Systems Thinking Case Study #6:
Systemic structure of Hand-Foot-Mouth Disease (HFMD) Cases
HOW COME CASES OF HFMD CASES CONTINUE TO RISE DESPITE EFFORTS TO CONTROL AND PREVENT IT?
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DIALOGUE NOTES: WHAT DO YOU SEE HAPPENING?
SINGAPORE : The number of hand, foot and mouth disease (HFMD) cases has continued to
increase, with 785 cases reported last week. According to the Health Ministry, this is more than
double the number of cases in the preceding week. It is also significantly higher than the weekly
average of 113 in January and 174 in February this year.
2,964 cases of hand, foot and mouth disease have been reported since January this year.
8 in 10 cases occurred in children under the age of 6. More than half were in the age group of 3
to 6 years attending child care centres, kindergartens or other pre-schools.
Of all the cases reported so far this year, only 54 were hospitalised.
So far, the majority of the cases have been mild infections. There has been no case of serious
complications like myocarditis - also known as inflammation of the heart muscle - or encephalitis, a
brain inflammation.
In the region, 8 deaths from HFMD were reported in Sarawak and 1 death in Brunei.
The Health Ministry says the task force combating the disease in Singapore will tighten the
guidelines for closing child care centres and kindergartens should the disease break out at these
centres.
The aim is to break the chain of transmission and prevent further spread of the disease.
Title : HFMD cases continue to climb, 785 cases reported last week
By : Pearl Forss, Channel NewsAsia
Date : 28 Mar 2006 2020 hrs (GMT + 8hrs). More updates here.

WHAT WOULD IT LOOK LIKE IF WE LEARN TO APPLY THESE STRATEGIES?
WHAT MIGHT MAKE IT DIFFICULT OR GET IN THE WAY OF MAKING THESE HAPPEN?
WHAT KEEPS OUR CONVERSATIONS LIKE THESE AND IS MAKING IT DIFFICULT TO SEE THESE STRUCTURES?
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