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Covid-19 protocols, such as quarantine and swab tests, may have become routine for many Singaporeans. But such measures may impact people with disabilities a little differently.

One lady, Singaporean Amylia Koh, took to Facebook to share her negative experience after her brother, who has additional needs, was issued a quarantine order.

Covid-19 outbreak at Adult Disability Home

On June 2, the Ministry of Social and Family Development (MSF) stated in a press release that 27 people at an Adult Disability Home had tested positive for Covid-19.

MINDSville@Napiri is a home for people with intellectual and developmental disabilities, by the Movement for the Intellectually Disabled of Singapore (MINDS). It is located at Lorong Napiri.

Precautions were taken after the first case was detected. Testing was administered, admissions, discharges and visits to the home were suspended, and residents, staff and their close contacts were placed on quarantine.

On June 7, MOH said that the cluster had grown to 32 cases.

Koh's experience

Koh, 26, is a Singaporean and a Special Education teacher. Her brother, who is 34, is a client of MINDSville@Napiri.

According to Koh, he has an intellectual disability and is reliant on his family to care for him.

After the June 2 announcement by MSF, the family expected that he would also be issued with a Quarantine Order. He received one on June 3.

Koh shared that their request for her brother to serve a Home Quarantine Order was denied by the Ministry of Health (MOH) on the night of June 3.

Speaking to Mothership, Koh said that MOH did not clarify why the request was turned down, but said it could have been due to space constraints as there are four people living in her flat, and there might not be enough room to isolate individually.

Koh said in her Facebook post that after this, she informed the MOH officer that since her brother was supposed to move to a Government Quarantine Facility, she would move in with him and be his primary caregiver there. She added:

"The MOH officer acknowledged this information and said he would update my details alongside my brother’s.

I was anxious myself because my brother would be out of his routine, in an unfamiliar setting, away from our parents. People with special needs thrive on routine and might engage in maladaptive behaviours due to change."

Not listed as a caregiver

However, when the time came for the pair to board the shuttle bus taking them to the quarantine facility, Koh found that she was not listed as a caregiver. She was barred from boarding the bus.

Koh said she told the CISCO officer that her brother was intellectually disabled and needed a caregiver to accompany him. Although she tried to elaborate further, she said the CISCO officer on site and the MOH officers over the phone did not seem to understand.

After some "dispute and disagreement", they were instructed to wait for the next pick-up instead.

Koh said this demonstrated the "incompetence and lack of organisation" on the part of the MOH administrators.

She also claimed that not only did the personnel seem unprepared to handle the quarantine of people with special needs, they also supposedly "demonstrated a severe lack of compassion and understanding" when caregivers tried to inform them of their needs.

Difficulties with being swabbed

Koh said she had previously asked, before the Quarantine Order, about possibly using the new breathalyser test for people with special needs. However, she said her queries were met with "uncaring" responses.

This non-invasive test, which can return results in a minute, is currently being trialled in Singapore. On May 25, it was announced that the test has undergone clinical trials at three locations since June 2020.

Koh then recounted the difficulties her brother faced when undergoing a swab test for Covid-19:

"Although I was the caregiver and the person who was most equipped to handle my brother and his needs, I was instructed to watch from a distance. All the swabbers took turns trying to swab my brother, who became increasingly frustrated and was on the brink of an aggressive meltdown.

His agitation, discomfort, and frustration were apparent, brought about by his inability to comprehend the situation, and his being surrounded by unfamiliar masked faces, away from his caregiver. After a good 30 minutes, they finally heeded my suggestion and allowed me to step in and assist them."

Koh also highlighted possible dangers, such as an agitated person pulling off the Personal Protective Equipment of the swabbers, thereby exposing them to risk of infection, or injuring himself.

Suggestions to help the process

Koh explained that people with intellectual disabilities may struggle to comprehend abstract concepts, such as an invisible, infectious virus.

People with special needs also may not understand the importance of instructions such as washing hands or wearing masks.

Koh added, "I can only imagine how stressful and traumatic it must have been for the MINDSville clients who were accompanied by their ageing parents during the QO."

She suggested having trained professionals to help front-liners engaging with people with special needs.

She also suggested using non-invasive testing methods on people with special needs, and making sure that the information about their families (such as who their caregivers are) is shared with the necessary departments.

Caregivers of people with disabilities should be heard

Speaking to Mothership, Koh shared that she contacted MOH, who received her feedback and apologised for her experience.

Koh said that logistical difficulties was cited as a reason, but she said this was not an excuse to "trivialise the matter" and that better preparation could have prevented the difficulties.

She gave credit to the front-liners who are trying their best to meet the needs of the majority, and was thankful for the MOH officer she spoke to who expressed empathy and was "willing to hear (her) out."

She added that her post was intended to raise awareness of people with disabilities, and that their caregivers should not feel "resigned to fate", but should be heard instead.

You can see her post below:

Rahayu Mahzam: Processes will be reviewed

15 minutes past midnight, on June 9, PAP Member of Parliament Rahayu Mahzam shared a Facebook post discussing the situation.

Rahayu is the Parliamentary Secretary for Health, and has a son with special needs.

She said that MOH had heard feedback from Koh and another person, Cindy Chee. She added:

"We understand their grievance and it is indeed unfortunate that they had to go through such an experience.

We recognise that the swab process and the quarantine can be more challenging for persons with special needs as they may not be comfortable with unfamiliar people or environment.

My colleagues at MOH will work to improve on our processes."

Rahayu said that personnel trained in administering swab tests are not specially trained to deal with people with special needs.

The authorities are looking into engaging trained professionals, and volunteers from the National Council of Social Service.

The use of alternative tests will also be considered, and the processes for people with special needs will be reviewed.

Rahayu also said that communications between the various agencies involved in managing the quarantine process will be improved, and that caregiver requests for those under quarantine, with special circumstances, are accommodated.

She said, "We have reminded Certis, our agent for quarantine orders, to be mindful and exercise compassion when dealing with persons with special needs."

She also thanked Singaporeans for their understanding and cooperation, as the processes are improved. You can see her post below: