Laughter helps children heal. Credit: Jorge Luis Baños/IPS

HAVANA, Apr 3 2013 (IPS) – Three-year-old Yanaghy García has been in the William Soler Children s Hospital, in the Cuban capital, for a month. He suffers from epilepsy, but he forgets about it all for a while and smiles at the antics of Mantequilla, a clown.

He is doing well and getting better. When I see him smiling like that, it s as if he were playing with his friends again, the boy s grandmother told IPS. Vicenta Echevarría knows how much happiness visits by the clown, who works as a volunteer, bring to the children.

Mantequilla is actress Reyna de la Paz, who has been delighting patients and caregivers in the hospital every Tuesday and Thursday since 2011, when a doctor asked her to give one of her performances in the haematology ward.

She works directly with children who have to spend a lot of time on the oncology, haematology and organ transplant wards. My presence in the hospital benefits not only the patients and their relatives, but also the doctors, who sometimes have very complicated cases, and service personnel, she said.
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I m a theatre actress, I didn t have any background in this kind of therapy. I learned gradually alongside the doctors and paramedics. It s been a big challenge, she told IPS.

De la Paz is one of several self-taught volunteers who visit hospitals in this country as clowns.

To make up for their lack of training, the Canadian Association of Therapeutic Clowns offered a workshop in March, which Mantequilla attended.

A dozen paediatric and rehabilitation specialists, circus professionals and the La Colmenita children s theatre company are participating in the Therapeutic Clowns for Cuba Project, an idea promoted by Dr. Adrienne Hunter, a Canadian who lives in Cuba.

Hunter facilitated links between the worldwide professional organisation Therapeutic Clowns International and the health ministry. As a result, the Canadian association created a training course that combines medical knowledge and circus arts.

I firmly believe the Cuban health system is going to include this programme. Laughter is life! said Hunter.

Canadian therapeutic clown Joan Barrington was one of the tutors for the course, which held practice sessions at the William Soler Hospital.

Everyone paid close attention and really embraced the theory behind the profession, Barrington, who since 1998 has headed a foundation to take therapeutic clowning to children s hospitals in her country, told IPS.

What we do is to accompany the patient during his or her illness. Children cannot choose when to go to hospital or what medication they must take, but they can choose when and how to play with their friend the clown, said Barrington, the inventor of Bunky the Clown.

In her view, the essential features of a therapeutic clown are vulnerability, openness and being in the right place at the right time.

It s not about the clown, but about the kids in bed; they guide me to where they want to go and what we re going to play. Children in hospital can t go out, but we can travel with our imagination, she said.

Since 1986, circus artists and health personnel all over the world have embarked on what is now known as therapeutic clowning. The movement is mainly based on volunteers and its participants maintain that laughter is a complementary form of healing, especially for children with illnesses that require long-term hospitalisation.

While laughter has been applied as a healing technique for mental and physical ailments for years, Dr. Hunter Patch Adams in the U.S. has contributed the most to its use as a therapy in contemporary medicine since the 1980s in many parts of the world.

Patch Adams, whose life inspired the 1998 film of the same name starring Robin Williams, dressed as a clown to attend his patients, which is why he is known as the laughter doctor.

Today the 67-year-old activist recruits volunteers who dress as clowns and travel the world to entertain people of all ages who are going through difficult times. His mission has taken him to Cuba several times, most recently in 2008.

Scientific studies and polls of medical personnel and parents report that the presence of therapeutic clowns in hospitals brings physiological and emotional benefits.

Roberto Álvarez, a health ministry official, said at the conclusion of the workshop in Havana that this practice is supportive of medical personnel, and that his ministry is committed to gradually extending the experience of therapeutic clowns to all children s hospitals on the island.

Cuba s infant mortality rate is 4.6 per 1,000 live births, according to 2012 figures, and its under-five mortality rate is six per 1,000 live births, one of the lowest in the world.

According to the National Statistics and Information Office, in 2011 the second cause of death for children between the ages of one and four was malignant tumours. Cancer requires long periods of hospitalisation, affecting the child population.

A visit from a clown changes the whole dynamic and energy flow. The experience has been a great stride forward. We would like to see it taken up in other hospitals in the country, said Elena Povea, deputy head of the William Soler Hospital.