When a parent or loved one is diagnosed with cancer, children become silent witnesses to the disease – straining to understand whispered conversations, filling knowledge gaps with their worst fears, and shouldering emotional burdens that no one realises they are carrying.
Dr Karen Singh, a radiation oncologist who practises at Netcare Alberton, Netcare Park Lane and Netcare Milpark hospitals, has witnessed this heartbreak unfold throughout her years of treating cancer patients. Watching children hover at the edges of consultations, desperate to understand but excluded from the conversation, she realised these young family members needed their own way to process what was happening. This inspired Mama’s Garden of Hope, a book that helps children understand cancer treatment through gentle metaphors and explanations, making them feel included rather than isolated.
One particular moment crystallised the need for this book. During a routine consultation, Dr Singh noticed a young girl sitting outside her office with a colouring book. “Her crayon barely moved,” recalls Dr Singh. “Her little ears were practically twitching, trying to catch and digest words like ‘chemotherapy’ and ‘radiation’ through the open door. When her parents emerged, she quickly looked down at her colouring book, pretending she hadn’t heard a thing. But children always know more than we think they do.”
That evening, stuck in traffic, the story began to unfold in Dr Singh’s mind. Later, over a single weekend, the entire narrative about unexpected journeys, which mirrored the very experiences she had witnessed in her consulting rooms, poured onto the pages. Her three children became her first editors, helping her keep the language honest without letting it drift into clinical territory or condescension.
Working with a Japan-based illustrator over six months, Dr Singh focused on details that mattered: the mother’s hair transitioning from long to short during chemotherapy, then slowly growing back as treatment progressed. Every design element was carefully considered. Vibrant illustrations engage young readers, while larger print and thicker pages accommodate chemotherapy patients whose blurred vision or weakened grip might otherwise make it more difficult for them to share story time.
“Children understand far more than we give them credit for. They’re already carrying the weight of what’s happening. They don’t need protection from the truth; they need the tools to process it,” asserts Dr Singh.
The book uses garden metaphors to make cancer treatment comprehensible. When Emma’s mother develops cancer, it is explained as “a tiny weed trying to grow in her body”. As the seasons change throughout her treatment and recovery, Emma becomes “Mama’s little helper,” discovering that healing comes not only from medicine but also from small acts of love. Making tea, fluffing pillows, and sharing bedtime stories become as important as any treatment, showing children how their care helps keep families strong through difficult times.
“Cancer touches virtually every South African family in some way. We all know someone, a colleague, a friend, a family member, whose life has been changed by this disease,” adds Dr Chris G Mathew, managing director of Netcare Cancer Care.
“Our philosophy has always been that nobody should walk their cancer journey alone, and we’ve come to understand that this includes the children who see their parents or grandparents going through treatment. These young family members need support too, not just to cope, but to feel they can contribute meaningfully to their loved one’s healing,” he says.
How to talk about cancer with children
- Name the illness: Using the word cancer dispels mystery and fear surrounding the “C-word”.
- Invite questions: Create safe spaces for children to express their fears and curiosity.
- Include children appropriately: Let them be helpers rather than helpless observers.
- Acknowledge emotions: Validate children’s feelings of fear, anger or sadness.
- Maintain routines: Provide stability through familiar activities and schedules.
- Prepare for changes: Explain physical changes, such as hair loss, before they occur.
- Celebrate small victories: Mark positive milestones throughout treatment.
The book has sparked important conversations at literary festivals, where Dr Singh uses puppets and roleplay to engage young audiences. Children’s surprisingly mature questions about screening, causes, and prognosis have inspired Dr Singh to begin work on a companion book about grief and loss.
“While performing the story, I’ve been struck by children’s courage in asking, ‘What if Mama dies?’ These children deserve honest, compassionate resources for every possible outcome,” she notes.
For families walking the cancer journey, Mama’s Garden of Hope does more than comfort. It gives families the words they’ve been searching for and creates a safe framework for conversations they’ve been avoiding. Most importantly, it shows that children belong in the healing process, not outside it. The book illustrates that true healing extends beyond medical treatment to include every family member, ensuring that no child feels left out when their family needs unity most.
Dr Singh’s own childhood experience informs her conviction that stories can be powerful tools for coping with health challenges. Born with a squint requiring major surgery, she spent weeks with bandages over her eyes as a child, leaving her reliant on audio stories during recovery. Today, she’s known for anticipating what patients need before they ask, understanding firsthand how the right story at the right moment can make all the difference for families navigating a cancer journey.
All proceeds from the sale of the book support the Childhood Cancer Foundation (CHOC). Mama’s Garden of Hope is available at drkarencreative.co.za.
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