7 Homework Motivation Tips that Work

7 Homework Motivation Tips that Work

May 7, 2022   Return

All children go through a phase where they just don’t feel like doing their homework, sometimes. So, what can you do to motivate them and make studying a fun experience?

Tip#1:  Take a break and don’t nag

Don’t nag, no matter how much you are tempted to. Some kids are natural rebels, so the more you nag them, the more they will refuse!

Just like how you would like a break after a long day at work, your kids need to wind down too after a long day at school. Allow them to spend a little time (about 20 minutes) to unwind such as playing football or watch a bit of TV. Get your children to set the time when they have to work on their homework and make sure that they stick to it.

Tip#2: Use the word “study”

Instead of guilt-tripping your kids by saying “it’s homework time”, why not say “it’s study time”? “Study time” is broader and can reflect on either studying and/or doing homework. It also gives the impression that they can also use that time to study while doing homework.  

Tip 3#: Get them on a routine

Studying will become a habit once you get your kids to study around the same time. Isn’t it just wonderful to see your kids doing their studies on their own without you telling them to? Have a chat with them and establish a study schedule through which they can determine the time they would like to spend studying. Ensure your child is doing this on a daily basis, and all other activities such as meeting up with friends are listed out too,  so that there will be a healthy balance between study and life. Most importantly, ensure that they follow through what they’ve scheduled for themselves. 

Tip #4: Play a supportive role

As much as you would like to help your children with their homework, remember this, it is their homework. So, let them be responsible for it. The purpose of having homework, in the first place, is to test their understanding of the subject while making use of the knowledge and skills they have learnt. Be a supportive parent and don’t criticize or punish your child. Encourage your child to be independent in getting the homework done.  Understand the problems they face (if there are any) and provide rational solutions.   

Tip#5: Praise and appreciate their effort

Let your kids know that you appreciate the efforts they make in attempting to tackle their homework independently, even if they do not get it all right.  Use encouraging words such as “You have done an amazing job, keep it up!” to induce positivity while providing them the confidence to be more persistent in accepting new challenges. 

Tip#6  Set goals and rewards

You can motivate your kids to study by giving out a reward when a goal is achieved. The goal set must, of course, be achievable by your child. It should reflect on their ability in making improvements for the desired goal. The form of reward given can be varied, for instance, it can be a movie trip, an ice-cream, a sleepover, etc.

Tip#7  Minimise surrounding distractions

The TV, mobile phone, computer and hand-held games can be distracting. Limit and control their use. For example, they can only watch the TV when they are done with their homework. If your child likes to listen to music while doing homework, make sure that the music he or she is listening to is not too distracting.

 

References:

Center for Effective Parenting. Available from www.parenting-ed.org

Today Parents. Available from www.today.com/parents/secrets-getting-kids-do-their-homework-8C11080329

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ABC – Allergy, Bacteria and Children

ABC – Allergy, Bacteria and Children

May 7, 2022   Return

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Prof Hugo Van Bever   Professor in Paediatrics, National University Singapore

“Do you know that in the past, many years ago, when I was young and handsome, they said that having a big head at birth increased your risk of allergy?”

Amused laughter greeted Prof Hugo Van Bever as he took the stage for a talk during the recent  “Gut Microbiata Modulation: From Insights to Clinical Practice” session. Organised by the Obstetrical & Gynaecological Society (OGSM) and the Malaysian Paediatric Association (MPA), the session enabled Prof Hugo to share his insight into the latest approaches adopted by the medical community to address allergies in children, especially food allergy.

Prof Hugo, who is currently a Senior Consultant with the Division of Paediatric Allergy, Immunology & Rheumatology in the National University Singapore, pointed out that the rate of allergy among children has been rising over the last 30 years. While the cases of respiratory allergy (allergic rhinitis) has plateaued (although still high), the last 5 years saw a huge increase in the number of children with food allergy.

Just a little bit

Treatments of allergy can involve the exposure of allergens through carefully controlled doses to the allergic person, until the person’s body becomes accustomed to the exposure and their symptoms eventually get better over time. This process is called desensitisation, and we may apply a similar process to infants so we can reduce their risk of certain food allergies when they are older.

Food that makes little ones go, “Aargh!”

  • According to Prof Hugo:
  • The most common food allergy in infants and toddlers is egg allergy.
  • In pre-schoolers, peanut allergy is the most common.
  • Seafood allergy is the most common food allergy among older children.

Prof Hugo brought our attention to the Learning Early About Peanuts (LEAP) study in the UK, in which researchers found that infants who were given peanut-containing foods had as much as 80% lower risk of developing peanut allergy by the time they turned 5. This finding led the American Academy of Physicians (AAP) to recommend offering peanut food products (such as peanut butter) to children who are at risk of peanut allergy from a young age. 

Prof Hugo speculated that, as we continue to conduct research into this area, it is possible that we would one day have nutritional guidelines to help parents minimise their children’s risk of allergies from an early age.

5 tips for parents

  • Let the child play outdoors more. Most parents worry that their children would suffer allergic reactions when these children are let loose into the wilderness, but Prof Hugo stated that this is far from the case. Allergens such as house dust mites gather in greater concentration indoors, especially in the bedrooms, so the more time children spend in there, the greater is their exposure to allergens. “The bedroom is the zoo of the house dust mite,” Prof Hugo remarked. “Don’t let your child live in there!”
  • Keep clean, but not too clean. Keeping the child’s environment totally sterile actually increases the risk of developing an allergy, Prof Hugo said, as the body never gets a chance to become desensitised to allergens. It may be fine to keep a pet, or to let the house get a little “messy” now and then.
  • Breast is best. “Breast milk is a living milk,” Prof Hugo stated. No other milk in nature is as good as a mother’s milk. A mother’s milk is complete when it comes to nutrition, and, unlike any other milk, it contain antibodies from the mother to support an infant’s immune system.
  • Keep good bacteria around. “Bacteria are our friends,” Prof Hugo declared, “so don’t kill our friends!” Our gut is the natural home for many types of helpful bacteria that support the immune system. Dosing a child with too many antibiotics at an early age, therefore, may kill these helpful bacteria before they have a chance to settle down in the gut. Prof Hugo recommended prebiotics as a means to help children who may need some extra help in maintaining a healthy population of useful bacteria in the gut.
  • Use moisturiser. Research shows that children with eczema face a higher risk of developing food allergy. Moisturising the baby’s skin from birth can reduce this risk by as much as 50%, as the moisturiser can act as an extra barrier of protection. “Any moisturiser will do,” clarified Prof Hugo.

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Beating back bullying

Beating back bullying

May 7, 2022   Return

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Words by Hannah May-Lee Wong

Farah Putrinegara A. Bahrom
Clinical Psychologist

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Bullying is a distinctive pattern of harming or humiliating someone who is perceived as weaker, smaller or more vulnerable. It is often an imbalance of power coupled with aggression, where the weaker person is deliberately attacked on more than one occasion.

According to clinical psychologist Farah Putrinegara, there are two modes of bullying: direct and indirect. Direct bullying is when a person is targeted, and the bullying happens only between the bully and the victim. Indirect bullying involves other people; for example, the bully might harm his victim’s reputation, spread rumours or say something to damage relationships.

There are also different types of bullying:

  • Physical bullying consists of harmful actions such as hitting, pushing or damaging property.
  • Verbal bullying includes cursing, throwing insults or saying something hurtful (for example, calling someone ugly or fat).
  • Relational bullying involves ruining someone’s reputation or spreading rumours that cause others to distance themselves. This type of bullying is often indirect.
  • Cyberbullying is bullying using technology. It could be a form of damage to property, like when a bully has information that he uses against the victim. There could be verbal aggression and relational aggression; for example, spreading rumours online. It could also be when the bully contacts the victim online and makes threats.

Victims of bullying are often people who are different from the rest. This could be in the form of having disabilities, looking different or even just being socially awkward. “Children who are timid, have a quiet personality, who do not typically fight back, or those who rarely speak up in class also tend to be the target of bullying,” said Farah.

How do I know if my child is being bullied?

As a parent, you’ll need to be more aware and observant to pick up subtle changes in your child. Here are some signs you should look out for:

  • Your child has suspicious and unexplained injuries such as bruises, or their clothes are torn or ragged.
  • Losing belongings such as books, stationery, electronics or other valuables.
  • Avoiding school, sometimes making up excuses like having a stomach ache or headache.
  • Change in eating habits – eating more than usual or having decreased appetite.
  • Having nightmares, even becoming too afraid to sleep alone.
  • Not wanting to mix with friends or other children they were once close to.
  • Make passing remarks like “that girl said she does not like me” or “I don’t like that person” could be a clue that bullying is occurring.
  • More seriously, a child might self-harm.

If you spot these signs, don’t ignore them. Investigate the cause and consider seeking help to solve the problem, such as speaking with your child’s teachers or someone from the school.

What are the long-term effects on the victims of bullies?

Constant fear, depression, anxiety, loneliness and low self-esteem are some of the psychological issues that, if not resolved, can carry on into adulthood. In some cases, bullying changes how the victims react to situations and how they interact with other people. If a person accepts being bullied instead of standing up for himself, he may always choose to keep problems to himself and this in turn may become the way he deals with other kinds of conflicts in the future.

Some children may be affected academically; even the brightest students can experience academic decline if they are distressed by bullying. If a child falls behind academically, it will take much effort to play catch up and this may affect his or her future academic opportunities.

What can I do if my child is being bullied?

Firstly, show you care by asking if the child is alright. Use gentle words like “are you OK” or “what’s going on”. Avoid being too forceful and avoid accusing him or her of doing something wrong.

It may not be wise to immediately schedule a meeting with the bully’s parents to confront them. “It’s not a good idea to have a meeting with teachers, parents and the bully together with your child in the same room,” said Farah. “When the bully is present, your child might get scared or be too afraid to tell the truth. Ask the teacher for help but it’s also important to ask your child his or her opinion. Instead of coming up with your own extensive list of solutions as a parent, you need to include your child in a trouble-shooting phase so that the child feels empowered. Meanwhile, you can still give suggestions and come up with ways to solve the problem together.”

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When bullying goes online

Cyberbullying is a relatively new development and can be difficult to detect. How can we know if our child is being cyberbullied and what can we do about it?

Parents can look out for changes in a child’s use of electronic devices, such as:

  • A child who likes to go online often suddenly avoids the internet and prefers doing other things like watching television instead.
  • Hiding what he/she is doing online by covering the screen, minimizing the window or closing the browser when someone walks into the room.
  • Getting jumpy or nervous when he/she gets a message, email or social media notification.
  • Deactivating or recreating social media accounts.
  • Saying things like “a lot of people don’t like me in school”.

Here are a few things you can do to tackle cyberbullying:

  • Investigate the cause of your child’s change in behaviour; don’t ignore signs, subtle though they may seem.
  • Ask your child if anything is bothering him/her. Give him or her a chance to express their thoughts before taking matters into your own hands by checking their phones or computers.
  • Suggest to your child to tell the bully that “my parents are the administrators of my laptop and they can see what you are sending me” or “my parents check my phone sometimes and they know what you are doing”. If the bully is a child of similar age, chances are he would be scared that Aunty and Uncle might find out, and eventually he may stop bullying.
  • If things do not improve, document the cyberbullying and keep records in case you decide to talk to teachers or school authorities.
  • Call or meet with teachers to tell them what is going on. If your child’s school fails to stop the bullying or it escalates, you might need to involve law enforcement. In the meantime, remove your child from the situation by switching classes or even switching schools.
  • With regards to your child’s emotional wellbeing or mental state, you may want to consider seeking professional help. Sometimes, it’s easier for a child to talk to a third party instead of to you. Look for qualified counsellors or clinical psychologists who have experience in handling children and issues such as bullying.

 

Why are some children bullies?

“Bullying is not something you are born with, it is something you learn,” stated Farah. “It is more common among neglected children, children of divorced parents or children who lack attention from their family.” Some children whose parents are involved with drugs or alcohol cope by bullying other children. In other cases, children may be bullied at home by their siblings and they try to regain power by bullying their friends to feel better about themselves.

“Sometimes, children may be young and simply can’t tell right from wrong. They just follow what their friends are doing,” Farah explained. “Some kids might say things like “if you don’t join me in doing so-and-so to that kid, then you’re not in our group”. So peer pressure might be a factor.” Another reason could be that some kids are just more assertive or impulsive and do not realize that their behaviour constitutes bullying.

My child is a bully! What should I do?

Bring up the subject by asking your child, “Someone told me you bullied so-and-so. Is that right?” Give him a chance to explain his side of the story before you proceed further. The next step would be to figure out why he did it. For example, a child could have low self-esteem and feel better about himself when he bullies others.

Then, give your child meaningful consequences. For example, if it is cyberbullying, take away his computer. It is important to explain to him why his actions were wrong. Try to get him to understand how the other person feels. After he realizes his wrongdoings, you can teach him ways to make things right again. Farah suggested getting your child to apologize, writing a letter or doing something nice to make it up to the other person. Monitor your child to see if the bullying happens again. It may be good to obtain a third person’s perspective, especially since emotions such as shame or embarrassment may cloud your judgment. If you think you need help, speak with a counsellor or psychologist. Seeking professional help is highly advisable if a child’s aggression becomes unmanageable, for example, if he lashes out physically or gets out of control. The child may have other underlying issues that have yet to be discovered.

 

What can we do to reduce incidences of bullying?

As with most issues, awareness and education are important. All of us ought to know what constitutes bullying and how to handle it. As parents, we need to be good role models for our children because they will follow closely what we do. “When times are tough and we’ve had a tiring day, we need to remember not to let it out on our kids because they will pick it up and start behaving as such to someone else,” Farah reminded. “Model good behaviour, teach them what it means to be a good person and that our actions have consequences.”

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Internet Safety For Children

Internet Safety For Children

May 7, 2022   Return

WORDS JENNIFER F. NETTO

There’s nothing more comforting than to have your chicks safely back in the roost as they unwind on their gadgets in the solace of their rooms. But are they truly alone in their rooms and are they truly safe? Online gadgets are windows to another world, and no one is looking out for your child there. So how do we shield them from the unwarranted possibilities that lie in that realm?   

INTERNET, A DOUBLE- EDGED SWORD

The Internet has evolved tremendously and shrunken the size of the world we live in. The way we communicate, socialize, educate, trade, and run daily businesses of small to large scales have seen a paradigm shift from Graham Bell’s first telephone in the 19th Century to Zuse’s first binary computer invented in his parent’s living room in Germany in the early 20th century. The emergence of the Internet era brought marvels in the way the world worked around time and space, but like a double-edged sword, it continues to bring destruction in the hands of irresponsible people. While we have heard much in the media of grown adults being scammed out of their money and integrity, agencies and multinational companies succumbing to cybercrimes, and governments dealing with cyber security issues, our children are unfortunately not spared in this coded pandemic.

SPIDERS OF THE WORLD WIDE WEB

“With great powers come great responsibilities,” said Uncle Ben and he was right! The Internet has changed the way children learn and interact. It has become a wonderful medium for kids to research school projects, communicate with teachers and peers, and play interactive games that enhance their motor and cognitive skills. But if this infinite channel is used irresponsibly, it can be detrimental to our young ones because the threats on the Internet are real and they are not to be taken lightly.

According to the Malaysian Communication and Multimedia Commission (MCMC), the major threats that are faced on a daily basis are cyberbullying, sexting, pornography, violence, racial abuse and hatred, addictive online gaming and gambling, and online fraud and deception. These have become serious threats for anyone going online. The Malaysian Council for Child Welfare reported that suicidal and self-harm cases are on a rise among children as a result of cyberbullying and cyber gaming.  

These threats cannot be brushed aside as children are being exposed to these dangers at a very tender age. Parents cannot afford to be oblivious to what they open their child to, as such ignorance is costly. You might think that your child is safe because he or she is merely playing through an app which is not opened to the World Wide Web via an internet browser, and assume he or she cannot be bullied or be preyed upon.

Online apps allow a child to interact with others, and online predators may pose as a child or teen looking to make new friends. These posers may prod your child to exchange personal information, such as address and phone number, or encourage your child to call them so that they can see the phone number via caller ID.

SUPERVISION OR SNOOPERVISION?

The Asian parents of the Internet era are slowly breaking the stereotypical Asian parents of yesteryears—nosey, zero privacy and a litany of distrusting questions all day are slowly phased-out in these times, as privacy and independence take precedence. However, online safety should not be a variable in the changing trends of parenting. It is absolutely crucial to be extra vigilant on your child’s Internet activity because they cannot be entrusted with this heavy responsibility entirely on their own. Yes, your teenager is turning into an adult and in order to gain their respect you may think it’s necessary to trust them and to give them their space and privacy. But being teenagers ourselves, once upon a time, peer pressure and hormonal impulses is known to get the better of anyone and it is not a trust issue. So instead of snooping around your kids to see what’s going on in their lives, openly supervise them. Open a strong channel of communication with them so nothing is kept a secret in fear of being judged or punished or worse—outcasted.

Remind them, daily if you must, of the importance of staying safe with their personal information, passwords and photographs, and of not accepting strangers on their social media or gaming apps or revealing their whereabouts to strangers on the Internet. Raise their awareness about the perverts online who can possibly threaten your child sexually; who prey on the young, innocent, immature, and self-esteem of children. A study from the Journal of Adolescent Health confirms that explaining the consequences of actions by sharing with children or young teens the unfortunate real-life stories from the media caused by Internet threats can help them know how real these threats are. This can open a path for them to go to their parents when they start feeling pressured, afraid or threatened by friends or other online users.

It also helps to be their social media followers and gaming buddies. Take time to participate in their online activities as a way to monitor their behaviour and those who interact with them. On another note, as much as you are protecting your child from threats, be sure your child is not a threat to others. Educate your young ones on the importance of digital integrity and reputation—to be considerate and kind on social media, to respect others even when they have different views from yours and not to spread rumours or private contents of others. These habits can help prevent drawing trouble for themselves too.

CONTROL INTERNET USE

For parents with children who are too young to openly communicate matters, you can filter your kids’ Internet use by setting up iOS and Android profiles for them which can help you restrict or monitor the apps and games they download to their gadgets or the websites they visit. Some devices even come with time limit on Internet use—a good way to balance out their daily activities especially for parents who are busy working and their children are being cared by caretakers instead. Many software programmes and apps available in digital stores can give you detailed reports of your child’s browsing history and tell you how much time your child spent online and on each site. Utilise the child- friendly browsers by Google, Bing or Yahoo and block pop-ups that could surprise your child with X-rated content. Activate firewalls if you must. In addition, it helps to educate your child’s caretaker too—you can never be too careful.

IGNORE, BLOCK, DELETE, AND REPORT!

Knowing the lurking cyber threats can help in identifying them and acting accordingly. It is important to know when to ignore, block or delete the threat and to report them immediately. Some social sites like Facebook and Instagram have channels to do this within their portal. HT

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Nipping Obesity in the Bud

Nipping Obesity in the Bud

May 1, 2022   Return

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As of February this year, it was found that 1-in-10 Malaysians under the age of 18 were either overweight or obese. As if this revelation wasn’t alarming enough, statistics also noted that the number of overweight children had doubled over the last four years, with the latest number standing in at 1 million children!

Although some parents may be quick to brush these extra kilos off as something that their children will grow out of, this couldn’t be further from the truth. Unlike some things such as teenage acne, excess weight will not stop at childhood. Overweight children are very likely to become overweight adults if nothing is done about it. And with this comes a significantly increased risk of various health issues such as reproductive problems, diabetes, heart disease and sleep apnea.

So, it begets the question: what can children and their parents do to tackle this hefty issue? Now before he sheds light on the solutions, Mark Williams who is the official coach of the Standard Chartered KL Marathon (SCKLM) 2016 says it is crucial to first recognize the causal factors.

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Weighing in on the matter

Commenting on the worrying obesity trend, Mark says, “I was recently the keynote speaker for a well-known insurance company that had released a new life assurance package whereby your premiums would be lowered if you could prove that you were keeping yourself fit and healthy. My speech, therefore, was based on the current state of health and fitness in Malaysia so I did an awful lot of research on this matter.”

“Although it’s great to see Malaysia developing so rapidly, it has unfortunately come with some side-effects – one of them being obesity. I believe diet and sedentary lifestyle play important roles in this. People are now working longer hours so they spend most of their time sitting at their desk. Also, they don’t have much time to cook their own meals so they make do with fast food, which is so readily available especially in towns and cities. They also eat rather late in the evening which is never good. When food is consumed late at night, the body is more likely to store these calories as fat. Hence, people end up gaining weight. I find that there is such a fascination with food here in Malaysia that I’ve never encountered anywhere else in the world. I notice that food is to Malaysians what the weather is to us English – a topic for small talk!”

It takes two

These unhealthy lifestyle habits subsequently spill over to children. “Children are heavily influenced by their parents. So, why not turn things around by setting a good example for your kids; don’t depend on schools to teach your kids about healthy living. You may not win your kids over at first but keep reminding them about what is healthy and what isn’t. When they grow more independent and start making their own choices, they’ll be more educated and make choices that hopefully lead to a healthier life,” he enthuses.

However, Mark is quick to add that the responsibility of instilling healthy habits in children doesn’t lie solely on the shoulders of any particular party. “All aspects of a child’s environment have an effect on the child. It’s unfair for any party, be it parents or an educational establishment to put the onus for understanding healthy living on the other. “But parents do have the greatest interaction with them and the home is essentially where decisions on healthy living are ultimately made. This is why I believe change starts with parents,” he emphasizes.

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Let’s move it, move it

Discussing the kind of physical activities he would recommend for children, Mark says, “Anything that involves fun! Get out and about, and just let your kids run. For instance, take them to a playground. Don’t underestimate what children can do at a playground. A playground is practically a gym for children so give them access to one as much as possible!”

While Mark doesn’t disagree with the idea of having exercise routines for children, he believes there can be too much of a good thing. “Children really shouldn’t have too much of a workout routine. Creating too many routines will bring on boredom – and that’s the last thing you want. What’s important is that you give kids the facilities such as a safe, open field or like mentioned earlier, a playground and they’ll never get bored. Children need to enjoy what they are doing – or else, they will get demotivated. Motivation comes from enjoyment, after all. So, have fun!”

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Starting young

Although SCKLM has always had running clinics for their adult participants, this year marks its first year organizing junior running clinics. “I try to get down to grassroots level and teach child athletes (i.e. 4-9-year-olds) some basic things through fun activities, and help the older ones (i.e. 10-14-year-olds) with their technique through drills and practice.”

Delving further into the subject, Mark says, “Kids will start off with a warm-up comprising some fun activities. This is important to get the system going. They will then be assigned a distance appropriate to their respective ages, which they will run during each session. Their time will be recorded and put up onto the SCKLM website where they will be able to track their progress. Also, there’s no need to worry about facilities. We have a superb facility all to ourselves at the Majlis Sukan Negara (MSN) track in Setiawangsa. What’s more, the team from Dirigo Events will be there lending their support by providing refreshments.”

Taking into account all the great things that these clinics boast, surely the response has been good? “It’s been fantastic! About 80% of those who attended the previous session have returned for a second time. This tells me that they have gotten something out of these junior running clinics. Plus, parents have contacted me via my Instagram page (@markwilliamsadidas) to express how much their children enjoyed the sessions.”

When asked if parents can still sign their children up for these clinics, he says, “I’m afraid that they are all finished for this year, but we plan on conducting more sessions next year so watch this space!”

On the man himself

If Mark seems familiar, it’s very likely because you have seen him in action on the silver screen. Earlier this year, he starred as coach Harry Mountain in the Malaysian hit movie Ola Bola.

Talking about his foray into the entertainment scene, he says, “I play football for a veterans team. One day, our manager asked if anyone would be interested in playing the Arsenal coach in a Malaysian film about football. I auditioned and was told I got the part. But when I met with the assistant director, he informed me that they wanted me to play the role of the Malaysian coach instead. A bit-part role suddenly turned into one with 49 scenes! I was thrilled!”

One might think that making movies is all glitz and glamour but Mark begs to differ. “I was given some acting lessons and away we went. Filming was tough as most of it had to be done at night and I was the only person on set who also had a day job (Mark is Head of Geography at an international school in Sri Kembangan). On some nights at Stadium Merdeka, we would finish – or ‘wrap up’ as it’s called in the film industry – at 7am and I had to be at school by 8am!” But the complexities of filming haven’t dampened his spirits. “I’d love to do more acting. We’ll have to see. Hopefully, you all will see me on the silver screen again!” 

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Slowing the HFMD Epidemic

Slowing the HFMD Epidemic

April 28, 2022   Return

Words Dr Rakhee Yadav

Dr Rakhee Yadav

Consultant Paediatrician

 

Since April this year, there has been an increase in the number of hand, foot and mouth disease (HFMD) cases among Malaysian children. HFMD is a notifiable disease and the number of cases is closely monitored by the Ministry of Health (MOH) Malaysia. In fact, official reports from MOH claim there is an almost 30 percent increase in cases compared to last year. According to a statement by the Director General of Health, Datuk Dr Noor Hisham Abdullah, more than 40,000 cases have been reported nationwide so far. Every week, 73 new cases are reported nationwide, according to Health Minister Dr Dzulkefly Ahmad.

HFMD is a highly contagious disease that is caused by viruses from the enterovirus group, namely the Coxsackie A16 and Enterovirus 71 (EV71). However, this year there has been an increase in the number of cases from the EV71 virus. Those who have been infected by a particular strain may develop immunity towards it but they may still contract HFMD caused by other strains of viruses. It remains a myth that you can only develop HFMD once in a lifetime.

HFMD easily spreads through droplets which can be from an infected individual’s saliva, mucous, stool and even blister fluid. It commonly spreads via close personal contact with an infected individual, coughing, sneezing, touching contaminated objects or even indirect/direct contact with infected stool.

While HFMD is commonly seen in children below 10 years of age, those below five years have a higher risk as their immune system may not have matured to fight the disease. HFMD may also affect older children and even adults. Children who are frequently exposed to other children, for example in places such as daycare or school, have a higher risk as there is an increased degree of exposure.

Symptoms and complications

Symptoms usually appear three to seven days after exposure to the virus. The disease is contagious in the first seven days and to make things more complicated, there sometimes may not be any symptoms during this period. HFMD is characterized by fever followed by blisters which usually occur over the hands, feet and in some cases extend to the body and genitals. These blisters may be painful and/or itchy. They may also have painful ulcers in the mouth or sore throat, leading some individuals to have poor appetite and dehydration.

There is a spectrum of symptoms in HFMD, with some children developing a mild form of the disease while others may develop its severe form with complications. Although uncommon, there have been reported fatalities amongst children with severe disease and complications. However, it is imperative to note that not all complications are fatal. Secondary infection due to scratching the blisters or dehydration caused by poor appetite are the most common complications encountered. These are treatable and result in better outcomes.

More uncommon serious complications are usually related to EV71 infection. EV71 may cause complications involving the:

  1. Nervous system, such as meningitis (inflammation of the protective lining of the brain), encephalitis (inflammation of the brain) or even paralysis.
  2. Heart, causing myocarditis (inflammation of the heart muscles).
  3. Lungs.

Pregnant ladies affected by the Coxsackie virus may develop complications during pregnancy. Their unborn babies may develop congenital abnormalities as there is a small chance the virus could cross the placental barrier.

Treatment and prevention

Treatment of HFMD is supportive. In healthy individuals, the disease resolves within two weeks without any complications. Most cases are treated symptomatically with fever medications and creams to relieve the itchiness. Some children are given mouth sprays or lozenges to relieve the pain from their mouth ulcers. A soft, cool diet consisting of soft foods and cool items (e.g. porridge, yogurt, ice cream) may be given if a child refuses to drink or eat due to painful ulcers. In some instances, a child might need to be admitted for intravenous fluids due to dehydration, closer monitoring or specific treatment of complications.

To date, there is no vaccine against HFMD. As such, it is very important to prevent the disease from occurring and reducing its spread. The MOH has urged all childcare centres and schools to always disinfect their equipment and appliances using the correct disinfectants, screening all children upon attending class, ensuring proper disposal of diapers and practicing proper hand washing techniques for staff and children under their care. Disinfecting using a solution of bleach has been recommended by the MOH in their guidelines.

Schools with more than two reported cases are usually ordered to be closed by the MOH for disinfecting purposes. Parents and guardians are advised to isolate or home quarantine their children with signs or symptoms of HFMD. This includes avoiding public areas (e.g. shopping malls, indoor/outdoor playgrounds, school, etc). Parents working in the government sector and certain private companies are allowed to apply for quarantine leave which lets them take care of their child at home.

Prevention is better than cure and this is truly the case when it comes to HFMD. Everyone must do their part in preventing the spread by doing all we can to ensure a clean environment and avoid bringing sick children or even adults out in public. As parents, we should be more responsible not only for our own children but for others. Only then will we see a reduction in the number of cases in our country.

We can prevent the spread of HFMD by practicing home quarantine: stay at home and do not place your child in daycare or school until you or your child is completely free from infection.

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