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Toronto Film Festival
Curing injuries and inequality

The Cave, a documentary about women doctors working in an underground hospital in war-torn Syria, was the opening film of the documentary programme of the 44th Toronto International Film Festival held during September 5-15
The Cave, a documentary about women doctors working in an underground hospital in war-torn Syria, was the opening film of the documentary programme of the 44th Toronto International Film Festival held during September 5-15 | © Courtesy TIFF’

The Cave, a new documentary on civil war in Syria, shows the unflinching work of women doctors in an underground hospital.

By Faizal Khan

The idea of going underground was simple for Dr Amani, a 30-year-old paediatrician in war-torn Syria. "Death was lurking on the surface," she says about moving her team to a subterranean hospital they modestly called, The Cave. Dr Amani is the head of the hospital, a labyrinth of secret tunnels under the Eastern Al Ghouta neighbourhood on the outksirts of Damascus. A fierce war between Syrian forces and rebels rages above the ground, sending  a stream of severely wounded women, men and children to the underground hospital.

The story of Dr Amani and her hospital is the subject of a new documentary film premiered at the 44th Toronto International Film Festival (TIFF) held during September 5-15. Titled The Cave, the 95-minute documentary directed by Syrian filmmaker Feras Fayyad reveals the senseless violence unleashed by a long-drawn war on innocent people struggling to stay alive. Co-produced by Germany and Denmark, The Cave opened the TIFF Docs programme on the first day of the festival to a packed international audience.

Fayyad, who focused his camera on ordinary people rescuing victims of the civil war in Syria in his previous film, Last Men in Aleppo (2017), once again chooses a group of people determined to help the victims of violence. This time, the director, winner of an Oscar nomination for Best Documentary Feature for Last Men in Aleppo, brings global attention on women doctors like Dr Amani, who are determined to make a difference. In their pursuit to serve the wounded, who constitute mostly children, Dr Amani and her team of female doctors are forced to face chauvinistic men who would rather have them stay at home than run a hospital.

Gender and violence

"A male manager can do a better job," confronts a man whose injured wife is admitted to the hospital. "Women should stay at home," he tells Dr Amani, who was voted twice by the hospital employees to the top post of its manager. Unfazed by the insults, Dr Amani continues her work, operating little children, directing the staff in their work, and ensuring medical supplies. Sometimes when she gets a call from her worried father back home, she has to listen to him saying it would have been easier for her if she were a man. Her colleague, Samaher, who cleans the wards and cooks for the 150 employees of the hospital, too is not insulated from gender injustice. Samaher is often taunted by her male colleagues who complain about the quality of rice in their meals.

Shot between 2016 and 2018 when Al Ghouta was under a siege by the Syrian military trapping 400,000 inhabitants, The Cave exposes the huge cost of war on innocent civilians, especially children. In one scene, Dr Amani is seen removing rubble from the mouth of an infant while in another she listens to a little girl telling her how she was hit by a rocket fragment while out fetching water. "Children love her," say her colleagues about their young doctor-manager.

Keeping the nerves

Life in the tunnels is stiffling for both doctors and their patients. "It is like living in a grave," comments a woman whose child is injured from a bombing by fighter planes. Dr Amani and other women doctors try hard to remain calm under the extreme pressure. "We live because we can become something important," says a female doctor. "Your hands are more beautiful than mine," Dr Amani tells an injured child whose father was killed in a car bomb attack as she braids the young girl's hair. When she comes out of the underground sometimes to enquire about the wellbeing of people in nearby homes, the young doctor tries to help widowed mothers by offering them jobs in her hospital.

Everything is not easy for the women doctors though. There are moments when they arre as much frustrated by the intermittent bombing as the dwindling supply of medicines and malnutrition among the growing number of child patients. "I don't know what makes people have children in these circumstances," laments a hospital employee as they hang on to every bit of humour to lighten the atmosphere. One day, the hospital staff celebrate Dr Amani's 30th birthday by substituting popcorn with cake and having imaginary pizza with extra cheese.

Resilience and love

As the number of attacks rise and the wounded arrive with frightening regularity, the doctors and nurses see their senses stretched to the limits. Even the sound of chopping vegetables become unbearable. "We are witnessing the destruction of humanity around us," says one doctor. "No one can imagine the things we have seen," she adds. 

"Fayyad's intimate portraits of the brave, tenacious hospital staff emphasize the camaraderie that buoys morale when circumstances are at their worst," says Thom Powers, the TIFF Docs programmer. "The claustrophobia of Amani's workplace is mitigated by the high spirits of her crew, while occasional forays above ground temper relief from close quarters with harrowing scenes of a city reduced to rubble," adds Powers. "There are many scenes in The Cave that can break your heart, yet the film leaves us, above all, with a powerful sense of the profound resilience, dedication, and love that endures in the midst of staggering hardship."

When Dr Amani and her staff leave their hospital after the end of the siege in 2018 leading to evacuation of Al Ghouta, they had saved thousands of lives. The film, which is based on the concealed diaries of Dr Amani and footage shot inside the underground hospital, uses modern technology like surround sound and digital cinematography to capture the powerful atmosphere in a war zone. Fayyad showed the final cut of the film to Dr Amani, who now lives in Turkey, before its world premiere at the Toronto festival. "She likes the hospital as a memory that is far away," says Fayyad.