After Cicely documentary- Interview with the director

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The film features five female leaders in palliative care in Mongolia, Bangladesh, Vietnam, Taiwan and Singapore – two doctors, a nurse and a mother – who have turned their personal tragedies into courage and strength to help others die a good death.

Following in the footsteps of the founder of the modern hospice movement, Dame Cicely Saunders, each of these five women has shaped the palliative care movement in their countries with their fierce dedication to the dying.

After Cicely features the following inspirational women:

  • Mrs Salma Choudhury, founder & chairperson at ASHIC Foundation (Bangladesh)
  • Dr. Odontuya Davaasuren, professor, General Practice and Preventive Medicine, Department of Health Sciences, University of Mongolia (Mongolia)
  • Dr Thuy Bui Thi Bich, Head of the Department of Infectious Diseases, Haiphong Medical University (Vietnam)
  • Professor Chantal Co-shi Chao, College of Medicine, National Cheng Kung University (Taiwan)
  • Sister Geraldine Tan, Administrator, St Joseph’s Home & Hospice (Singapore).

Watching After Cicely

The film can be viewed on the After Cicely website. There are also photo stories featuring the filming location, and a Tumblr where anyone can submit words, photos, videos and links to be displayed on the virtual wall. 

Interview with the director

The director of the film, Jean Qingwen Loo, was commissioned by the Singaporean philanthropy organisation, The Lien Foundation, to produce a film about inspirational women in palliative care.

What inspired you to make this film?

I come from a journalism and a documentary photography background. I’ve always wanted to experience the world through stories. Photography, film and feature writing became a great way to do it because you can go and work on projects, and it grants you the privilege to enter people’s environments and worlds. The process of interviewing is actually a process of discovery. You get a sense of how other people live, and in this case, how these five women help other people to die a good death.

It’s something that really struck me because I lost my dad in 2011 and I didn’t get a chance to say goodbye to him. So in a way, the fact that these people were around means that there’s a chance for people to go in peace. You say your goodbye properly and you can settle your affairs.

The thing that really touched me was that these five ladies have their own personal stories to tell. The whole idea of overcoming personal loss and having that transform into an energy that’s so great that you are able to push forward such a movement. I thought that was very selfless and it was the kind of story that you must tell because they are not your overachievers, they’re not politicians, they are just ordinary people trying to do something. So I felt that was very meaningful.

Did you have any experience with hospice and palliative care prior to the making of the film?

I was completely a newbie to palliative care and hospices. It is a very personal experience, it is not the kind of advocacy that you can force down peoples’ throats to ask them to donate a dollar. It’s a personal experience, and it’s a matter of timing and the importance of having conversations. Prior to this, I was completely new to it, but this has really given me an in-depth understanding about how the hospice industry works.

The coolest thing is that it’s really about meeting the people behind the policy regulation and rules. You see an entire movement being humanized through the actions of people like Professor Chao or Dr Odontuya. Even in countries like Vietnam, Dr Thuy Bui Thi Bich couldn’t speak English, and there was so much going on, but we could tell the effort that she had put into her work.

How did you get involved in the project?

The Lien Foundation has an arm called Lien Aid, who deal with water and sanitation issues. They bring clean toilets and affordable water solutions to places like China, Vietnam and Cambodia. They previously commissioned me to work on a project called the Children of Mekong, which I took on with a couple of friends

Through that project I came to know Mr Lee Poh Wah, the CEO of LIEN foundation, and we were just having coffee and chatting about what sort of project we could work on. So the idea came about where we said – hey why don’t we do something in tandem with international women’s day where we celebrate women for their good work. Because for people who don’t know about these ladies, you probably won’t know about them unless you read about them in a newspaper article. And they are not the sort of people to stay in the limelight or fight for the limelight.

So I think that the whole idea that women can do especially in this area because they are… by nature they are more sensitive and it’s all about being sensitive and having empathy and how do you channel that kind of love and energy to your family and your community. I think that this is the sort of story that anyone can relate to.

Can you tell me a bit more about the women with whom you worked in the making of this film, and why did you approach them in particular?

These five women are all friends of Dr Cynthia Goh – she works very closely with the Lien Foundation in Singapore, and she is like the mama of palliative care here. We sat down with Dr Cynthia Goh and chatted about who would be suitable candidates, because we are looking for her contemporaries in developing countries. We wanted to use this film to give them encouragement and recognition, to show we are interested in what you are doing and we recognize that it’s tough and that there’s bureaucracy, and people are interested in your story and we wanted to give them encouragement.

I think, for example, in Vietnam, Dr Thuy Bui Thi Bich really felt it. Prior to this she was mostly working in HIV medicine and infectious diseases. So to actually have someone go down there to interview her and document her for a few days allowed people to take notice of the good work she is doing in Vietnam.

What challenges do you think women face in Asia when talking about the taboo subject of death?

I think that one challenge – one observation – that I noticed that in many parts of Asia is that expression of grief is quite a bit challenge. For example we interviewed Mrs Salma Choudhury about the origins of the ASHIC Foundation and how that led to her current work. During the interview, it felt as if no one had spoken to her about it for years, she would go about doing her work, but to actually look inward and be more personal and open yourself up to your own take on death, that might still be quite a big barrier for women in Asia to talk about it or express it openly.

What was your experience of making the film?

I went into the project very optimistic. I wasn’t expecting to witness a death, and it happened in Taiwan. I don’t know if we call it fate or luck, but that really anchored down our film. Because when you talk about palliative care and the whole idea of saying goodbye, when you really put it down to the whole experience, we were humbled and privileged to witness Professor Chao counseling the four year old boy, and watching how her team helped the whole family to say their goodbye and prepare the 31 year old Leukemia patient for his death. We saw the entire process, and I think what they are doing in medical schools and it really boils down to during that process. You are there with the family, and no one is alone.

The whole idea is like what Sister Geraldine said, it’s an invitation. I guess we were very very humbled by what we saw. And we weren’t expecting anything. The thing about documentaries is that you can’t craft it. You can’t expect what’s going to happen. So in a way we went in with a certain idea that we are going to learn about these women in a short amount of time, we are going to ask questions and find the deeper true stories

It was really the opportunity and the timing that we got to witness things like that, and we saw them in action. For example, I saw how Professor Chao led an entire team of nurses, she would delegate responsibilities down to the little details like how light or dark the lighting should be and that really touched me in a very deep way

How do you think that Cicely Saunders’ work is carried forward by the women that you worked with?

People like Professor Chao and Sister Geraldine – I can see how they are more directly linked to Cicely Saunders because Professor Chao learnt from St Christopher’s and she spent quite a few years there. And I can see how they carry forward her spirit. There are certain things that she said about how palliative care is not about the shiny medical equipment, it’s about the right people at the right jobs at the right time. The correct person must be at the correct task at the correct moment.

I saw how that worked out in Taiwan and Singapore especially. These women are all very inclusive. You don’t see them fighting for glory. But rather, it’s all about how they lead a team of people. I saw how they guided their nurses. They made sure that they were different people working on different things towards a common goal.

What was touching was how many people looked up to them as mentors, say for example, Sister Geraldine in Singapore would go about her staff and you can tell that she had respect from them. It’s something you can’t fake, like how they would go up to her and talk to her like she was an elder sister and not like a boss.

In Taiwan in the hospital where we went, a good number of people there were volunteers – and some of them were actually housewives whose children had grown up, and they just wanted to get back to society. Some of them had lost family members in the ward, and after they received that sort of care from Professor Chao, they came back a few years later after they have gotten over their grief to give back to other families, so they’re working as volunteers now.

The whole concept that people would want to volunteer in palliative care showed me how the whole idea of how a giving heart can open many doors – because Professor Chao just gives her knowledge and she shares her experience and people really want to learn, and given the right context people will want to pick it up. I was particularly touched that there was such a strong support system of volunteers in Taiwan that were very active.

Is there anything else that you would like to add that we haven’t spoken about already?

I would like to say that coming from someone who is not in the palliative care community – there is a lot of effort and good work being done. I followed these women for around a week each, and I saw how there was a lot of effort and heart going on. And I think that it is especially important for young people in their 20s to be aware that there is such a thing as palliative care because there are many, many lessons to learn.

For me the lesson was that to live well in order to die well. And I guess this is a concept that anyone can apply to any point in time. You don’t have to be rich or successful in order to have a good life. It forces you to define what defines a good life, and it will help you to create a more meaning existence.

I saw how all these added up at the end of it, when we were observing some patients. It’s the whole idea that you come to terms with your entire life at the end of it. So I think a film like this should really inspire people to live well or to relook at their lives at any point in time. 

Thank you very much.

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