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In the Grip of a Virus
How Singapore reacted to a threat to its children

Hand, Foot and Mouth Disease

The timing was uncanny. Calls to make Singapore more conducive to bigger families had been echoing through the island since Prime Minister Goh Chok Tong brought the topic up yet again in his National Day Rally message in late August. Knowing the government's pledge of more cash for more babies wouldn't be enough to raise the worryingly low birthrate, discussions on how to make workplaces family-friendly were reaching a pitch. On Sept. 29, the government announced a program of more training and advice for employers.

The next day, two siblings aged 14 months and 30 months died of what was suspected to be hand, foot and mouth disease (HFMD). This brought to four the number of infant deaths over a month-long period. By the middle of last week, 510 cases of the disease had been diagnosed and 27 youngsters were in hospital. For pasteurized Singapore, the drama came as a sharp shock to the system — and was met with a swift response. The government ordered the closure of all childcare centers and kindergartens for at least 10 days. Public places where infants gather, including fast-food restaurant play-corners, wading pools and enrichment program centers, were out of bounds. Public-library activities for children aged 5 to 9 were discontinued.

Some 140,000 children in 557 childcare centers and 440 kindergartens were estimated to be affected by the measures. The result: a challenge for working parents and a time for employers to reveal just how pro-family they were — or were not. In a joint plea, the government and representatives of workers and bosses called on companies to exercise flexibility over annual leave, unrecorded time off, no-pay leave or alternative arrangements. This, the appeal said, would be "in line with companies' enlightened HR [human resources] practices and the spirit of close labor-management cooperation."

The government set the right tone. Civil servants were told they could have time off and take unrecorded leave as long as childcare centers remained closed. Government administrators urged all departments to make work arrangements as flexible as possible for staff who could not make alternative childcare plans. Sociologist Chua Beng Huat sees this government reaction as not just a "one-shot deal." He believes the government will probably be doing quite a lot from now on to be more family-friendly. "After all, this whole issue about getting women to have more babies is not really about money but about time." he says. "Whenever the government can give people more time, it will, in terms of flexi arrangements and so on."

Things were more mixed in the private sector. For one computer executive, the closures couldn't have come at a worse time. Her two children, aged 8 and 4, had just been through bouts of chickenpox. During that time, she and her husband had taken turns to be at home, using their annual leave. Their firm, which has 2,000 employees, does not have child sick-leave provisions and she feels she and her husband have worn their employer's goodwill thin already. She may be right. The company is offering no special arrangements.

Affected employees of the Silkroute Holdings Internet company were told they could take paid time off to sort out alternative care for their children without having to use up their vacation. Singapore Cable Vision, which has a 750-strong workforce, granted parents paid leave. Singapore Press Holdings and F&N Coca-Cola (Singapore) allowed staff to take time off at short notice, but are counting it as annual leave. Parents working in corporations with pro-family arrangements already in place were the least put out. Singapore Airlines offers up to 14 days a year for mothers who need time off to look after sick children under the age of 6. Staff are using this allowance during the scare. Some employees of Hewlett-Packard switched to working from home, which is already a practice. The company doesn't expect any loss in productivity.

Many Singaporeans simply fell back on relatives. But this was not a solution available to expatriates such as computer professionals Rajeev Deshpande and his wife, who are from India. They intend taking turns to stay at home and care for their three-year-old daughter. "Even though we have many friends here, they could be facing the same difficulties," says Deshpande. His employers understand that he and his wife have few local options. Though nothing has been formally worked out with regard to his leave, Deshpande is confident some kind of satisfactory arrangement will be reached. Colleagues are helping to clear his workload.

Besides issuing appeals for employers to rally around, the government has set up a HFMD Task Force and hotlines to deal with the situation. The advice to parents is clear: the disease, though usually mild, is highly contagious, so children should be kept away from crowded places. It also advises parents to look out for a fever lasting two to three days, a sore throat, mouth ulcers, a rash (usually blister-like in appearance) over the hands, feet and sometimes the buttocks, vomiting and diarrhea, tiredness and weakness (see story this page). Doctors were told to report all suspected HFMD cases.

Health Minister Lim Hng Kiang stressed there was no cause for alarm. The government only wanted to cut the chain of transmission, "rather than muck around, wondering what virus it is." Investigations on that front are underway. In 1997, 50 children died from HFMD in Sarawak. A year later in Taiwan the disease claimed 78 victims, most of them children. Singapore youngsters may not like being cooped up most of the time, but the authorities believe it is the only way to ensure those kinds of figures are not repeated.

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