Facility: Centre de réadaptation Marie-Enfant de l’Hôpital Sainte-Justine 5200 Bélanger Street East Montreal, Quebec H1T 1C9 www.hsj.qc.ca/CRME/index.asp Rehabilitation: 55 beds Long-term care: 20 beds

Liaison : Sylvain Grenier (514) 374-1710, poste 8230 grenier.sylvain@sympatico.ca

The program

With the financial assistance of the Starlight Children’s Foundation Canada, Dr Clown set up a program at the Centre de réadaptation Marie Enfant in September 2002.  Children are in a very stable environment in this facility.  There are two main units: the rehabilitation unit and the long-term care unit.  In the rehabilitation unit, the children, who have suffered neurological trauma because of illness or an accident, could be learning how to walk and talk again.  In the long-term care unit, children have several disabilities each, which require them to stay in hospital much longer.  There is also a respite care service for parents who need to leave their children for a week or two to recover from the stress of providing the intensive care their children require.

Dr Clown has a variety of roles at Marie Enfant:

	Since many patients are there for several months, the clowns can get to know them well and build a satisfying relationship with them.
	For patients in rehabilitation, going from one therapy to another, the clowns provide a relaxing and amusing break, when the children can joke around and have fun chatting with other children and the staff.
	Physiotherapy and occupational therapy can often be stressful for a child.  In such cases, the therapists sometimes ask the clowns to accompany them during the treatment.  The artists then assume the role of facilitator.  The therapist informs them discretely of the goal for the session, and they find a way to turn it into a game in which the child carries out the required task by playing the game.
	Clowns can also be asked to provide company for patients in isolation, putting on masks, gowns, and gloves to enter the patient’s room.  The child then has a chance to play and interact with other people.
	In the long-term care unit, where the children are physically and mentally disabled, the artists take part in numerous exercises in sensory stimulation.  Because they are clowns, they can often communicate with the children in a new and different way, by sneezing, for example, or by losing their hats, singing, or running away with a wheelchair.

What they have to say

In both units, according to what we have been told, the staff has come to appreciate the artists’ visits and to accept the clowns as members of their “family.”

Children “What I like about the clowns is that you can do anything with them.  They’re funny.  You can dress them up, that’s funny.  You can get them to do anything!”  (12-yr old patient) “They fit in with the children, and that’s the most important thing!  We can’t get enough of them!  For us, the clowns are a super-duper extra!  We want more!”  (An orderly in the long-term care unit) “If the kids can actually forget they’re having therapy, you know it’s good!  They’re having fun!”  (An orderly) “It’s hard for the children to stay here for a long time.  Sometimes it’s for a whole year.  V., for example, doesn’t go to school . . . Seeing the clowns occupies them.  There are times when they don’t know what to do with themselves, but with the clowns they can do something, they don’t think about their disability.”  (An orderly)

Parents “Our children could not do without the clowns.  Clowning should be an institution.  Absolutely necessary – that’s the only way I can describe it.”  (Mr J.) “For me, it’s a necessity.  I know that it’s supposed to be good to be critical, but with the clowns, I like everything!  There has never been anything in their behaviour that bothered me.  I only have good things to say about them.”  (Mr S.) “I think there should be some in every hospital!”  (Mrs T.)

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