Entering the Paediatric Oncology ward of the Lagos University Teaching Hospital (LUTH) Yaba, where children are treated for cancer, you would naturally expect a solemn environment. That was not the case if you had visited on the 1st of March 2018. The atmosphere was practically festive, the ward, colorful, lively and far from unnerving, unlike many hospitals.
In the middle of the waiting area, Timothy Olaonipekun, an 18-year-old cancer patient was standing, Intravenous (IV) line still set, paint brush in hand, keenly listening and taking instructions from two people wearing nicely designed dark blue T-shirts. A minute later, Timothy nodded and started painting meticulously on a 2ft x 3ft canvas. Close to him, Victor, a much younger patient, with an IV line also in his arm and stood close to another canvas with about four other young people in the same blue T-shirts.
These young people helping transform the atmosphere in the ward were medical students and artists from the “Arts in Medicine” Fellowship organized by Tender Arts Nigeria.
Art and Medicine, an uncommon union?
Many caregivers are not formally taught to have empathy for their patients and can sometimes be insensitive to their emotional and mental states. They tend to be more concerned with delivering prescribed treatments and discharging the patients. This creates a gap between patients and caregivers and may adversely affect how patients tolerate their treatments. Similarly some family members also isolate or distance sick members of their families, creating a huge gap in their support system.
The Arts in Medicine project seeks to address this by transforming the healthcare delivery space using creativity.
Juxtaposing arts and medicine seems unlikely at first glance. But the truth is that for the complex human system to stay healthy, there’s an interplay of physical and psychological processes. The popular definition of health by the World Health Organization buttresses this fact because it looks at health from a holistic point of view, including a wellbeing component, looking beyond the mere absence of disease or other infirmities.
New Term, but backed by Evidence
The concept of using ‘Art in Medicine’ is unusual, if not strange in Nigeria. This is not the same in other parts of the world. Creative arts therapies were established between the 1930s and 1960s in the United States; and arts in medicine, also commonly referred to as arts in healthcare or arts in health, began to emerge as a discipline in the 1980s.
East African countries including Kenya, Rwanda and Uganda are taking the lead in this area. with various community engagements and a collaborative partnership with the University of Florida Center for Arts in Medicine including an International Arts in Medicine Conference in Uganda in 2013. South Africa is home to the first ever art therapy institute in Africa, Lefika La Phosido.
According to Psychology Today, using arts as therapy involves the use of creative techniques such as drawing and painting to help people express themselves artistically and examine the psychological and emotional undertones in their art.
There is a growing evidence of positive outcomes from the application of Arts in Medicine.
This 2017 systematic review of the effect of creative arts therapy and arts medicine on psychological outcomes in women with breast or gynecological cancer suggests that that arts-based interventions may be effective for improving psychological outcomes for targeted populations.
Making the arts work in the Nigerian health space
The Arts in Medicine project is a project of Tender Arts Nigeria which started in 2015 to help transform the healthcare experience for patients, their family members and caregivers. It also seeks to increase awareness of the opportunities inherent in art as a form of diversional therapy for patients. “When you hear the word, “hospital’, what usually comes to mind is pain and this sometimes increases your stress level. Making hospitals more colourful and calming, and encouraging patients to express themselves using various forms of creative arts helps divert their attention from their pain and to tolerate their treatments better. This eventually reduces the duration of their stay in the hospital,” says Kunle Adewale, Founder of Tender Arts Nigeria and Project Coordinator of Arts in Medicine Project.
To achieve this, Kunle connects with the patient during an in-depth conversation with them. He then guides them to express themselves using any preferred medium of art, whether it is painting, writing, drawing or music.
Applying this innovative therapeutic method has yielded notable results for Kunle and his team across all the health institutions in which they have worked, including mental health institutions, Kunle says.
It has helped patients at the drug unit of Federal Neuro-Psychiatric Hospital, Yaba, sickle cell patients undergoing treatment at Sickle Cell Foundation Nigeria and Children with Cancer at the Lagos University Teaching Hospital (LUTH).
Art Therapy for healthcare: Successes
One of the most profound stories of the efficacy of arts in medicine method was shared by Ogochukwu Anochie, an art instructor and a fellow of the Arts in Medicine project.
“I joined the Arts in Medicine fellowship because I had an experience with art therapy last year. I was diagnosed with an illness and part of the treatment was depressing to me and I lost a lot of weight. I started thinking of what could uplift my spirit,” Anochie said.
“I remembered my drawing board and went back to it. It relaxed me. I forgot about the stress, the treatment, the pain and the changes in my body. My nerves were just relaxed. When I went for further processes, I was calm because I always looked forward to going back to my drawing board after the treatment. So, I joined the fellowship because I wanted to share that experience with others.”
Sickle cell patients Paul Ataigbe, Khabir Ayodeji, and Gbolahan Anuda painted the Hope Towers installed inside the Sickle Cell Foundation office in Yaba. They all agree that painting helped them manage the crisis and pain of treatment that is peculiar to sickle cell warriors.
Mr. Ebenezer Adeleye, Program Coordinator, Sickle Cell Foundation Nigeria, shared how a painting by a young sickle cell patient depicted her isolation at home. This was followed up by inviting the patient and family members for a group counselling and the situation was improved.
According to Mr. Ebenezer, experience has shown over time that the disposition of their patients before treatment influences their pain tolerance. Good dispositions that are engendered by the diversional therapy offered by arts leads to lower levels of pain after treatment.
Timothy, the 18-year-old cancer patient who was getting discharged when the fellows came around, was uplifted enough to share a message of hope with all sick children all over the world.
“Where there is life, there is hope” he said.
At the Drug Rehabilitation unit of Federal Neuro-Psychiatric Hospital Yaba, the excitement was palpable. Over 50 patients actively participated in their last session. They took part in various creative and expressive arts including painting, singing, writing and even spoken word poetry. Both patients and staff of the unit repeatedly asked the project coordinator when the fellows will return for another session.
Sustainability, scale up and challenges
Kunle says he has been able to sustain the project through institutional, international and local partnerships. Some of his partners include the Foundation for Photo/Art in Hospitals, Italy, the Public Affairs Section of the United States Consulate in Lagos, the University of Florida Center for Arts in Medicine, the Nigeria Medical Association (NMA) and the Lagos State Center for Arts and Culture.
The Arts in Medicine fellowship will culminate on the 24th of March 2018 with an arts exhibition at Terra Kulture in Lagos. All artwork done by patients and fellows during the fellowship will be on display at the Terra Kulture Art gallery. After the exhibition, all the art work would be distributed across hospitals in Lagos State free of charge, Kunle said.
“One of the challenges faced by implementing this art in medicine project remains funding. There is low awareness of the potential of art to transform healthcare,” he added.
He also cited lack of locally documented evidence and research as one of the reasons it is difficult to convince patients, their families, caregivers, and some professional bodies on the potential of arts in medicine.
Gradually, they hope that their creative intervention will help reshape the narrative first in Lagos, then in Nigeria as a whole.
While Nigeria grapples with the many issues plaguing its health sector, and with frequent the complaints of poor service in many clinical environments, perhaps, it will be a good idea, at relatively low cost for the relevant authorities, organisations and individuals within the healthcare space to focus more on providing holistic care to patients. One way to do that is to make hospitals and other health facilities less intimidating and more welcoming… so that they truly become a place where people come to get healed… in body, mind and spirit…
A great addition to the huge portfolio of management options available for the care of the infirm from doing nothing, presenting a charming personality, placebos, drugs, surgical interventions and many others. Congratulations. Not surprising, Arts in Medicine works because on the final analysis, the Almighty God created us perfectly and holistically such that not only does each organ depend on a reciprocal state in other organs for its maximum efficiency but also that the physical and psychological blend immeasurably. Such a dept of fusion is difficult to appreciate and understand in totality. One quick lesion I see from all this. We doctors must learn and recognise our limitations from the Anatomy, Physiology and Biochemistry and so on that we have studied despite their tremendous capacity to do good and know that what is really important to a patient is wellbeing and not only the absence of disease. At all times we should be humble, open our minds and be ready to explore as we do not necessarily know it all.
I AM EXCITED THAT SOME YOUNGER PEOPLE ARE PIONEERING THESE EFFORTS WITH VISIBLE RESULTS. I SAY THIS BECAUSE OF THE PERVADING CANVASS OF GLOOM STRETCHING ACROSS THE HEALTH LANDSCAPE IN NIGERIA AND WHICH HAS PERSISTED FOR TOO LONG.
WE REALLY NEED TO BRING OUR HOSPITALS AND HEALTH INSTITUTIONS FROM THE ” WAR ZONE” SYNDROME THAT HAS SUBSISTED TO A LESS TENSE, MORE RELAXING ENVIRONMENT WHERE PATIENTS CAN FIND SUCCOR AND HEALING
BRAVO KUNLE ADEWALE and COHORTS
This is an eye-openet fior me. I once viisited children cancer ward in a leading Kenyan hospiital but overlooked many brilliant paiintings on the walls . Thanks. For this story. Have read it twice and there was no element of Widespread “miracle cures” as I had assumed. keep up such good work. Thanks
This is wonderful, yes art can heal. I have seen instances where it acts as a calming, soothing activity. Medicinal art therapy.
Arts medicine has been with us for generations but it is now been looked at critically by medical practioners worldwide particularly in the USA. I am a medical practiioner and a pioneer in Arts medicine. I have an article published as an editorial of Gazette of Medicine ( Amadi E.S., Arts Medicine, Any Justification? An editorial, GAZ MED, 2014; 3 (1)) i have been to the National Sickle centre and I appreciate all the works of art done by Arts in Medicine. In 2017 I published a book titled Psalms of Infirmity, it is a work of Arts medicine. It is a combination of two dimensional abstract art and poetry.
Keep up the good work!