Last Wednesday, a nurse from Tan Tock Seng Hospital (TTSH) wrote in to the Forum page of The Straits Times to complain that her gynaecologist at Mount Elizabeth Hospital did not want to see her when she arrived to keep an appointment with him. 

The nurse said that she was very upset and “felt discriminated against because I worked with TTSH.” Apparently, her gynae had told her it was because of Sars that he wanted to protect his other patients. She went on to say that when some of her relatives avoided her, she understood that their fear arose either out of ignorance or inaccurate information.

But, she said she was appalled and shocked by “the fact that I was denied medical care by a highly trained specialist who fully understands the implications of Sars.” She then quoted the Prime Minister as having said that “life could be lived as normally as possible” and added “perhaps that advice is meant for those who are not TTSH staff.”

I disagree with this nurse’s view that, in that instance, her gynaecologist had discriminated against her just because she worked at TTSH. On the contrary, I think the gynae did the right thing. I venture to add that because the specialist fully understood the implications of Sars, he was right to have refused to see her then. We are all adults and can take care of ourselves. However, we need to realise that there are yet-to-be-born children in the wombs of those would-be mothers frequenting the centre the nurse had visited.

I would have thought that the nurse who I am sure is trained to think of probable scenarios should have spared a thought for the other pregnant women visiting the centre and instead asked her gynae for advice before she stepped into the centre in the first place. Then, the whole ugly episode would not have taken place at all. The gynae, I am sure, would have made special arrangements to see her.
 
Another reader of The Straits Times wrote in to the Forum page last Saturday to say he was “appalled at the behaviour of the gynaecologist in question.” This reader continued, “The Health Minister has said that Tan Tock Seng Hospital is safe. Isn’t it ironic that health-care professionals should be alarmed when a staff member from TTSH visits a clinic?”

Doesn’t the reader realise that it wasn’t just another clinic, but a specialist centre for pregnant women? There are two lives at risk here. Of course, we can always say the mother, being an adult, should be able to take care of herself, but what of the unborn foetus who is at a much higher risk?

The management of Parkway Group Healthcare, which has responsibility for Mt Elizabeth Hospital, rightly replied last Saturday that “the decision as to whether to see a patient is left to the doctor.” 
Much has been said about discriminations against TTSH staff and some of what is said are true. But, before we start quoting the PM’s words, let us put things in the right perspective first.

I join others in support of the unsung heroes and heroines of the medical profession, particularly those at TTSH, battling Sars. But, alarm bells must continue to sound at specialist clinics for pregnant women when health-care workers and others known to be at a higher risk for Sars present themselves there. This is to alert doctors who may wish to take additional precautions. 

Some 200,000 secondary school students across the island return to school today after a two-week break. Schools were closed on 27 March 2003 to contain the SARS outbreak here.

Just what is in store for these students when they walk past the school gates? Anxious to calm parents’ fears of their children catching the SARS bug at school, the Ministry of Education (MOE) has been very busy behind the scenes taking steps to ensure the safety of all students at school. 

MOE has come up with an educational package to explain to students the importance of personal hygiene and social responsibility in curbing the spread of SARS. To monitor effectively the situation in schools, it has put into place post-school-reopening procedures for schools to follow. Schools here have also been disinfected before their reopening today. Classrooms will certainly smell of lysol - a disinfectant used in hospitals. The disinfecting of classrooms will be a daily routine.

Teachers have not been resting on their laurels either. They have been busy attending meetings and forming groups to process students even before these students go back to school. Over the past few days, teachers have been calling up the parents and guardians of these students to check whether the students are in good health. If a student is not feeling well, the parent/guardian is advised not to let the student come to school. Also, students who have travelled to index countries the past two weeks have been reminded to attend school only when the 10-day quarantine period has expired. Such checks prior to school reopening serve to reduce any risks to the rest of the school population. 

So when students walk through the school gates, they can expect to be screened by duty teachers who will be on the outlook for anyone who looks ill. If the teachers sight such students, they will lead them to an appointed area for the students’ temperatures to be taken. And no one, except the students, will be allowed to go through the school gates. Those who have official business will have to fill in a declaration form and be screened before they can come in.

Students who have been found to have a fever during lesson time will be asked to go to a holding room set aside specially to monitor fever cases. In the room, both the student and teacher will adorn disposable masks. If the situation warrants it, the principal or vice-principal will call for an ambulance. So you see, the MOE is not leaving any stone unturned. And the students aren’t the only ones being monitored. Their teachers’ health will also be checked regularly by appointed fellow staff members and teachers will be asked to seek medical attention immediately if they feel unwell during school hours.

Assembly periods for the whole week have been postponed, save for that today. Today, principals will brief students on the SARS situation. Thereafter, these students will attend some programmes arranged by the MOE to educate them on personal hygiene and social responsibility. Recess periods have also been rescheduled. Most schools now have different recess times for each level of students so instead of the usual two recess periods - one for lower level & one for upper level - there are, perhaps, four recesses.

The rationale behind these steps is clear - to avoid situations in which large numbers of students congregate. Students are also not allowed to stay back after their school hours. In fact, CCA and enrichment classes have been postponed indefinitely on the orders of MOE. Some schools which have earlier agreed to participate in extra-school competitions have been prudent enough to back out of these events - their students’ welfare comes first, not glory.

Schools do not expect 100 per cent attendance in the first few days of the week, but, with so many precautions in place, I am sure both parents and guardians will realise that their children are in good hands at school.

The last two Mondays I had been harping on the topic of SARS. This week I will go on rattling about SARS - because this newcomer has made a great impact on the world we live in. Its greatest impact must be in the area of personal relationships. Many of us are no longer rational in our behaviour. We nervously look over our shoulders every time someone near by coughs or sneezes.

In fact, just the other day, I was in the public library when I inadvertently let out a cough when browsing through some new books near the entrance. A woman who had just entered the library immediately grimaced and moved away from me.

I admit I was taken aback by her reaction and therefore showed a particular interest in her actions so later I conveniently found myself browsing through books at the shelf near where she was seated. Sure enough, she sported the same traumatised look when someone sitting adjacent to her coughed. To add to her horror, another chap on the left - some two metres away - started coughing. There was kind of a rhythm in the way each cough reciprocated the other. I didn’t hang around long enough to find out more. 

You must be thinking I was haughty to have behaved that way. Yes, indeed I was! But, I was interested in finding out some people’s reactions to coughs and sneezes nowadays - since the SARS invasion of our lives.

Have we become sort of hysterical lately? If not, why do I read letters (to newspaper forums) from nurses complaining that people they meet on the MRT and in the public areas give them a wide berth? I was listening to the radio programme Car Toons one recent evening and heard someone who had dialed into the programme complain that one of her friends, a nurse, was not allowed by the landlady to move into her rented room in an HDB flat. This chap who called into the programme also said that there was a message in the lift lobby saying that TTSH nurses should not use the lifts. 

Now, I do not know whether that is true or not, but the incident does demonstrate the kind of unfriendly behaviour - now making its rounds here - that is unbecoming of us Singaporeans. These nurses put their patients’ well-being above themselves and in return, we - the members of the public whom they serve - spite them just because SARS has driven spikes into our lives. Now, is that fair?
We Singaporeans should adopt responsible behaviour. We should not let SARS run our lives. We must go on living, albeit with some minor changes in our routine such as coughing into tissue paper and washing our hands with soap whenever the opportunity arises. And, we should not let our fears get the better of us. 

I know some of you who read this column are bound to ask me whether I, when put into the same situation as those I have mentioned earlier, will be able to demonstrate the kind of exemplary behaviour I have been expounding today. Well, frankly, I base my actions on two facts which I have learnt from the Ministry of Health’s advisories: 

1. So far, those infected by SARS have been in close contact with the index (source) cases
2. Those who were in the hospitals but had no close contact with these index cases did not get SARS
With the Government having put in place checks at the airports and monitoring of arrivals from the index countries, there is little chance new index cases will get into Singapore unnoticed.

We should not let SARS wreck havoc in our lives or cause friction between us and others we meet in the daily course of our lives. I know that I won’t. I won’t go around wearing a mask. I won’t give nurses a wide berth. But, I will wash my hands with soap every chance I get, for I know germs like living matter such as my skin.

Just last week, in this column, I was telling the readers on this Web site that we should go on with our routine in spite of the war in Iraq and the SARS health scare. I said that we should take control of our lives and not let terrorists dictate terms to us. I added that we should not let them unnerve us. I also talked about SARS rather casually.

I admit I had mentioned SARS as if the disease wasn’t going to be a problem here. I was dead wrong! In the space of a week, the Government has ordered the closure of all schools up to Junior College level from 27 March to 6 April 2003 and stopped all extra-curricular activities and competitions in schools. Childcare, pre-school and student care centres have also been asked to close for the same period.

The number of SARS index cases has risen from three to five as at today. A third person has died of SARS. The latest index case reported yesterday (Sunday) is a 17-year-old boy from Bo Wen Secondary School in Hougang. It is believed he contracted the disease while he was in Hong Kong recently. Thank goodness, the Ministries of Education and Health acted swiftly in closing schools last week, otherwise, the disease would have spread like wildfire since schools, being dense gathering areas, are the ideal grounds for the disease to make its rounds.

We can do our part by heeding the Government’s warning against travelling to SARS-infected cities like Hong Kong and Beijing. We should not be complacent and just think of ourselves first. In fact, the fourth index case reported on 28 Mar 2003 is a lady who went to Beijing and Hong Kong the very day the Government issued an advisory requesting our residents not to travel to the cities for the time being. Now that the lady is back, and has brought the disease back to Singapore, we can expect a string of new cases as a result of her inconsiderate act.

I myself found it strange at first that while SARS has been bothering us here, it has not made its way into Malaysia. I have now surmised that we Singaporeans are partly to blame for the spread of SARS. We in Singapore have a higher standard of living than many people in our neighbouring countries - in short, we have a good life. And with the good life, comes trappings, such as holidaying overseas. So we have - if I may use the term - invited SARS into our country.

These are not exactly the best of times, what with the war going on in Iraq. SARS has indeed made an impact on us here. Many of us have kept away from the shopping centres and the food courts. We are even wary about taking the cab, for fear of catching the dreaded disease - the lady who returned from Hong Kong (4th index case) took a cab from the airport to the hospital. The authorities yesterday found the cab driver and have since ordered him to be quarantined.

Besides causing great inconvenience to all of us here, SARS has also had a negative impact on our already vulnerable economy. It is likely that our travel and tourism industries will be affected. What can we do? We can only take things in our stride. The disease has so far been contained, thanks to the quick action of the authorities here. The Government has acted more quickly than the Hong Kong authorities have over there. Let us not cause complications by venturing overseas in these trying times.

Perhaps, one good thing has come out of the whole affair - many of us have been able to spend more quality time with our children at home. The disease has brought families closer, I am sure. 

Today’s the first day of school in the Second Term for primary and secondary school students in Singapore. It was a week’s break for these kids. Yet, in the space of only a week, so much has happened in the world. For one thing, coalition forces are attacking Iraq to liberate its people from a tyrant. And, for another, a new contagious killer virus is on the rampage in Asia and other parts of the world.

So, our kids return to school today knowing that the world has changed so much in such a short time. But, then, the only thing that is constant in this world of ours is CHANGE - there’s always change happening all around us.

This week, we come to terms with the fact that the killer virus Sars has infected 51 people here so far. We hear the health authorities advising parents with children who are having a fever or flu to tell their children to stay at home and not come to school. That’s good advice actually. We want the disease to die its natural course here in the next few weeks. From three index cases, the disease has spread to 51 people in total so far. Thank goodness, there are no new index cases to cause complications here.
 
Many of us have also been keeping away from the crowds. We avoid going to shopping centres in the city area for fear of catching this dreaded disease. But, that’s not the only reason for avoiding the shopping centres. With the war going on in Iraq, we are also fearful of reprisals from terrorists sympathetic to the cause of Iraq’s tyrant and his gang. So, even though we know Singapore is a pretty safe place to be in, we are nevertheless as nervy as those in the USA.

We can’t avoid getting these feelings. Since 911, our notion of the world we live in has changed irrevocably. We know that there are crazy people out there who have no qualms about killing thousands of innocent people to further their morbid cause. So, we stay away from crowded places in town - better safe than sorry eh?

But, that’s exactly the wrong type of thinking. We should never let these terrorists dictate terms to us. We should not let them unnerve us. The Government has taken security precautions, such as implementing stringent checks at border points and the port, and guarding important commercial buildings. We should also do our part by continuing our daily routine. After all, how can we call ourselves Singaporeans if we do not go shopping - I mean, whether we are men or women, shopping is in our blood.

I am not talking nonsense. We should carry on with our lives and not let these terrorists succeed in making us fear for our lives - mindlessly.