There are special clowns you won’t find in the circus, or in the theater, or at children’s birthday parties, but instead in children’s hospitals, standing next to the doctor or nurse, trying to make patients laugh.

Dream Doctors in Israel is building a nationwide professional community of medical clowns who learn a combination of nursing and comedy skills to make hospital experience less traumatic and more pleasant for children.

The project started 10 years ago, with only three clowns in one hospital. Today Dream Doctors has 72 professional clowns active in various pediatric wards and clinics at 20 hospitals across the country.

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While hospitals around the world invite clowns as visiting entertainers, at Dream Doctors the clowns are a full-time part of the medical staff. This project turns “clown therapy” into a standardized, research-backed healthcare profession. In this model, the clown therapist is not an outsider but a member of staff, with regular hours and responsibilities.

Part of the medical staff

Daniel Shriqui, director of the Dream Doctors Project, tells NoCamels: “In other places clowns come into hospitals in the afternoon, after rounds are over. Here, we work integrally together during rounds. I don’t see the medical clowns differently than any other part of the team. It’s not entertainment, it’s not just a performance; it’s therapy.”

[youtube]https://www.youtube.com/watch?v=K3q0l1fesHM[/youtube]

But what does medical clowning have to offer? Shriqui explains that “medical clowning is about taking a reality that can be horrible, and putting it in another way, so the child will experience it from another place.” He adds that “if you want to understand a child, you have to go inside his world and play his game. The best way to work with children is with the imagination of their world. This way you empower them. This is what we do. And if the child is more positive, the whole atmosphere is better.”

According to Shriqui, “there are many children that come back to visit the clown. There are children who won’t go through the procedure without the clown. Once the doctor starts with a clown, he won’t finish it without one.”

The criteria to become a medical clown are demanding and Dream Doctors requires academic training. “In our organization in Israel, we try to pick mature people with families, who have experience in the theater arts and a rich world from which they can relate to the children and they have to go through a difficult training,” says Karin Schneid, program coordinator for the Magi Foundation that funds Dream Doctors.

“We also encourage them to get a degree from Haifa University, where we have a one-of-a-kind accredited BA program in clown therapy. We are also planning a master’s program. But mostly, you have to have a great heart.”

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Clowning therapy requires therapeutic, medical, artistic, psychological and nursing skills. Shriqui mentions that “the clown makes a show where the hero is the patient.” As a Dream Doctor clown put it: “Laughter and pain, and happiness and sadness are all mixed up in our work.”

Pain relief, stress reduction

Research on medical clowning was conducted in Israel and results suggest that putting trained clowns on the medical team leads to measurable benefits in pain relief, stress reduction and stronger immunity. “Even before research was conducted you could tell it was successful because of the growing demand from children, parents and doctors to bring in clowns,” says Shriqui.

Dr. Amos Etzioni, director at one of the participating hospitals, adds: “I have no doubts that since Dream Doctors came to us four years ago, we have seen incredible changes in everything that is happening in the hospital.”

To date, only ten Israeli hospitals are not employing Dream Doctors and the waiting list is growing larger from clinics in demand of clowns.

Nearly one hundred thousand patients, mainly children, are annually exposed to medical clowns in Israel.

Dream Doctors is now planning to turn to elderly patients, particularly those with Alzheimer’s disease and Dementia.

Bridging the gap

The success of this paramedical model is also apparent in the growing global interest, especially from the United States, Canada and Australia. In an international congress that took place in Jerusalem last October, over 250 representatives from 20 countries came to inquire about the medical clowning approach.

In the meantime, the Dream Doctors project is also reaching out to third-world countries. In January 2010, they contributed to the humanitarian mission to hospitals and orphanages in Haiti following the earthquake.

Additionally, Dream Doctors says they are a tool to bridge the gap between different cultures in Israel. Hospitals in in the country are multicultural meeting grounds for immigrants from the former Soviet Union and Ethiopia, ultra-Orthodox and secular Jews, Bedouin, Druse and Israeli Arabs.

“Clowns facilitate interactions across religious, ethnic and national lines. Their expressive abilities enable them to bridge between opposites, elicit smiles and inspire trust in the medical team and the treatment process,” says Shriqui.