Unable to have kiss goodbye from their parents or play with their siblings, life can be tough for children in the Bubble Unit.
Youngsters are expected to spend at least three months living in a germ-free bubble while they undergo bone marrow transplants.
And it falls to the expertise of play specialist Paula Askew to keep Bubble Unit children engaged and upbeat.
With up to 30 children, from as young as nine months up to teenagers, cut off from their normal lives and routines, Paula and her nursery nurses rely heavily on the Bubble Foundation charity to provide vital toys and equipment for each child that comes through the door.
Paula, who has worked at the unit for 19 years, is faced with the challenge of creating fun, interactive sessions for children of all ages as well as preparing them for what is to come when they undergo a transplant and are hopefully on the road to recovery.
She said: “Play is hugely important for a child’s recovery and our role is to use play to prevent the negative effects of having to undergo these procedures.
“It could be helping a very young child meet the developmental stages a child not on the unit would have such as learning to sit up or giving them those life experiences their peers are having and being someone an older child can talk to.
“When they are in the bubbles children are isolated from their normal lives.
“Everything has to be clean that they come into contact with past a blue line the floor because their immune system is rebuilding.
“So that is all of the toys, a DVD or board game, the people they come into contact with - which is why there is no kissing or facial contact - even a chocolate bar or a drink will first be wiped clean before it goes into their room.
“When we are doing arts and crafts you can’t clean paper so every child will have a new pack of unopened paper. It can be very isolating but through play you can keep children engaged and aware of what is going on and help prevent any detrimental effects.
“Sometimes children can be here for four months sometimes a year or longer. When they are in a bubble they can feel cut off from their families as siblings under 12 are not allowed in the room because of the germs and bugs they can carry. An adult can say I’ve had a cold and I still don’t feel quite right but a child can’t always do that.”
Before a bone marrow transplant a child will undergo chemotherapy to clear out their own immune system. After the transplant they will then need to be protected from any germs while their immune system regrows.
Opening the door to Paula’s office is like arriving in Aladdin’s cave with trays of arts and crafts, shelves of toys and drawers for each child with age-appropriate play equipment.
But everything the team does, the activities they run, parent support they offer and distractions the toys can provide from the reality of being away from home, is only possible because of the work and donations to the under-threat Bubble Foundation.
In an average year the unit needs funding of £6,000 for arts and crafts materials, £5,000 for Sky TV and £50 per child to create individual play chests for young patients.
With technology and things such as Skype going someway to keeping cut-off children in touch with friends and family, play staff are keen to secure the funding needed for more laptops and tablets.
Paula added: “These devices mean children can speak and see their families regularly but we have 10 beds on the unit and only two devices at the moment.
“We cover a huge area, taking in everything north of Birmingham as well as Scotland, Ireland and even abroad, with children coming for treatment from places such as Portugal, Finland and Russia.
“Not all children and families can speak English but play is universal and given the right equipment and setting all children know how to play and that is how we have been able to prepare patients for treatment using demonstrations and dolls.”