We Ukrainian parents and volunteers can do so little for our children with cancer. In our country, suffering from crisis, almost all of our activity is focused on searching for financial support to give the child everything necessary for its treatment.

Our rehabilitation and education programs are, so to speak, still in the embryo stage. But we never forget that the emotional condition of the child is one of the most important components of the treatment.

The doctors who treat our children constantly remind us of that. They prescribe the small patients ”vitamin J” (joy). The doctors allow actors and clowns to attend our department. Sometimes the clown is even allowed to visit the sterile box or the intensive therapy ward.

When the child with cancer is admitted to the hospital, the first thing the anxious and terrified parents think of is to get the child busy with pencils, paints and handicrafts-any kind of creative art.

Such a decision has a lot of advantages from the parents’ point of view:

*   this  kind of activity is usual practice in all institutions involved in working with children;

*  any adult is able to make something of that kind and teach the child as well;

*   this activity does not demand much expenditure;

*  at least the child can do that alone without anybody’s help, as he or she might with reading.

 This is the way most parents think. That’s why each child admitted into hospital has a notebook, an album, a pen, pencils and fountain pens amongst his or her things. Sometimes there’s a set of colored paper or several colors of beads. The parents can not even imagine how right they are, placing such strong hopes on handicrafts and creative art as a means of support in the disease.

We can divide the whole art-therapy into three STAGES, though the division will be a bit hypothetical. In fact, there is no strict border between the stages and the point at which the child goes from one stage to another is very peculiar to each child. Moreover, not each child goes through all stages as must.

The first stage of creative art activity has the clearest aim: to fill the child’s free time, to save him or her from dullness and boredom, to draw away the child’s thoughts about death.

Our organization works for the department of onco-hematology, which admits children for treatment from all over Crimea. Crimea is the resort region of the Ukraine. The area of the Crimean peninsula equals the area of Belgium or Albania, and is twice as big as Israel. I give these figures here to show the following situation: the children with oncological diseases spend the greater part of their treatment -and this is from 6 months to a year - in hospital. Most parents live in distant regions of Crimea but even those who reside in the administrative center of Crimea where the hospital is located, have no opportunity to transport the sick child safely to their home or are not able to provide the child with the necessary safe conditions at home, especially after they have received a course of chemotherapy.

When the child has problems in the course of the chemotherapy, he or she has no opportunity to study the school subjects without the help of parent or teacher. Even if child’s state of health allows him to study, this is impossible given the hospital conditions. There is no educational center here; the children have no opportunity to obtain correspondence education as well.

During the first weeks at the hospital, it is simply a must to find some activity for their hands. I know this for sure due to my own experience. During the first two months of treatment, my son and I studied thoroughly the whole book of origami, and we could have made thousands of paper cranes, but it was necessary to find more difficult models and levels to draw away the dark thoughts.

A child with cancer undergoes the severest psychological trauma which is caused by a set of factors, and we cannot save the child from the impact of these factors.

*  First of all, there is the astonishing information about the disease, which is life threatening.

*  Secondly, the separation from the child’s relatives and friends for a long period of several months.

*  Thirdly, the tough course of treatment with its painful procedures and consequent loss of hair.

*   Fourthly, children see the suffering of other patients, and very often learn of their death.

 But we can help the sick children make their fears, emotions and hopes visible. It is common knowledge that a picture drawn by a child can highlight his or her problems, on the one hand and on the other it can become a method of psychotherapeutic treatment.

This is the great field of research by psychologists and psychotherapists, by the way, which is almost unreal to us: there are no funds to pay specialists of that kind, and there is no volunteer psychologist here up to now.

Nevertheless, a lot of patterns are obvious even at first sight.

A newcomer to the department is never deliberately involved in the work; the process of art-therapy begins when the child watches other children work. But creative art is very contagious; all new artists are attracted by the process, willy-nilly. The child is never bored; there is no time for that.

During the first days or even months, the child can only, as a rule, use one dark color to draw its pictures. These pictures usually show something threatening. For example, July Donets, a very calm and reserved girl, drew animals with big fangs, claws and drops of blood. But when she was discharged to return home from the hospital, she presented the teacher with a picture of a tiger, no fangs and claws showing, all soft and fluffy like a cat.

The teacher analyzed the pictures of Volodya Stogny, an orphan, and noticed the connection between the attacks of aggressivity and the pictures. When the attack was close, Volodya painted the abstract picture in aggressive bright colors.

The pictures of Elena (Alyonka) Kornilova, age 4, need a separate world. This child had been treated for leukemia for almost all of her short life. She had fallen ill when she was one, and after two years of treatment she had had a relapse. Ten months later, in hospital, Alyonka had a third relapse, which led to her death.

Alyonka’s pictures repeated the only motive: horrible black sun, which looked like a jellyfish or wheel, spreading the tentacle-rays towards a small helpless figure (teddy-bear, small ship...) - and a small, but very bright sun, which saves the small figure and takes it aside of the black monster. One of her pictures had the black sun on the sea background at the bottom of the list, and the bright one shining in the sky. The girl captioned the picture with these two lines: ”I don’t like the black sun, I go for a walk with the red one.” The girl gave this comment: ”The black sun is a bad one, that’s why I’ve thrown it into the water, let it sink.”

There is no black sun in Alyonka’s last picture. No images in fountain pen, just color-abstract compositions, fine and delicate aquarelles of calm and harmonious shapes…

A special group is formed with pictures on medical topics. Children usually draw their doctors. There are several such portraits on the walls of the doctor’s room, carefully pinned near each doctor’s place.

Certainly the teacher directs the creative activity of the children, but with all possible tactfulness and without pressure.

The teacher offers the children the chance to prepare happy pictures for any holiday, showing the child’s family on the picture- and of course the child is supplied with the brightest and the most joyful pencils and paints. Once the patients of the department were given the theme: I am back home! The enthusiasm the children showed needs no words! To the current survivor’s day, the entire department (children, parents, doctors, and led by the teacher) created a huge poster: blue sky, a sun, white clouds, flying birds, green grass and blue sea. The artists made this picture, dipping their hands into the paint and stamping their hands on the white paper. All the images were made by their handprints. But unfortunately one of the small artists experienced an allergic reaction to the paint, her hand got all inflamed. That’s why the teacher never applied this method of painting again.

But when each child creates something without any help, choosing the topics itself, the pictures or handicrafts turn out to be jolly and festive. They are full of suns, rainbows, blooming trees and blossoms, butterflies, all kinds of animals and very often waves of the sea. The names of the pictures speak for themselves: ”My dream”, ”Rainbow”, ”Spring in Cosmos”, ”Merry Clown”, ”Sunrise in Crimea”, ”We are all going to build a new house”. Children with leukemia drawing holidays, they are happy in this life, they are confident that they will overcome this disease.

The personality of the creative art teacher is of great importance through all three stages of art therapy. During the work with children, the teacher not only teaches them art, but also works as a psychologist.

Skilful teachers usually involve different kinds of creative art activities: painting and drawing, embroidery, handicrafts with beads, application, origami and three-dimensional applications. Materials of quite different kinds are used in creative art activities and match perfectly.

The staff list in the onco-hematological department includes a position for a teacher. For five years, Olga Pavlyuchenko worked with our children. The results of her efforts: our children’s artwork has been successfully shown at various exhibitions, the high quality of the pictures and their expressiveness. She had a great task - to teach the children to overcome different crisis conditions and to obtain inside support with the help of creative art. Olga Pavlyuchenko has kindly granted many important observations and given a factual material of this report. Unfortunately, the state of her health does not allow her to work at the department any longer, but we strongly appreciate her contribution to the psychological health and education of our children.

The second stage of art therapy begins when the child needs something more than just drawing and painting, splashing out his or her emotions, moods and problems. The child feels that it is not enough for him that his works are carefully kept by his teacher or his parents and doctors. The child feels it boring to compare his works with the works of other sick children.

The second stage of art therapy begins when the child with onco-disease wants to compare his creations with the works of healthy children.

It is critical that an adult should be with the child at that moment – a parent, social worker, teacher, or volunteer - a person who can organize the event.

The first stage of art therapy has solved the problem of supporting the spiritual side of the child; it has given the child a support in coexistence with the serious disease and lethal danger. But the works made in the hospital fulfill one more aim - to become the sick child’s ambassador to the normal world that surrounds their hospital, to let the children’s works show the people and the world the reflection of their souls.

And now, from that moment, emotional therapy takes on the features of rehabilitation. Rehabilitation is included and aimed not only at supporting the spirit at this moment in time, but also in the future.

*     First, a child, whose works take part in competitions and exhibitions, gets used to the thought that his or her life is still usual, and that it is normal that it lasts nevertheless.

It is twice as good if the competition or exhibition takes place in the kindergarten or school which the child attended before the disease. In this case the child becomes confident that he or she is still taking part in the school life as well as the other healthy children do. Usually there is no such competition, the child simply exchanges pictures with his former classmates, keeping the communication with them from above the hospital walls, and receiving his or her classmates’ support.

*     Second, the emotional charge of that work is so high that usually they take the first place awards or get the largest number of appreciation -the spectators’ love award. Three years in a row, the works of the onco-hematology department patients obtained the Grand Prize of the Festival of Disabled Children’s Art. In 2001 all three prizes of laureates were awarded to our children. These are the winners: Misha Norenko (ALL,14), Masha Galaburda (ALL,11), Denis Alexeev (AML,14), Olya Baraovskaya (ALL,13), and Volodya Rodionov (ALL,10).

So, the child’s self-esteem grows a lot, because he realizes that he or she is not only worse than other children, but has in some aspects become much stronger and better.

That’s why we usually try to give the child some material evidence of his or her victory or even participation in the competition - a diploma, a prize or photos from the exhibition.

*    Third, the quality of the children’s artwork is very high, so it is possible to organize auctions like exhibitions or exhibitions with charitable aims. Exhibitions of that kind are regularly held in the administrative center of Crimea, Simferopol. There were some exhibitions in the capitol of the Ukraine, Kiev, and abroad- in the Netherlands and in the USA as well. Now we are planning to organize such exhibitions in Canada and Russia. All the money obtained at these exhibitions is spent on the purchase of new material for art and handicrafts activity, but the main part of the money is spent on medication for some individual cases or for the whole department. Children become conscious that their works are not only high in value, but can also bring real money and be a financial support for their parents. These thoughts give the children the possibility to be proud of themselves and make them seek new expressive means and fresh ideas and to fly higher and higher.

Now the third stage begins - creative art is not only emotional therapy, not only the rehabilitation, but real, steady hope - not hope, but confidence! That this real, special child with the diagnosis of ”cancer” has a real future – a future as a valuable, even more useful member of society. In aspiring to new achievements, mastering their creative talents, in search of new artistic decisions, our children acquire the skills of their future professions. The recovery means not only the clinical state, but also returning to the previous style of life.

Unfortunately, in our country we see - especially from the side of the state - strong disregard and neglect of sick and disabled people. In such circumstances, our children seem to have very low status. But we observe quite the opposite situation when the children return home: their status increases. Such children become popular and take the leading place in different child communities. They continue to take part in competitions and continue to win them; and consequently they start to teach other children not only their skills in creative art, but their new knowledge about real values in life, which they have learned from their own experience.

During the treatment, our children acquire enough different skills to continue their world at home, as well as to enrich their knowledge. They become confident in themselves and their powers, and continue to help their parents, producing creative art work for sale.

Volodya Rodionov (now 12) makes competitions with sea shells and pebbles, makes applications and embroidery.

Masha Demchuk (12, now undergoing treatment)- creates wonderful bead bouquets and compositions with the help of her mother.

Olga Bavarovskaya (15)- together with her mother does embroidery; almost all of the doctors have her embroidery compositions. Unfortunately, Olga has had a relapse and has been preparing for a bone-marrow transfusion in Kiev.

We need volunteers - men of art, we need them badly. We need people who can constantly and professionally teach our children creative art. We want our children to work as the children in Moscow regional hospital do, where the department of onco-hematology and transplantation of kidneys is supervised by the volunteer group, organized by Reverend Alexander Men.

If something non-material is invested, the skills and kindness of the teacher or the volunteer for example, the children can pay back the investment many times over.

Joy, admiration from the world, hope - we can see everything in the work of our children! Our children, who are considered by many people as incurably ill, can give us such positive energy that we feel able to make our gloomy world bright, taking their emotions as paints.

They usually bring their creative art work as a present to their doctors. We write poems and songs as well, and sometimes even books…

Marina Novitskaya

Co-coordinator of raising awareness activity

Mercy Mission ”Overcoming”, Ukraine

This report was presented at the ICCCPO meeting at Barretstown (2003)