This is the second in a series of articles on the recent San Francisco International Film Festival, held April 5-19. The first part was posted April 26.

Muhi—Generally Temporary, directed by Israeli filmmakers Rina Castelnuovo-Hollander and Tamir Elterman, was one of the most moving and affecting films screened at the recent San Francisco film festival. “Muhi” is short for Muhammad, the name of a Palestinian boy from Gaza, who as an infant was rushed to Israel for emergency medical treatment. The movie follows Muhi’s story over the course of four years or so.

The documentary film’s prologue takes place at a checkpoint between Israel and Gaza. Only an infant, Muhi is being taken by ambulance to an Israeli hospital. Several years later, he is four and has had both arms and legs amputated due to an infection he developed while waiting for a bone marrow transplant donor. “Generally Temporary” refers to Muhi’s current status in Israel, a specific, hellish type of limbo. His compromised immune system renders him untreatable in the inadequate, besieged medical facilities in Gaza. The return to his family would likely be a death sentence.

As required by Israeli law, Muhi must be accompanied by an adult over 55 while in that country. In this case, it is his grandfather Abu Naim, who has been vetted by the Israeli authorities but is not allowed to leave the hospital grounds. In the years that Abu Naim has acted as Muhi’s caretaker, he has been separated from his own family in Gaza. In the course of the filming, piling tragedy upon tragedy, Abu Naim’s teenage son, Nasrallah, who has suffered a head injury, is treated in a Palestinian-run hospital in East Jerusalem and dies, having been returned to Gaza prematurely.

One of the movie’s central protagonists is Buma Inbar, an Israeli committed to helping Palestinian children living in Gaza to have access to medical care in Israel.

Aside from the heartbreaking sequences of the energetic, exceedingly bright and perceptive Muhi, bounding along hospital corridors as he adjusts to his new artificial limbs, one of the film’s strongest elements is its documenting of the deep friendship between Buma and Abu Naim—an Israeli and a Palestinian who have both lost sons in the conflict. (Buma’s son, who was in the Israeli army, was killed in Lebanon.) Muhi also has profound affection for Buma, and speaks both Hebrew and Arabic.

Although separated by a small physical distance, Hiba, Muhi’s mother, is a world apart from her son, and must endure a nightmare of bureaucratic procedures to enjoy brief visitations. Muhi’s father has reportedly been proscribed for political reasons from ever seeing his son while the latter remains in Israel. At times, the inhuman situation brings the brave youngster to the brink of emotional collapse.

Barbed wire, heavily armed soldiers and checkpoints figure prominently in Muhi—Generally Temporary. The scenes of Buma, Muhi, his mother and grandfather waiting interminably to make contact underscore the determination of the Israeli government to terrorize and intimidate Gaza’s residents. On the other hand, the essential humanity of both the Palestinian and Israeli peoples is ever-present.

Although the filmmakers choose to limit the scope of their documentary, attempting to navigate around larger geopolitical issues, it is worth noting that Castelnuovo-Hollander’s decades-long history of recording the region’s horrors as a photojournalist has not made her hard and callous, as it has so many others. On the contrary, along with Elterman, she imparts to her debut film an extraordinary level of empathy and concern for the plight of the Palestinians.

Distressingly, a postscript title reveals that the Israeli government has closed Muhi’s file, preventing his mother from ever again making the trip to see him.

Since the 2014 ceasefire ending Israel’s most recent, devastating war against Gaza, the Palestinian population has endured horrific social ills. A Palestinian film crew, shooting the Gaza sequences in Muhi—Generally Temporary, provides a glimpse of the poverty, electrical blackouts and oppression.

The Israeli authorities’ brutal blockade of Gaza and its dense population of 1.8 million people has now been in place for a decade, since the electoral victory of Hamas in the territory. A recent report by the Euro-Mediterranean Human Rights Monitor found that 65 percent of Gaza residents suffered from poverty, 72 percent were food-insecure and 80 percent had grown dependent on international aid, while unemployment in the strip hit a record 43 percent in the last quarter of 2016.

Ashraf al-Qidra, a spokesman for Gaza's Health Ministry, recently told Al Jazeera: “Around 4,000 Palestinians need to leave Gaza for urgent medical treatment but they can’t because of the siege. Cancer patients are particularly affected as their condition is deteriorating. Our whole medical system is crumbling. We can’t get equipment in and we cannot train our doctors.”

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We spoke to Rina Castelnuovo-Hollander and Tamir Elterman in San Francisco.

Joanne Laurier: How did you come across this story?

Rina Castelnuovo-Hollander: One of the things I’ve done over the last three decades has been to cover big events and news stories. And I always want to know what happens to ordinary people behind the conflict. I was working on a story about Palestinians and Israelis who lost family members in the hostilities, and I photographed caretakers Buma [Inbar] and Abu Naim, and there was the little child, Muhi. I wanted to know more because I discovered that Muhi’s mother lived one hour away from the Israeli hospital, in Gaza, and yet Muhi doesn’t know her. He goes through all these surgeries and amputations, but he doesn’t know his own mother.

I was also captivated by this relationship between Buma and Abu Naim. They call each other ‘brother’ and they are really close friends. It was a continuation of what I’ve been doing the past year in the bereavement series.

I realized that the hospital was a rare meeting ground for Israelis and Palestinians. Because there are hardly any cross-border relationships existing today. When people share rooms and wards, they can’t remain enemies. It took a while before I realized I had to start filming, that still photography couldn’t do justice to the story of Muhi and the caretakers. But I didn’t have enough experience in film. That’s when Tamir [Elterman] joined and suggested it should be a feature-length film. So then we did more than three years of filming.

JL: You mentioned at the film’s question-and-answer session that there were separate Palestinian and Israeli film crews. How did they coordinate?

RCH: There could not be direct contact between us--not that we didn’t want that. So we did it very carefully. We suggested to the Gaza crew: just be there with the camera and sound, and record what takes place. They did a great job. We did it very carefully because we know how difficult it would be for the Gaza crew. As I said at the Q & A, when Abu Naim went to Gaza, we stopped on the Israeli side and they picked him up on the other side.

Tamir Elterman: They did an incredible job in Gaza. When we would get the footage back, we would celebrate the job they had done.

David Walsh: Could each of you briefly explain your background?

RCH: I started as a photojournalist with the Associated Press. I then started freelancing and ended up with the New York Times. And I have covered mostly the Israeli-Palestinian conflict, first in Lebanon. I did cover the Gulf War. I am Israeli.

TE: I’m from Berkeley, California. After graduating from university, I followed a film project in Israel about someone who wanted to serve in the Israeli army. That’s how I found myself in Israel for three years, and then I left to do my graduate work at Columbia’s School of Journalism.

A year later, I found myself back in Israel reporting on the war in 2012, I went to Syrian refugee camps and then started with this film four years ago. I have been based in Tel Aviv for most of the past ten years.

JL: The film begins with Muhi as an infant. How did you get that material?

RCH: It is real footage of Muhi as a baby, with his family. While we were working on the film, we were approached by someone who had footage of Muhi when he had his arms and legs, and of Buma and Abu Naim, and the grandmother.

DW: When did you start filming?

RCH: Just before the 2014 war in Gaza.

TE: The difficulties we had put the surreal nature of the situation in the forefront--we were filming with the conflict emerging.

DW: It’s a region that has known enormous suffering. The checkpoints figure largely in the film and in people’s lives.

RCH: Obviously the child’s world is divided by the conflict and the border. The border issue is very complicated. You can’t just say, “Oh, there is a fence.” I wanted to focus on the people and their need to get health care.

When you live in Gaza you must first apply to a medical committee and be approved to be treated outside. That takes a while. When you are approved, you then have to apply to the Palestinian Authority and be okayed for financial backing. Then you have to ask, “Where are you referring me?”

And they decide whether you go to a Palestinian hospital in the West Bank or an Israeli hospital. If you go to an Israeli hospital, you have to go through Israeli security screening and if you get the final approval, you are allowed to enter. Children need to be escorted. So then you need an escort who is over 55 years old. Sometimes family members don’t qualify because of the age restriction, so then it is a neighbor.

Buma spends all his time at the border--he is this one-man operation. The other day he spent hours at the border because this 12-year-old girl did not have anyone to accompany her. So he and the hospital managed to find someone who would act as a chaperone.

It’s very complicated. So when these kids finally get to an Israeli hospital, often the doctors don’t let them go back to Gaza because they’re afraid that if they send them back, they won’t be able to return. If you go back, you have to go through the process all over again. It takes weeks and months.

Now, if it’s an emergency, like it was with Muhi, it can take 24 hours.

DW: Do you know how many Palestinian patients there are in Israeli hospitals at any given time?

RCH: The number is in the thousands. We saw many Palestinians from the West Bank and Gaza in the hospital when we were filming, because Muhi was being moved from ward to ward. We would see them there at all hours because, for example in rehab, the Israelis can get treatment and then go home. They don’t sleep there. The people who actually stay are the people who have a long way to go.

JL: Abu Naim’s injured son, Nasrallah, was sent back to Gaza from a Palestinian-run hospital in East Jerusalem, in Israel, after surgery. Do we know what happened to him?

RCH: Yes, they said he was OK. We tried to look at the papers, but we could not make much sense of them. Abu Naim was sure his son was fine and great.

TE: After the surgery in Israel, they told him he was going back to Gaza, he had finished his treatment here. He would start rehab in Gaza. And, tragically, he died.

DW: What is the state of the medical facilities in Gaza, after years of war and destruction?

RCH: I have not been able to go there since 2006. There are hospitals in Gaza, but they say they lack training and equipment. I know there are 200 doctors in Al-Shifa, but if they don’t have the latest equipment, or if they don’t get the latest medications … Everybody complains bitterly that Nasrallah did not have to die like that.

JL: You describe Muhi as living in limbo. He’s now in an Israeli hospital with his grandfather and the situation will remain like that, until Abu Naim is thrown out of the country.

TE: Abu Naim says he was waiting for someone to come and ask him to leave, but nobody ever came, and now he’s supporting himself and Muhi working as a hospital janitor.

RCH: When we started, we thought Abu Naim was going to be deported because he didn’t have his permit, but he got it. So, I have no reason now to presume that somebody’s going to throw him out. If that happens, we could make a bit of publicity.

DW: Could you say a few words about Buma?

RCH: Buma is a contradiction in many ways. We don’t even know his politics. He is only dedicated to help children to get medical care. But he does not belong to any organization. He’s not paid by anyone.

DW: Do you know anything about his history?

RCH: I know he was an ordinary man who, like everybody else in Israel, did his army service. He was in all the wars. In the Yom Kippur War [1973], he was telling me, he lost all his friends and was traumatized. When his son went to high school, he went to be a paratrooper, was sent to Lebanon and was killed with all of his group.

After his son was killed, Buma told me he considered taking his own life because he felt responsible for his son’s decision to join the army. But then he decided the only way we can live in this place is if there is peace and understanding. He joined a parents’ circle for a while. Shortly after, he met Abu Naim and they became very close, especially after they both lost sons. They both lost their sons because of war and conflict.

TE: Buma has a slogan: “Leaders sign peace treaties, but people make peace.”

DW: Well, that reminds me of a quote from Brecht: “When the leaders speak of peace, the common folk know that war is coming.”

JL: There is a snapshot of Buma’s politics in the scene when he is with Muhi, who as a child has no political filters. So when Muhi talks about loving Netanyahu and that he will take care of Gaza. Buma slyly says, Yes, Netanyahu ‘will really take care of Gaza—and how.’

RCH: But Muhi always says, “I love Buma.”

JL: Even though the film is about a deeply personal story, it expresses a much bigger reality, involving millions of people in the Middle East.

RCH: The film is about contemporary issues.

JL: Yes, the US is building up the border and walls …

DW: Many things strike you about the film. Above all, the compassion and sympathy of ordinary people on both sides. And then the cruelty of governments, frankly, the increasing cruelty of the authorities. Of course now, Trump has dropped the biggest bomb the US has, the next thing to a nuclear bomb. They’ve killed hundreds of thousands of people in the region.

RCH: We are witness to masses of people forced to leave their homes and seek shelter. We are consumed with the question of access to health care and how the people are going to survive. Hundreds of thousands of people don’t talk politics, they talk survival.

TE: We stay focused on people who are caught in the conflict and are unwittingly born into it, like Muhi. And we really wanted to stay focused on that level.

JL: This is a deeply compassionate and conscientious film. We still don’t know what’s going to happen to Muhi--or the population for that matter.

RCH: We hope of course there will be some kind of solution in which kids like Muhi can grow to their full potential. Muhi was born with acute intestinal malfunction and he went to Israel for a bone marrow transplant and they could not find a donor. Muhi developed bacteria. With his weakened immune system, this meant the only way to save his life was to amputate his arms and legs. He has a colostomy bag which is also a major reason that he cannot return to Gaza. There is a huge shortage of colostomy bags in Gaza.

Muhi is so smart, he’s one in a million. And he sees no difference between people.

To be continued