Even though the children are not physically sick, they are so desperate to avoid school that the symptoms of these ailments appear on Mondays.

The spotlight was thrown on Singapore's competitive education system following recent suicides of two girls, one aged 10 and one 12-year-old, because they did not perform well in examinations.

Surveys of nine to 12 year-olds in the city-state have found one in three say life is not worth living because of the fear of academic failure.

Five percent of all pupils in Singapore are now said to suffer from "school refusal," and the health ministry has brought in an Australian expert to study how Singapore's school system impacts on the health of children.

Doctor Jill Sewell, a child health specialist at the Royal Children's Hospital in Melbourne will spend a week visiting hospitals and talking to children before making recommendations to the ministry.

"These (school refusal) pains can be very real. But underlying these physical symptoms is deep anxiety," Sewell said.

She told the Straits Times that paediatricians in Singapore have identified stress and competition as the real problems among school children.

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