It takes more than medicine to get well

MANILA, Philippines — Imagine your five-year-old child enjoying the slide at the playground. Then all of a sudden, you hear a loud cry for help. You rush to the playground, and you see your child writhing in pain and could hardly stand up.  You rush to the emergency room, and doctors disclose your child has a broken leg and would have to be confined in the hospital. In a span of four hours, your child’s world changed drastically. Your child is now lying in bed surrounded by strangers, in a cold room with an unusual smell and beeping sounds.  The pain and fear of an unfamiliar environment contribute to your child’s incessant tears.

Wouldn’t it be great if a member of the health team approached your child after the medical team has stabilized his or her condition, with the assurance that everything would be fine and offered different age-appropriate activities while waiting for test results or an available room?  And once confined in the room, wouldn’t it be helpful if somebody would come in and listen to your concerns, offer comfort while waiting for your child to come back from surgery or just provide general psychosocial support?

There are some hospitals in the Philippines that offer this kind of psychosocial services, and they call it Child Life Services. Child Life Services are therapeutic services designed to address the psychosocial needs of pediatric patients that accompany health care experience. And “in both healthcare and community settings, Certified Child Life Specialists help infants, children, youth and families cope with the stress and uncertainty of acute and chronic illness, injury, trauma, disability, loss, and bereavement. They provide evidence-based, developmentally and psychologically appropriate interventions including therapeutic play, preparation for procedures, and education to reduce fear, anxiety, and pain” (Association of Child Life Specialists www.childlife.org).

Dr. Angie Sievert-Fernandez, Ph.D. CCLS, and Ninin Sumpaico-Jose, MA CCLS (both Certified Child Specialists from Kythe Foundation, Inc) conducted a study titled “Addressing the Emotional Distress of the Hospitalized Child: The Role of the Child Life Program” in one partner hospital. They used Child Drawing in Hospital, a validated tool to score children’s level of anxiety. The drawings below belong to a patient who is living with a rare disease called Blue Rubber Bleb Nevus Syndrome. The patient, then aged 12 years old, was asked to draw her perception of the hospital before and after the implementation of Child Life Services.

One does not need to be a psychologist to see the change in the child’s hospital world after the implementation of Child Life Services. Child Life Services such as play, education about the illness, preparation for medical procedures and emotional support for the family proved to lower the level of anxiety and help the patient cope with the stress in the healthcare setting. The patient is now 20-years old, taking maintenance medicine and is living a well-adjusted adult life. 

Charm was 13 years old when he was diagnosed with osteosarcoma at Philippine Orthopedic Center. He did not want to enter the playroom then because he felt the activities were just for small children. Until one day, Ms. Ninin (Kythe Child Life Specialist) conducted a polvoron-making session. Charm gave it a try, and he found himself enjoying the interaction among pediatric cancer patients.  He then looked forward to the weekly activities in the hospital. The activities helped him cope with his situation. Unfortunately, the doctors needed to amputate his left leg to prevent the cancer cells from spreading. The good news is after a year of chemotherapy; Charm was declared cancer-free. Charm, or Kuya Charm as the children fondly call him, is now the Child Life Coordinator at Philippine Orthopedic Center. Charm has gone full-circle and is paying-it-forward. 

There is indeed value in providing Child Life Services for children in the healthcare setting. In 2014, the American Academy of Pediatrics came out with a policy that Child Life Services should be considered an essential component of quality pediatric health care and are integral to family-centered care and best-practice models of health care delivery for children. The National Integrated Cancer Control Act, which was signed into law on February 14, 2019, has a provision that institutes Child Life Services for children with cancer in all appropriate hospitals and facilities. 

The following hospitals are offering Child Life Services, namely: Armed Forces of the Philippines Health Service Command, Philippine Children’s Medical Center, National Children’s Hospital, Philippine Orthopedic Center, Quirino Memorial Medical Center, Tarlac Provincial Hospital, Cebu Cancer Institute, Southern Philippine Medical Center and The Asian Hospital.  Certified Child Life Specialists from Kythe Foundation Inc. trained the personnel from the aforementioned hospitals on how to implement Child Life Services. 

There is a need for parents and families to see the value of healing presence and play therapy for the child.  When we see the value of Child Life in hospitals and utilize the service, we increase the demand for holistic medical care.  We likewise increase the quality of public health in the country.

I recall a quote by Patch Adams played by Robbin Williams, and he said, “You treat a disease, you win, you lose.  You treat a person, I guarantee you that you’ll win, no matter what the outcome.” — Maria Fatima Garcia-Lorenzo, RPsy CCLS 

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Girlie Garcia-Lorenzo is the president of Philippine Alliance of Patient Organizations (PAPO) and the co-founder and Executive Director of Kythe Foundation Inc. She advocates for patient’s rights and is engaged in health policy development.