Cuba’s Therapeutic clowns: Much more than the desire to heal

A report by Nuria Barbosa León for Granma.

Sparking a good laugh and shaking off sadness is the greatest desire of therapeutic clowns, people of great human sensitivity who build relationships of complicity and affection with long-stay hospital patients, as MSc Aniet Venereo Pérez-Castro, otherwise known as the clown Celeste, explained to Granma International.

She defined therapeutic clowns as people who don the representative red nose and provide moments of amusement and relaxation for those suffering from chronic conditions.

Professionals from different specialties such as doctors, rehabilitators, psychologists, artists and others volunteer their time and talent in this effort to provide patients with necessary hope, which can contribute to their rapid recovery. They also visit nursing homes, psychiatric hospitals, psycho-pedagogical centers, and institutions for adults with chronic diseases.

In the first interaction with the patient, a relationship of acceptance and security must be developed. In some cases, children may be afraid of clowns, or patients may be apathetic, in which case the artist does not impose participation. Often, on observing interaction with others in the same ward, these initially reluctant patients become curious and join in the activities.

“Cuba has a clown academy, located in the eastern province of Las Tunas, where graduates are trained in the art form, and the inclusion of a therapeutic module has already been proposed. We formed after the Canadian, Joan Barrington, director of Therapeutic Clowns International, visited us in 2012, taught a course, and trained several instructors. Subsequently, they have been responsible for multiplying this knowledge throughout the country, supported by the Cuban Ministry of Public Health,” the national coordinator of Cuba’s therapeutic clowns group explained.

On Barrington’s second trip to the island, an improvement course was opened, in which circus artists were included. “This training served to take the methodology of the international therapeutic clowns foundation and adapt it to our traditions. We also linked it with popular education techniques and created our own courses and workshops,” Venereo added.

The starting point for learning is visual contact, which is why clowns are trained to interact through the observation of others. They work with the absurd and the ridiculous, and anyone assuming this role should seek to create a character based on their own personal experiences.

The training process for therapeutic clowns begins with a basic workshop including discussions on communication and acting techniques, and costumes are created. Although it is impossible to measure the results of this project in figures, the improvement in patients’ mood, acceptance of treatments, and adaptation to hospitalization, especially among children, is palpable.

This movement has advanced significantly, and today Cuba has over 200 therapeutic clowns working in different health institutions across 11 provinces. The First Cuban Congress of Therapeutic Clowns: Art and Health was held in October 2018, as a space to share experiences with other professionals from around the world. The event, linking science and art to develop strategies for the future, saw the presence of 116 delegates, of whom 90 were Cubans. There were 25 presentations, 12 workshops, two keynote addresses, and 8 poster presentations. Three areas were debated during the Congress: science, culture, and social work.

Agreements were reached to support the creation of mid-level specialist accreditation in this field, with courses to be taught in the School of Health Technology. The decision was based on experiences in health institutions, as therapeutic clowns often assumed the tasks of social workers in terms of palliative care, accompanying families during difficult moments.

Reyna de La Paz Campos Falcón, who plays the character of Mantequilla, noted the value of the happiness clowns provide. “We teach our colleagues in training that the essence of this type of activity is found from within, externalized in the act of interacting with the patient. We work very closely with children to dispel all the fears that arise faced with a clown. For me it has been a very rewarding experience, which helped me overcome difficult situations faced in my own life,” she explained.

Training courses cover clowning techniques, which include acting, pantomime, balancing acts, magic, puppeteering, color variety, and balloon modeling. A fundamental aspect is the identification with each patient’s condition, as rather than working from a script, these clowns prepare their performances in response to patients’ needs. Their duration is also dependent on the patient and whether they are enjoying the act or not.

“We visit oncology, heart disease, and hematology wards. Rapport must be established in the first visual contact with the patient, necessary to undertake the activity. By letting the patient decide the artistic act, for a moment they enjoy a pause in medical routines. This rapport also creates ties with their relatives. Many hospitalized children live in other provinces and come from dysfunctional families. We see single mothers who leave other children at home in order to care for one child, so more than the clown therapy, we become involved like social workers, hence the need for a well-trained clown,” Campos emphasized.

This view was shared by Canadian, Melissa Halland: “I am a therapeutic clown because I understand that being in the hospital is a difficult time for any human being. In many cases, healing the body entails pain. I believe that the mind and emotions are important to recovering from an illness. This actor or actress is an individual who helps to cure, because he or she provokes joy and feelings of love among human beings.” Halland plays the character of Fifi, working with the sick in the cities of Montreal and Quebec.

She told Granma International that Canada has a network of therapeutic clowns in each city, integrated with different humanitarian associations, who provide their art free of charge in health institutions, but are financed by non-governmental organizations and by solidarity contributions, to cover travel and other expenses.

She noted that attending the Congress in Cuba was a wonderful experience, and that, “It touched my heart. I have seen the interest shown by the Ministries of Health, Education, and Culture to support this activity, something that is lacking in Canada.”

Meanwhile, Iliana Levy, from Colombia, visited Cuba for the first time to attend the Congress. A graduate in Literature and Linguistics, she has been clowning for over ten years, and is focused on the social work of a therapeutic clown in hospitals and other unconventional settings.

“The experience of the Congress has been a dream come true. I am very grateful to the therapeutic clowns organization of Cuba, who have made us feel at home. I feel that we share joy and vitality. They offered me the opportunity to interact with Cuban patients, and it turned out to be an extraordinary experience,” expressed Levy, otherwise known as the clown Gladys Banana.

Cuban Karelia León Despaigne reported that her seven-year-old son, Yasier, was very sad on learning he would be admitted to the William Soler Pediatric Hospital, where he underwent complex heart surgery for interatrial communication. “Our children need that encouragement offered by the therapeutic clowns; they came with their balloons and extravagant costumes. They even gave out red noses to make others feel like clowns too,” she noted.

These artists share the dream that in the future hospitals will be cultural/health centers where, along with medical treatments and care, patients will be able to come into contact with art, to create and follow their dreams.

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