The invisible struggles of those with hidden conditions on Singapore's public transport

Straits Times

6 hours ago

Ms Ratnah Hafizah, who has multiple sclerosis, said carrying a May I Have a Seat Please card has given her confidence to take a priority seat on a bus without the fear of being judged by others. PHOTO: COURTESY OF RATNAH HAFIZAH
The invisible struggles of those with hidden conditions on Singapore's public transport
SINGAPORE - For 34-year-old university administrative employee Vivien Shiw, getting off a train at the next stop just to rest on a bench on the platform is routine.
Though she looks young and healthy, she lives with autoimmune diseases Sjogren's and vasculitis, as well as arthritis, which make standing for long painful.
When the pain in her legs worsens, she sometimes squats in the MRT train.
Another passenger like her, Ms Ratnah Hafizah, has multiple sclerosis, which is also an autoimmune disease. She used to take Grab rides to pick up her son from kindergarten, even though his pre-school was only one bus stop away from her home.
Ms Ratnah, who is 33 and self-employed in branding and content writing, said carrying a May I Have a Seat Please card, which she ties to her bag, has since given her the confidence to take a priority seat on buses without the fear of being judged by others.
The card was first piloted as a sticker by the Land Transport Authority (LTA) in 2019 to help passengers be aware of those with hidden or invisible medical conditions who need a seat during public commutes.
It is part of the Helping Hand scheme, an initiative by the Caring SG Commuters Committee – comprising several ministries, agencies and public transport operators – to foster a more inclusive public transport system.
The May I Have a Seat Please initiative includes a lanyard and card for passengers with long-term conditions, while the sticker version is meant for people with short-term medical conditions.
The card was created for those with hidden conditions such as chronic pain or fatigue, dizziness, heart disease and arthritis.
It is also for commuters recovering from a stroke, those with physical injuries, ongoing cancer treatment or prosthetic limbs, and early-stage expectant mothers.
As at May , LTA said it has distributed about 10,600 stickers for short-term conditions and 20,400 cards for long-term conditions.
Passengers can collect them for free at the passenger service centre at MRT stations, bus interchanges, and at selected SimplyGo ticket offices. They do not need to show proof of their conditions.
Some with invisible conditions are still doubted because of their youthful appearances.
A 21-year-old university student who wanted to be known only as Ms Lim has multiple health conditions that result in leg pain when she stands for longer than 20 minutes. She said she was laughed at by a passenger service employee when she requested a May I Have a Seat Please card.
Diagnosed with endometriosis, ovarian cysts, pelvic congestion syndrome and adenomyosis, she said the staff member did not believe she was unwell, even after seeing her medical records.
'I did receive (the card) in the end, but it left a sour taste,' she said.
For some commuters, the card has not really worked.
Ms Shiw, who has been carrying the card for about a year, said she often gets stares from other commuters. No one has offered her a seat on her journey from Sengkang to Kent Ridge for work.
The only visible sign of her condition is the rash she gets when she puts too much pressure on her legs, but people do not associate a rash with the need for a seat, she said.
Her fear is that she will fall down, as she has trouble balancing.
LTA said it will continue to work with public transport operators to improve the Helping Hand initiative.
The authority said all public transport operators have training programmes, developed together with social service agencies, to equip staff with skills to spot and assist commuters with disabilities.
Since 2016, training in commuter inclusivity has been part of the Enhanced Vocational Licence Training Programme conducted by the Singapore Bus Academy for all bus captains. Over 10,455 bus captains have completed the programme, LTA said.
More than 4,500 of SMRT's front-line staff – including station managers, bus captains and service ambassadors – have completed the operator's inclusive service delivery training, developed with social service agencies and special education (Sped) schools.
The training includes role-play scenarios and hands-on learning to develop skills and sensitivity to help commuters with diverse needs.
Over 7,000 SMRT staff are certified Caring Commuter Champions, trained to support commuters with disabilities.
Madam Aileen Goh, 59, a senior assistant station manager at SMRT Trains, has helped unwell passengers and those with dementia by escorting them to the station's WeCare rooms to rest, and providing them with water and snacks while contacting their family members to pick them up.
She said her training has taught her to look out for those who need help and given her the confidence to assist them, such as by slowly approaching elderly passengers wandering around the station and gently checking in on them.
Mr Dalvinder Singh, a bus captain at Tower Transit Singapore, said the May I Have a Seat Please card has made it easier to identify passengers in need.
In 2024, he noticed a commuter with visual impairment waiting at a bus stop with the card. He approached to offer help, informed him of the bus service number, guided him on board, and later helped him alight at his stop.
'Before the cards were introduced, we would usually rely on visual cues or if the commuter approached us first. Now, with the lanyards and cards, I can take the initiative to offer help more confidently and appropriately,' said Mr Singh.
Help for passengers with autism
Passengers with invisible disabilities, such as dementia and autism spectrum disorder, can also get additional help at Changi Airport.
Changi Airport Group worked with Sped schools and organisations to launch in 2022 a customisable step-by-step airport guide and specialised training for staff.
Front-line airport staff are also trained to recognise LTA's May I Have a Seat Please lanyard and the Hidden Disabilities Sunflower lanyard – a global symbol for hidden disabilities launched by England's Gatwick Airport in 2016 – as part of their induction.
Selected staff, such as those in supervisory roles, are nominated to be care ambassadors and receive specialised training to spot and support passengers with invisible disabilities such as autism, attention deficit hyperactivity disorder, Down syndrome or dementia.
Since August 2024, over 330 staff members across 15 organisations at Changi Airport, such as Certis Aviation Security and the Immigration and Checkpoints Authority, have been trained as care ambassadors by Rainbow Centre, identifiable by a pin they wear on their uniform.
Parents of children with autism said the special accommodations made by airport and public transport staff make a world of difference when travelling.
Ms Edwina Fan and her 18-year-old son Wallace Tan fly about twice a year to visit his grandparents in Taiwan.
When Ms Fan explained to airport staff that Wallace was unable to look into the camera to pass through the e-gate, which is more commonly used now, the staff led them to the manual counter.
She said staff also acceded to her request for Wallace to board the plane first with his family, as he is uncomfortable with crowds, and for him to be served his meals earlier.
On public transport, Wallace, who is triggered by sounds such as babies crying, wears headphones and has his family's helper by his side.
On public transport, Wallace Tan, who is triggered by sounds such as babies crying, wears headphones and has his family's helper by his side.
PHOTO: EDWINA FAN
Ms Fan recalled how Wallace once had a meltdown, and MRT staff formed a circle around him on the platform to give him space. They also stopped another passenger from filming a video of him.
She hopes for wider recognition of the Hidden Disabilities Sunflower lanyard in Singapore, and for the symbol to be included on signage for priority seats on trains.
Ms Tiffany Tee took her son Atkins Soong, who has autism, on his first overseas trip in 10 years in May.
She said airport staff did not pressure the 14-year-old to make eye contact when checking his passport, and allowed him to play with his piece of Blu-tack as he passed through the body scanner.
Ms Tiffany Tee took her son Atkins Soong, who has autism, on his first overseas trip in 10 years in May.
PHOTO: TIFFANY TEE
Airport staff also let Atkins bring a slime toy – considered a liquid of over 100ml – on board to calm him down if needed.
A flight attendant also showed him and his father to their seats on the plane.
'We are less stressed by no staring or additional unwelcome remarks falling on us,' said Ms Tee, 49, who does administrative work.
She said improved awareness of autism has made transport staff more compassionate.
'The experience encouraged us to bring him out more often. We are less afraid to bring him out.'
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