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When we talk about impact and outcomes from creating new Operating Rooms and training new surgeons, it’s easy to talk about the number of operations completed, the surgical site infection levels, the years of disability prevented and even the economic returns for the host nation. But what if these aren’t the real success story? What if there’s something else, something more important?


During the first four years of a child’s life their brain is physically growing at an incredible pace. At birth, it’s actually the least developed of the body’s organs but by age four it has done a lot of catching up. That growth is significantly affected by the experiences the child has.

Synapses in the brain grow and connect in a way designed to protect the child from threats as they grow. So much so that evidence suggests the brain of a child brought up in a hostile environment will be physically smaller than that of a child brought up in a loving one by age 4. Meaning the child brought up in a loving environment will be better equipped to face the world they set out into as they start school.

In high-income country studies, it is even suggested factors as small as the pram/buggy/pushchair a parent selects can influence their child’s development. One faces outwards to the world, leaving the small child uncertain if they have been left alone, the other faces back towards the parent, giving the child a sense of safety and security.


It’s letting each child know they are in a safe space, a secure environment. That they are loved.


Poor experiences in early years, even seemingly insignificant ones, therefore have the potential for a lasting, lifelong impact. 

This matters in surgery because having an operation is scary no matter what age you are! And it matters to Kids Operating Room because a high percentage of our patients are under 4, meaning what happens to them now may well have an impact on their lives when they are older.

And of course, that impact from a single experience might not be overly significant. But it might be enough to build in a fear of hospitals. It might be enough to make our infant patient less willing to seek medical advice when they’re an adult, or even a parent themselves.

The real success of our work is therefore more than just the safe operations, it’s letting each child know they are in a safe space, a secure environment. That they are loved.

That’s why our reception spaces, Operating Rooms, recovery bays and often ward spaces too are transformed from practical (but often sterile, or worse, run down) facilities into child-friendly environs designed to distract, de-escalate, and calm the child.

In a KidsOR facility the anaesthesia provider can talk to even the smallest child about the colours, the animals, perhaps playing a game to count the birds or find a butterfly. All putting the child at ease.

The parents can also see that the space they are in is the right one, designed to care for their child, which can help their stress levels - something every parent knows their child picks up on. Artwork in the surgical setting for children isn’t just a nice thing to do. It shows our patients, now numbering 30,000 a year, that they are going to be cared for here; that they are loved.

The operation they receive today may well save their life, the love we show them may well make it easier for them to return one day in the future, potentially saving it again then too.

David Cunningham is Chief Executive Officer of Kids Operating Room

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