Cancer diagnosis and treatment can be a deeply traumatic experience for any child and their family.
For families in Low- and Middle-Income Countries (LMICs), the impacts can be even more intense and overwhelming – painful, confusing, frightening, and disempowering, with few emotional supports available.
Yet even in the most challenging situations, we can ease the burdens. With trained professionals and compassionate, developmentally appropriate care, we can help children and families cope, build resilience, cherish moments of joy, and thrive. This is the gift of Child Life.
Why Child Life Matters
Retinoblastoma care involves frequent invasive procedures, life-altering surgery, and complex, intensive therapy. Simple procedures like applying eye drops can quickly become traumatic for everyone involved. Without preparation and support, children may become overwhelmed and fearful, resisting the care needed to save their life.
Procedures take longer and are less safe when a child is distressed. They often require more nurses and stronger sedation. Communication with anxious parents can break down, and stress multiplies.
Intense stress and emotional trauma can delay a child’s healing and normal development, with lasting negative effects on their physical and mental health.
Yet this suffering can be avoided or greatly reduced.
Child Life Specialists use play, preparation, education, and self-expression activities based on natural child development to help families understand the medical experience, develop coping strategies, and build emotional strength. They transform how care is delivered, reducing trauma, improving cooperation, lowering costs, and helping children heal with confidence.
While Certified Child Life Specialists are university-trained professionals, child life approaches can be used by doctors, nurses, social workers, teachers, parents, and others, and with children of all ages. Even the tiniest babies can benefit from techniques like infant massage and comfort positioning.
Child Life also strengthens children’s rights in healthcare, as defined by the UN Convention on the Rights of the Child. These include the right to be informed, to have pain managed, to be supported emotionally, and to play and learn – even while undergoing medical care. In LMICs, these rights are often overlooked. Child Life makes them visible and possible.
Building Kenya’s Child Life Leadership
We have been investing in Child Life in Kenya since 2007, building a team of trained professionals and creating a model for sustainable, locally led support. This was the first child life training program in Africa.
Annual Child Life clinical training began in 2008 at Moi Teaching and Referral Hospital in Eldoret, in partnership with the Sally Test Paediatric Centre. The training program is led by WE C Hope’s Certified Child Life Specialist, Morgan Livingstone, who has extensive experience of resource-limited child life provision through her work with Operation Smile.
Through this partnership, Kenya has grown a strong child life program, leading the way for child-centred care across Africa. We’ve trained more than a dozen Child Life Specialists and Assistants, supported regular clinical supervision, and developed a robust program at the Shoe4Africa Children’s Hospital. The hospital’s Child Life team now includes:
- Certified Child Life Specialists
- Child Life Specialists and Assistants
- Playroom Supervisors
- A Technology Specialist
- Teen Program Facilitators
- A Program Manager and support staff
Together, they support over 200 children daily across outpatient clinics and inpatient wards. They provide a wide range of services tailored to the child’s diagnosis and needs at every age and stage of treatment.
What Child Life Support Looks Like
Child Life is much more than play to occupy children in hospital. The program of in-class learning and hands on practice includes training in:
- Medical play and simple language to prepare children for procedures.
- Using cloth dolls to explain medical procedures in a non-threatening way, and aid self-expression for a non-verbal or distressed child.
- Role play and recreational activities to ease fear and anxiety.
- Distraction play and comfort positioning to reduce fear and pain, and increase safety and co-operation during procedures.
- Creative expression, art, drama, music, and storytelling to empower children and support emotional healing.
- Massage and guided imagery to manage pain and help the child relax;
- Infant massage to soothe babies and build healthy attachment.
- Palliative care, including grief and bereavement support for the family;
- Communicating with the family;
- Cost saving through child life practices;
- Parent support sessions with the medical team to build trust and understanding.
Even during the COVID-19 pandemic, the Child Life team continued to innovate and ensure children received the support they needed. This unprecedented time saw daily virtual supervision, design of new clinical preparation materials reflecting COVID-safe care, and special distraction therapies like immersive video and gaming to support children through difficult procedures.
In partnership with Child’s Play Charity, we funded a new Technology Specialist role, enabling broader access to digital tools that ease anxiety and support learning. The child life team use tablets and video games to support distraction during procedures, and custom-made digital books that prepare children for surgery or new procedures. All content is designed to be inclusive, with alt text and audio descriptions for children with visual impairment.
Growing the Profession in Africa
Kenya is now home to the most advanced Child Life program in Africa. But we see far beyond one training program in one country – the Sally Test Child Life Program is seeding change across the continent.
We’ve hosted international child life interns from Ghana and South Africa, who completed intensive placements in Kenya to build their skills. We’ve also supported remote mentorship of a child life leader from Malawi, strengthening the supports available to families of children with cancer and other critical illness.
We also support Kenya’s child life leaders to share their knowledge and advocate for child- and family-centred care. They have presented at many meetings, including:
- International Society of Paediatric Oncology Africa Congress and World Congress.
- International Society of Ocular Oncology Africa Congress.
- Association of Child Life Professionals Conference.
- One Retinoblastoma World conference.
With energy and dedication, they highlight the power of Child Life to transform cancer care, inspiring other countries to begin developing their own programs.
University-level Child Life programs are now in development in Kenya, Ghana, and South Africa. These efforts, supported by WE C Hope, are creating new professional pathways and a future in which Child Life is embedded in African healthcare systems.
Help Us Expand Child Life
With your support, we are building a future where every child has access to psychosocial care that supports their development, dignity, and right to thrive – even during cancer treatment.
Together, we can:
- Train more Child Life Specialists across Africa and beyond.
- Support continued professional development.
- Equip hospitals with child life tools and resources.
- Build awareness of children’s rights in healthcare and the value of child life.
Child Life is not an optional extra. It is essential care for every child facing serious illness and complex treatment.
Articles about Child Life in Africa on our blog:
Child Life in Kenya: The Sally Test Child Life Program
Transforming Paediatric Care: Child life in Low- and Middle-income Countries
