Donka Hospital in Conakry, Guinea - the largest public hospital in the country - is similar to many African hospitals. Built in 1959 just before independence, it was designed based on a European model, with little consideration for the realities of Africa. The most important hospital in the country, its plight typifies the crisis affecting the entire African health sector.

Over the years the hospital has accumulated substantial debt that neither the Guinean state nor international agencies will pay. Compelled to develop its financial autonomy, the hospital enforces a pay-as-you-go policy. This financial strategy is rigorously applied, but at a high human cost. In this hospital of last resort, families strive to save a child or parent, but without money, there are no drugs and little chance for survival. Revenues rise, but access to treatment diminishes.

As we follow the floor-to-floor progress of patients, their families, doctors and nurses, portraits alternate to form a living chronicle where tragedy meets hope.

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Select Accolades

• Golden Spire Award, 1997 San Francisco Film Festival
• Best of the Festival & Best International Documentary, 1997 Hot Docs