As a child, Chiong Yee Keow was born into a family that belonged to the bottom 10 per cent of income earners in Singapore. After years of study and practice to become a doctor, she started Neighbourhood Health Service Kids (NHS Kids). The local community health service project targets families with children six years old and younger who are part of the rental flat populace under NUS Medical Society led by medical and social work students from National University of Singapore (NUS).
The first NHS Kids community screening was held on Jun 30, 2018 and Jul 1, 2018. In 2018 and 2019, 179 and 203 children from Boon Lay Drive were screened respectively. The programme has since expanded to serve the residents of Kembangan-Chai Chee and Boon Lay.
While making healthcare services accessible is a cause worthy of itself, “health screenings are just an excuse to enter the lives of these families,” Yee Keow shares. At 34, NHS Kids is how she directly contributes to levelling the playing field for children from low-income families.
“Health is seen as a neutral topic, and definitely, we care for the child and family. So we use that to broach the topic of social barriers which are affecting the health of their child.”
On the day of screenings, Early Childhood Development Agency (ECDA) is also present to enrol these children into various free programmes that will help to provide them with holistic development.
In 2020, the COVID-19 outbreak prevented students from doing home visits, but the need for their work was never more important. Instead of taking a step back, NHS Kids held a series of educational workshop webinars.
Parents gleaned insight on how children’s physical, social and emotional development could be affected during the pandemic. Strategies on how to circumvent these issues were discussed, talks on common childhood illnesses and Q&A sessions were also organised as part of their efforts to continue offering support to these families.
“I think families are a lot more receptive if we don’t start with: ‘Oh, we’re going to ask you about your family. How much do you earn? What do you work as? How many meals do you take in a day?’” Yee Keow explains.
At screenings, doctors and student volunteers go through a child’s health booklet to ensure they have not missed any crucial vaccinations or check-ups. A general health check is conducted to catch signs of any medical issues, growth difficulties and poor nutrition. Following that, a developmental assessment and dental screening are provided.
If parents have any concerns, they are referred to the on-site dietician or paediatrician, depending on their query. Here, they are educated on what to look out for and the type of diet their child needs, and in the case of mothers, there are family planning stations to cater to their specific needs.
For a child, nothing is more important than their first 1,000 days of life.
The child is growing bigger and stronger, and neurodevelopment is at its peak. These neuron connections are responsible for developing their social skills, speech and language. Health and development are closely linked; this is why the quality of maternal prenatal nutrition and a child’s diet in their first two years matters.
But what happens if you are a child born into a low-income family in Singapore who might not always have access to adequate or nourishing food? From a tender age, these children begin life at a disadvantage to their peers from higher-income families.
In light of these issues, NHS Kids aims to cast the net wide and rectify these problems before they take root too deeply.
“Sometimes it’s very embarrassing for some families to admit that they need help and they don’t want to reach out for it. Through [health screening], in a very non-judgemental way, [we can preserve their dignity and still] ask them how we can help them,” Yee Keow laments.
“These parents actually want the best for their children, just like any other parent, regardless of their income level. They want their children to have better lives also which is why they come to the health screening in hopes of breaking their children out of the cycle.”
Throughout her formative years and during the time spent kickstarting NHS Kids, the biggest lesson Yee Keow learnt was that you cannot do things alone.“Growing up, I realised that it really takes a lot of community effort to push things along. It takes a whole village to raise a child. The combination of a familial support system, social service organisations and medical healthcare professionals to make sure everything is on track is crucial.“And you know, I still want to pay it forward. I want to give back all the kindness I’ve received in my life to these children because I think there is value in every child, and they will be valuable members of society and their families.”
Currently, Yee Keow is pursuing a Master’s in Public Health while pushing for NHS Kids to expand to as many regions as possible. Her goal is to develop a holistic child health strategy that encompasses the entire system in Singapore for children. Other projects she is involved in include being the paediatric lead for the upcoming KidSTART programme.
“[With health screening], the magnitude of change can be so huge, even if it looks so little at the start. But we just have to guide [children from low-income families] in the right direction and I think the best way to do so is to set them up for success.”