Rx 16 / Evaporating Borders
Iva Radivojevic, film still from “Evaporating Borders,” 2014. Courtesy of Slought Foundation.
One day in early July, sixty-five migrants were found floating in the Adriatic Sea off the coast of Croatia. Squeezed onto a boat without fuel, they were only interested in landing in an EU country... Some days later, nearby in Mediterranean waters about fifty people die in a similar attempt to reach Italy. A little further south at August’s end, a boat was carrying four men, one woman and two children. None survived.
-iva radivojevic, evaporating borders
The photograph is striking for its minimalism: we see a precarious small boat with a green hood. The boat is solitary and vulnerable, adrift in vast, dark waters with no shore in sight. A somber tone pervades the scene, though the bright upper right corner, towards which the boat is sailing, offers a faint glimmer of hope. The serenity of this image belies one of the starkest human rights violations of our lifetimes. We do not know the boat’s destination or the fate of those aboard though we idealize opportunity in their flight.
Iva Radivojević’s essayistic documentary, Evaporating Borders, takes us to the front lines of the European Union refugee crisis through a series of vignettes. Guided by the filmmaker’s personal reflections, the film investigates the effects of large-scale immigration on the sense of national identity, passionately weaving together themes of migration, tolerance, and belonging. Radivojevic explores how the erosion of borders—both physical and metaphorical— defamiliarizes the narratives of selfhood through which identities take shape and reproduce themselves. Shots of a boy swimming in the ocean evaporate boundaries between ‘us’ and ‘them:’ is he a refugee swimming to shore, or a tourist in Dubrovnik? Is this survival or leisure?
The film begins and ends as we peer through a window, gazing at the sea. Radivojevic’s intentional framing implicates the viewer as an outsider, distanced, as permanently stateless populations proliferate across the globe and at home. Yet communities, both domestic and international, have responded with aggressive xenophobic rhetoric and policy—or even indifference—while families are separated, children wrenched from their parents. The film still speaks to our current moment and raises fundamental questions about our desire to impact the lives of others, our ability to grieve for those we don’t know, and our understanding of the true costs of displacement.
reflections…
Our civic and health care landscapes are rife with ubiquitous borders that multiply in pernicious ways, obstructing entry to those in extremis. For example, a mandate issued in September 2018 known as the “public charge” rule utilizes pre-immigration health screenings, a practice dating to the nineteenth century at ports such as Ellis Island and rigorously enforced by the current administration, to detect health conditions and illnesses that could potentially exclude individuals from receiving visas or permanent resident status.
This century-old practice has fallen under intense scrutiny in the medical community for its haphazard delivery and biased, non-evidence-based standard of care—for example, people with HIV were denied green cards until recently. Those presenting with mental health and substance use disorders can similarly be rejected. Further, the infiltration of law enforcement within health care settings deters immigrants, both legal and undocumented, from seeking appropriate care. Even more troubling is the less visible involuntary medical repatriation of undocumented immigrants who receive emergency medical care and are forcibly returned to their country of origin. Burdened with the humanitarian toll of the border crisis, physicians are frequently confronted with compromising ethical and clinical dilemmas in the care of immigrant populations. How can we better train, educate, and support physicians in the care of and advocacy for undocumented immigrants, refugees, and asylees?
As suggested in a recent New England Journal of Medicine article, should medical schools be required to provide human rights education? Similarly, what is the role and responsibility of professional medical organizations, associations, and medical institutions in supporting physicians who care for undocumented immigrants and speak out against the border crisis both here and abroad? How can clinicians work in alliance with policy makers and human rights activists to fortify health care delivery to immigrants and refugees? How can we support continuity of care and eradicate barriers in obtaining necessary medical and social services for immigrants and refugees within our local communities?
sources
Castañeda H, Holmes SM, Madrigal DS, Young ME, Beyeler N, Quesada J. Immigration as a social determinant of health. Annu Rev Public Health. 2015;36:375-392. doi:10.1146/annurev-publhealth-032013-182419
Crosby, S. S., & Annas, G. J. (2020). Border babies — medical ethics and human rights in immigrant detention centers. The New England Journal of Medicine, 383(4), 297-299. doi:10.1056/NEJMp2003050.
“Evaporating Borders.” University of California Television, 23 Feb. 2016, youtu.be/tL66kGtPM0I.
How health systems can address health inequities linked to migration and ethnicity. Copenhagen, WHO Regional Office for Europe, 2010.
Khullar, D., & Chokshi, D. A. (2019). Challenges for immigrant health in the USA—the road to crisis. The Lancet (British Edition), 393(10186), 2168-2174. doi:10.1016/s0140-6736(19)30035-2.
Kidia, K. (2019). Physicians as border guards — the troubling exam for immigrants. The New England Journal of Medicine, 380(15), 1394-1395. doi:10.1056/nejmp1901727.
Radivojevic, Iva. “Evaporating Borders.” IFFR, 4 Sept. 2015, iffr.com/en/2014/films/evaporating-borders.
Rapold, Nicolas. “Review: ‘Evaporating Borders’ Examines the Immigrant Crisis in Cyprus.” The New York Times, 18 June 2015, www.nytimes.com/2015/06/19/movies/review-evaporating-borders-examines-the-immigrant-crisis-in-cyprus.html.
Seeking Refuge - Programs. Slought, accessed 5 Aug. 2020, slought.org/resources/seeking_refuge.
