Laugh treatment: Isabela Maia, of Brazil, volunteers with Patch Adam's nonprofit organization, clowning to bring joy and laughter to children at hospitals in downtown San José. See photo report for more.

Keely Kernan | Tico Times

Flu epidemic or no flu epidemic, the clowns were going in. Two bus loads of them. Thirty-seven clowns in total.

The hospital workers weren't quite sure what was going on. Clowns seem to have that effect on adults. Not so, the children. The kids welcomed them with open arms, particularly those little ones wearing plaster casts.

The clowns, professionally trained in the art of juggling, tickling and balloon-twisting, are members of the Gesundheit Institute and the School for Designing a Society, international non-government organizations established to improve health care systems and society.

Traveling in convoy from their Quaker-run hostel base to San José's National Children's Hospital on Sept. 11, the clown crew warmed up on their buses with improvised songs, such as “When the clowns go marching in” and “The clowns on the bus go round and round.”

While silliness was very much the order of the day, the reason behind the clowns' descent on San José's hospitals and clinics was an altogether more serious affair.

“Like doctors, it is the job of the clown to walk towards suffering,” said head clown, 21-year-old Melanie Meltzer from the U.S. state of Washington. “We are here on a humanitarian clowning mission, to deliver a bit of joy, care and sustenance to the children and change health care for the better.”

The clowns are inspired by the work of Patch Adams, the U.S. physician depicted in the 1998 film named after him starring Robin Williams. Adams is a professional clown and founder of the Gesundheit Institute, a free community hospital in Virginia. The clowns tour the world prescribing Adams' particular brand of medicine – a concoction of humor and play.

It was the first such mission for many of the clowns so, as well as a one-week josh with the sick in three of the city's hospitals, they will also participate in evening debates at the Quaker lodge, Casa Ridgeway, discussing the role of the clown as an activist, among other topics.

Brazilian Isabela Maia, a 26-year-old former Broadway actress, who fled the bright lights for the circus, said, “I was doing Broadway but suddenly felt that my life had become empty and unfulfilling. I felt that I didn't belong to anything of any importance.

“I decided to go to circus school in Brazil, a move that upset my parents who thought I would end up juggling on the streets for a living, but I told them it was something I needed to do,” she said.

See the Sept. 18 print or digital edition of The Tico Times for more on this story.