Children with cancer must often spend several months in a hospital ward receiving painful treatments that are crucial and necessary in order to save their lives.

The paediatric cancer patients being treated at Japan Heart aren’t left unattended or idle, however, as there are numerous entertainment and education programmes held at the hospital for them – including a recent virtual trip to the zoo.

Some of the children taking the trip were strong enough to walk on their own, while others were too weak and needed assistance or a wheelchair. Some of them had intravenous drips. Others were in obvious pain, which is something that they become sadly accustomed to after being in the hospital for months. All of them gathered together in a room at the hospital with a projector that would serve as their virtual zoo.

The virtual visit to the Phnom Penh Safari zoo located on the outskirts of the capital was organised to entertain paediatric cancer patients who are unable to leave the hospital’s cancer ward due to the condition their health is in and other circumstances.

“Most paediatric cancer patients have a long hospital stay of six months to one year. And they cannot go out during hospitalisation because their immune system is weakened by chemotherapy,” Japan Heart intern Sasaki Miyuko told The Post.

“The children have to stay in the hospital all the time – especially now because going out frequently is not permitted due to the risk of Covid-19 infection. Online events have made it possible for children who can’t otherwise go to the zoo to feel like they’ve been there,” she says.

Miyuko – now in her fourth year at Yokohama City University School of Medicine’s Department of Nursing – recalls that she had a bad experience while staying in the hospital several times when she was young, but despite her hospitalisation being difficult she remembers having fun on holidays like Christmas and while attending concerts there.

“Therefore, I want the children in the paediatric cancer ward to have some fun memories of the hospital and spend time doing something that lets them forget about the pain their treatments are causing them for a while,” says Miyuko.

Miyuko interviewed children with cancer across a range of ages up to 13 years old. All of them said they liked animals so she decided to work with Phnom Penh Safari to hold a zoo event that all of the children could enjoy together.

“I thought it would be too boring to just play animal videos and that it would be better to have an interactive event where the camera moves to what the children want to see and the zoo keeper answers the children’s questions,” she says.

It took several practice runs to set the virtual zoo visit up properly since it involved a mix of live and recorded video streamed over Zoom using its spotlight function but they managed to get it working.

Over the course of 90 minutes, 22 children with cancer went on a virtual tour of the zoo led by zookeepers who not only answered their questions but did things that regular zoo visitors wouldn’t be able to do such as feeding the giraffes and taking a ride on the elephant.

“This is the first tour on ZOOM that the safari has organised for Japan Heart. We wanted to help because the children with cancer are in so much pain and they struggle with the cancer treatments for a long time. So our zoo and Japan Heart decided to work together to make it happen,” Sok Suthlen, the sales and marketing manager at Phnom Penh Safari, tells The Post.

Miyuko says that four staff from Japan Heart went to the safari on the day of the children’s virtual visit. The children got to see them undergo an orientation and then they headed over to the part of the zoo with giraffes and elephants accompanied by the zoo keepers. Four more staff members remained back at the hospital to help out with the event on that end.

“The staff members from the hospital were excited to guide the children and the zookeepers from Safari answered the children’s questions and interacted with the animals,” Miyuko says.

A few days before the date of the virtual tour, Miyuko distributed tickets to the zoo to all of the children and told them they’d be going to the zoo. The children knew they weren’t allowed to go outside and some of them wondered if she planned to bring animals into the hospital instead.

Though some of them might have preferred either of those scenarios, all of the children and their families enjoyed the virtual zoo visit and were eager to answer questions for the zookeeper’s quiz at the end.

When the zookeeper fed the giraffes some of the younger children came up and pretended to put the grass into its mouth by mimicking the zookeeper’s on-screen movements.

The children also applauded and laughed at the antics of the trained monkeys in the monkey show and they were suitably impressed with the size of the elephant when the zookeepers showed it to them.

The distraction and fun provided by the zookeepers and their animals was enough to take the children’s minds off their illnesses for a little while no matter how painful their cancer treatments happened to be, Miyuko said.

“After the zoo tour the children were all asking when the next event would be,” she says. “Now the pressure is on for us a little bit because the zoo is going to be hard to top, but we’ll try.”

Suthlen says he wishes the children were able to come and take a tour of the zoo in person in order to get the full sensory experience but obviously that would depend on their health and the priority right now obviously has to be the life-saving treatments for their cancer they are receiving from Japan Heart.

“A physical visit gives children a better sense of the size of the animals and they can see how they behave up close. And though you might not think of it as a feature at first, the smell of the animals – even when unpleasant – really does drive home the fact that these are living creatures. But the virtual tour is the next best thing given their circumstances,” says Suthlen.

Miyuko explains that the children cannot leave the cancer ward during their hospitalisation because their immune systems are weakened by chemotherapy so it’s too dangerous during a pandemic because one infected child could spread it to the rest of the patients.

“This makes visiting the zoo impossible for them to do while being treated and – though it’s sad to say, but this is the reality with cancer – some patients may never get the chance later on because they will die in the hospital or not long after they are discharged,” she says.

Japan Heart treats more than 80 paediatric cancer patients each year. Many children are cured at Japan Heart – which is to say their cancer goes into remission and they appear to be cancer-free – and they are eventually discharged from the hospital.

However, some children – for example those who arrive at the hospital after their cancer has already advanced and spread to other areas of their body – won’t benefit from any known treatments and the only option is to give them palliative care to ease their dying.

“Therefore, every day they spend alive – even if it’s in the hospital – is valuable. So they look forward to these events very much. We also do things like birthday parties and holiday parties in the hospital but this was the first time we’ve had such an elaborate large-scale event in collaboration with an outside organisation,” said Miyuko.

Though the virtual tour of the zoo was complicated to plan out and execute it worked out well in the end and Japan Heart intends to hold another event for the kids with Phnom Penh Safari in the future.

“There are five different animal shows at Phnom Penh Safari, so for another event I’m thinking about getting videos of all of those to show the children. I know the staff at the zoo have busy schedules but they have been so great about making time for our patients and I can’t thank them enough,” Miyuko says.

To see clips of the virtual tour of Phnom Penh Safari or to donate to Japan Heart visit their Facebook page: @japanheart.hospital