With their bright attire and jolly demeanour, medical clowns Avital Dvory and Shahar Zvi, who are part of Israel's well-known Dream Doctor Project, were able to put rare smiles on the faces of young Thai patients during their recent stopover in Bangkok.
Led by Dvory, the Israeli duo spoke to hospital staff about their therapeutic work with children and adults, as well as paying visits to sick youngsters at Samitivej Srinakarin Hospital and Klang Hospital in the capital.
Explaining the origins of the project, they said the clowns are professional stage artists who have been trained by medical experts to offer a form of therapy for patients during their hospitalisation. They have travelled the globe offering their special support work to hospitals and also disaster areas. A group of them first came to Thailand after the devastating tsunami in 2004.
Their unique contribution to not just patient treatment, but also their recovery and rehabilitation process, has helped patients take better control over their emotional health during a vulnerable period in their lives, said Dvory.
For over a decade, she said the project's activities, which have been designed to positively impact on the time patients and their families spend in the hospital, ensures a more pleasurable and less traumatic inpatient stay. Moreover, research has shown the presence of medical clowns as part of a treatment team can significantly reduce the level of anxiety among children.
Dvory and Zvi did background research on the type of music and activities Thai children like prior to their visit. Their encounters were interesting to say the least.
"There was a really anxious sick child we visited, who seemed to be so afraid of us that he hid under his blanket," he said. "It was understandable that he became tense because we are foreigners and were wearing clown attire. I played some soothing music to relax the youngster on my guitar. Avital took out toys which jump to create a playful environment.
"We also blew bubbles while we let the toys jump around on the floor. By then the boy, who could not see us, but only the toys, the bubbles and with the music in the background, was also jumping and talking to the toys. When we were about to leave the hospital, the nurses told us that he was wondering where we had gone. So it was mission accomplished."
Dvory continued: "Each situation we are in is different, so we adapt our performance to the needs of that particular patient. While visiting another young patient, I made sword balloons for both Zvi and the young boy. They play-fought and when the boy was able to beat Zvi, he had a big smile on his face. He felt in control of the situation, and that was our aim. In a way, young patients feel victimised because hospital staff around the clock are checking up on them. They feel anxious and are not able to deal with their emotions.
"All the therapeutic performances we stage are based on making the patient feel he/she is in control of his or her situation, using the state of mind of a clown which in my opinion is honest, curious and naive.
"When you are very naive you don't see a sad point of view, you don't see the disease, you only see the situation in a positive light. Having worked with children with cancer, I see them one day with hair and the next day without. As a clown, I don't look at the child's bald head as a result of having to undergo chemotherapy, but rather as a new hairstyle or fashion statement."
Dvory, who has been with the medical clowns project since its inception 12 years ago, said that their ultimate aim is to help patients, both old and young, connect with their suppressed emotions. A combination of performance skills and therapy training enables her to guide adult patients through their confused state of mind, offering them emotional relief through outbursts of laughter, angry, grief and crying.
In a nutshell, they said it helps sick people to connect with their inner strength, making them realise they are in charge of their situation.
Zvi said adults, in particular, suppress their emotions because they might not want to show their vulnerable side to others, making it all the more necessary for them to release these emotions. As clowns are associated with fantasy, young patients don't view them as a threat and are more confident to play along with them.
When Dvory, a puppeteer and actress by profession, worked with a physiotherapist whose young patient needed to get back to walking after an operation, she adopted an empathetic approach.
"It is obvious that the child was in pain," she said. "Whatever way his family tried to convince him to walk, he had no desire to experience that pain. This is where my work begins. After I am able to bond with the patient, I devise a game which is designed around the treatment.
"When I know a child needs to walk, I set up a game to encourage him to do just that. During our game, the child is actually playing with me, and thinks that he is about to win the game, while simultaneously undergoing his physiotherapy. Therapeutic clowning is the method we use whereby an assortment of artistic skills are used to address patients' needs.''
Dvory said that the satisfaction she gets from being a medical clown is more than words can express.
"For me it's a mission to share the gift I have," said the mother-of-two.
"It's a reminder to people that you always have a choice when it comes to either being positive or negative about the situation you're in. I have sometimes met families that just don't want to laugh because they might be going through a rough time being sick.
"Having a positive state of mind is a choice. A case in point are two five-year-old patients who died one week apart due to cancer. One died like a wilted flower while the other a warrior. We have power over our state of mind. We will die anyway, how we plan to live our life is in our hands."
A member of the Israeli Medical Clowns Project helps ease the tension for a young Israeli patient about to undergo an operation.
Avital Dvory and Shahar Zvi visiting patients.
Avital Dvory speaks to Thai nurses about Medical Clowns under the Dream Doctor Project.
