Tens of thousands of New Zealanders have serious food allergies, and hundreds are hospitalised each year, often because hospitality staff have mistakenly served them something they’re allergic to. A new law was supposed to stop that happening – so why has so little changed?

When my husband, who is allergic to dairy products – like, call-the-ambulance-NOW allergic – saw parmesan cheese sprinkled all over his dinner, we politely asked the waiter to take it back to the kitchen.

We had, of course, already had detailed conversations, both before booking, and when ordering, to make sure it was going to be safe for us to eat at this pretty fancy hotel restaurant.

Then the plate came back from the kitchen. With the parmesan still on it. ‘The chef says it’s fine! He’s been on a course!’

An alchemy course so he can magically turn cheese into edible gold? Or was it at medical school, and he wants to practise injecting adrenaline into my husband to stop him dying from anaphylactic shock?

Possibly this chef thought that hard cheese, which might have low lactose levels, was in a different category from other cheese. But my husband isn’t lactose intolerant (where consuming the lactose present in some dairy products makes you sick), but rather allergic to the protein in cow’s milk, which is present in every single dairy product. So the lactose is irrelevant for him.

This is not something I’ve always known, either, but since meeting my husband, who has been in hospital with life-threatening anaphylaxis uncountable times since infancy, I’ve become adept at explaining the difference to front-of house staff and chefs, many of whom have very little understanding of food allergies – or, indeed, of what’s in the food they are serving.

I often have to start by explaining what dairy is, when it becomes apparent they don’t know or haven’t listened to me. It’s not eggs. Eggs are fine. It’s not gluten. Give us all the gluten you’ve got!

Things that contain dairy that I’ve seen on my husband’s supposedly dairy-free orders include pesto genovese (made with parmesan cheese), buttered toast, roti, yoghurt, cream, and mozzarella. On one memorable flight, his ‘dairy-free’ breakfast consisted of a croissant and a glass of milk.

Processed foods are a trap for young players. Salami, ham, bread, potato chips, and hummus are among the products that have surprised us by containing dairy products, so we ask staff to check the ingredients of those things, too.

Cross-contamination is a problem, as well. Frequently, a dairy-free item from a cabinet is retrieved using tongs that just picked up a cream doughnut or cheese scone. That’s enough to have us in hospital.

Around 6-10% of kids in Aotearoa have food allergies, and about half of those are unlucky enough to still have them in adulthood. That’s not an inconsiderable number of New Zealanders. Why are they still in such routine danger in eating establishments in this country?

And it is real danger. A recent study found that hospital admissions for food-induced allergic reactions are increasing sharply – by a factor of 2.5 over ten years, with the sharpest rise among Pasifika people. Of course, this doesn’t include all the people who came out in hives, started wheezing, or experienced other, non-life-threatening reactions because they’ve been mistakenly served an allergen.

Over those ten years, the study recorded 3,157 hospitalisations among adults, including 1,588 cases of anaphylactic shock – the terrifying state of having your blood pressure drop through the floor, among other symptoms, as your immune system attacks your own body. Without intervention, anaphylactic shock results in death.

This is what Jessica Hammond’s nine-year-old daughter went through on Saturday. As she recounts in this video, a sushi bar wrongly gave her daughter sushi containing nuts, which she’s highly allergic to.

People with food allergies – tens of thousands of people in Aotearoa, remember – don’t expect that every establishment will be able to cater for us. But we do expect that if we explain the situation, and the staff undertake to serve us, that they will do so with basic safety and competence.

Or we’d like that to be the reality.

The new Food Act 2014, overseen by the Ministry for Primary Industries and local councils, now requires food businesses to have written Food Control Plans, and MPI resources specifically give advice on how to keep customers safe from allergic reactions. If a customer asks about allergens, a business is required to give ingredient information. If a customer has an allergic reaction, the business has to keep a written record of what happened and what action has been taken. I’m here to tell you that these requirements are routinely ignored, as Jessica’s daughter’s experience demonstrates.

Many times, we have gone back to restaurants and cafés, met with managers, written letters, and almost never have we had any evidence that they have learned from their mistakes or changed their dangerous practices.

https://www.youtube.com/watch?v=RLD5N37waVI&feature=youtu.be

The good news is that for anyone in the hospitality who wants to keep their customers safe, there’s the fantastic video above for front-of-house staff, detailing everything they need to do to keep a customer with an allergy safe. Watching it with my husband, we were torn between applauding the great information, and despairing at how little of it is followed in real life. For every food safety practice the video outlines, we have a story of a business endangering his life by forgetting or flouting it. Dozens of stories. Hundreds.

There are some great food businesses out there, doing all this stuff right, and those are the ones we go back to, and tell other people living with allergies about.

But my impression, from the number of times this month that I’ve had to prompt serving staff to use clean utensils, is that the vast majority of people working in hospitality have not read MPI’s documents and do not understand how to keep allergic customers safe. The system is failing us.

In Aotearoa we hold food providers to a high standard of food hygiene, and we inspect their premises, qualifications and practices to be sure the public is safe from salmonella, listeria and botulism. What about being safe from anaphylaxis and other allergic reactions?

It’s partly a problem of management and leadership. The time my husband’s pasta dish came out artfully drizzled with lethal pesto, we had been ordering from a very attentive woman, who seemed to be right on board. When she took our order to the kitchen, and explained to the chef, I saw him roll his eyes at her. If the kitchen staff don’t respect the wait staff – or the customers – then the establishment is unsafe for people with allergies.

Later that week we met with the manager, who was sympathetic and apologetic, but had an air of pessimistic futility about her ability to change the behaviour of her staff. We didn’t go back.

I do understand that some food professionals feel a bit cynical about people’s dietary requirements – are they just fads? – but there’s also the matter of the contractual relationship, and the customer service ethic involved in working in hospitality.

My blood boils to remember the woman, the owner of a small café, who, when cooking for my husband, started to re-use a pan she’d just used to cook something in butter. She didn’t realise I could see her, but her colleague at the counter did, and awkwardly suggested she use a new pan. “They won’t notice. A little bit won’t kill him,” said the owner, with her back still to us. “Actually, it might,” I said.

That cook (who didn’t apologise) wasn’t just ignorant about allergies, she was also pretty casual about breaching the contract we had made. I explicitly and carefully asked for dairy-free food, and offered money for it. She accepted my money, said she would do what I asked, and was blithely content to provide contaminated food. She wasn’t living up to her end of the bargain.

Here’s what I want hospitality staff to know:

• what an allergy is
• that ‘even a little bit’ can be deadly for people who have allergies
• what words like ‘dairy’ and ‘gluten’ mean
• what the most common food allergens are (dairy, egg, soy, peanuts, tree nuts, wheat, fish and shellfish), but that people can be allergic to any food
• what the food they are serving actually contains, whether they have made it themselves or not
• how to avoid cross-contamination, like using clean implements to prepare and serve food
• the importance of listening carefully, and double-checking, when customers are describing dietary requirements
• how to make sure all staff are competent and careful in these matters.

These things are legal requirements, now, thank goodness. But they’re still not the reality in commercial kitchens around the country.

Allergy-sufferers in Aotearoa face other dangers, including the lack of subsidies for their life-saving adrenaline injector pens (they cost around $150 a pop, with a shelf life of around a year), the difficulty of keeping young children safe in schools and early childhood education centres, the inconsistent labelling of groceries (I’m looking at you, Wattie’s soups), and the expense of feeding themselves when so many everyday products can kill them. Babies with eczema from food and other allergies go through agony – and so do their helpless parents – as they encounter conflicting advice from health professionals and inconsistent access to specialist formula and medical help.

Those are problems for another day’s rant, perhaps. But today, can we just agree that allowing food providers to endanger our citizens with their ignorance of food allergies – and just plain bad customer service – is not okay?

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