10 days in Haiti, 12 children’s heart repairs
Filmmaker Travis Pollert discusses his documentary, “Open Hearts,” in which a team of doctors performs cardiac surgeries in Port-au-Prince
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The goal was simple: Spend 10 days in Haiti and repair a dozen children’s hearts.
The documentary “Open Hearts” tells the story of Dr. Jeff Kempf and a team from Akron Children’s Hospital in Ohio, surgeons from Italy, and local doctors and nurses who came together at Port-au-Prince’s St. Damien Pediatric Hospital to operate on 12 kids with congenital heart defects.
About 500 children are born with heart abnormalities in Haiti every year, but the country lacks specialist care, Dr. Jacqueline Gautier, CEO of St. Damien, said in the film. So the team also had a larger goal: to empower local medical personnel to provide ongoing pediatric cardiology care. A cadre of St. Damien staffers came to Akron for a six-week training program before the January 2017 trip, and one staffer who appears in “Open Hearts” ultimately became Haiti’s first pediatric cardiologist, according to the film.
Co-directors Travis Pollert and Jacob Kostelli shot roughly 100 hours of footage, about half in Akron and half in Port-au-Prince. (Kostelli died this past January.) They captured doctors grappling with the lack of illumination in the operating room, at one point trying to use the film crew’s lights. They were flies on the wall as the team decides who will get the operations: Some 300 children applied, but only 12 would get the lifesaving treatment.
Pollert, 38, founder of the Cleveland Film Company, doesn’t have a personal connection to CHD. In 2015, a film festival had organized a screening of one of his short films at a local rotary club. There, he met Ken Fogle, the chairman of Gift of Life Northeast Ohio, a nonprofit that provides cardiac care to children in the developing world. Fogle connected him with Kempf, a retired physician at Akron Children’s, who had been working on bringing medical care and education to Haiti since the country’s deadly 2010 earthquake.
As a filmmaker, Pollert had worked with nonprofits and had struggled with questions about community and fellowship. “What is our responsibility to each other in a general human sense—across borders, across capacity, across chance? You were born with a heart defect and I was not,” he told me. “I don't think there was anything either of us did to earn those things.” The film doesn’t fully answer the question, Pollert said, but “it does suggest that, well, we owe something to each other.”
“Open Hearts,” which came out in 2021, is told from an American perspective, not a Haitian one, Pollert said. Still, it brings the viewer into a world where basic cardiology care is desperately needed and not guaranteed, with gut-wrenching decisions along the way. Fogle told me in an email that he and another Gift of Life official believe that all the children who underwent operations during the trip are still alive, “but security in [the] country is very bleak.” Parts of “Open Hearts” were difficult for me to watch, but I came away from the documentary with a renewed sense of my own astonishing luck, as well as a reminder of both the hardship and the good that exists the world over.
Read on for my interview with Pollert, who spoke about why this topic interested him, the experience of filming in Port-au-Prince and what it was like to watch open heart surgery from a few feet away.
“Open Hearts” is streaming on a number of platforms in the U.S. and Canada. Visit this link to see where you can watch it.
Given that you don’t have a personal connection to the CHD community, what drew you to this topic?
When we got involved, we really weren't trying to make a feature film or any of this. We were not closed off to the idea, but we weren't trying to force anything. It was more like we wanted to just give them our attention. We had spent 2016 developing a documentary model that was very lean and very light, basically following LeBron [James] through his championship in Cleveland and other sports figures going into the NBA, and really being fly on the walls, but in a way that we really had no control over where the story was going. We were really just trying to be and catch and to let our camera capture real, true, verité things and to develop that in a way that was lightweight and had the proper boundaries.
So when we went into this process, we just tried to say yes and put our camera in the right spot. And as we did, [Jacob and myself were personally] afflicted by the process, but also we realized that what we had captured was something that was very special. It took us forever to figure out how to put it together. That's why, when we reviewed the footage, we said, “Hey, there's something special here.”
You said you didn't go in thinking, “We're going to make an hour-long documentary.” It was more like, “We're going to get some footage, see what happens,” and maybe make some nice fundraising videos for Gift of Life.
We weren't closed off to making a bigger film, but we weren't trying to force that. Documentaries are just as much structured stories as narrative films. They're just as written, even though there's a reality to them. As we're watching these stories unfold in front of us, we were seeing the dramatic arc start to take shape.
What was the experience like being in Port-au-Prince?
[Jake and I] had both traveled so much for work at that point that there's a certain amount of confidence that we had in, “Listen, we got everything in a backpack. We can hit the ground anywhere and we can get to the hotel.” Our mind is like, “Oh no, we can just grab a cab. We can make this work.” And I remember saying something along the lines of that to Dr. Brittany Potts [a physician and one of the film’s producers]. She was like, “These are your instructions at the airport.” I was like, “Great, can you guys pick us up? If not, we can just grab a cab.” And she said, “Do NOT take a cab!” It was right from the moment that we got there, I realized, Okay, I have to take a step back and just learn here.
My presence there and my ability to just exist and to operate was that I was under the protection, for lack of a better term, of the hospital system and their resources.
We went out for a day and did B-roll around the city with a driver/bodyguard and the media person who helped translate. Even that day had its own hotspots of little moments. This seems like this is going to be a bad situation, but I'm watching what's happening and I'm watching the people I'm with. I can feel my nerves going up and I can see what this person is getting in our face about, but I see the bodyguard not being worried yet. We stayed [at a villa operated by the hospital]. They built and staffed it, and it was their way of having volunteers come in and out, and the volunteers all pay their fee. It wasn't a lot of money. It might've been $25 a day [per person]. It was a way for them also to provide jobs for the people in the [community].
What kind of interaction did you have with the patients and their parents?
We had some interaction with them, but I don't think any of them spoke English, and I didn't speak Creole. We did a little bit of communicating through translation, but just a little bit. When we started making the film, we had this ideal that we had to realize was wrong where we thought we were going to tell this film from the Haitian perspective. But we didn't have that.
Whether it was communication barriers or we didn't push and ask those questions, the story that we had in the can was the Akron perspective, was Dr. Jeff’s perspective, was that ER team's perspective, with the Haitians that we were working with, the doctors and the nurses and the technicians that were sharing with us along the way. We got to see the Haitians, but we didn't really get the chance to fully understand or to capture the Haitian perspective. When we realized that in the process of [editing], we got to be a lot more honest with ourselves about the film that we captured. We were able to tell an honest story because it was a story from an Akron perspective, that I think showed Haitians in a way that they all felt good with.
They were all there to have their kids healed. And that was really scary. And they did a great job, and they were all very strong. So our interactions were friendly and minimal because of the barriers, and respectful. We tried to do our jobs to make sure that we captured what we needed to, but especially in some of the tougher moments, we got the couple of shots that we needed and we're like, “Okay, we're going to leave now. We're going to step out.” We didn't have any negative interactions in terms of a parent or somebody feeling like we had overstepped our boundaries. It's hard when you walk in and it's a girl in a respirator and there's beeping and everybody's looking at one bed. What's going on? The air's sucked out of the room, and nobody's talking. In that moment, Jake and I looked at each other and we didn't speak. We just quietly hit record and tried to stand back and get the shots. And we asked a couple questions of the nurse, and then we were like, “We need to get out of here.”
One thing that really struck me was the section on patient selection. There were several hundred kids who wanted to get treatment. The team had to choose 12 with a few backups. That seemed gut-wrenching to me. What was it like to witness that?
[Patient selection] was not just about, “Let's get the kids who need it the most.” That was actually one of the things that floored me. To [the doctors], they’re looking at it like, “We have a certain amount of resources. We can do 12 slots in this time. This is all we can do. And so what do we want? We want 12 kids to be healthy at the end of this.”
If you take the ones that need it the most, they are also the ones that are the most likely to have complications. If you have a kid with a high risk of complications go in on slot number four, let's say, and they end up on that respirator for multiple days, they could tie up that resource and undermine the ability for [the doctors] to do all of the next eight. If they thought a kid was a good candidate for going overseas and being able to be healed outside of this [particular mission], then they would move them off the list. There weren't parents in the room, but they were doctors advocating from a compassionate, personal, emotional standpoint. But then you also have the logical side: These are the resources.
That's the reason [that scene is] in the middle of the film. This is the trial of humanity. We are deeply emotional. We are deeply logical. We are responsible for what we've been given—this earth, each other, however you choose to count resources. If you count resources in grain or food or dollars or cents, we're responsible for it and there are consequences to our decisions. To a certain degree, you can't win. Not in that one moment. A win would be all [300] kids. The 12 kids being saved is going to be a win. And even that is a severe compromise.
Speaking of uncomfortable scenes to watch, there's also a section of the film where you're right in the operating room, and you see the kids being operated on against swells of classical music. To be honest, I had to cover my eyes during that section. But it was also a powerful moment to have in the film. Can you talk about the thinking that went into including that footage?
The heart surgeries themselves were a critical component. They were the crux of the trip. We weren't doing anything without permission [from the parents]. The way we handled it was, Jake and I both filmed, and we only filmed one at a time. We ended up filming a couple of the heart surgeries and then collaged them together. You mentioned the classical music. The combination of art and logic that you imagine with classical music is very much given to [lead surgeon Francesco Santoro] in that cinematic scene. The precision and the craft, it's a touch, it's a hand. His hand is on the knife. The execution of his team, it's like they literally plug everything in and they get all of the pieces in the right spot, and then they turn the heart-lung machine on, and it starts working, and then they turn the heart off.
As a witness, you're watching the heart beat, and the way that it beats, it kind of pumps one side to the other. When you're watching the heart in the open cavity of the chest, I mean physically watching it, it's almost like it's oscillating, turning left and right inside of it. It's literally something in the chest. And then they turn it off and it stops. And then they cut into it, and they will take [a piece of] the pericardium and they'll sew [it as] a patch [to close] the hole [in] the heart and they'll put it all back together, and then, and then, and then—all of the rest of the procedure. And then they turn it back on. It's really uncanny to watch.
What's going through your mind as you're a few feet away from that?
You're having this visceral experience of what you're seeing, but you're also in work mode. And so you're trying to make sure you don't squander the opportunity that you have. You're trying to make sure you get the shots. Should I be in a long lens right now? Should I be in a wide? Should I be doing something? Should I just be holding? Don't be antsy. To a certain degree, having the camera allowed us a little bit of our own little wall. We are constructing. There’s no take two here. We're doing our job to try to get this.
Interview has been condensed and edited.
Have you watched “Open Hearts” or other documentaries about CHD? I always love to hear what you think! Tap the button below to leave a comment, or email me at theheartdialogues@substack.com.