Posted by Vicky on | June 25, 2012 | No Comments
When Doctor Fong’s son, Craig, had a serious allergic reaction at his school (in January 2012), major flaws were found in the Ministry of Education’s (MoE) policy that deals with medical situations in local Singaporean schools.
Craig has potentially life-threatening allergies to peanuts and shellfish; his allergies are so severe that he needs to take antihistamines and an EpiPen with him to school. Craig has been in ACS Junior for five years, and his mum has always taken care that the teachers and staff are all informed of his allergies, and she also ensures that she trains his teachers in the use of the EpiPen – all this to enable the school to help Craig should an anaphylactic emergency arise.
Perhaps the most shocking part of Dr Fong’s story is the fact that not once in any of the meetings, nor in the EpiPen training sessions did anyone mention that under MoE policy, staff of local Singapore schools are not allowed to administer any medication to students, even with written parental consent. To the contrary, the school had assured Dr Fong that they would do their best should Craig suffer a serious allergic reaction whilst in school, thus giving her some peace of mind.
As it stands, staff and teachers in local Singaporean schools are not permitted to even administer paracetamol if a student has a fever, let alone use life-saving equipment like the EpiPen. Privately owned and international schools operate under a different license, and the MoE do not govern how they handle medical emergencies in these schools.
Craig’s allergic reaction was a direct result of eating in the school canteen. The school had recently changed vendors, for the first time since the school had moved to the new Winstedt Road site four years ago. Craig had ordered the Japanese curry rice, which he had eaten before with no problems.
As Dr Fong explains, “as he ate his curry he developed a ‘funny feeling’ in his throat – he initially thought it was due to the spice, so he carried on eating. When he was about two thirds of the way through his meal he felt nauseous and threw up. However, unlike previous “mild” attacks, he didn’t feel better and his throat continued to feel tighter and tighter. He even started to feel a bit short of breath.” Craig was in fact so frightened by his reaction that he ran to his classroom to find his teacher (who was not there), so he headed for the office and then to the sick bay. When he got to the sick bay, he was scared, his throat was tight, but he was only told to call his parents and to wait for them to take him home!
Fortunately, Craig’s situation did not escalate to a full blown anaphylactic reaction, and a dose of anti-histamines (given at home) was enough to set him right. His mum believes that her son expelled most of the allergen from his body when he vomited, but it was truly a close call. It was too close for comfort. His mum still shudders when she recalls the incident. Administering the Epipen in such a situation would not have harmed Craig in any way, but withholding it if he had collapsed could have proved fatal.
Determined to find out why the school did not deal with Craig’s allergic reaction in the way they had ensured her they would, the next day Dr Fong wrote in to the school. To her horror, she was told by senior staff that actually, no one in the school would have been allowed to administer the EpiPen even if Craig had collapsed on the premises! She also found out the school canteen vendors were unaware of the ingredients in the food that they served – and the notion of cross contamination was non-existent.
The fight for change
There are two issues that Dr Fong is seeking to highlight – the first is the MoE’s policy with regards to administering medicine in emergency medical situations, the second is that school canteens should label their food, and know their products.
She does not, however, blame the school for Craig’s incident, but rather, sees it as an opportunity for change. And change is exactly what she is fighting for, and with incredible results.
She posted the letter she wrote to the school on her Facebook wall, describing the incident at Craig’s school, and this letter was subsequently forwarded to someone at the MoE. Fortunately, policy makers saw the letter, and quickly drafted a new policy to address the problem.
Craig’s school (ACS Junior) is now spearheading a pilot scheme, which will hopefully be rolled out nationwide in all local schools.
Under this new policy, the school will be allowed to use medicine and medical devices in exceptional medical emergencies. It is a new protocol, which Dr Fong states “clearly delineates what should be done in emergency cases involving kids with medical issues like food allergies, asthma, epilepsy etc. It basically attempts to protect both the child and the ‘non medically-trained’ teachers. For food allergies, the new policy allows for the use of the EpiPen, only after staff have been trained, by a doctor, on how to use the device. There must also be a clear action plan certified by the doctor, and the parents need to sign a Letter of Acknowledgment that they will not hold the school liable for any damages.”
Dr Fong is hopeful that the policy will be extended nationwide, covering all schools in Singapore. She is quick to point out that it will take time as the MoE needs to work with the Ministry of Health (MoH), as every case currently needs a doctor to come and educate and train designated staff.
There are a few words of advice that Dr Fong has, “For parents with allergic kids, do come forward and inform the school for the sake of your child. I am glad to have begun this chain of events that I know will only mean a safer school for my son, and for many, many other kids with medical issues.”
Amazingly, in less than 10 weeks, the MoE passed the new policy for Craig’s school and as Dr Fong states, “I am grateful to them for listening with their hearts and for realizing the urgency of this change”.
Thanks to one mother’s fight for change, the MoE has given guidelines to all national mainstream schools how to manage the special medical arrangements requested by parents. Parents who need to organize a similar scheme to Craig’s Scheme should speak to their school management, and as Mrs Lim Thian Loke (Chairperson of The School Health Committee, MoE) states “Where there are exceptional cases of medical emergencies which necessitate school personnel to carry out timely intervention, the school personnel would need to be trained to administer the specific type of medical intervention required by the child, which could be the administration of the EpiPen”.
Unfortunately the MoE currently does not mandate school canteen operators to label their food ingredients. Schools, parents, students and the canteen operators will need to work closely together for labeling to take place, and for greater awareness in food allergies.