At Oslo University Hospital, sick kids aren’t confined to bed. They fish, chop wood, shoot arrows and paint pictures, all in a woodland cabin 650 feet from the building.
This outdoor care centre is called Friluftssykehuset — in Norwegian, friluftsliv translates to “being out in nature”, and sykehus means “hospital” — and it’s part of an experiment to see if nature can speed up healing.
It’s an idea grounded in research: multiple studies have shown that spending time outside can decrease stress and improve both mental and physical health. Others suggest that physical activity can prevent illness and mental disorders, and help those affected by trauma heal.
“Bringing patients outside the hospital helps them relax and find the strength to get through their treatment,” said child psychiatrist Maren Østvold Lindheim, who helped spearhead the idea. “Being in nature gives them the feeling of possibility: they have more energy, more hope and more creativity.”
Lindheim works in the hospital’s Department of Child and Adolescent Mental Health, which helps counsel children through treatment.
She and her colleagues work with patients across the hospital, from children with cancer to those suffering from chronic illness. Many fear treatment — undergoing surgery, having their blood taken or even just speaking to counsellers — and have to be restrained, which can lead to further trauma.
Oslo University Hospital psychiatrists, psychologists, doctors and nurses developed the cabin to help ease these children into therapy and counselling, and give them a respite from daily life in a hospital.
Lindheim and her colleagues had been bringing patients into the woods near Oslo University Hospital for years. It started with just a few children at a time — soon, they were bringing groups into the forest to build fires and canoe on a nearby lake.
But only children who were well enough could participate in these trips. With the cabin, the hospital can now give all children the feeling of being away from the hospital, minutes from its premises.
The 375-square foot cabin, built in partnership with architecture firm Snøhetta and the Friluftssykehuset Foundation charity, is uniquely designed for children.
There’s a zig-zag path leading from the hospital to the house, which has two rooms and a bathroom and is constructed entirely of wood. Windows face away from the hospital and into the forest, giving children the feeling that they’re in the woods. And the cabin’s walls are slightly slanted. Its unique design is intended to spur curiosity, Lindheim said.
All, from birth to 18 years old, are welcome, as long as they get their doctor’s permission. The cabin can fit about 10 people inside at once — but most children play outside around the fire pit when they visit, even in plunging temperatures.
Parents are encouraged to accompany patients to give children the feeling of a regular day out with family. It’s also open to adult patients in the afternoon and on weekends, and can be booked via an online system.
“It’s rooted in the Norwegian mentality, because we are out in nature so much,” said Lindheim. “We encourage patients to be out and do things to make them stronger. It’s easier for them to go outside than we think.” There’s a second cabin at Oslo University Hospital’s sister hospital, Kristiansand. They each cost NOK 5 million ($757,000) to build.
Because the idea is rooted in Norwegian tradition, what may seem like a dangerous, impractical idea to medical staff in other countries was an easy sell at Oslo University Hospital. “The mentality here is very creative, and we intuitively felt it was the right thing to help children get these experiences,” said Lindheim.
But despite buy-in from the hospital, it took a long time to get the outdoor care centre up and running. The cabin has been in the works since 2014, and finally opened in June 2018. There were many regulations to be considered, from wheelchair accessibility to who would be allowed to visit.
Lindheim and her colleagues plan to document the results of their research into how nature affects sick children, in order to inform how other hospitals can help young patients. The physicians will experiment with different ways to use nature in treatment.
Thus far, it’s having a clear effect, said Lindheim: “For once, they can feel like normal children.” —Jennifer Guay
(Picture credit: Øystein Horgmo, Ivar Kvaal)