A punch in the gut.
Ellis' portrayal of Filipino corruption, family, and destitution is awfully sharp for a foreigner. He left it to the actors to translate the script - it's as much theirs as it is his. While the cultural cues and off-the-cuff colloquialism are glossed over by subtitles, the result is a film that does what it does in earnest.
Impoverished human drama is not new, but its voyeuristic expression in the washed out colours and day-to-day criminality of Manila is no less real, no less awing, and no less ugly.