Hot Docs 2013 Interview: TALES FROM THE ORGAN TRADE Director Ric Esther Bienstock

Ric Esther Bienstock's documentary about human organ trafficking is both beautifully made and refreshingly sophisticated. I spoke with the Emmy Award winning director as her film is set to make its local debut at Toronto's Hot Docs festival.

What I adored about your film was the whole notion that it opened up questions for debate without ever coming across as polemical.  How important that was to you when you tackled a subject matter like this?

Well, it was imperative.  I mean, you nailed it - I started out thinking it was going to be a very black and white issue and issue, the story of exploitation, a story that we kind of read in the media and that we've seen before in other films. As I kind of got deeper and deeper into the world, I started questioning my own ethics, I guess.

I really wanted filmically to do the same thing - Where you watch it, and it's what you think it's gonna be, and then you slowly get taken into the kind of nuanced, complex world that really typifies the organ trade.

A major pet peeve for me is when with some films, particularly theatrical documentary at festivals have 90 minutes agreeing with something the audiences already is in lockstep  with and it's just an exercise in preaching to the converted. So, when I see films like yours that genuinely challenge preconceptions, I feel the need to jump up and down and champion it! My point is, I guess, thank you for your moral ambivalence!

Well, thank you for getting it.  Really, I mean it! It was not... it was not an easy way to go, in the sense that I don't want to be seen as advocating for "hey, let's pay people for their organs!"

On one hand I started wondering myself for people like Eddie Boy in the film, is selling a kidney the worst thing in the world for him?  I mean, maybe it's not?  The black market is bad because it's unregulated, but... Well, I'm glad you said that because that's what made it interesting to me, to be honest.

And part of that interest, I assume, is you also become a character in your film when you actually track down the notorious doctor. Were you always going to be an on-screen presence in this story?

There were four different stories I track in the film: The American guy who needs a kidney, the Canadian woman who's on dialysis and her family, the Philippine story and the Kosovo story. Part of that [division] was a filmic imperative, as there was not one strong narrative that would tell the whole story.

With the Kosovo story, I realized the prosecution isn't what's interesting, but I wanted to track down all of the people from one certain operation and how they all converged in this clinic in the middle of a brand new country.  It just seemed like that would tell me something. 

What I find really interesting about the organ trade is that it's illegal, and that people always they talk about the drug trade and the arms trade and the human trafficking and organ trafficking [in the same way].  But organ trafficking is very different because the people who are going to buy organs are regular, law abiding citizens. They're not criminals, they're people who probably never broke a law in their life. 

The people who are selling their kidneys are desperate.  Even the people who are doing these operations, they're trained surgeons and doctors, so it's a bizarre amalgamation of normally law abiding citizens who do this.

I thought, well, if I spoke to each one of them and found out how each of them made their way to this clinic it would be very interesting. I asked Raoul, how did you find your way to Kosovo? When I tracked down the donor I asked, how did you get there and just the mechanics of it? I thought [these] were interesting and the motivating factors. 

So I really wasn't planning to be in it until I realized this tracking down of these people. I mean, I didn't make a meal of it! The only one I really talk about in terms of my involvement was the notorious Turkish surgeon, because he's so notorious and he's called Dr. Frankenstein.

Often with these movies you will have some nefarious character, some bogeyman there that the filmmakers just couldn't get or couldn't get on record. The strongest thing for me again is not just the moral shades that you do but also the characters, the fact that you were able to draw on such a diversity of people.  If you could go even more into detail about going to a website and putting into a comment page to talk to an International fugitive, emailing "Hey, can we talk to you?", and it actually working?

It was so ridiculous!

Before we found him, I shouldn't admit this, before we found his webpage, we had been trying to find him through someone he went to school with, all of these different ways, because his website didn't come up at first in our searches. So finally, when I found his webpage, it was almost like.. it was ridiculous. This notorious surgeon, arrested 6 times!

I sent him my e-mail, and he e-mailed me back very quickly, within the hour. He basically said you spelled my name wrong, which I did in the e-mail I sent to him.  And that was it.  So I was thinking, Oh my God, I get a hold of this guy whose name I've misspelled? 

So I sent an e-mail right away saying don't mistake the fact that I misspelled this for a lack of professionality.  Would you be willing to just meet me for a coffee?  And I spelled coffee wrong, on purpose. 

It's very hard in e-mails to be a person as opposed to just a journalist.  In my initial request to him I crafted a letter saying if I just wanted to vilify you, then I could just use the stock footage. Initially he said he wasn't interested, and then he wrote back and he said that he Googled me to find out what I'm about.  I guess he saw that I had made other films and he said meeting for a cup of coffee doesn't sound so bad. 

So i flew to Turkey to have a cup of coffee with a crew on hold in case.  When I landed in Turkey I had a contact there because I needed a crew and I don't speak Turkish. She said who are you meeting, and when I told her he's quite well known in Turkey because he's also a fantastic surgeon and he's notorious there.  She said he's wanted by Interpol, if I wanted to meet him I couldn't go alone.  I said, don't be ridiculous, he's a surgeon!  Nothing's going to happen, I'm not blowing this.

I get into my hotel room, and the moment I get there the phone rings. It's him, and I'm wondering how he knows I walked in just this second, unless he has someone downstairs, so it started feeling very... cloak and dagger. 

We were supposed to meet the next day at this restaurant on the Asian side of Istanbul.  I had my contact put me in a taxi and give him the address because he didn't speak English, and I walk in, and the doctor is sitting there at this restaurant with his mother and his father and his wife and his young child. All of a sudden there's kind of all the niceties of "hello, pleasure to meet you"... It was really cognitive dissonance and very surreal.

I spent the whole dinner trying to be really polite to everybody and also convince him to be in the film. After the whole dinner he said that he didn't see any benefit to being being in my film. I said well, let's talk about it some more, can we meet tomorrow, and he said he'd think about it. 

The next day I was just waiting for his call - it was very tense for me because I'd just schlepped all the way to Turkey! He called and  said meet me at 1:00 at this restaurant. His wife was there, and he said, "I'll do the interview." I said, that's great, but what changed your mind? He said, "my mother liked you." 

I wish it was a better story, because my conversation was so incisive, I convinced him on ideological reasons, but basically his mother trusted me. I was honest, I said I would not misportray him, that what he said would will go in.

The truth is the interview, is a bit disingenuous.  He has Interpol hanging over his head. He didn't really admit to anything, he didn't talk about it like the Israeli doctor did.

Exactly.

[He didn't] talk about why he ideologically does this. 

And it completely comes across in the film - his reticence is absolutely made explicit.

I make no judgments. I'm hoping that it comes across that it's not like I believe everything he says. That's why I ended up interviewing his mother and his wife because, I thought that every alleged organ trafficker still has a mother who thinks, "Why is everyone picking on my son?"

Such a nice Jewish girl going to Turkey to talk to Frankenstein's mother.... When we talk about cognitive dissonance, you have the master of cognitive dissonance as your narrator.  How did working with David Cronenberg came about?

Sometimes I narrate my own films. Somebody else suggested [Cronenberg] to me and I thought it was brilliant. He is associated with a kind of intelligent discomfort with body parts and our relationship to our body. I loved his voice, by the way. What i wanted was more of a deadpan, not emotional read, I just wanted someone to take you through the story and not be this omnipresent voice in the film.

It's a bit of a wink, but he's associated with that, and we're all very uncomfortable about the idea of selling body parts. The film ethically made me feel uncomfortable because you're talking about something that is really anathema to what we think our moral and ethical standard is, so it just felt like it made intelligent sense, it had a context.

It's tremendous because it feels like he's just trying to tell you the story, not like he's narrating.

I know one of your previous films showed on PBS's Frontline.  I think it's completely underappreciated by particularly people who are slightly snobbish towards television documentaries, not recognizing that occasionally within the idiom of PBS you're getting some of the strongest documentaries ever made. 

Well, I had to recut my film Sex Slaves for Frontline. They generally just do domestic stories and there were no Americans involved so they wanted me in it.  I'm not in the international version or Canadian version of the film, but they wanted me in it telling how I got the story and that made it more relatable to their audience.

But I think Frontline does fantastic work.

Do you see a fundamental difference between an ostensibly cinematic documentary and one made for a television audience?

It's funny that you say that's cinematic - was just at a film festival in New Zealand, and while I was being interviewed they talked about the filmmaking part. I said that what I always try to do is investigative cinema.

On the one hand, it's a real journalistic endeavour. Besides dealing with the issue, I want to make a movie that has all the peaks and valleys of any non-fiction film, one that looks good, that draws you in.  I don't want to make films that just preach about a specific issue. 

I tried to do that with Sex Slaves too - Obviously, it's a really good issue, but it's all through characters. Character's always the most important in the kind of stuff that I've been doing.

Was there something about this narrative, as broad as it is, was there a direction you had wanted to go to that you were just unable to?

Don't get me started! Whenever you make a film, you're always trying to get more and more access and more story.

It's hard right now for me to remember because I think not one story really played out the way I expected.  For example, Walter gets an altruistic donor, and that changed the entire film.  The donor, the Moldovan woman who I found, she was the last piece of the puzzle and the toughest to actually find, that was real sleuthing to find her. 

I didn't put it in the film because it just wasn't necessary at that point in the film, but it was real sleuthing to track her down. I had to find out who she was first, and I couldn't get the evidence from Jonathan Rattel,  the UN prosecutor. There's a defence attorney in Kosovo, and he has all the evidence, so I convinced him to let me look through his files and found her passport. I then went to Moldova to track her down, so there's a whole story there.

If she had been hard done by or ripped off, the film would have had a very different tone as well. 

So I guess that at the end of the film, you never know what's going to happen.  I imagined the film might end with someone languishing on dialysis thinking about this. 

In films like this that are investigative, there are so many different roads I start talking initially because really, until I'm in it, I'm following the puck in so many ways.  I'm following the puck and you just end up following it in different directions.  You come back with all of your footage and you make the film out of all of that. 

It would have been great to have had one narrative story that carried the whole film but there was no way I could do that. Initially, i thought I might have been able to, but there was no way I could do that and cover all of the emotional beats that needed to be covered in the film. 

You have a strong connection with (award winning documentarian Simcha Jacobovichi). How do you help each other out? 

I always laugh and say that Simcha does biblical archaeology and I do sex and death.  Simcha and I have worked on and off together for a very long time, so I produce or executive produce a lot of his stuff. He's based in Israel now, so I run the production company from here, and he produces or executive produces my stuff. That's just a long standing relationship. 

How did you get the film made?

HBO Documentary films in the States and Shaw media in Canada and Canal D in Quebec and Rogers Documentary fund funded it. They were really supportive, because the film took way longer to make because it really was investigative and things had to play out.  And I have to give credit because that was a luxury that you often might not have with a television funded documentary. 

I have to say that the support, the reason I'm so overwhelmed by the support - I mean everyone's happy when you get funding - But I was overwhelmed by the fact that the film took a very different take as I went on location and they supported that. They gave me the time and the space to do this.

I was getting panicked as it got later, and both Shaw Media and HBO said take your time, make it good.  It does take time to do things like this, particularly when they're investigative, because real life just does not happen on a schedule.

I'm not just asking a banal question because you're a professional so of course you're telling your story and you're going to be able to maintain objectivity, but when you're in the conditions that you're in, there must be some sense of humanity there that is challenged.  Can you expand on seeing such drear circumstances but still being the Western reporter there telling the story?

It's a really good point because a lot of my stories have [dealt with] that. Sex Slave, Ebola, most of the stuff I've done, not all, has been pretty dark. 

I've filmed all over Africa, is that the urban slums in Manila  was the worst I've ever seen. Everyone's crammed into a small place, there's no running water, there's no toilets of course, there's jerry rigged electricity.  One of the challenges is going to go back to my hotel at the end of the night after interviewing somebody and mining their misery. Eddie Boy or Joe Boy, I mean, how much worse can it get that you can't stand up in your own house because it's so low?

Often when I'm shooting stuff I'm very sympathetic to the characters, I'm just getting the footage. It's physically uncomfortable and it's emotionally charged and challenging, but you just do it because you're so inside the story.

My emotional reactions often happen in the edit suite when I finally let go and start watching the footage. You're in a zone when you're doing that.  I'm not a news reporter, I really hang out with my characters to get them to feel comfortable with me to start feeling like the cameras are invisible. That's the only way to get that kind of access is to hang out and have them realize that you're not just going in for a quick soundbite. 

There have been a lot of stories about the organ trade but all of these guys in the village, they've been spoken to by the media before and they've all said it's horrible, it's terrible. I hung out with them a few days and went to cock fights with them and shared meals with them, then they started loosening up and started talking openly.

That's when you start getting footage of them saying yeah, I bought a washing machine with the kidney money and I blew the rest on drinks. Finally they were comfortable enough, despite the language barrier, to really be a bit more natural. I think that's where you get the real story, but from an emotional point of view, seeing poverty. That's something that you do, and I don't know how that affects you. 

Some people say maybe that's why I'm so neurotic and miserable and find the negative in everything, even when I'm here.

You may claim to be be neurotic and miserable, but your film exudes life!  Who knows how we'd behave in similar circumstances. The film certainly raises questions about the black market versus calls for regulated transactions...

Well, we all have to sign our donor cards, there's no doubt about that.

It is very easy to judge when you're not in that situation, but if you know that you're not going to survive on dialysis and make it to the top of the list, that's a death sentence, you just need a donor, you can't find one.  When people are faced with life and death, they're going to choose life if they have the wherewithal to do it, you can't blame them.

On the other side of the equation is you have to give people who have no other choice. Yet poverty itself is not a reason to do anything.  We never say it's OK to sell your child because you're poverty stricken, you would never want to go there. What makes this so morally and ethically complex is that we're OK if you give a kidney, we're just not ok if there's money in the transaction.

I'm very interested in why, money changes it.  I believe that it actually does, but why does money change it. Money is not morally neutral anymore.  If you wanted to give me your kidney Jason, they'd have no problem with it. That's what's so striking about this particular issue. 

Keep your hands off my kidneys! You said money changes the issue, makes things more complicated. This is one of the motivating factors of why people in documentaries tend not to paid interviews. When you're shooting in such stark poverty, the pressure must have been enormous to somehow contribute to better their life in order for them to tell their story.  How do you deal with that?

That's been raised a lot, not only in the context of this film but in general in the documentary community. 

I don't believe in paying for interviews because I do believe that you influence people.  I don't want people who talk to me to feel beholden.  I actually think it's detrimental to getting a story, getting a real story.  I really believe that. 

Having said that, there is no way that I am going to mine someone's misery for days on end and then leave to go back to Canada without giving them a thank you, an honorarium.  And if I'm done, if I'm done filming, then I think I just couldn't live with myself if,

I know it's a hot button issue. With Sex Slaves I remember that I was getting an Emmy in New York, and I'm wearing a dress that costs more than those women make in a year, and I'm having a 5 course dinner and all the glitterati were there. I thought, how would I feel if I had not given them an honorarium.  I'm only there because of them. 

People have to use their own judgment. Chequebook journalism, that's bad, for all of the reasons that you already know.  But did I help Eddie Boy afterwards?  Yes.

It's very sensitive.  Someone said to me, why would you admit that you do that? First of all, I think even the people who don't admit they're doing it [are doing the same]. There's different ways to characterize it - I paid them for their time, I paid them for their electricity. There's all these, but I just think you have to be careful and not go "I'll give you money for your interview." You do see it sometimes, people saying exactly what you'd expect them to say.

The biggest luxury that we have as documentary filmmakers is the time to get to know people and to make them comfortable, comfortable enough to be natural on camera. 

Thank you. I really adored this film, and have been more than a bit evangelical about it to fellow critics.

I'm so thrilled that you get it, that you get the tension and that it speaks to you.  It really means a lot. You're taking away exactly what I wanted you to from the film.

Tales From The Organ Trade plays Toronto's Hot Docs on Sunday, April 28, Monday, April 29, and Thursday, May 2.