Director’s view: A peasant and a businessman

Director: Paul Roy

With 1.2 billion people, India is a country with no shortage of intriguing and often astonishing stories. However, it can be quite intimidating for a filmmaker to get a handle on any one individual story without being overwhelmed by the sheer volume of people and possibilities.

It seemed to me that a hospital was the one institution where all people are equal. They are there because they are sick, and illness is the greatest leveler of all. Thus a film in a hospital would give me, as a filmmaker, a dual opportunity.

Firstly, a chance to look closely at the inside running of an Indian hospital, but also to give me access to all levels of society, wealth, religion and professions, in one location. The film would hopefully be a microcosm of modern Indian life in all its fascinating and myriad variety.

The Narayana Hrudayalaya hospital in Bangalore was chosen as the subject for this series after an extended research trip to a number of hospitals throughout India. Most were very reluctant, suspicious or refused straight-out to entertain the idea of being filmed over four months in such depth and to give the complete access I required to make a film free  from interference or hospital spin.

In the end, the Narayana Hrudayalaya hospital almost chose itself because of its unique approach to providing high-end healthcare for all, regardless of means, and because of the enthusiasm and complete openness of its founder, Dr Devi Shetty.

With just one meeting and no pre-conditions, Dr Shetty gave us total access to all areas of the hospital and to all employees and patients as long as they agreed to be filmed.

Indian Hospital was filmed over 16 weeks by two two-person crews. The Narayana Hrudayalaya hospital complex is massive. It comprises four separate hospitals – cardiac, eye, orthopedic and cancer – with 3,500 beds and many thousands of outpatients each day.

It draws people from all over India. And with so much happening and such a range of medical specialties and cases to choose from, the initial difficulty was determining who to film and which patients and doctors to profile.

Two weeks were spent researching the main departments, introducing ourselves to the main players, and drawing up a list of interesting story possibilities, characters and events to cover in the coming four months.

Over those next months, my crew and I had unfettered access to the entire hospital. As is the want of an observational documentary where just hanging around is half the game, we spent up to 12 hours a day there, six days a week .

Over the last 35 years, I have filmed in many hospitals around the world. Almost from day one this hospital felt different from any other. This was commentated on by others in the crew as well. In many hospitals there is an air of anxiety and  rush – they seem impersonal and alien, and a place you want to get out of as soon as possible.

At the Narayana, even with the comings and goings of thousands of outpatients a day, there was a feeling of calm and positivity generated by the staff. Almost without exception, employees  – whether nurses, cleaners, doctors, security or lift attendants – were proud to work in this hospital, where so much good is done for so many, and all staff are treated as equals.

Despite managing a multi-million dollar business, Dr Shetty has an open door policy for all staff. A first year nurse or a lift attendant can always come to see him face-to-face with a complaint or query. This access and trust, it seems to me, makes a huge difference in the way the hospital functions.

The specialist medics in particular – many of whom could earn enormous salaries anywhere in the world – have actively chosen to work here. Money is not their motivation, and religion or faith often plays a major role in their lives.

Because the hospital never turns anyone away for lack of funds, the personal freedom not to have to worry about the financial bottom line gives the medics great peace of mind, allowing them get on with their jobs of providing the best possible care.

Once when I was filming in an operating theatre, a peasant from the country earning $2 a day was followed by a businessman earning upwards of $10,000 a week. Both had the same surgeon and received identical medical care. The only difference was that the businessman returned to a private room and the peasant’s operation was performed for free.

I found this refreshing and reassuring after the obsession with wealth in the West and, increasingly, in many parts of India.

In the course of filming, we came across many wonderful and sometimes remarkable patients and their families who generously shared their experiences with us. Some are featured in the series – Prahbu, Navya, Vicky, Rajeshwari, Venkatesh, Bimesh. They came with different, often life-threatening, illnesses from very varied backgrounds, religions, and financial circumstances.

For the 40 per cent of the poorest patients, with little or no money, being admitted to this hospital was not just a life-saving event. Leaving the hospital with no crippling debt and being free to return to work, study or help within the family would benefit their family’s fortunes for years, possibly generations, to come.

These four months were rewarding and illuminating to me as a filmmaker, and reconfirmed that India in general, and this Indian hospital in particular, is not like anywhere else in the world. I believe that this series reflects some of that variety and uniqueness as well as the passion and optimism that I experienced while making it.