Clown doctors have been proving that laughter is the best medicine in Northern Ireland since their introduction in 2005. Richard McClelland, 44, from Derry, graduated as a clown doctor on April 1st, 2010. It couldn’t have been any other day in the calendar.

Like all clown doctors, he wears a red nose, which is the universal symbol of clowns, and a silly costume to work. He goes by the name Dr Dapper. He says part of the appeal for children with his clowning around is that it allows them to have control.

“The clown doctors are people who the children can tell what to do. They’re people who they can say ‘no’ to because in a hospital environment they feel kind of powerless and trapped in a way. They don’t really want to be there. The procedures aren’t that nice; they have to go along with them, but the clown doctors can relieve that in the way that they can say ‘no’ to a clown doctor. That can become really funny.”

Great way with children
According to Alison Patience, staff member at Forest Lodge, a respite home for children with learning disabilities, "The children just love them. They can offer something the staff can't – the zaniness. They have such a great way with the children.

“Very few of our children would have verbal communication skills. They rely very much on sensory-type activities, and they love music. Music is a great way into children’s minds, and the clown doctors use music a lot.

“There was a young girl who used to come to Forest Lodge. She’s now an adult. Her mother reported that she had asked for the clown doctors to be mentioned in her prayers at night. This was a girl with limited speech and she had told her mum this.”

The practice of professional clown care goes back to a programme launched in New York in 1986. The European Federation of Hospital Clown Organizations is based in Brussels. There are clown doctors in four of Northern Ireland’s hospitals, including the Royal Belfast Hospital for Sick Children, and several of its respite homes.

“It’s recognised that laughter increases the blood flow around the body, that it promotes the production of endorphins, the body’s natural painkillers.

"Those physiological phenomena are well established," says Eamon Quinn, operational manager, Arts Care, the arts and health charity that oversees clown doctoring in Northern Ireland.

Clown doctors are drawn from the ranks of circus performance, acting, dancing, theatre and music, among other professions.

They must be of a certain age with appropriate life experience before they can begin their training.

Nina Conti, the ventriloquist and Bafta-nominated documentary-maker, has just started working as "a giggle doctor" in the UK. "It's quite careful work," she says. "You have to get really good at reading situations, and following hospital regulations and hygiene procedures. You have to be sensitive about when you can approach children, which takes a little while to learn, and to find the funniness in what is often a difficult situation, but as a clown you're an exception to the rule. I find watching the other senior giggle doctors incredibly inspiring.

“You don’t just walk up to a bedside and start with your tricks – you must be invited. You might just be funny with a light switch in the corner until you notice somebody is laughing and you’ll come over. It’s not like, ‘Hello, here I am. Let the fun begin’, because in the wards that wouldn’t be right.

“Some people might be sleeping, but having said that you’re appealing to the well part of the child. It’s not clouded in sickness. You’re doing proper, silly stuff. It’s just learning the appropriate way to introduce it.

“I’ve seen some extraordinary things. One girl got out of bed and started to do a dance for the giggle doctor, and the dad ran up to him afterwards and said, ‘Do you know she hasn’t got out of bed for six weeks, and she didn’t even notice she did then?’ People say stuff like ‘she hasn’t smiled since she got here’. It’s because obviously the parents are very worried. Giggle doctors are a breath of fresh air.”

Age no barrier
McClelland also visits respite homes for the elderly suffering from dementia, as part of Skylarks, a pilot scheme launched last year in Northern Ireland. Clowning is a universal idea that appeals to people regardless of age, he says, but adds that the Skylarks have to be very gentle in their approach in order not to confuse or startle the residents. Their costumes, for example, are more muted, and he goes by his own name, Richie, instead of his clown name, Dr Dapper.

“You have to be much more sensitive to their condition – dementia and Alzheimer’s – to make sure they’re not feeling threatened or scared.

“Depending on their levels of dementia, you find with the more set in that their inhibitions tend to go so they are more childlike in their ability to play. Their behaviour is freer.

"Quite often music is very powerful. The thing with dementia is that the last part of the memory that goes is the part associated with music, and songs that they would have known through their lives, even though sometimes they mightn't know where they are, or know their own name, they'll know all the lyrics to a song like Danny Boy ."

For more information, visit artscare.co.uk .