KYIV, Ukraine (AP) — Their costumes are put on with surgical precision: Floppy hats, foam noses, bright clothes, and a ukulele with multicolored nylon strings. Moments later, in a beige hospital ward normally filled with the beeping sounds of medical machinery, there are bursts of giggles and silly singing. As Ukraine’s medical facilities come under pressure from intensifying attacks in the war against Russia's full-scale invasion, volunteer hospital clowns are duck-footing their way in to provide some badly needed moments of joy for hospitalized children.

The “Bureau of Smiles and Support” (BUP) is a hospital clowning initiative established in 2023 by Olha Bulkina, 35, and Maryna Berdar, 39, who already had more than five years of hospital clowning experience between them. “Our mission is to let childhood continue regardless of the circumstances,” Bulkina, told The Associated Press. BUP took on new significance following a Russian missile strike on Okhmatdyt Children’s Hospital in Kyiv in July.

The attack on Ukraine’s largest pediatric facility forced the evacuation of dozens of young patients, including those with cancer, to other hospitals in the capital – and the clowns did not stand aside. Together with first responders, Berdar and Bulkina helped with clearing the rubble after the attack and attended to the children who were relocated to other medical facilities. But even for them, the real heroes there were young patients.

“When the children were eva.