Emmy and BAFTA award-winning filmmaker Sasha Joelle Achilli has previous experience of pandemics. She was in Sierra Leone during the Ebola crisis of 2014-2015 working on the documentary Outbreak (2015). She saw the health system there overwhelmed and the public struggling to cope with a phantom disease which upended their lives. Even so, the London-based filmmaker was “not prepared” for what she witnessed when she returned to Italy (she was born in Milan) earlier this year to make Italy’s Frontline: A Doctor’s Diary, for PBS Frontline and BBC This World.
This is one of the very first documentaries made during the Covid crisis. “You kind of think it is never going to happen at home…until it does,” Achilli reflects on the anguish and mayhem she witnessed in an A&E department in Cremona in northern Italy just as coronavirus was taking hold.
The film reunited Achilli with Dan Edge (executive producer on For Sama), her collaborator on Outbreak. “I was just writing to him [Edge] as a friend, telling him what my family [in Italy] were telling me and then later that day, he said, ’do you want to go to Italy to make a film?” is how the director recalls the circumstances which led her to the hospital in Cremona, uniting her with her inspirational protagonist Dr Francesca Mangiatordi.
“I was thinking that if we could get access to a really strong character, a doctor inside a hospital that was overrun in northern Italy, we could tell a good story,” the director remembers of her original idea. She wanted to explore the “psychological and emotional” impact the pandemic was having on the health workers. By chance, Achilli saw an image on social media of a nurse in a hospital in Cremona slumped at her desk beside her computer, looking completely exhausted after a 12-hour nightshift. The photo was credited to the doctor, Francesca Mangiatordi. Achilli contacted Mangiatordi by Facebook.
While shooting at the hospital, the filmmakers wore the same PPE (personal protective equipment) as the nurses and disinfected their equipment continuously. Yes, the director acknowledges, it was jarring to be chasing the story and paying such close attention to hygiene at the same time. “It is really challenging in the first few days because you need to get into a routine. That’s where my assistant producers were so good…when I got into my tunnel vision, there was a constant reminder of ‘we have to change our gloves’ or ‘we have to put on an extra layer of PPE before we go into that room’.”
Physically, the process was exhausting too. Achilli was “self-shooting”, her mask was suffocating and the PPE was hot and uncomfortable. However, like the doctors and nurses she was observing, she soon became accustomed to the rigours of working in the eye of the pandemic.
Achilli didn’t intend to stay for long. The original idea was to spend three days in Italy and to make a 15-20 minute piece, a “snapshot” of Italy at the height of the Covid crisis. She had been given two days’ access to the hospital. That was stretched to three. Then, when the press officer at the hospital realised what she was trying to achieve, the director was told she could stay as long as she needed.
In the film, Francesca is shown working punishing hours in a desperate bid to help patients. She is also filmed with her family. She is a strong-willed and heroic figure likened by her young son to a Marvel superhero. Nonetheless, she is continually faced with deeply distressing and heart-breaking decisions about whose lives to save. The doctor also knows that she herself has a strong chance of catching the disease.
Filmmaking went on until Easter. Achilli shot some extra material in May. By then, the disease was in abeyance and so the documentary had a natural conclusion.
The editing had started when Achilli was still in Italy. She had shot just over 100 hours of material. At one point, there were several editors in different time zones working on the project as Achilli and her team raced to finish the 52-minute American version of the film in time for the May 19 deadline and for the slightly longer 59-minute BBC version a few days later. Florence Pugh (the British star from Lady Macbeth and Little Women) agreed to provide the English-language narration.
The film will be broadcast on the BBC later this month. It has already shown in the US to considerable acclaim. “We finished the BBC version of the film two weeks ago and I was pretty spent after that. So I am giving myself my actual lockdown experience,” Achilli says, at last with some downtime.
Back in Cremona, Dr Francesca Mangiatordi has already seen the film. “She loved it,” Achilli says. “For her, it’s her catharsis. Every time she watches it, she cries. She’s a very stoic and strong person who doesn’t out her tears very easily…her and Christina the nurse and [her friend] Laura, they all felt like I was able to capture what they were truly experiencing. I could only do that because I spent so much time with them there. I didn’t just come in and out, like news crews did.”