Three-year-old Nguyen Thien Bao was being treated at the National Hospital of Pediatrics before being moved to an orphanage at Bo De pagoda in Hanoi city's Gia Lam district.

He was then hospitalised at the National Institute of Hematology and Blood Transfusion (NIHBT) two weeks ago for treatment of his cancer.

On his second day at the hospital, a man in baggy clothes with a red nose and large shoes appeared in front of his bed, where he played music and made a heart-shaped balloon for him. The child received the gift timidly, while a volunteer standing next to him burst into tears. "Thank you for coming here today. We can see the happiness on his face," she said.

The man who brought joy to the child was David Barashi, a 37-year-old medical clown from Hadassah Medical Center in Jerusalem, Israel. So far this year, he has been in charge of the Dream Doctors project, which healed the pain of 2010 earthquake victims in Haiti and carried out the "Art-Joy-Love" programme for HIV-infected orphaned children in Ethiopia and Uganda since 2005.

Under the coordination and support of the Embassy of Israel in Vietnam, he spent two weeks here providing training courses for medical team members at hospitals in Hanoi and Ho Chi Minh City, and performed at the hospitals as well.

Medical clowning, which combines theatre performance with drama therapy and elements of nursing, has grown in popularity in recent years to become a worldwide practice. However, it is still a new concept in developing countries, and this was the first time Vietnam had experienced this psychological therapy.

"I think medical clowning has a lot of potential in Vietnam, and even in the world. It can add more techniques and tools for medical staff to communicate with patients," Barashi said.

"Medical clowning brings patients back to their childhoods and enhances their self-confidence, which they lose when hospitalised. Medical clowns provide patients with joy and pleasure. They also need to listen and be sensitive to the environment around them to understand patients. For children, they should create a positive environment and perform all activities with the children."

Seeing Barashi walking around the hospital room, saying hello and playing with children, Hoang Thi Thuy Lan from Hanoi's Dong Anh district, whose daughter was in the hospital for the second time for blood cancer treatments, said that activities like this encouraged the mental well-being of child patients and their parents.

"After the first chemotherapy treatment, she was afraid of returning to the hospital. We had to lie to her and say that we were going to a park," she said. "Kids here are all sick and cannot go out to play, so a program like medical clowning will help entertain children and reduce their fears."

For nearly 10 years, Barashi has voluntarily taken care of thousands of victims of natural disasters, conflicts and diseases in many countries around the world, including India, and organised training courses in the US, France and Thailand.

He said that the first requirement for becoming a medical clown was to learn theatre and how to work with an audience. "They need creativity and need to be very sensitive. When we come as a clown to hospitals, it is not about us, but about people around us," Barashi said.

"When working with victims of typhoons, tsunamis and earthquakes, you have to do different things, but all are on the same basis. First, you listen and see what is going on in front of you, then you start to do something very slowly.

"It is the same as if you are in hospitals but, of course, the effect and all the equipment around the beds change you a little bit. However, it brings the same impacts in the end: making patients not change their reality, but change their viewpoints about reality. We try to find positive sides, good things about reality and empower them. That is what clowns do anytime and anywhere."

Nguyen Trieu Van, head of NIHBT International Cooperation Department, said medical clowning was quite new in Vietnam, and expected more programmes like this to be carried out in the hospital.

"There are policies and social activities in the country to connect patients and doctors and increase the will of patients. However, the appearance of the medical clown helps us understand more about the new approach, which means treating patients not only requires medicine, but also involves their mental health," he said.

"Medical clowns bring joy and smiles to patients, making them not feel they are undergoing treatments. It also adds more energy to patients as they fight their diseases, enhances the efficiency of treatments and reduces children's pain."

Before starting his next trip, Barashi said he was willing to train more Vietnamese doctors and nurses about medical clowning. "I hope many medical clowns will arrive here. In Vietnam, it is just the beginning".-VNA