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Clowning around to help children cope with the hospital experience.
Child Life: care of the child.
Cancer treatment is a stressful and potentially traumatic experience that can overwhelm a child’s natural ability to cope and cooperate with their doctors.

    
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This can inhibit their healing and normal development, with lasting negative effects on their physical and mental health.

Child life meets the distinct needs of young patients, promoting effective
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coping and optimal development through play, preparation, education, and self-expression activities that are based on normal child development.

Even the tiniest babies can benefit from techniques such as infant massage and comfort positioning. 

The American Academy of Paediatrics affirms that child life is “an essential component of quality paediatric health care”, and child life services have become a standard in most children’s hospitals in resource-rich countries. However, child life is virtually unknown in resource-limited settings.

In the management of retinoblastoma in resource-limited settings, child life approaches can:

ease a child’s fear and anxiety through role play and recreational activities;

encourage understanding and cooperation through medical play in preparation for medical procedures;

foster cooperation during medical procedures through distraction play and comfort positioning;

reduce the need for potentially dangerous (and often unavailable) sedatives and pain medications through non-pharmacological pain management techniques;

support children and their families confronting grief and bereavement issues, such as the loss of an eye, through self expression activities and printed resources.

Increased cooperation from young patients can also help reduce medical costs by:

eliminating the need for anaesthesia during procedures such as lumbar puncture or radiotherapy;

decreasing the number of nurses required to complete painful procedures such as inserting an IV;

minimizing the use of expensive pain medications. 

In addition, improving a child's treatment experience and psychosocial wellbeing will increase the chances for successful integration into society and school. 

Certified Child Life Specialists (CCLS) are university trained professionals.  However, essential child life methods can be employed by physicians, nurses, social workers, teachers, parents and others to help children effectively manage stress and overcome challenging life events. 


Pilot Project

During our pilot project in Kenya in 2007, Canadian Certified child life specialist, Morgan Livingstone shared basic skills with nurses and auxiliary staff.  She demonstrated the value of simple approaches such as:

comfort positioning to reduce a child’s anxiety and increase co-operation during painful procedures;

therapeutic massage to control pain;

use of cloth dolls to enable self-expression in non-verbal and distressed children;

use of cloth dolls by medical staff to explain medical procedures in a non-threatening way.

Morgan is a member of our KNRbS team.  She has extensive experience of resource-limited child life implementation through her work with Operation Smile.


Building A Child Life Progam

To achieve systemic introduction of child life support in Kenya, we will:

facilitate a series of practical in-job training courses for medical professionals and auxiliary staff from across Kenya;

train women from several credit union cooperative groups across Kenya to produce the simple cloth dolls used in self-expression and medical preparation play with retinoblastoma patients;

provide start-up materials to enable the women’s groups to produce low-cost dolls for sale to hospitals and families undergoing treatment; 

oversee development of educational resources to help children, their families and the wider community to understand surgical eye removal and other aspects of retinoblastoma, and the continued capacity of enucleated children to be active members of society.

Introducing child life into retinoblastoma care in Kenya will:

enable patients to effectively manage stress and actively cooperate with their medical care;

reduce costs associated with treatment;

reduce stigma which currently impedes take-up of curative therapy and hinders post-operative psychological healing.

Achieving cure for children with retinoblastoma requires both elimination of the cancer and care of the patient’s social and emotional well-being.  Child life support is not an optional extra, but an integral part of the child’s medical care package. 

We aim to ensure that the whole child is cared for, enabling each child to move forward through life as a happy, confident individual.
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         Rati's Challenge          Kenyan Rb Strategy          Guidelines

         
National Registry          Awareness Raising          Co-ordinated Care

         
Child Life Support          Family Support          Artificial Eye Service
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