoot at the hospital in Dar. That will be our first stop tomorrow.

Tanzania Day 3

4 06 2011

The day began watching the sun rise over the Indian Ocean. The tropics are best early in the morning, and here that rings true. The atmosphere was calm and pleasant as we drove through the palms on our way into Dar es Salaam. After a ferry ride across the bay, we were on our way to more remote villages down the coast.


A man yelled at me for taking a picture of his vegetables. Two boys playing with bike tires ran past me, and then back again.


While it has the smell of leaded fuel, burning garbage, and a pungency I haven’t identified, there is a purification going on in my spirit, a deep cleansing metaphorical breath.


Houses of mud, stick and thatch. Shirtless farmers in fields. Football jerseys and motorcycles. Lumber yards and piles of gray bricks. Tarp-covered pool tables and soft drink advertisements. Rainbows and rows of corn.


First location was literally in the middle of nowhere, but I still couldn’t dodge hits on the radio mics. A huge radio tower rose to the sky right behind the clinic.

The clinic director wouldn’t let us shoot, but there were used syringes lying on a table out in the open. When he left his office, the DP ran in with the 5D to get some inserts. A man saw this and ran over to the next building to tell the director, so we thought it healthy to jump in the vehicles and get out of town.


Dark brown backs, bent and rising just above the tips of the grass. A woman walking the road, a hoe over her shoulder, chatting cheerfully into a cell phone. Even out here they have service. You hear me AT&T? Oh yeah, probably not.


We stopped at a government clinic run not by a medical doctor but a “clinical technician”, who was less than thrilled to repeat his title when asked.

He had had twenty patients so far in the day. One syringe, damp on the inside, sat on his desk. When asked if he had opened the syringe yesterday or today, he answered, “Oh, yes. I opened it this morning!” It was noon.

Then we went to see a witch doctor, but he didn’t use syringes.


We got caught in a storm while shooting verite in a crowded market square in the center of a small town. As the rain REALLY started coming down, a young man asked me, “Are you trying to ruin our lives?”

Huh? We were in the middle of shooting, so I easily slipped away. But as soon as I settled in a new spot behind the camera, he was beside me again. “Are you trying to ruin our lives? What are you doing with this photography?” I explained our documentary to him and that the objective was actually to help Tanzania and save lives. He nodded but looked away towards the camera, only slightly interested.

“When you are done, where do you go?”

“Hmm? Oh. We’re all from California.”

“No. Today. How could I find you?” At this point I’m not sure if it’s a language barrier, but the line of questioning is cruising past my comfort zone. “What hotel are you staying at? I might have some friends who want to discuss their ideas with you on how the film should be.”

Um, not sure about that. I suggested he talk to my producer. Dissatisfied, he moved away.

The next moment a fight broke out between two of the guys on the street we had only moments ago been filming.

Tanzania Day 2

4 06 2011

Looking east towards India. Never imagined I’d be saying that. Perhaps that’s why it feels good. But it’s quite a dubious statement, in a way. I mean, it’s pitch black out there. The tide has pulled back so far I can’t even hear the waves. And a twenty-foot band of trash defiles the otherwise bucolic beach to the left and right fringes of its reach. I’ve applied so much DEET that it’s probably repelling people as well as it is the mosquitos. That’s a small concession to make. The Campari is wearing off, and 6 am call will come quick and rude.

Today our subject and sponsor took his presentation to an assembly of officials from the national health ministry of Tanzania, including the head minister herself. She surprised us all when (whether for the cameras of to save lives, she only knows) she enthusiastically endorsed not only self-disabling needles but also the need for more comprehensive needle management, including storage and incineration of used syringes. It was a big step towards the adoption of a safe needle policy in Tanzania, which would be the first of its kind in all of Africa.

That these were exciting developments goes without saying. It’s great for our film, and it’s invaluable validation for the team that has been working tirelessly over the last few years to make this dream a reality. But this is only a step. Until those in power really walk the walk and mandate the self-disabling/self-destructive needle technology, it’s all just pomp and circumstance. Until the health care providers who are reusing dirty needles change their ways, it’s all just empty self-aggrandizement.

The plan tomorrow is to drive three hours into the interior of Tanzania (malaria country) in search of some serious back-water medical clinics that reuse needles as the standard of care. The WHO nightmare. Ironically, or so I have heard, deaths from the reuse of needles is double that of the deaths from malaria. Yet the WHO employs hundreds if not thousands of people in the malaria cause, while they keep only one part-time position to deal with the issue of contaminated needles.

Millions of lives hang in the balance. Like the litter problem presenting itself on the beach in front of our hotel, awareness and education are key. Better choices must be made by parents, and clinics cannot continue thinking that they can reuse needles. Babies deserve to pursue a happy and healthy life, not to be infected with HIV or hepatitis before they know how to walk.

Tanzania Day 1

2 06 2011

Sunset comes at 6:30. We are recounting the first day of shooting at the roof bar of our hotel. As a call to prayer reverberates across Dar es Salaam from the north, we toast with Tuskers malt lager. It’s our ritual, easier on the knees, and besides, we like to know what kinds of brew our host country is capable of, from Kilimanjaro to Kingfisher.

So I am comfortable calling this day 1, after a modest but somehow adequate three and a half hour sleep. Today required us to shoot slightly covert. At least from the sound prospective. Our subject had a meeting with the secretary of the national health minister, which he had to pay $3800 to schedule (we filmed our subject counting the money).

Any sound guy would share my trepidation with having to trust a Canon 5D to record production sound and a DP who refuses to monitor. Not that he even could if he wanted to on this particular camera. It became clear, really fast, that all I had to do was test, test, test….and then trust.

The director and DP went in to film the meeting while the rest of us waited outside learning Swahili from the parking attendant and talking about soccer stars. He thought I looked like Messi, and called me that for the rest of our time.

We hung out for thirty minutes under broad reaching trees while women in respirators swept up leaves and dirt from the street. Students passed by, some with smiles for us and other with scowls. All of a sudden I see the DP making double time down the street towards us.

“Get in the car now. We are going back to the hotel.”

Evidently the ministry was not too keen on the filming and wanted the footage. Which, incidentally, includes a shot of the secretary taking the $3800 and putting it directly into her purse. No receipt, no ledger entry, no thank you.

The second half of our day consisted of visits to clinics to determine (and film) whether or not they maintained cleanly and responsible management of used needles. Naturally, many of the directors were uneasy at the presence of cameras in their facilities. But few of them had anything really to worry about…until the last one.

It was immediately clear from the used syringes standing by in cups that they were not destined for the incinerator. In fact, several were used to aerate an IV bottle for a woman suffering from malaria symptoms. Instead of letting gravity do the work, which I have heard is pretty dependable, they used the needles to puncture holes in the bottle to allow the air to push the solution into the vein of the woman who seemed positively unaware of the danger she was being subjected to.

However necessary for our documentary, the scene was simply quite gruesome. Misuse of needles is a massive problem. It’s responsible for millions of new cases of infectious disease every year. It’s why we are here in the first place. And according to our schedule, there is way more in store.