By Dr Wee Soo Yen / Dr Khor Swee Kheng

We are writing as concerned doctors to propose practical solutions on childcare for children of frontliners.

The Ministry of Women, Family and Community Development recently released a post-Movement Control Order Prevention of COVID-19 Transmission Guideline for childcare centers. The guideline states that "frontliner's children are at higher risk of getting infected from their parents and the safest place for them is at home. However, if they are sent to childcare centers, they must be separated from other children."

After statements from the Malaysian Pediatric Association (MPA) and 250 pediatricians and the Academy of Medicine Malaysia, the Director General of Health, Dr Noor Hisham clarified that the guideline was to prioritize these children and affirmed that there is no discrimination.

We believe that there are several challenges when providing childcare for front-line workers. One, an immediate issue that might arise is childcare centers will refuse to care for the children of frontliners due to fear and inconvenience, leading to a potential domino effect. This could lead to parents who are frontliners to stay at home to care for their children. This then reduces the already stretched number of our professionals in the field. The reduction of manpower might disrupt the work dynamics of our frontline operations and dampen their spirits.

Two, discrimination against the frontliners' children might also ignite and build stigma against frontliners in our country. We fear inappropriate panic and misconception against these individuals. This is unfortunate because since the beginning of the Movement Control Order, Malaysian citizens have been very appreciative of frontliners for their sacrifices. We have witnessed heart-warming initiatives like online appreciation, providing fast track queues at supermarkets and producing personal protective equipment (PPE) from homes.

There is an urgent need for our government leaders to address the matter and give sufficient reassurance to these frontliners. Childcare centers operators and frontliner parents should be included at the discussion table. Another important stakeholder worth mentioning is the community, for instance, neighbors or relatives living nearby who are trustworthy and willing to help these frontliners.

Equality and justice are important. Frontliners' children and families should be treated fairly, without discrimination and stigma. Frontliners are one of the most affected populations during this COVID-19 crisis, being physically and mentally vulnerable. We must care for them.

Thus, we would like to offer several suggestions. One, decisions must be inclusive. Frontliner parents should not be forced to stay at home because childcare centers refuse to take in their children. At any childcare center, children of frontliners should not be separated from their peers, where possible. We welcome the idea of creating new childcare facilities specific for government hospitals as this will be useful for the frontline health professionals. In all cases, childcare centers must adhere to preventive measures such as social distancing, wearing face masks and regular hand-washing.

Two, the execution of standard operating procedures (SOPs) must be done carefully. Childcare center operators need to understand the importance for them to comply with the SOP and guidelines by the ministry in their daily operations. References and materials should be made readily available for all operators, in a checklist format. Proper training should be conducted as per manual to all staff by childcare center operators. To ensure proper compliance, Department of Social Welfare should perform routine and ad-hoc checks.

Three, we can adopt the "social bubble" concept at childcare centers. Instead of separating the children by their parents' occupation, childcare center operators can group the children in a childcare center into a few 'social bubbles'. The children are allowed to interact only in their specific 'bubbles' where they are only exposed to constant peers to limit exposure. This method will not only limit virus transmission, it also can improve the social well-being of these children.

There must be a more delicate and rounded approach on the subject matter moving forward. Frontliners are the heroes of our nation who have been staying at work for us during this health crisis. We must ensure their children are properly cared for.