A clown can infuse joy and hope in dreary cancer wards – Diya

A little laughter can go a long way and independent filmmaker Diya Banerjee’s documentary, The Hope Doctors aims to draw attention to this very fact. The film talks about the concept of ‘medical clowning’, and the immense amount of joy and hope that these clowns bring to the lives of patients enclosed in dreary medical wards. Diya speaks to us about the making of her film and why she believes that laughter is a hugely needed medicine in India, especially in public hospitals.

Tell us about the theme of The Hope Doctors.

The Hope Doctors is a film that talks of compassion as a theme. And how in our increasingly insular lives this vital emotion – that is capable of connecting people and of course healing – is missing. Using this as a narrative trope, I look at how arts can bring relief in each of our lives and that too in an unconventional space such as a hospital. It talks of the poetic freedom that a clown brings to dreary cancer wards – where she uses laughter, play and lightness – to infuse love, joy and hope. This is where our medical fraternity needs to work more.

How did you chance upon this concept of medical clowns? What inspired you to make a film on this subject?

I was introduced to Ashwath Bhatt, a theatre artist, during an Arts Management programme in New Delhi. Ashwath at that point told me how he was using clowning to address deep-seated issues of trauma and grief among children facing challenging medical or life conditions.

On one really hot and sultry afternoon, I accompanied Ashwath to Can Support, a cancer-support unit (NGO) working towards giving rehabilitation and support to children with cancer. I observed how he intermingled with the parents and the children and used clowning as a technique to make them relaxed, cheer them up, and even cooperate with the counselors at the unit. It was then that I decided that this subject needs visibility. I decided to work on a film on medical clowning.

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The title is very fitting. How did you zero in on it?

I met with many doctors, patients, and hospital staff for the research of my film. While the doctors went about their day-to-day appointments almost mechanically, totally desensitized to the patients’ shock and trauma, the patients saw the doctors as godly creatures who could give them back their lost happiness and health. It was not just medicines that they needed – they craved for hope, and love. I saw people, irrespective of class or stature, on their knees looking for that sliver of hope in their day-to-day battles with life-threatening diseases and pain. That’s when I knew that the film was beyond just medicine and clinical support. It had to talk about compassion, hope and remedying a decaying system that has been losing its human touch thanks to excessive commercialization.

A question that comes to my mind is – The medical services in our country, especially for the lower income strata have several complexities. How important is ‘medical clowning’ in the scheme of things here?

True. The economically weaker sections of the society can only access the public hospitals. However, the ratio of doctors to patients in these hospitals is totally lopsided. Add to that, there aren’t enough beds, enough support staff, enough hygiene or enough infrastructure. I have focused on public hospitals in the film because I feel that should be the starting point for interventions such as medical clowning.

Imagine traveling huge distances to visit a hospital and then queuing for hours with a child who is in pain, not getting a bed in the hospital, being forced to live on the streets or at a temporary accommodation in unsanitary conditions, running pillar to post to get a BPL (below poverty line) ID card so that the family can purchase medicines at cheap prices, leave regular jobs, leave their other children at home without any supervision, and stay put near the hospital for months on end …. The stress is enormous. It is so crippling that it affects the entire family and their stability. In such scenarios, I am not saying that the medical clowns can work miracles, but yes they can definitely alleviate prolonged suffering, offer some form of comfort, have the child in a better mental condition to cooperate with the medical regime and also motivate the hospital staff. It is so badly needed in India – especially in the public hospitals.

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Was it easy to obtain case studies of patients and film within a hospital? What kind of research did you’ll have to undertake to put the film together?

No. It was pretty challenging because the interviewees were often scared of stigma, of being mocked, many were scared, and often most were severely distressed to even articulate about their condition. It took considerable relationship building with the children and then with their parents to earn their trust and then their consent for filming. The interesting bit was that when the children saw Ashwath in the Cancer Support Unit – clowning and doing all kind of silly tricks – they instantly cheered up. So we knew we had to convince the parents of letting us show the world, through their stories, why we need therapeutic or medical clowning.

Also I used to often run into the kids at AIIMS during my research phase. They’d walk up to me and ask if the clown is with me. Slowly, the kids started seeing me in the hospital and at the rehabilitation center and we developed a close rapport. Once the kids recognized me, the parents too knew that we wanted to capture their lives in all earnestness and not sensationalize or be condescending to their vulnerability. Once they opened up – they all wanted to share their experiences, they all wanted to be heard, they all thought that they need relief from their everyday battles and that they need to be treated more humanely …

Have there been any positive instances since the making of your documentary?

Yes, of course. I think the film has made people sit up and talk of compassionate healthcare. Public hospitals are already interested in exploring clowning and seeing how it fits their structure. At least, the film has been able to throw light on how medicine and therapy can go hand-in-hand and what’s the scope in India. I can tell you for a fact that clowning is practiced in hospitals in countries such as Canada, Israel, Italy, and some states of USA. In my film I say that this can work in public hospitals, especially, where doctors face huge volume of patients. The kind of personalized care one gets in a private hospital can hardly be achieved in India’s public hospitals. Most of the onus to be compassionate with the patient falls on the doctor in such scenarios.

Dr Rachna Seth from AIIMS, a pediatric oncologist who features in the film, details the kind of pressure she faces on an everyday basis. She goes beyond her call of duty to look into the needs of every child admitted under her care. With a little help of medical clowning – this stress on the staff and the patients can ease phenomenally. Similarly at Aravind Eye Hospital in Puducherry, the chief medical officer Dr R Venkatesh approached Fif Fernandes and Hamish Boyd, the clowns, to start teaching clowning to their staff nurses. They are together implementing a structured course wherein the nurses are taught how to administer care and to use clowning as a distraction or a support therapy so as to aid patient recovery and treatment response.

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Which hospitals have you shot in?

I have shot at AIIMS, New Delhi, and Aravind Eye Hospital in Puducherry.

How has PSBT given an impetus to your film? How was the response to the film at the Open Frame Festival?

I think PSBT does a fantastic job. It lets independent filmmakers express themselves without the fear of censorship, own their narrative and explore complex audiences. Despite the dismal financial support to filmmakers in today’s time, PSBT invests in stories they think that the world needs to see. The experience has been rich on so many levels as a first-time filmmaker with PSBT.

Unfortunately, I wasn’t able to attend the Open Frame Festival as I was out of the country. But I did receive a lot of positive words on the Internet and also from Delhi’s discerning audience members. It feels good.

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What were some memorable experiences from the making of the film?

I was filming with a 14-year-old girl who had lost one of her legs to amputation due to bone cancer. Her father had had to quit his job when he moved to the city with his family to get her treated at AIIMS. The entire family was traumatized. Anchal Yadav narrated that when she was lying in the hospital with one of her leg cut off she felt that her life had no purpose. At that time she wanted a friend by her side to tell her that things will be okay. I can never forget those words. You can deal with the disease but what do you do with the spirit?

The other experience was seeing how Dr Rachna Seth remembered the names of each of her patients. She probably saw 50 patients a day, sometimes even more. But each kid that she spoke to – even for the ten minutes of her busy consultation – she had a personal connect with that child. To me that was just amazing. To find doctors as dedicated as her, and then see them work everyday without an iota of selfishness was very moving.

And hurdles that you had to overcome?

From getting permission to shoot at AIIMS, to finding the right case studies, to following up with whirlwind schedules at Auroville, patchy skype calls for research (Auroville apparently has very poor internet connectivity), to shooting in Delhi’s sweltering heat… the challenges have been many. But I think it has been a rewarding experience.

What next lies in store for The Hope Doctors – any festivals/screenings lined up?

The film has been screened in Kerala and New Delhi at two separate film festivals (details below) and has been telecast on Doordarshan. There are some screenings that the film will see internationally. I am also trying to have the film on air on German television and other networks.

Festivals screenings as follows:

8th International Documentary & Short Film Festival of Kerala; India (26 Jun 2015 to 30 Jun 2015)

PSBT Open Frame Film Festival (18- 22 September, 2015) New Delhi; India

The Auroville Film Festival AVFF 2015, (2 Oct to 7 Oct 2015); Auroville, Tamil Nadu, India

APHA Global Public Health Film Festival (Trauma, Grief, Hope and Laughter) during the 143rd APHA Annual Meeting and Expo (Oct. 31 – Nov. 4, 2015) in Chicago

21st Kolkata International Film Festival to be held on- 14th – 21st November 2015; Kolkata, India

River to River Florence Indian Film Festival, (5-10 Dec 2015); Florence; Italy

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According to you, how important is it for films to have an impact on society – be an instrument of social change?

I don’t think films necessarily need to trigger social change. While the arts can do that of course because it deals with the society’s psyche and addresses things beyond the ‘day-to-day’ – I feel social change happens when there is a collective will. While films, music, theatre, performances can shape that movement, and embolden it — what is needed is an inner awakening, and a real desire to transform. It is only then that social change can perspire and society can evolve.