Clowning away fear and anxiety

Men and women in silly hats and wigs wearing red foam noses pose with children in hospital room

Gaza’s clown doctors during a recent visit with young patients. (Courtesy Clown Doctors Team)

It’s not unusual to pass a ward at the Abdelaziz al-Rantisi pediatric hospital in the center of Gaza City and hear the trill of a child’s laughter.

It is a welcome sound in a place that is too often one of pain and fear and the occasional flight attempt from a doctor’s office.

On one recent winter morning, it was Rafat al-Satari who was laughing out loud on a hospital bed, preparing for dialysis treatment. The cause? Two red-nosed clowns pulling funny faces and doing magic tricks had just delivered a cake to his room on the occasion of his sixth birthday on 26 February.

The clown cake delivery is a result of a 2013 initiative by Majed Kalloub, who founded the “Clown Doctors Team,” to pay visits to child patients around the Gaza Strip. The idea, he said, was not only to provide some relief to the children, but to help medical staff do their work.

“Who is the clown doctor,” Kalloub told The Electronic Intifada. “A helping hand for the real doctor. Our work doesn’t only make the children happy, it also helps them accept what their doctors do.”

The initiative has been popular with patients and hospital staff alike. According to the director of the Abdelaziz al-Rantisi hospital, Dr. Mustafa al-Ayla, the initiative has changed the atmosphere at a hospital more used to the sound of crying.

“The clown doctor team created a comfortable environment for the patients, and they’ve became a major addition to our treatment besides the usual medication,” he said.

Laughter is best medicine

“Laughter helps the respiratory and cardiovascular system,” Dr. Ayla added. “It relaxes the muscles, lessens stress and reduces pain. So we are keen to exert all possible efforts to enable the team to do their work here.”

Kalloub — Dr. Nuts to the children — is in little doubt as to the benefits his team bring.

“Imagine being a child in hospital away from the familiar surroundings of home and friends and relatives,” the 24-year-old said just after delivering the cake to Rafat. “You’ll be anxious and lonely and probably also in pain. This is where we help.”

Kalloub and fellow clown Ala Miqdad — Uncle Aloush to the children and one of six other clowns on the team — have worked with a number of organizations in the Gaza Strip, including the Italian human rights group International Cooperation South South (CISS). They didn’t stop their work during Israel’s assault on Gaza in 2014, when they worked not only hospitals, but shelters where people had sought refuge, trying to ease the fears of young children.

They take as their inspiration the Big Apple Circus, which was set up by two American street performers who, after returning from a tour of Europe in the 1970s, were inspired to start a circus in New York. In 1986, they began providing entertainment to children in hospitals there.

Changing attitudes

Rafat enjoyed his birthday. Speaking softly, the boy said “Dr. Nuts and Uncle Aloush” had helped him not fear the doctors.

Next to his bed, his initially skeptical mother was also won over.

“I found it strange at first,” said Ayat Mansour, 37. “Here my child is crying and then these two come and play silly games for him. But I could see how his face changed. I could hear him laugh again. Now I think it’s essential.”

Every morning now, Rafat waits eagerly for the clown. “He is much less anxious after they visit,” she added.

Rafat’s loud birthday celebration also drew in Dr. Ayla, who not only came to see what the brouhaha was about, but even joined in the games — and had some cake.

Successive Israeli military assaults on Gaza and a nearly 10-year blockade has had a hugely negative impact on both the psychological and physical health of children, and Dr. Ayla suggested that long-term health impacts of Israeli warfare were just beginning to show.

“We’ve estimated a seven-fold increase in the number of chronic diseases among children, especially in cancers and heart diseases, that we think is due to the use of gas and chemical residue resulting from the illegal use of prohibited weapons,” he said.

A recent study by a Gaza doctor found a statistically significant spike in the incidence of congenital heart disease in babies born directly after a major Israeli onslaught, of which there have been three in less than a decade.

Opposite Rafat’s room, two other clowns from the team were doing their thing for 10-year-old Mariam al-Quqa.

Reaching Mariam

Close-up of smiling young girl

Mariam’s mother said that her daughter refused to speak at hospital until she was visited by the clowns. (Courtesy Clown Doctors Team)

Mariam had kidney failure and comes now for regular dialysis treatment. But she is not fond of being at the hospital. “At home, she’s a normal happy child,” said Sanaa, her mother. “Here, she refuses to speak.”

Until, that is, Zakia al-Bayoumi and Bisan al-Surdi, both 21, got hold of her. The team’s two female clowns have proven hugely popular among the children and tend to dialogue with the young patients as much as they perform for them.

When “Dr. Ziko” and “Dr. Biso” first met Mariam, she had been receiving regular treatment at hospital for three years. Then, hospital time was silent time, said her mother: Mariam simply wouldn’t talk.

And when their usual performance failed to elicit much of a response, al-Surdi tried something different. She took off her clown doctor costume, lay on the bed beside Mariam and whispered to her for 15 minutes, while Zakia continued to pull faces.

It worked. At one point, Mariam’s face lit up and she urged the two clowns to continue.

“This was the first time Mariam talked in hospital,” said a grateful Sanaa. “Apparently nothing eases her fear of hospital except the clown doctor. I’m happy they’re here for her and the other children.”

The team’s work is not limited to hospitals. They also pay visits to patients’ families and organize parties for those who have been successfully treated.

It is rewarding work, say the clowns, but it carries emotional risk.

“We are welcomed by staff and families. The children look forward to our visits,” said Kalloub. “The work presents no challenge on that front.”

“But we can’t escape reality: the hardest part of the job is when we receive a call from the hospital informing us that one of the children we performed for and made laugh is no longer with us.”

Hamza Abu Eltarabesh is a journalist from Gaza.