Exposed: The Rise Of A Superbug

Filmmaker Q&A with Director Mo Scarpelli

Is there a particular documentary film or filmmaker that had a major influence on your career?

Early in my career, I was greatly influenced to jump the journalism track into rich documentary storytelling after falling in love with stories from MediaStorm (mediastorm.com) and also watching all of Drea Cooper and Zack Canepari’s ‘California is a Place’ shorts (californiaisaplace.com). The human elements of these narratives — free from ‘information’, prioritizing not just content, but form – – really inspired me.

 

What motivated you to make your impact video?

When I found out that drug-resistant TB was on the rise, and that humans have no effective vaccine to protect against it, I was floored that this ancient infectious disease could be rearing its head without the world paying attention. I was on fire to tell the stories of those experiencing MDR-TB, but also those working to fight it despite the risks of infection and the odds of changing the tide anytime soon. I also had a terrific and creatively open relationship with the producing partner, non-profit biotech Aeras, which had leadership and a staff very open to putting human story at the forefront of the film series (versus information or facts).

 

Please tell us what camera(s) you shot with primarily – and any other special equipment that you used and why you used it.

We shot on a Canon 5D Mark II with great Canon glass. Production was on a tight timeline so that we could finish the film series in time for debuting at a major global health conference; we needed to be light and nimble as we were traveling with a small crew to five countries in one month to produce the EXPOSED series.

 

Please tell us about any special styles or techniques that you used during the production of your film to help tell your story.

Though we had a tight timeline, and the film’s narrative would be drawn largely from interviews, I wanted to get as intimate with the subjects as possible. To keep the interviews visually interesting, we shot with a tight lens on a slider, and tried to ebb and flow with the emotions of the interviewees. We’d also use the long lens to linger with subjects’ reactions and emotions as much as possible.

 

How did your story evolve from day one, to the very last day in post? Is your story what you thought it would be?

Originally, we thought this chapter of EXPOSED would intently focus on the story of a doctor — in this case, Dr. B, a relentlessly hardworking and jovial doctor who has been fighting TB in India for years. But when I met Phumeza Tisile while in South Africa to interview researchers, I was so struck by her harrowing very-near-death experience, and realized it was essential to weave this into the story of MDR-TB. Phumeza’s story elevated the film to be not only more universal (given she lives in South Africa, not India) but also offered such a personal human story about what how XDR-TB (extensively drug-resistant TB) can completely undermine a young life, and how the drugs we have to fight it are just not equipped to deal with its power.

 

Please describe the most rewarding experience you had while making this film.

I loved getting to know the unyielding positivity of Dr. B. From afar, his job seems incredibly arduous and difficult – and it is! – but spending time with him really rejuvenated our faith in the human spirit to overcome great obstacles.

 

What advice can you give to other impact filmmakers?

Ask open-ended questions. You may think you know about an issue because you read all the reports and talked to all the ‘experts’ – but the only thing that really matters for film (I believe) is the experience of a human being, and as the filmmaker, you have the power to translate that experience. Listen deeply, be open to contradictions and complexities that defy what you think you know — and the story stands to be much richer and more honest as a result.

 

What’s your favorite part about the filmmaking process and why?

I loved getting to know those we filmed with; I always love being exposed (no pun intended…) to completely new ideas, lifestyles and trains of thought. The 30+ interviews we did for the EXPOSED series gave a lot of room for this and it was amazing to dive so deeply into the state of tuberculosis in the world right now (something that before this, despite working on global health stories for five years, I knew so little about). I loved my crew, too. My crew for this film was just the best — while we worked long days and the topic was sometimes depressing, they didn’t sacrifice fun, ever. We had a great time getting to know the subjects, the interviewees, and the issues in a deeply human way.

 

What’s the one item you always take with you when working out in the field and why?

Gaff tape — saves your gear, your sanity, sometimes your life.

 

Can you describe any obstacles you encountered in making your film and/or in your distribution/exhibition efforts?

The style and pace of this film was made for viewing online, so one hurdle we  have had is utilizing the film in venues outside of the web or global health conferences. Also, EXPOSED is a four-part film — unless viewers see it on Aeras’ site (aeras.org/exposed), it can be hard for audience members to know there are actually three more chapters of the series to also view! See all the films at aeras.org/exposed.

 

What do you want audiences to take away from this video?

Despite centuries of scientific progress on many other global health issues, TB remains today the second deadliest infectious disease in the world. EXPOSED follows the humans behind the fight against one of the oldest and deadliest diseases in human history. Through their personal stories and with context from TB experts around the world, we are hoping to raise the profile of the growing drug-resistant tuberculosis epidemic, and call for more innovation that can rid the world of this disease once and for all.

 

Please list key points that should be covered in a post-screening discussion:

Many people think of tuberculosis as a disease of the past, but the reality is that TB is an urgent public health crisis. Each year, more than 9 million people become sick with TB and 1.5 million people die of the disease. In fact, TB is the leading cause of death among people living with HIV, causing one out of every four deaths. It is also the third leading cause of death for women, affecting people during their most productive years (ages 15-44).

While control programs are making progress in reducing deaths from TB, global TB incidence relative to population growth has remained consistently high. There are almost 1 million more cases of TB in the world today (9 million) than in 1990 (7.8 million). And because of growing drug resistance, TB is becoming much more difficult and expensive to treat.

Women and children are particularly vulnerable, with childhood TB remaining a hidden epidemic in most countries. Every year, approximately 550,000 children develop TB, and close to 80,000 die from the disease. By 2010, there were more than 10 million children left orphaned by TB.

TB is also the third leading cause of death for women of reproductive age (15-44 years) worldwide, killing half a million women in 2013. It is a known risk factor for pregnant mothers and their infants. Babies born to women with TB are more likely to be premature or low birth-weight, increasing the risk of neonatal death, and pregnant women with active TB are more than four times more likely to die in childbirth. Transmission from mother to child is estimated to be 15 percent within the first three weeks of birth.

A toolkit for the EXPOSED series can be seen here:

http://smhttp.24906.nexcesscdn.net/80B0A2/aeras-cdn/img/uploads/attachments/EXPOSED_Toolkit_2014.pdf

And more information about TB and the need for new vaccines can be seen here: http://www.aeras.org/pages/need-for-new-vaccines

 

Please provide information on any recent developments regarding the issue or subjects of the video. How have things changed or not changed?

MDR-TB rates unfortunately continue to rise throughout the world. However, much progress has been made for new vaccine possibilities. Aeras and global partners now have more than a dozen TB vaccine candidates in clinical trials around the world. Learn more :

http://www.aeras.org/pages/global-portfolio

Updated info on developments in TB vaccines can be seen on Aeras’ blog here: http://www.aeras.org/blog

 

What opportunities are available for those interested in getting further involved?

Become a TB advocate! Learn how here: http://www.aeras.org/pages/engage

 

Please provide any additional resources (websites, links to additional videos, forms, articles, etc.) relevant to the context of the issue discussed in your video:

The full EXPOSED series can be seen here: aeras.org/exposed

 

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