An immersive, firsthand introduction to the hospital reputed to have the world’s highest birth rate, Motherland not only provides an expressively etched account of specialized medical care, but also a telling perspective on dominant social trends and health care policy issues in the Philippines.
Through conversations and interactions among medical staff, patients and family members at Manila’s Dr. Jose Fabella Memorial Hospital, Ramona S. Diaz’s documentary highlights several major issues subjecting many disadvantaged women to a repetitive cycle of pregnancy and childbirth. Prominent among them appear to be endemic poverty, a pervasive cultural bias favoring large families and a lack of access to education, medical care and family planning services. Following its Sundance world premiere, Motherland should continue to garner attention on the festival circuit and draw an inquisitive audience when it subsequently appears on PBS’ POV documentary program.
Explores issues with an emphatically compassionate approach.
As the Philippines’s leading public maternity hospital, Fabella often serves as the destination for Manila’s most impoverished pregnant residents. Up to 150 patients at a time readily tolerate the overcrowded dormitory-style wards where two women and their newborns may share the same bed, sweltering in the tropical heat because the facility has no air conditioning.
Still in her 20s, new mother Lea Lumanog wasn’t even aware that she was pregnant with twins until she checked into the public hospital’s Neonatal Intensive Care Unit (NICU), which specializes in treating premature or underweight infants. When her baby girls are born, she’s so overwhelmed that she just refers to the firstborn as “A” and her sister as “B” as she tries to grasp the enormity of her new responsibilities and juggle the twins’ care. Once she’s out of the delivery room, the attentive but harried nurses on the NICU ward demonstrate breastfeeding methods and the hospital’s signature “Kangaroo Mother Care” procedures. Since Fabella is too underfunded to afford incubators for premature newborns, the staff provides mothers with garments resembling elongated tube tops so that they can snuggle their infants on their chests to keep them safe and warm.
Days pass before her husband arrives for a visit, because he’s too broke to afford transportation to the hospital. Facing a bill of over $1,000, he can only muster a $20 payment, borrowed from his sister. After he fills out some paperwork, a social worker tells him that a Christian charity associated with Fabella will cover the balance of his expenses.
On the other side of the ward, mid-30s Lerma Coronel has even more to manage, since she’s just given birth to her seventh child, while her unemployed husband is caring for the others at home. She’s quite frank with the new mothers in particular about the challenges of parenthood, commenting regretfully about the expenses of a large family and warning them not to have too many kids. Although her child is still under the recommended weight for a healthy baby, she insists on leaving the hospital, coercing her husband into signing the required discharge forms against his better judgment.
At 17, cherubic Aira Joy Jubilo is among the youngest mothers featured in the film, frequently appearing completely bewildered when she has trouble breastfeeding and her preemie is slow to gain weight. Although her mother visits the hospital almost every day, her boyfriend continues making excuses about not showing up, forcing Aira to rely solely on her family for financial and emotional support, even though her mom has several other kids at home.
Throughout the film, hospital medical staff and social workers try to persuade some of the younger mothers and those with larger families to go on birth control or agree to tubal ligations, but most decline, embarrassed by the physical intimacy of IUDs or convinced by personal beliefs that family planning should be avoided. Despite the many daily challenges they face, the staffmembers remain incredibly supportive of the mothers and children, confidently imposing an uncertain calm over the chaotic ward and its frequently shifting residents.
Diaz shoots verite style, eschewing any formal interviews, experts’ opinions or archival footage. As her handheld camera fluidly follows its subjects through the hospital, an intimate portrait emerges of Fabella’s role as an essential social safety net in a nation overtaxed to provide basic medical services for its constantly growing population.
Her approach falters somewhat in its ability to consistently track her subjects and maintain the continuity of narrative throughlines, a deficiency that could be resolved by the periodic use of titles or explanatory cards. Cinematographers Nadia Hallgren and Clarissa De Los Reyes, along with co-editors Diaz and Leah Marino, otherwise craft a fluid series of shots and transitions that lends the film an impressive immediacy.
Diaz’s previous doc, Don’t Stop Believin’: Everyman’s Journey, about a Filipino performer plucked from obscurity to become the lead singer for rock band Journey, profiled a rising pop star. The women of Motherland emerge as an entirely different class of heroines, demonstrating Diaz’s insight and compassion in documenting their experiences without judgment or condescension and allowing them to convey their own individual perspectives.
Production company: CineDiaz
Director-writer: Ramona S. Diaz
Producers: Ramona S. Diaz, Rey Cuerdo
Executive producers: Brillante Mendoza, Sally Jo Fifer, Justine Nagan, Chris White
Directors of photography: Nadia Hallgren, Clarissa De Los Reyes
Editors: Leah Marino, Ramona S. Diaz
Venue: Sundance Film Festival (World Cinema Documentary Competition)
Not rated, 94 minutes