Review: The brilliant, infuriating Romanian healthcare documentary ‘Collective’ is a COVID-era must-see

On Oct. 30, 2015, a deadly fire swept through a Bucharest nightclub called Colectiv, killing 27 people at the scene and spurring furious protests over lax safety measures. For those who took to the streets, the tragedy was the latest evidence of the hopeless incompetence and corruption of Romania’s Social Democratic leadership, which soon collapsed and was temporarily replaced by a technocratic government.

But the full extent of that incompetence and corruption had yet to reveal itself: In the four months after the fire, another 37 Colectiv burn patients died in local hospitals, many due to bacterial infections left unchecked by disinfectants that were later found to be defective — a revelation that compounded a nation’s anguish with fresh waves of shock and outrage.

The contours of that tragedy and many others are laid devastatingly bare in “Collective,” an extraordinary new documentary from Romanian director Alexander Nanau (“Toto and His Sisters”). Suspenseful and gripping, despairing and deeply human, the movie first screened at the Venice and Toronto film festivals last fall, though its virtual release this week feels particularly well timed. A year ago, “Collective” played like a nonfiction genre piece, a journalistic thriller by way of a political procedural. Seen now, during the gravest world health crisis in more than a century, Nanau’s exposé of medical malpractice and pharmaceutical corruption feels like a grim warning, a prequel to a real-life horror movie still very much in the making.

If the COVID-19 pandemic has served as a metaphorical blacklight, exposing socioeconomic disparities and emergency-response weaknesses in nations around the globe, then Colectiv focused its own penetrating laser beam on the appalling failures of Romania’s healthcare system. The fire is briefly evoked at the outset with a harrowing blur of footage: a wall of flames accompanied by a wall of screams. But the tragedy played out long after that terrible night: Nanau shows us the grief-stricken relatives of those who died in the hospital, demanding to know why their loved ones had succumbed, in some cases, to relatively minor wounds.

They got their answers thanks to the dogged muckraking of Catalin Tolontan, a prominent journalist for the sports daily Gazeta Sporturilor. Nanau appears to have shrewdly embedded his camera crew with Tolontan and his colleagues, tracking their promising leads, rebuffed inquiries and hard-won “Eureka!” moments as the truth gradually comes into focus.

Their investigation reveals that active ingredients in widely used hospital disinfectants had been heavily diluted, sometimes to as low as 10% of their advertised concentration. The weakening of these decontaminants rendered them useless against the spread of pyocyanic bacteria among patients, though it did effectively funnel millions of euros into the pockets of their manufacturer, Hexi Pharma, and the hospital managers who purchased them.

A feel-bad story in just about every respect, “Collective” does give working journalists their feel-good due; at one point Nanau throws in a stirring shot of newspapers speeding off a printing press, evoking ripped-from-the-headlines Hollywood dramas like “All the President’s Men.” In this case, however, the publication of damning secrets is not a triumphant end but a queasy beginning. The news that a pharmaceutical firm has been supplying diluted disinfectants to more than 350 Romanian hospitals — and that top officials had turned a blind eye for years, despite repeated intelligence briefings on the matter — raises ever more troubling questions and sets off a flurry of chain reactions, including at least one mysterious high-profile death, within the political and medical establishment.

“Collective” races to keep up with the fallout, and it’s a testament to Nanau’s resourcefulness (to say nothing of his persuasiveness) that the movie switches midstream from one important protagonist, Tolontan, to another. Amid the furor over the disinfectant scandal, the minister of health resigns and is replaced by Vlad Voiculescu, a political outsider known for his advocacy on behalf of patients. Boyish-looking at 33, and possessed of a gentle yet forthright idealism, Voiculescu speaks openly and with palpable disgust about a “dysfunctional state” that happens to have one of Europe’s highest preventable-death rates. His utter ease with the camera — not only at press conferences but also in the offices and boardrooms where he and his colleagues discuss much-needed reforms — feels like an oasis of transparency in a desert of money-grubbing cronyism.

The depths of this corruption, which has bred soul-crushing cynicism and despair among leaders and citizens alike, will come as little surprise to moviegoers who have followed the remarkable ascendancy of Romanian cinema over the past two decades. In that time, some of the country’s (and the world’s) finest filmmakers have found rich inspiration in the waste and disillusionment of post-Communist life, treating it less as a startling discovery than as a dismal, matter-of-fact reality. Watching “Collective,” which will represent Romania in this year’s international feature Oscar race, might prompt particular memories of Cristi Puiu’s 2006 masterwork, “The Death of Mr. Lazarescu,” in which an ailing man is repeatedly neglected, mistreated and shunted from one hospital to the next, becoming the latest casualty of a profoundly broken system.

If “Mr. Lazarescu” was a drama that unfolded with unblinking realism, then “Collective” is a documentary paced with the urgency of a thriller, in which the dubious qualifications of hospital managers and the specifics of lung-transplant protocols somehow become as riveting as any chase sequence. The steadily pulsing tension of Nanau’s filmmaking — the nimbleness of his cinematography and the sharpness of his cutting (his co-editors are George Cragg and Dana Bunescu) — becomes inseparable from the void that opens in the pit of your stomach. Poignant, redemptive human moments — many of them courtesy of Tedy Ursuleanu, a Colectiv survivor whose physical and emotional recovery becomes a source of national inspiration — jostle alongside the horrors endured by the dead and the dying, one of whom is shown suffering in silence with maggot-infested wounds.

Nanau doesn’t linger on that grotesque image for longer than necessary, nor does he milk it for its obvious metaphorical import. But he understands that the larger malaise he’s diagnosing is hardly unique to Romania. You might recognize some of its symptoms in your own government: in systems that prioritize profits over patients’ well-being, in blasts of nationalist rhetoric and in high-stakes elections whose outcomes suggest that some voters have an awfully selective relationship with the truth. As one subject notes with all-too-relatable weariness: “It’s like we are living in separate worlds.” The horrors of “Collective” are sickeningly specific; the implications, as suggested by its comprehensive indictment of a title, are universal.