Send in the ‘Clownselors’
A Clownselor at the NIID
With a colourful mop of hair and clothes and a big red nose, was a clown at a medical conference at a Colombo hotel recently and lo and behold, the same clown was later seen roaming the lengthy corridors of Angoda’s National Institute of Infectious Diseases (NIID).
They are the ‘Clownselors’ from India who have provided evidence that there can be healing through humour!
This is why they were going from bed-to-bed at the NIID’s Paediatric Ward, bringing smiles not just to the children but also to parents and staff.
Later we see the face of one of the clowns, sans the make-up and the huge nose, as we sit down to chat about this novel concept with Founder & Director of Clownselors Foundation, Sheetal Agarwal (39), just before she heads back to Mumbai, India, where she is now based.
The other Clownselor who accompanied Sheetal to Sri Lanka was Founder – Rewire and Psychologist, Pooja Agarwal.
The visit of the Clownselors to the NIID was facilitated by NIID Director Dr. Aruna Sandanayake and Consultant Paediatricians Dr. Punyani Banduthilake & Dr. Sepalika Ilangakoon along with Dr. Sevantee Gosh, Dr. Lahiru Kodituwakku and Dr. Prashani De Silva of the Medical Unit of Médecins Sans Frontières South Asia.
Born in Kathmandu, Nepal, to a business family which was running enterprises selling Indian sarees, every Saturday, Sheetal and her parents would visit a home of Mother Teresa’s Missionaries of Charity where elderly patients with leprosy were being looked after.
When trouble began brewing in Kathmandu in 1996, with the Maoists targeting the business community, Sheetal’s family relocated to Haryana in India, as her grandmother lived there. In 2002, the family moved to New Delhi and Sheetal secured a BA in Sociology and an MPhil in Social Anthropology, embarking on a career in teaching.
While on a retreat in Gujarat in 2016, she had got an introduction to ‘medical clowning’ through another woman.
“Intrigued,” was Sheetal, for she had only seen dwarf clowns in circuses and so she pored over medical clowning material and was also mesmerised as she watched the 1998 film, ‘Patch Adams’ starring Robin Williams.
In this true story, American Hunter ‘Patch’ Adams voluntarily commits himself into a mental institution in 1969 to help his fellow inmates. Leaving the asylum, he vows to become a doctor but finds that the arms-length attitude towards patients does not address their emotional needs. Then he goes where no doctor has gone before – setting up the Gesundheit Clinic in West Virginia, he uses humour and pathos for the benefit of his patients.
Looking inward, Sheetal says that she was “extremely” introverted as a child, while she and her three siblings were also pampered a lot by their parents.
With a suggestion that she should pursue her passion for medical clowning at least at one hospital in Delhi, she had posted her idea on Facebook seeking volunteers, getting responses from 33. She had also written to the Home Ministry in Delhi, receiving a prompt reply, with a meeting soon after and permission to approach hospitals.
When Sheetal sounded out the Chacha Nehru Bal Chikitsalaya, the Director had agreed with the words: Let’s try it. At least there won’t be side effects.”
It was 2016 and they had permission, but no trainer, no background in theatre and the volunteers had got whittled down to five – Sheetal, her sister, two friends and a street clown. She had “dinosaurs in my stomach” as they showed up at the hospital to perform some tricks with balloons and a favourite act of one clown falling and another either trying to help or forming a human train with the others and going round and round, singing.
The success was obvious at this crowded 200-plus-bed hospital where two children occupied a bed. An instantaneous change was seen, with parents happy that after a long time their children were laughing and those who had stopped eating were tucking into their food again.
“It was five hours of medical clowning and I myself couldn’t stop smiling. I felt contentment and through this process, many feelings within me got healed. What happened around me resonated within me,” says Sheetal.
Humour for a little one at the NIID and (below) the staff joins the action
She was also engulfed by emotion – realizing that she had so much to be grateful for. All the clowns were “smile hungover” for a long time afterwards and there was no return to their old lives.
There were some ground rules that they scrupulously followed, for medical clowning was not just clowning but distraction therapy. Following good global practices, they never asked patients what had happened to them and the maximum touch was a high-five or a handshake. Carrying a child was a ‘no-no’, she underscores as were taking selfies with them.
Realizing that they were using loads of plastic balloons which were not very environment-friendly, Sheetal and her Clownselors launched into body language, puppets and eco-friendly and re-usable wooden stuff in their work, along with rattles to interest infants. They took their clowning to three different groups – patients, caregivers and staff.
In 2018, she got a call from the Indraprastha Apollo Hospital in Delhi, the first private hospital to contact the Clownselors. It signalled her entry into medical clowning full-time, giving up her teaching job.
Sheetal says that this low-cost human-centred intervention has a proven therapeutic approach. It improves the emotional well-being of patients, families and staff, through humour, playfulness, entertainment techniques such as physical comedy, magic, music, storytelling and improvisation and empathy, while creating relief, connection and dignity.
A 2024 piece in the ‘International Journal of Advanced Research in Science, Communication and Technology’ (IJARSCT) has stated that the findings of a study underscore the effectiveness of medical clowning therapy in improving paediatric quality of life among oncology (cancer) patients, while the ‘International Journal of Creative Research Thoughts’ (IJCRT), the same year stated similar findings and the reduction of negative emotions among child patients.
The ‘International Journal of Clinical Pediatric Dentistry’, in an article quoting a study the same year, concluded that humour yielded the power of healing, distracted paediatric patients, reduced their anxiety and alleviated their pain, conferring the patients with a sense of laughter, creativity and care. Therefore, it could prove to be valuable as a non-pharmacological approach to behaviour management.
Within the short span of nine years, the Clownselors have touched more than 800,000 lives and Sheetal explains that psychosocial care is often sidelined in India’s resource-limited healthcare settings, despite its significance in patient recovery. The focus remained largely on treatment but patients faced anxiety, isolation and fear.
“With clear links between emotional distress and slower recovery, emotional care remains a critical but overlooked component of healing and medical clowning addresses this gap,” she smiles.
After medical clowning entered both paediatric and adult wards, they have reported reduced anxiety; decreased need for anaesthesia; reduction in pain; and better mobility. In the Outpatients Department for tuberculosis sufferers at Mumbai’s Shatabdi Hospital, patients had become notably more communicative and engaged post-session. In oncology and palliative care, both patients and caregivers had described the experience as uplifting and emotionally relieving, often referring to it as the “highlight” of their hospital stay.
Two incidents which are etched in Sheetal’s mind are the Clownselors mimicking the Salman Khan towel-dance around the bed of a 13-year-old. “She was skeletal and could not move,” says Sheetal. However, she did get better because she had something powerful to look forward to – the antics of the medical clowns.
The other was a comatose girl, whose mother begged the Clownselors to make her laugh, adamant that her daughter was just sleeping. They kept talking to her and a few visits later, her little finger moved and in the fourth week, she was out of her coma.
…….And from last year, the Clownselors are spreading their therapy among prisoners of the Anantnag District Jail in the state of Jammu and Kashmir and hundreds of jawans in Leh in Ladakh and Srinagar in the Kashmir region.
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