by Les May, CEIM
In November of last year, the first time I crouched down to smile and make eye contact with Runcalyan, a seven-year-old girl living at an AIDS orphanage in the countryside of Cambodia, she grabbed my ears and squeezed and twisted them hard enough to make me yelp. I took her hands softly in mine and, in broken Khmer, let her know she’d hurt me and asked her to be gentle. She responded by crushing my nose between her thumb and index finger with surprising strength, and I let out another cry of pain. I might have assumed she wanted me to leave her alone if she hadn’t immediately afterwards shown her longing for attention and contact by following me around and leaning against my side. Over many weeks at the orphanage, I often saw the same patterns of children and adults approaching others to inflict pain and humiliation as if these were among the few ways they knew of seeking interaction and contact.
In June of this year, during my fourth visit to the orphanage, I met Runcalyan again, and found in the short time we’d known each other, she’d become a very different little girl. She ran up to me with her arms spread wide, gave me a hug, and kissed me on the cheek. Then she wrapped her tiny fingers gently around mine and led me hand-in-hand across the dusty courtyard of the orphanage. As we walked together toward the baby-blue housing complex where she lives with thirty other children, she spoke just one word in an enthusiastic tone, “Massage.” When the other children saw me approaching they came running to meet me too and echoed that same word with excited shouts, “Massage! Massage!”
The profound shifts from aggression to gentleness that Runcalyan, and many of the other 250 children at the orphanage, made in the last half-year were fostered, in part, by a pediatric massage program I founded called Buds to Blossoms. Through this program, I lead groups of volunteers to a rural AIDS orphanage in Cambodia several times a year. There, we live and work as members of the community for one to two weeks at a time providing infant massage education and offering nurturing touch and interaction, including gentle massage, to children and their caregivers.
Before being orphaned, many of the children faced discrimination, abuse, and neglect. Some were raped, prostituted and enslaved. Now, nearly all of them have HIV and compromised immune systems. Some also have painful and disfiguring opportunistic infections or mental and physical disabilities.
Because of the high rate of HIV infection and abandonment of HIV-positive children in Cambodia, an average of one newly orphaned child arrives at the orphanage each week. The new arrivals have often recently undergone traumas, including witnessing the wasting away and death of one or both parents. They’re sometimes emaciated and in the advanced stages of AIDS. In this context, the relief from pain and stress and the boost to the immune system that massage provides are crucial benefits that greatly improve the children’s quality of life and may even help save lives.
Yet, the work of the Buds to Blossoms volunteers is much more about showing the children they’re loved and providing them with the one-on-one nurturing attention that’s been scarce in their lives than it is about massage technique. The children at the orphanage are cared for, primarily, by workers who have little time or motivation to meet their need for an abundance of nurturing touch and communication, even after being provided with massage education. They live in a culture where adults seldom touch children beyond toddler age and tend to leave them to cry without comforting them when they’re distressed. A number of the children have received not only the first massages of their lives from Buds to Blossoms volunteers, but also some of their first hugs.
As in infant massage, when doing pediatric massage, the Buds to Blossoms volunteers begin by making eye contact, smiling and asking permission. We keep the work fun and engaging for the kids by including songs and games, painting hearts and flowers on their skin with massage cream before beginning our strokes and encouraging the kids and their caregivers to massage each other while waiting their turn for massage from a volunteer.
After receiving massage and watching the volunteers model nurturing touch, the children are less aggressive, adults and children are more openly affectionate, and many of them massage each other and us. As the personalities and behaviors of many individual children and adults change through this work, a more compassionate culture flowers at the orphanage. By teaching heartfulness through touch, the Buds to Blossoms volunteers support the children to develop the capacity to provide better care to future generations than they themselves have received.
In addition to drawing on the concepts and practices of the IAIM program in the context of pediatric massage, the Buds to Blossoms program includes infant massage classes for a teenage mother with HIV and professional caregivers of babies with HIV at an orphanage nursery. These classes have been particularly important because the caregivers previously showed little interest in touching and communicating with the babies affectionately and the children were often withdrawn. Infant massage classes are promoting bonding between the babies and their caregivers and noticeably improving the quality of care they’re receiving.
Cambodia is one of the poorest countries in the world, and it’s easy to see that infant massage education and pediatric massage programs are helpful for its orphaned children and their caregivers. But are such programs also needed at orphanages in wealthy countries where conditions are relatively good?
During a tour of an orphanage in Tokyo last year, a staff supervisor showed me to the preemie ward, an enclosed room where two babies lay isolated from human contact, and asked, “So of course we wouldn’t want to massage the premature babies, right?” Even in an orphanage, in one of the world’s wealthiest cities, the staff weren’t aware that it’s safe to gently massage premature babies, that studies have shown they typically gain much more weight on days when they receive massage, and that treating these children as if they’re too fragile to be touched can only undermine their health and development.
Nearly a year ago, when I was just getting involved in infant massage, I planned to relocate to Japan for work, so it made sense for me to launch infant massage outreach programs to support orphanages there. I designed a program called Kizuna Baby. Kizuna Baby includes free infant massage education for orphanage staff and a volunteer program in which I recruit local people, provide them with a course in the program of the IAIM and arrange for them to regularly visit and massage babies at orphanages in their own communities. I launched the Kizuna Baby program last year in Tokyo and found orphanage directors and staff enthusiastically welcomed it.
Earlier this year, I was busy planning more volunteer trainings to be held in May in Tokyo and three other cities when the tsunami struck. After checking in with baby orphanages in the hardest-hit region, to see if they had any need for material support and finding out they were ok, I offered to include them in this year’s expansion of the Kizuna Baby program. One of the orphanages accepted the offer.
Given the stress and health risks that have come with the recent crisis, the benefits of infant massage are clearly more important than ever to babies, caregivers, and communities in Japan. Before the disasters struck, I was often asked “Why Japan?” by people who assumed the country has enough resources to take good care of its disadvantaged children without outside help.
One good answer to this question came from orphanage directors and staff who told me that even though the Japanese government requires baby orphanages to have one staff person for every two babies, one of the highest orphanage caregiver-to-child ratios in the world, the staff seldom find time to give the children the one-on-one attention and touch they need for their well-being and optimal development. This might not come as a surprise to anyone who’s taken care of two babies at one time. In fact, at any given time, some staff are usually doing tasks other than directly caring for children, so some caregivers end up looking after three or more children at once. So it turns out that, even in Japan and even in the absence of natural disasters, many orphanages need infant massage outreach programs and want volunteer help.
The Kizuna Baby program is now offered in five Japanese cities. Thirty volunteers received training in the IAIM program through Kizuna Baby in May, and twenty are currently doing infant massage volunteer work on a weekly basis. Thanks to the program, disadvantaged children are getting a lot more one-on-one attention, and feedback from orphanage directors, staff and volunteers has, overall, been very positive. The program now has systems in place to minimize administrative overhead, including a website-based calendar that volunteers can use to make appointments for their volunteer work visits.
Now that the Kizuna Baby infant massage volunteer program concept has been proven and its design and operations have been revised and streamlined based on the first year’s experience, it’s ready to be expanded to other regions of Japan, as well as to parts of the world where conditions in orphanages are far less favorable, and the need for community volunteer support is more urgent. Networking with the national branches of the IAIM will be an ideal way to recruit the volunteers needed to launch similar programs elsewhere and adapt the program’s blueprint to suit local conditions, languages, and cultures. I’d love to hear from IAIM members, from any nation, who are interested in working together to set up similar programs in their communities, so we can help bring the benefits of infant massage and pediatric massage to more disadvantaged children.
As educators of infant massage, when we look within our own communities and out into the world to learn how we can be of help to children, families and caregivers who are facing hardships, the IAIM program and the wisdom and compassion it embodies can lend depth to our vision. When I last gazed across the fields of the orphanage where I work in Cambodia, at the hundreds of children there, each of them longing for someone to show them love, my eyes turned down to my palms. As I stared at them, they seemed so small and inadequate, and I told myself I just don’t have enough hands to give all these children the nurturing touch they need. Then, in a moment of clarity, my focus shifted toward the horizon, and I saw a sea of other hands there, radiating warmth, poised to reach out.