Christmas in Nicaragua

Surrounded by clowns, a patient touches a "pinata," a decorated figure containing toys and candy, at the oncology area of the La Mascota Children Hospital in Managua, Nicaragua, Dec. 18, 2012. Each year members of "Club of Clowns" clown school visit hospitalized children before Christmas to make them laugh as part of an alternative therapy.

A clown juggles in front of patients and their relatives during a visit to La Mascota Children Hospital in Managua, Nicaragua, Dec. 18, 2012.

A clown paints the face of a hospitalized child during a visit to La Mascota Children Hospital in Managua, Nicaragua, Dec. 18, 2012.

The director of "Club of Clowns" clown school, Tito Aguirre, center, known as "Dr. Quelokura," embraces the mother of a patient during a visit to La Mascota Children Hospital in Managua, Nicaragua, Dec. 18, 2012.

Clowns jump for pictures during a visit to La Mascota Children Hospital in Managua, Nicaragua, Dec. 18, 2012.

The director of "Club of Clowns" clown school, Tito Aguirre, center, known as "Dr. Quelokura," performs in front of a child on wheelchair during a visit to La Mascota Children Hospital in Managua, Nicaragua, Tuesday, Dec. 18, 2012.

The director of "Club of Clowns" clown school, Tito Aguirre, known as "Dr. Quelokura," gestures in front of a patient during a visit to La Mascota Children Hospital in Managua, Nicaragua, Dec. 18, 2012.

The director of "Club of Clowns" clown school, Tito Aguirre, known as "Dr. Quelokura," delivers a present to a patient during a visit to La Mascota Children Hospital in Managua, Nicaragua, Dec. 18, 2012.