Zhang Hanlin, a 3A currently completing his dual degree at Columbia University, writes about a thought-provoking Chinese documentary film he saw at the 74th Cannes Film Festival last year.
“Are they acting it? Or is this the reality?” My French friend, a fluent Mandarin speaker and an experienced cinephile, asked in overwhelming astonishment after we watched the Chinese documentary film H6 at the 2021 Cannes Film Festival. This film presents a penetrating observation of the Chinese medical system through cameras set in the Sixth People’s Hospital in Shanghai. It shows how the most unprivileged patients survive financial difficulties and how people of all paces of life in the hospital work together to fight against miseries.
A scarcity of medical resources and insufficient insurance coverage set the background of the stories. Such a context proves shocking for many Western audiences, including my friend. Despite her expertise in films and her familiarity with Chinese culture and society, she couldn’t tell if the heartbreaking stories were fictional, or she might have been reluctant to believe the cruel reality. This reaction was common in Cannes. After the screening, many tears and much applause were dedicated to this film. Some audience members remained seated and unrecovered from the immense sorrow. Others expressed shock and praise in their conversations.
The film starts with a wide shot of many confused and numb faces in the enormous and crowded buildings of the Sixth People’s Hospital. The camera records a moment when families take out cardboard boxes, make them into a bed, and sleep on blankets in the corridors of the hospital to save money. This moment triggered a few laughs but mostly a deep silence among the audience. It then naturally shifts to a wordless close-up shot of an elderly disabled man stumbling alone on the streets of Shanghai. An agonizing worry occupied the auditorium when we followed the long-take camera of the man trying to catch an approaching bus to the hospital. The bus stopped, opened the door, and closed it before he could hobble there. The shot ends with him standing on the crowded street and resignedly watching the bus driving away. This metaphoric moment indicates the harsh clash between remaindered individuals and fast-growing urbanization, centralization, and capitalism. Will he make it to the appointment on time? Will he be able to afford his treatment? The shot cuts away, deferring the answer until much later in the film.
The film honestly presents the practical difficulty of getting healthcare services in view of the problematic and insufficient allocation of medical resources in China. Indeed, hospital visits are usually expensive, time-consuming, and associated with physical discomfort. Because medical resources are highly centralized in metropolitan areas, many have to travel from their rural hometowns to Shanghai for hospitalization. The struggles are real, yet how much can medicine help? The director, Ye Ye, extends her camera to many outdoor scenes to provide multi-faceted contexts of individual stories. One of the most tragic and complicated cases in the documentary is that of a three-year-old girl who was run over by a bus in front of her grandpa’s fruit stand and almost lost her leg. The penniless family must settle the legal dispute with the bus driver who refused to compensate, and they have to decide on whether they should spend a huge amount of money for a slight chance of preserving her legs. The camera often returns to the agonizing family nervously wandering outside the hospital and discussing how to fund the surgery. Fortunately, the girl recovered from the edge of death with her complete, though less flexible legs. Their storyline ends with an outdoor scene in front of the grandpa’s fruit stand, with other kids in the family playing on the street which buses occasionally traverse.
This scene leaves the audience a huge space for thoughts. Even if medical adversity is overcome, the dangerous living environment and miseries of life still surround the individuals. Hospitals can save patients in tragic accidents, yet the access to qualified healthcare services can still be unaffordable given China’s insufficient social safety net. The coverage of public healthcare depends upon urban or rural residency, employment status, and affiliation to the state apparatus, which leaves marginalized social groups disadvantaged in front of medical services. In lack of government funding, hospitals are primarily responsible for their own account balances, which highlights the profitability of their maintenance and transfers the financial burden to patients. The brutal medical capitalism and limitations of medicine in relieving social sufferings center the discussions of the film.
In the press conference following the film’s screening at Cannes, I got a chance to propose a question to Ye Ye: “What is the inspiration of this film?” She replied, “The joyful pessimism of Chinese.” Her inspiration can be interpreted in multiple ways throughout her cinematic presentation. Despite the overloaded hospitals and absence of universal healthcare, the entire medical services in China have reached an internationally advanced level within three decades while serving the enormous population, which is in parallel with the coetaneous socio-economic change in China. Indeed, individual life in the fast-changing and highly uncertain social context can be full of risks. However, such a rapid and massive upgrade in medical levels, though not necessarily affordable for everyone, has brought hope and joy to many suffering patients. As attested by the ambiguous chances of survival in medical urgencies, issues of affordability, and general life miseries that patients experienced in the film, revival from hospitalization is not merely a medical issue. Instead, it is intersected with the broad image of the social reality, raising questions of: How can health services in China be made more affordable for all? How can we establish respect and care for disabled individuals in hospitals and in societies? How can we facilitate health and well-being among the most underprivileged social groups in their living environment? These questions inspired by the film are not unique to the Chinese system. Under the Covid-19 pandemic when global hospital services are severely challenged, the issues of overcrowded hospitals and unequal access to health services have become internationally urgent.
The realistic, profound, universal, and humanistic take of this film is what shocked, impressed, and touched the audience in Cannes in this special year of 2021 when this film festival just revived from the pandemic. Although the film itself might not be a commercial success in the film market, its captivating and compassionate portrait of contemporary social realities in Chinese hospitals makes it a masterpiece.
Featured image: Ye Ye. H6. Nour Films. 2021