Madonna's documentary highlighting the plight of Malawi's estimated one million Aids orphans has been given its world premiere in New York.
The film, which the singer produced and narrated, tells the story of several children, many of them born to mothers who have died of Aids, most of whom lead desperate lives.
On the red carpet at the Tribeca Film Festival, Madonna told reporters how I Am Because We Are contains a message of obligation.
"We are responsible for each other and that if we can help in any way, shape or form, we should," she said.
The documentary includes some excruciating scenes showing the agonising grief of a mother who has just lost her child to Aids.
There is also a harrowing moment when a young boy - a victim of genital mutilation - is being treated by medical staff.
But director Nathan Rissman said the idea was not just to shock audiences.
"We decided, if we were going to wake people up, we were going to try to point them in the direction of how we can solve these problems.
"There are so many solutions out there and I think that the more that we discuss this, the more that we have a dialogue about what to do, the better," he said.
I think that she just believed in me, and she saw something that she realised that we can get something done together
Film director Nathan Rissman
"So I think and I hope and pray that I found the balance of myself in the film as well as the stories of the children," she said.
The film is being launched just as Madonna waits for her adoption of a young Malawi boy to be finally approved by a court in the country.
The documentary shows the pop icon in a very positive light, but Madonna says she was ambivalent about appearing on camera.
"In the beginning I wasn't in the movie at all, but then I realised because I was narrating that it was important that I let people know that it was my personal journey and my experience.
The film's director has been referred to as "Madonna's gardener" or "Madonna's nanny's husband", while Rissman acknowledges that he is very much part of Madonna's inner circle.
"Both my wife and myself have worked for Madonna and her family for the past four years, and my wife has a relationship with the family that pre-dates mine, but I wouldn't necessarily say that's how I got the gig," he says.
One aspect of Rissman's talents that impressed Madonna was the home movies he shot of her children, which may have played a role in him landing the job as her documentary director.
"I think I proved myself to Madonna and her family as a trustworthy colleague, co-worker, somebody that would share Madonna's creative vision, and I think that she just believed in me, and she saw something that she realised that we can get something done together."
He may be a first-timer, but there is an intensity to the way Rissman has made this film, with much of it shot in cinema-verite style.
His camera does more than just convey the tragedy of the Aids orphans, but also shows optimism in the midst of the crisis.
Madonna is hoping to finalise the adoption of David Banda
In addition to extensive filming with the orphaned children in Malawi, the documentary includes interviews with Archbishop Desmond Tutu and former President Bill Clinton.
It also propagates the view that Malawians cannot just rely on outsiders for help - they have to take some responsibility for their own problems.
For many of the participants in the documentary, Madonna's efforts are being seen as a laudable attempt to bring attention to a humanitarian crisis that much of the world ignores.
This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.