Behind the Scenes with TRF 2021 Film Festival Documentery “A Place to Breathe”

With TRF’s 2nd Annual Film Festival right around the corner, here is a glimpse into the making of A Place to Breathe. This interview was published in July of 2020 and we share parts of it now as a highlight before the festival.

Film/Video Studio curator for Wexner Center for the Arts, Jennifer Lange spoke with Michelle Grace Steinberg about her film A PLACE TO BREATHE. They discuss all things from the detailed animations featured in the film to how the subjects and filmmakers are dealing with COVID. Interview conducted by Jennifer Lange. 

You made this film from the very unique position as a healthcare practitioner at a clinic in Oakland, California, which is one of the clinics profiled in the film. Can you talk a bit about the genesis of this project? What are some of the ways that your position as a healthcare practitioner influenced your approach to the characters and the subject of the film? In turn, what were some of the challenges of balancing your role as healthcare practitioner and filmmaker? 

Norma Calmo and Edgar Salazar at Street Level Health Project, Oakland, CA

First, thank you for doing this interview and for all of the support that the Wexner Center for the Arts has offered us on A Place to Breathe. In a precise sense, the idea for the film emerged when I came across a Public Radio International story in 2016 on the Metta Health Center, the refugee-focused branch of Lowell Community Health Center, discussing the inspiring model of culturally responsive care that they provide to immigrant communities in Massachusetts under the leadership of Sonith Peou. In a more general sense, this project was percolating in me for many years prior to that. My life and time are split equally between filmmaking and healthcare provision. As a nutritionist and herbalist at Street Level Health Project in Oakland, I have spent more than a decade providing free integrative healthcare to immigrant communities and have seen firsthand the benefits of wellness approaches that center the whole person, taking into account both one’s cultural and structural needs. Likewise, the powerful work of my colleagues, who have themselves experienced many of the same situations as our patients, and their journeys to heal themselves by supporting their communities is incredibly inspiring.

Being in the room with people choosing to share their trauma and vulnerabilities, while striving to make changes in their lives, opens up a new world to those who have the privilege of assisting in that process. The interaction is a partnership; one that creates the deepest type of empathy. It is our hope that by allowing a glimpse of this experience in A Place to Breathe, we can perhaps move the world in a more compassionate direction. Our vision for the film speaks to the transformations needed in both healthcare and immigration policy, even more resonant during this COVID-19 crisis in which the communities featured have been disproportionately impacted. But we hope that it can also grow our capacity as human beings to truly value and learn from cross-cultural interactions. To harness the creativity and power of cinema to this end felt like the perfect fit and an ideal challenge for the medium.

Our model of filmmaking involves a collaborative process in which we feel deeply accountable to those who share their stories. In this case, those people were often my patients and colleagues. This definitely increased the stakes for me personally and at times it was challenging to navigate the crossover between what had previously been two separate worlds of healthcare provision and filmmaking. Yet I think this overlap ultimately positioned us to engage extremely sensitive and complex subject matter with a deep level of respect and commitment to the impact of the filmmaking process. At least I very much hope that is the case. 

One of the most striking themes of the film is the cyclical nature of care within these two communities. Individuals who participate as patients in these systems move on to pursue careers as caregivers/practitioners themselves. Everyone’s story of trauma is totally unique but their paths to healing converge and bring them together in ways that really underscore the importance of building community. Could you talk about how those cycles were fostered and share your thoughts on the importance of community in wellness, health and healing?

Rodrigue Kalambayi at Middlesex Community College, Lowell, MA

Throughout A Place to Breathe we draw parallels between the protagonists’ stories across the two health centers and cities over the course of approximately two years. As their arcs unfold, a common thread emerges in the desire to heal their own trauma through helping their communities. The film illustrates how these pathways to wellness simultaneously lead to community and self-empowerment. Each person’s story arc falls at a different stage in the cyclical nature of the healing process including trauma (experience prior to leaving their country of origin, as well as in the U.S.), transition (both the physical journey to safety and adjustment in a new society), education (whether learning English or healthcare skills), and implementation (as they begin working in their communities). These stages constantly overlap, and rather than linear, often have a cyclical nature for both the individual and the community.

In the US, as filmmakers, we often feel pressure for storytelling to conform exclusively to the journey of the individual. However, in many societies, the experience of the individual cannot be extricated from that of the collective. Both in our last film, Beyond Recognition (2014), working with the Ohlone Indigenous community, and in A Place to Breathe, where we had the honor of working with Cambodian, Congolese, Guatemalan, Mexican, and Uruguayan protagonists, this commitment to the community as a whole is a critical part of people’s stories.

I notice the same tendency in many Western healthcare contexts, an attempt to extract the individual in a way that fails to address the healing nature of her/his/their community. This is what makes the models of both of these health centers unique. In these spaces, the role of the community health worker is key and it is imperative that these dedicated healers be recognized for the deep knowledge that they bring to health settings via their relationship with their own communities—not only as lay health workers or interpreters, but as the bearers of cultural wisdom. Likewise, it is crucial that people have opportunities to become providers—whether doctors, nurses, social workers, acupuncturists, etc.—in their own communities, where their shared experiences can create the type of connection and understanding with their patients that it is crucial to healing. They are also in a unique position to collaborate on treatment plans that value communities’ traditional healing practices. This process is profoundly reciprocal, as we see in the film, as both patient and practitioner grow through the engagement. However, it can also be uniquely challenging, as we learn through Norma Calmo and Yania Escobar, since that level of connection can sometimes trigger trauma in the healer. It is imperative that there are mechanisms of support for what practitioners experience from that side of the interaction as well. These are all considerations that we hope the film will highlight for audiences, whether the general public, medical institutions, or policy makers. 

A very distinctive feature of the film is the use of animation.  Each of the characters in the film share very personal stories of past trauma and you present those stories very sensitively and respectfully through animated sequences. How did you arrive at this strategy and, in turn, what was your process of working with animators? 

Animation by Héloïse Dorsan Rachet and Anna Benner

It became clear fairly early in the editing process that we needed to designate a separate space to hold the memories of home, including many traumatic experiences that the protagonists carry with them. In part, it did not feel right to have people on camera while describing some of their most personal, painful moments as we wanted to create some privacy even as they reveal these parts of themselves. For the viewer, we also wanted to build a connection to the sights and sounds of these visceral experiences that was potentially truncated in exclusively verbal storytelling. Animation seemed to offer us the most latitude for this purpose, allowing us to develop symbolic connections and atmosphere, as well as capture the fragmented nature of memory.

This became an extremely collaborative process between myself as the primary editor, Robyn, my co-producer, and the two brilliant animators who joined us (after several rounds of trial and error with other artists, who each helped us grow our vision). An animated short film from Iran called The Tree provided some initial inspiration as we love how they split the screen to provide glimpses of multiple perspectives simultaneously. Due to our budget and timeline, it was necessary to have two artists who could work on different stories concurrently. We are so grateful for the incredible talent and patience of Héloïse Dorsan Rachet (who did the Kalambayi’s and Norma Calmo’s stories) and Anna Benner (who did Socheat Chan’s parents’ story). They had never worked together previously. Anna is based in Berlin and Héloïse is in Paris, so even pre-COVID, we were all collaborating remotely.

Together, we selected individualized color palettes and culturally relevant elements unique to each of the three stories, while they developed a joint approach to the use of symbolism and the split and black screen spaces. In addition, our composer, Elton Bradman, provided the soundscapes that brought these sections to life. This process ultimately fostered the creation of three animations that we hope respect the uniqueness of each story and culture, while sharing an aesthetic continuity that holds the universality of trauma and migrant experiences. A critical point in the process was bringing the original scripts, storyboards, and character drawings to each of the protagonists to sign off on in advance. It would have been inconceivable for us to try to depict these moments without the assurance that the individuals who experienced them felt resonance in the style and approach. That layer of accountability to those who share their stories permeates the entire documentary process for me and I would love to see more discussion of that imperative in artistic circles. 

Street Level Health Project and Lowell Community Health Center/Metta Health Center were already battling the challenges of operating under the current administration’s efforts to curtail access to healthcare and the rights of immigrants and refugees, not to mention its targeting of undocumented individuals. COVID has likely exponentially increased the challenges to these organizations. To the extent that you feel comfortable commenting, can you share a bit about these challenges and also how both organizations are operating during the shutdown? 

We started this project in April 2016, before the current administration. The night of the presidential election, I was searching the internet for footage of the Khmer Rouge genocide in Cambodia to edit a concept preview for a grant, while simultaneously checking election results. It was quite surreal. That isn’t to say that any of these issues began with Trump. Deportations of immigrants had escalated under Obama. But clearly the policies and rhetoric became exponentially more overt as Trump entered office. It galvanized our commitment to making a film that humanizes people regardless of their immigration status—whether refugee, asylum seeker, DACA recipient, or undocumented. These are very important distinctions in the opportunities that exist (or don’t exist) for immigrants here. But we deliberately chose not to focus on the nuances of these categories for this project and instead highlight the commonality of experience that brings people here. For the most part, few people choose to leave their homes, but rather are forced to, whether by war or other violence and repression, or economic necessity.

As it has for everyone, COVID-19 has presented unique challenges to the two healthcare centers in the film, which, in varied ways, were already operating under precarity. On Saturday, July 25, we will have an online event to share the latest trailer for the film and host representatives of both health centers in a discussion about how their services have pivoted to meet the needs of immigrant and refugee communities during COVID-19. I cannot speak specifically to the shifts at Metta Health Center/Lowell Community Health Center, so please tune in to the event for that; but as a Street Level Health Project staff member, I can say that we have morphed all aspects of our programming to try to stay relevant through the crisis. Due to long-term health disparities and inequities within the healthcare system (as with all walks of life), communities of color are disproportionately impacted by COVID-19. In the Latinx communities that Street Level Health Project primarily serves in Oakland, the rates of COVID are significantly higher than in many other communities. In particular, the Indigenous Mam population from Guatemala that we work with is being particularly hard hit and at the time of this interview, I expect that we have not yet reached the peak. 

My nutrition and herbal medicine consults are now by phone and I do free home delivery of supplements to patients. I am grateful for the close collaboration of Maria Vicente, one of our current Mam interpreters and community health workers, whose work makes this process possible. Our mental health counselors and medical director are also calling patients. Since our community has limited computer and internet access, Zoom visits are not an option, and suffice to say, telephone visits in multiple languages can present many challenges. With the leadership of our Executive Director Gabriela Galicia, other staff members set up a hotline to field the flood of calls for various support that have been coming in. They have continued dispensing weekly food bags to day laborers—increasing the volume as need has grown—as well as doing street outreach to share resources with community members. As undocumented immigrants are ineligible for federal relief money, Street Level created a fund to specifically support our worker’s collective members through the crisis. More information is available here.

We first started talking about the film and a residency over a year ago, with the goal of doing final color correction and sound mixing at the Wex in early 2020. COVID completely upended our finishing schedule and your plans to get the film—one that is so particularly timely—out into the world. The traditional mechanisms for premiering a film aren’t viable right now. Can you talk about some of those unique challenges you (and other independent filmmakers) are facing at this time? 

Originally, our artist residency was scheduled as two separate trips to the Wex. The first took place in February 2020 to familiarize the team there with the film prior to starting color correction and sound mixing. We planned to return in March 2020 to finish the color and sound process. However, as COVID-19 was rapidly appearing in California, we made the difficult decision to cancel our return a few days before the shelter-in-place orders took effect. In collaboration with the Wex team, we pivoted quickly to figure out a way to complete the color and sound remotely. There were significant challenges, which included watching and listening on different systems, from impromptu “home studios” that were not identically calibrated. The Roxie Theater in San Francisco also stepped up to provide us with a venue to pre-screen the DCP of the film for glitches—a part of our process with Wex that was impossible to do remotely.

Prior to COVID, the film was scheduled to be completed by the end of March and begin its festival run in April. However, our deadlines were pushed back, due to the extended nature of working remotely. We did not want to rush the process, especially as we were all living with uncertainty, unsure of how the virus would affect ourselves, our communities, those in the film, as well as the independent film industry. Most spring festivals were being canceled and postponed. Summer and fall festivals were unclear exactly how they would proceed. Many festivals moved to virtual platforms, which greatly reduced their programming selections. As you can imagine, this created a lot of anxiety. We spent the past four years putting our hearts and hard work into the project, but more importantly we felt responsible to the people who trusted us to share their stories and now we did not know when we would be releasing the film. 

One glimmer of hope is that early on, SF DocFest invited the film to screen in their festival, which was originally scheduled for the first two weeks of June. While the festival is uncertain of its new dates currently, they are still committed to having the event at the Roxie Theater once they receive the thumbs up to reopen to the public. It will most likely be a hybrid screening, giving people the opportunity to either view the film at the theater or in the comfort and safety of their homes. Festivals are traditionally an important path towards securing a distributor for a film, and since we are uncertain if A Place to Breathe will have an extensive festival run in 2020, we are working on alternative strategies that have shifted our distribution, social impact campaign, and audience engagement timeline. This includes reaching out directly to educational distribution companies; investigating public television broadcast options; and developing our partnerships with healthcare organizations to include the film as part of virtual conference programming. Through these difficult times, we have been fortunate and thankful for our filmmaking community coming together in creative ways to help us get A Place to Breathe out into the world! 

Find the original interview here.

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