Iquitos is the biggest city in the largest province in Peru, covering the entire Amazon. It is the home of its only mental hospital, the CREMI (Centro Rehabilitacion Enfermos Mentales Iquitos), which is a remnant of old movie images of insane asylum’s with dark, damp, dirty. Iron-barred cubicles. Peru is closing these archaic institutions and moving to a community-based model. This approach integrates the chronically mentally ill into the community, using supervised group homes and closely monitoring patients’ medications.

The CREMI decided to make the hospitals closing a cause for community celebration. They waited for the Festival de Belen, and the annual appearance of the clowns to publicly announce this ceremonial farewell to the chains of the past and moving into modernity.

The clowns have come to Iquitos to support the public health of the community every August for the last 6 years. This year 134 clowns from all over North and South America, Russia, Poland, Italy, and Australia came to inaugurate the festival with a parade down the streets of Belen. The clowns visit hospitals, old-age homes, hospices, AIDS shelters, and homes for teenage mothers; they paint homes, create street murals and conduct workshops for children mornings and afternoons, on dance, percussion, acrobatics, puppetry, making toys and musical instruments out of recyclable materials. Most importantly the clowns leave behind grass roots organizations dedicated to public and preventative health that are supported by an international community.

On the evening before we were to tear down the barred cells, the CREMI director, Dr. Nestor Aguilar, and a Pan American Health Organization (PAHO) consultant from Argentina, Dr. Hugo Reales (both psychiatrists), welcomed the entire clown group at our hotel. They explained the symbolic significance of the next morning’s event; we would be helping them joyfully announce this leap into the future. As a colleague, they asked me to join them in the ceremonial dismantling, but they had no idea that the next day their colleague would appear in his clown persona.

My clown self is a bulging, 6’6″ ballerina in pink leotard and tutu, topped by a flamingo headdress, clicking castanets and dancing flamenco. It doesn’t matter where I go or what language is spoken, this clown inspires at the very least a finger-pointing gasp, most people giggle and laugh, and on occasion a collapse hysterically. This ridiculousness always gets me out of my head and any lingering ego issues, and forces me to connect with people at a spontaneous heartfelt level. The ability to laugh, at ourselves, each other, even in troubled times, is a basic aspect of our humanity.

The Clown/Fool is an archetypal character that serves the societal role of poking fun, ridiculing and making public the cultures secrets. In so doing they serve the function of diffusing tension in the community and reduce anxiety. The Jester’s can get away with revealing that the Emperor has no clothes, because they are willing to reveal their own nakedness.

The next morning we drove to the CREMI, which sits in the middle of lush tropical vegetation outside the city limits. Doctors, staff, patients, families and cameras rolling, met us at the gates. On seeing me, Nestor and Hugo smiled and applauded. We marched in singing and dancing,and when the energy peaked the entire ensemble participates in pu lling down the bars.

I danced on the gates, laughing at the thought that I was Alan Bates in the King of Hearts, and if anybody looked at footage of this event they would have trouble telling the patients from the visitors. Dancing on the doors of these crumbling walls is one of my highlight clowning experiences, but it turned out that the best part of my visit happened afterwards.

I was dancing on the barred gates with Joel, a male patient in his 20s who after we were finished wouldn’t relinquish my hand and invited me for a walk around the grounds. The walk took 40 minutes, during which we walked arm in arm, Joel spoke Spanish (which I don’t understand), and I spoke English (which Joel didn’t understand). We talked animatedly and understood each other, I taught him the chorus to “She’ll be Coming Round the Mountain” and he repeated. When she comes. We walked together, arm in arm, both understanding everything being said, because like all loving connections the contact is far more important than the content.

Laughing, smiling and touching are a fundamental aspect of our humanity. Welcome the clowns.