Setting up child life services in India: appreciating cultural differences while embracing our similarities

Jeanine Clapsaddle is a Child Life specialist from Children’s who is in India for two months to help set up Child Life services at Manipal Hospital.

Jeanine’s trip is in partnership with the Priyanka Foundation, which was established in memory of a former Children’s patient who wanted other kids around the world to get the same Child Life services she received during her cancer treatment.  Jeanine is documenting her experiences through this blog series.

This is the second report from her trip:

 

Several days ago, I met a boy, Ballal, who was admitted to the PICU with an injury from an accident. He left his home in search of something fun to do and wandered into a factory that was in full operation. He came into contact with a machine that wrenched his right arm off at the shoulder and left him with a gash from above his eyebrow, down his nose to his chin. He is 6 years old.

A referral was made to Child Life from the attending nurse to “bring him toys and make him happy.”  I hear this request at Children’s as well and understand that it is an easy way to compartmentalize a creative and varied therapeutic practice.  In this case the statement was less about knowing the full offerings of Child Life, but more about a cultural belief that children should not be unhappy, for any reason, and playing with toys is a curative for unhappiness.

Although I may not speak the language, the gestures of pacifying and soothing are universal, as are some of the coping reactions some parents lean on when a child is in pain.  Things like shushing to the point of a parent putting their hands on a child’s mouth to get them to stop crying, giving them money or prizes to soothe them, tricking them into coming to the hospital or not properly informing children about the need for their healthcare experience so as not to upset them—these are all easy traps to fall into that can actually increase tension for a child.

In Ballal’s case, he was attempting to talk to his mother about his accident to better understand what had happened to him, to sort through emotions of guilt and shame, and to plead with her to stop the antibiotic infusions, which he found painful.

His mother was afraid of upsetting him so she shushed him and told him not to talk about it. We were able to talk with Ballal’s mother and explain the potential reasoning behind his questions. We also developed a plan for giving him some basic information to help him cope with the infusions as well as provide some diversion for him during the infusions. Although she did not come to a point where she could engage her son’s questions, Ballal’s mother was able to make room for services that could support him and she witnessed his decreased stress level through play.

When I came to India, I anticipated that the cultural rules and mores would be so different from my own that it would take me the entire duration of my stay for me to begin to see and vaguely understand these customs. What I have come to find is that the dynamic between parents and children is one that changes very little regardless of where you are at on the globe.

Ballal’s story is not so far removed from patients who come to Children’s who are involved in farming accidents, children who are too young to be left unsupervised, children who just do not want to be in the hospital, and parents who do not want their children to suffer, emotionally or physically.  How many times have I approached new families at Children’s and faced parents reluctant to educate their children because the medical information is too frightening for them as parents that it is too scary for them to know how to share with their children.

Sometimes when we meet families who come from a cultural background that is different from our own, we quickly call to light the differences between us in hopes of acknowledging and respecting those differences. Somehow, when thinking about Ballal and his mother, I am reminded of the small ways in which we are the same and how much progress can be made by acknowledging our sameness.

Jeanine Clapsaddle
Child Life Specialist
Children’s Hospitals and Clinics of Minnesota

 

The first report from her trip can be read here.

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