The threat of swine flu is no easy challenge for working mothers in cases where early childcare programmes are unavailable. Gihan Shahine looks for alternatives It scared me to get a phone call from my son's nursery director recently telling me that my two-year- old preschooler was feverish and was not responding to medication. Caregivers at the nursery sounded nervous, and they immediately isolated my son from other children for fear of swine flu. Upon my arrival at the nursery, the director gave me a paper to sign. The paper included new regulations asking parents not to bring their children to the nursery if they showed signs of common flu, including a high temperature, sneezing and coughing, until they had completely recovered. It turned out that my son did not have swine flu, but the experience made us think twice about sending our 28-month-old son, Youssef, to daycare where children are often more prone to infection. Children at daycare centres share toys, cough and sneeze, and they are too young to follow regulations like washing hands or wearing masks. All this makes early childhood programmes great incubators for germs to spread rapidly. Meanwhile, according to US Secretary of Health and Human Services Kathleen Sebelius, swine flu is "a young people's disease", and "children under five years of age are at high risk of complications from the H1N1 swine flu." "While we think everybody should take the flu seriously, children less than five years old are at high risk for complications from the flu," she told USA Today. "Tragically, children do die, whether it's H1N1 or seasonal flu," she said. Babies under six months old cannot get vaccinated, and about 100 children have reportedly died of swine flu over the past few months in the US. No statistics are available in Egypt to know if any children have died of swine flu. "The problem is much worse in the United States, of course, but we have to be careful because, after all, we do not know if any children have died of swine flu here in Egypt," said Iman Bebars, chairperson of the Cairo based association for advancement and development of women. In Egypt, there is a wide range of daycare quality, and less-privileged nurseries, where less attention is given to hygiene, may be at higher risk of a swine flu outbreak. Meanwhile, there is little focus on daycare centres in the government's agenda to combat the disease. This contrasts with the United States, where the US Centre for Disease Control (CDC) has issued strict guidelines for nurseries to limit the spread of the disease, demanding all daycare centres to maintain daily checkups of both kids and staff, to have a thermometer available all the time, to isolate any suspect child or caregiver and to be more vigilant on sending sick children and care providers back home. Sebelius has also advised that children and caregivers at daycare programmes should take priority when the swine flu vaccine is available -- an option that many mothers in Egypt would not take for fear of the vaccine's unknown side effects. In Egypt, many quality daycare centres are taking similar precautions, but more focus is perhaps being given to schools in the national agenda to combat the disease. There has been no official statement as to whether daycare centres should be closed at a certain point, or whether the government will be providing closer inspection or issuing stricter guidelines to nurseries. Neither is civil society giving more attention to daycare facilities in efforts to combat the spread of the H1N1 disease. Bebars conceded that nurseries were not included in the awareness campaigns her NGO had conducted in impoverished areas like Manshiet Nasser, for example. "We have focussed on schools and youth clubs, but we plan to include nurseries in our coming campaign in Old Cairo," Bebars told the Weekly. It may be that there is little awareness of the fact that preschoolers are more vulnerable to H1N1 infection and complications from the disease. Or that, as Bebars explained, in impoverished areas like Manshiet Nasser, daycare centres are normally not an issue of concern. It is not just that many families have already decided to keep their children at home for fear of swine flu. Mothers in such areas already hold jobs like selling vegetables in front of their homes and keeping children at home is not a problem. Yet, anxiety over swine flu has deeply penetrated into the lives of Egyptian households more generally. Administrators at daycare centres repeatedly assure parents that strict precautions are being followed but to little avail. Officials have frequently told the media that everything is under control, but people tend to put little stock in government statements. Besides, nobody can rule out the possibility of a swine flu outbreak as we get deeper into the winter, and many mothers are deciding to play it safe and keep their preschoolers at home -- an option that many working mothers cannot afford. At my son's nursery, for example, the number of children has dramatically decreased, all despite the fact that the facility's administration seems vigilant about applying the new regulations. "We clean the whole setting, including toys, with disinfectants everyday, and we no longer admit schoolchildren into the premises in the afternoons," the administrator assured me. "We are taking it seriously because, after all, we are all in the same boat." However, many parents seem unconvinced. "We are sometimes seeing only four children in a class," said Eman, a caregiver at the nursery. "People are afraid, or perhaps they don't send their children in because they are sick. I don't know." Eman's eyes bespeak an inner anxiety. She is not afraid of swine flu. Rather, she fears that a possible outbreak will lead to closure of the facility, which, for her, will be a financial catastrophe. Moreover, Eman is not the only one. Swine flu is not just a health hazard. It is also a social and economic problem. Many mothers cannot afford to take leave or to risk their career by taking time off work. The possibility of an outbreak offers new challenges to working mothers who are now at risk of staying at home in case nurseries, or even schools, close down. In the absence of workplace regulations in case of an outbreak, mothers are left to adapt in their own way. For the government, on the other hand, closing down facilities may be the safest, or perhaps, easiest solution. At least seven schools and 26 classes have been closed over the past few weeks, while a nursery in the Cairo district of Gammaliya has been reportedly closed down. Many mothers have had to stay at home with their children as a result. "I have not done any work over the past week because we had a lot of schoolwork to finish at home," said the mother of one seven-year-old student whose school has been closed for two weeks. "It is a real disaster." For her part, Bebars feels that schools and nurseries should be closed until "we know where we are heading." The issue of what working mothers should do if schools and nurseries are closed has hardly been discussed, and it does not seem to have received attention in the national plan to combat the disease. This contrasts with the situation in the US, where the question has been an issue of concern, and pressure groups have been demanding that new work regulations and sick leaves should be designed in such a way that women do not lose their jobs in case of an outbreak. The US government website has advised mothers who cannot work from home to plan ahead for home childcare in case daycare facilities are closed. In Egypt, however, the financial losses that may occur as a result of women's leaves and absences have not been calculated, and in the absence of any new workplace regulations in case an epidemic hits the country, mothers have been left to fend for themselves. "We do not go far when it comes to planning," comments Madiha El-Safty, a professor of sociology at the American University in Cairo. "Actually we do not have any planning. Period." El-Safty expects that absences and leaves will be on the increase in the coming period, but she still does not expect the government to take action in that direction. "Women's work is not a top priority, and the issue will be considered a personal problem that every woman will have to deal with in her own way," she says. For her part, Bebars is not as critical of the government's handling of the problem. "The government generally is not good at planning, but swine flu has meant a challenge for the whole world because it is the first time we have faced such a problem," she says. Herself a feminist and women's rights activist, Bebars said that she had not been able to think too much of what working women would do in case of an outbreak. "When your children are at risk of dying, you do not think about your work," she said. It is not that women's work is unimportant, it is just, as Bebars argues, that "we cannot ask the government to do everything at one go, or else no one will listen." Bebars contends that up till now many countries have not reached a clear decision on when to close schools or whether they should be closed in the first place. Moreover, vaccines are either not available, are expensive, or have unknown side-effects. "In the middle of all this mess, no country has reached a clear-cut strategy dealing with women's work," Bebars said. She suggests that the government should give female civil servants paid leave to be able to stay at home with their children in case schools and nurseries are closed. After all, Bebars reasoned, government offices are already overstaffed. Those holding junior positions in the private sector should also be given flexible hours, and women should be allowed to work from home in cases where their jobs do not require attendance. In cases where a woman holds a senior or well-paid job, Bebars expects there will be little problem since such women can afford to pay for childcare at home. Even this last solution is not always plain sailing, however. The best solution, of course, is to find free babysitters -- that is, grandparents who can look after the children. Nannies are hard to find, and more often than not they are not properly qualified. Nadia, a journalist, considers that there is little problem in sending her four-year-old son to daycare since "strict precautions are in place" and "kids cannot stay home". She has a point: consultant pediatrician Amr Qatamesh advises that children should not stop going to nurseries because "they simply go nuts when they stay at home." "Life has to go on," he says. "The average life of an epidemic is two years, and we are only at the beginning. People should adapt in one way or another."
