Andrés Aguilar Larrondo

Using volunteers trained in clown techniques, improvisation, and communication skills, Andrés Aguilar is promoting a culture of volunteerism and civic engagement throughout Mexico.

Andrés is the founder and president of Risaterapia A.C. (literally meaning “laughter therapy” in Spanish), a citizen organization (CO) established in May 2002. The innovative idea driving Risaterapia is the construction of dynamic interpersonal relationships based on the principles of volunteerism and what Andrés calls “cheerful cooperation” with a special emphasis on the places where happiness is most lacking—hospitals, nursing homes, marginalized communities, and disaster areas and post-conflict zones. Risaterapia’s corps of volunteer Médicos de la Risa (laughter doctors) undergoes extensive training in improvisation and communications skills before visiting sites to engage vulnerable populations. Risaterapia volunteers are also encouraged to apply what they have learned to their daily lives and personal relationships. Unlike many volunteer organizations that focus heavily on the delivery of services, Risaterapia operates on the principle that their volunteers can be agents of social and cultural change. Andrés’s vision is to foment a grassroots movement of volunteerism throughout Mexico—and eventually other countries—based on human interactions and their multiplicative effect on people’s outlook and self-esteem. To this end, he and his Mexico City-based Risaterapia team have developed a low-cost replication model whereby interested groups in other Mexican cities are granted significant autonomy to start their own Risaterapia chapters. Risaterapia has ballooned in size in the five years since it was founded; encompassing 1,200 volunteers in nineteen cities throughout the country.

The fundamental problem that Risaterapia addresses—a problem that Andrés refers to as a lack of social fabric—appears abstract in nature but has a multitude of concrete manifestations in Mexican society. These manifestations are obvious in the places that the Médicos de la Risa visits: Hospitals (especially pediatric wards), nursing homes, marginalized communities, and disaster areas and post-conflict zones are all marked by isolation, depression, mistrust, loss, pain, and negativity. Hospitals in particular have traditionally been the realm of most organizations that promote laughter therapy.

In the early days of Risaterapia, Andrés realized the deficiencies the Médicos de la Risa were addressing were more pervasive and systemic than he had first thought. Hospital patients were not the only ones affected by a vicious feedback loop between a negative environment and negative attitudes. Andrés began to see the problem as a widespread and entrenched culture of suspicion, fear, and materialism throughout contemporary Mexican society. Given the fast pace of modern life and the individual’s increasing isolation from society, communities no longer have the cohesion they once did, or they may cease to exist.

This deterioration of community bonds has led to a disconnect between human beings that feeds what Andrés calls an epidemic of bad humor in modern-day Mexico. People avoid speaking to each other on the street or in public transportation; they pass passengers in stranded cars on the highway without stopping to help; and they immediately assume that any stranger who approaches them must be selling something or asking for money. This dynamic of mutual distrust, closed-mindedness, and seriousness, tears apart the existing social fabric in Mexico and impedes its repair, allowing self-interest to take root instead of a culture of generosity and cooperation. “Selfishness and insensitivity to others’ difficulties trap us in activities that apparently will resolve our own problems but end up isolating us from our environment…without bringing concrete responses to our personal problems,” says Andrés.

Although some people have advocated mandatory community service programs to rebuild social fabric, Andrés points out that many such programs are superficial and do not aim to effect cultural and attitudinal change in both volunteers and beneficiaries. Moreover, few community service or volunteer programs are designed with a specific focus on fun and enjoyment for everyone involved. According to Andrés, there exists a lack of understanding or an underestimation of the importance of happiness in daily community activity. While individuals who have developed pathological levels of depression, anxiety, and stress, have recourse to medical treatment, there are few concrete solutions available to everyone else who suffers from the same problems on a sub-pathological level. Reflecting on these problems through the lens of his background as a professional entertainer, Andrés saw an opportunity to connect trained volunteers with the most vulnerable groups in society to promote a culture of cheerful cooperation.

While there are organizations that appear on the surface to be similar to Risaterapia exist in various countries, including the U.S., Spain, South Africa, and Argentina among others, the use of laughter as therapy has hitherto had a narrow scale and focus. Many of these groups send professional clowns into children’s wards in hospitals, which is expensive and has no broader societal impact.

Risaterapia is distinguished from others groups with three innovative strategies. The first is a strong focus on the volunteer corps of the Médicos de la Risa. According to Andrés, Risaterapia is the only organization that trains volunteers to make site visits rather than use professional clowns and entertainers—the standard practice of most groups. Andrés believes that while the work of professional entertainers is valuable, the emphasis on their occupational background and employment stifles the spirit of service. Andrés emphasizes that the volunteers, not the patients, are the main beneficiaries of Risaterapia’s organizational impact.

Training volunteers to carry out Risaterapia’s mission is also the most effective and powerful way to ensure that Risaterapia and the idea of cheerful cooperation become a grassroots cultural movement, rather than merely another social program. This attempt to launch a movement is Risaterapia’s second innovative strategy and is built into the organization of Risaterapia’s volunteers throughout Mexico. The system is based on a low-overhead, “viral” model in which the Mexico City-based headquarters ensures quality control nationwide but grants its satellite groups in other cities—known as ‘constellations’—a great deal of autonomy.

The third part of Risaterapia’s strategy is the expansion of site visits beyond hospital wards. Though most groups focus exclusively on hospital visits, particularly pediatric units, Andrés realized early in the development of Risaterapia that hospitals were not the only places devoid of happiness and human contact. After brainstorming with his team, he extended the organization’s reach to nursing homes, marginalized (often indigenous) communities, and disaster areas and post-conflict zones. Andrés explains that their goal was to bring Risaterapia to the most vulnerable populations in society, rather than staying within hospitals alone.

The heart of Risaterapia’s strategy is the training of dedicated volunteers in improvisation and communications skills, empowering them to make regular group visits to vulnerable populations according to the volunteers’ level of experience and commitment. “At Risaterapia, the volunteer is always the first and foremost beneficiary,” says Andrés. By making volunteerism genuinely fun, Risaterapia encourages its Médicos de la Risa to engage the people they visit—as well as other people in their lives—in a two-way dynamic of human communication, thus bringing happiness to both parties. Andrés recalls countless stories of volunteers who claim that joining Risaterapia truly changed their outlook on life. “They tell me that they conceive of their lives as ‘before’ and ‘after’ Risaterapia,” he says.

In the initial stages of Risaterapia’s development, Andrés was most concerned about creating a systematic methodology that would not only institutionalize and standardize the organization’s practices but also enable its future replication. This methodology took the form of a rigorous, multi-step training process that allows individual volunteers to decide their own personal level of commitment to Risaterapia. Those Médicos de la Risa who are most highly motivated are given the opportunity to undergo very comprehensive and intense training in communications, psychology, leadership, and teamwork, in preparation for the most difficult site visits—those to disaster areas and post-conflict zones, which Andrés is coordinating for the first time in Risaterapia’s history.

Volunteers are organized by a ranking system based on experience, and all volunteers belong to self-organized groups called “constellations” that are coordinated by a veteran “supernova” or group leader. All volunteers must undergo a thirty-three hour basic training course in clown techniques, improvisation, and dynamic forms of play before beginning site visits. Individual constellations are given the freedom to select the public (or private) hospitals that they would like to visit. Before any Risaterapia volunteers visit a given hospital, the hospital’s administration must sign a contract with Risaterapia to avoid liability issues in the future. All site visits are conducted in pairs or in groups of Médicos de la Risa, who circulate through the hospital engaging individual patients as well as their family members and even medical staff. When a constellation arrives at a hospital, the entire ambiance changes palpably—the Médicos de la Risa, all of whom don characteristic red clown noses, have a ready grin or playful joke for every single person they encounter, from the unresponsive patient in intensive care to the family member sitting exhausted by his bedside, from the chief surgeon to the janitor mopping the hallways. At the end of each visit, which generally lasts between one and two hours, the constellation reconvenes, removes their signature red noses to resume their normal personae, and conducts a figurative “shower” to debrief as a group about the positive and negative aspects of the visit. This debriefing provides a space for catharsis and also allows the volunteers to seek feedback and learn from one another.

As they gain experience, volunteers are invited to participate in further training courses that enable them to visit nursing homes, marginalized communities, and disaster areas and post-conflict zones. The skills and experience required to connect with affected residents in these different sites are complex, and Andrés and his team are constantly revising and refining their training courses to reflect the lessons that they have learned during their visits.

The low-maintenance, low-overhead replication model that Andrés designed based on local autonomy has proven to be a successful one; Risaterapia now has 1,200 volunteers in nineteen cities throughout Mexico. The Risaterapia team also takes great care to document every volunteer visit, including the number of volunteer hours logged and the number of patients visited, thus enabling the measurement of its volunteers’ social impact. In 2007, the number of beneficiaries (calculated as the number of patients visited multiplied by four to account for family members, medical staff, and others who have also been impacted) increased by 240.9 percent over the previous year to 60,564. The number of volunteer hours increased by 229.3 percent between 2006 and 2007 to 39,743 hours in total. In that same year, Risaterapia volunteers visited fifty different hospitals, twenty-two nursing homes, and fourteen marginalized communities nationwide.

Andrés’s long-term vision for the organization involves the spread of this culture of cheerful cooperation to other countries around the world, relying more on a social movement than on the availability of financial resources. Risaterapia has joined a network of similar organizations worldwide known as the Red Nose Alliance, where Andrés is fighting to shift the status quo among such groups from a professional or employee-based model to one that is volunteer-based. He sees great potential for the Risaterapia model to spread to other regions of the world through the Red Nose Alliance.

Risaterapia is a registered Mexican CO with one eight-person office in Mexico City. The organization’s nationwide operations operate on a franchise model, with individual offices outside of Mexico City founded and run entirely by local volunteers with guidance from Risaterapia’s headquarters. Recently Andrés was faced with the decision of scaling up Risaterapia’s headquarters to enable more controlled and centralized growth in other regions of Mexico or scaling down headquarters to allow Risaterapia chapters in other cities and regions more autonomy. He chose the latter route, reducing operating costs by 37.1 percent in 2007 and reaffirming Risaterapia’s operational strategy as a genuine grassroots movement. While Risaterapia does partner with select businesses to generate income, approximately 60 percent of its fundraising is restricted to the civil sector to avoid conflicts of interest and to encourage civil sector participation in the organization’s “cheerful cooperation” movement.

Andrés was born in Mexico City in 1975. From a young age he realized that he enjoyed making people laugh and decided that he wanted to become a “professional idiot,” as he jokingly describes himself. Halfway through his undergraduate degree in communications, he auditioned for a place with Ringling Bros.’ Clown College, the intensive three-month program in Sarasota, Florida that the circus uses to train and eventually hire new clowns. The audition and selection process is extremely competitive: Of the 3,000 to 4,000 people who auditioned, thirty are chosen to enter Clown College and only five are ultimately offered a position with Ringling Bros. Andrés was one of those five in 1996. He toured with Ringling Bros. for the next two years.

In 1998, during a promotional visit for Ringling Bros. to a hospital in North Carolina, Andrés—suited up in his full Ringling Bros. clown costume—was about to enter the hospital room of a seven-year-old girl when her parents glimpsed him first in the doorway and silently shook their heads to deny him entry, signaling that this was not an appropriate time for a clown visit. As Andrés was backing out of the room, however, the patient turned in her bed, noticed Andrés, and motioned for him to come in. As Andrés gingerly attempted to engage the girl’s attention without angering her parents, she began to respond and entered into a dialogue with him. Suddenly the girl’s mother began to cry, repeating over and over that it was a miracle that her daughter was speaking—the girl had not spoken out of shock since suffering serious burns in a recent accident. The girl turned to look at her mother and said quite simply, “It’s not a miracle, Mom—it’s a clown.” At that moment, Andrés realized that hospitals were in great need of happiness and human contact. He decided that this, rather than working as a professional clown, was his true calling and quit Ringling Bros. soon afterwards.

Andrés returned to Mexico and resumed his undergraduate studies at the Universidad Anáhuac. In 1999, he and his future wife and Risaterapia colleague Ana Cecilia Madrigal Sodi gathered a group of eight friends and trained them to become the first Médicos de la Risa. Three years and many hospital visits and learning experiences later, Risaterapia was formally incorporated as a non-profit organization in Mexico.

Despite his many responsibilities as founder and President of Risaterapia, Andrés continues to make time to participate in hospital visits as Dr. Romanok, his Médico de la Risa persona, with the rest of his Mexico City staff as part of the constellation Polaris. He is a rare leader who combines long-term and high-level vision with a fundamental love of the day-to-day site visits that form the foundation of Risaterapia. Thanks in large part to Andrés’s leadership, the first five years of Risaterapia’s history have been tremendously successful. He is convinced that after the next five years, Risaterapia will have spread to fifteen countries and every state in Mexico.