Wednesday, September 14, 2005

The Next Round

I have finished one round of edits. Now it is time for the next one. The paper edits. I read through the mss, with pen in one hand and ruler in the other, making notes for changes as I go on. In this way,I hope to catch many of my mistakes and make for a more exciting read.
After I finish that, I have to go through the mss at random, using a different colour of pen, making sure that there is tension on each page.
After that, the changes are put on the computer and I will be done. Cue cheers.

Tonight I have a meeting. One of the things that will be discussed on the school's response to a child with food allergies. Since Friday, I have done a lot of thinking about it. On Friday, the head of the school sent home a notice requesting six discrete types of food not be sent to school -- Tracker bars, roast peanuts, Snickers, Mars bars and peanut butter. This is to protect a child who is severely allergic to peanuts. I saw red. If he is going to ban foodstuffs to protect this child, he needs to ban ALL nuts and nut products, plus any products made with peanut oil. Or indeed any product that might have come into contact with peanuts. This includes all cereal bars, bags of mixed nuts, trail mixes, biscuits with nuts, bakery goods, all nut and chocolate spreads, anything made with nuts and most chocolate bars. A large number of processed foods also contain peanuts. In order to know you have to read lists of ingredients. These lists change. Sometimes, mistakes happen. Recently oreo cookies were filled with a peanut flavouring and labeled as being original. A mistake on the production line but one which cost someone a life.
Banning a few items ultimately does not help that child. It simply means that a false sense of security develops.
Given the population of the school, such a ban is unworkable. There are 385 children plus staff. All of whom have to remember to be vigilant -- every day. Also there is a question of what happens if another child with a food allergy to milk or egg enters school. How do we treat them? It is simply impossible to ban everything.
By far the best way, is to insist on a cross-contamination prevention program. It was proved in a John Hopkins research paper that eating peanuts under normal cafeteria conditions does NOT put allergens into the air. But sometimes smears and traces of food are left on tables by messy eaters and a child can accidentally get foodstuffs on their hands. The best way to clean such things up is through ordinary housefold cleaners. Also all hands should be washed with bars of soap. Antibacterial rinses do not remove all traces.
At the moment, there is no system for washing tables, nor is there soap on a regular basis in the students' toilets. This is an accident waiting to happen, despite the head's pleas for people not bring in a few food stuffs.
Additionally ALL staff need to be trained in the use of epi-pen and the child needs to be encouraged to responsibility for his/her own allergy (ie eat only safe foods, eat in a clean place and not trade food).
All well and good but why was I so annoyed? Why did I feel so threatened? Simple answer -- I used peanut butter. Peanut butter for me is an important reminder that my children are also American children as well as British. When I first moved over here, peanut butter was difficult to obtain in Northumberland. It is not simply a snack, but a food I use extensively in preparing my children's school lunches. To be singled out when other food stuffs were not, got me angry. It got me even angrier when I discovered that other measures of basic hygiene were not being taken. It made me feel that my children were being singled out as they are some of the few that take peanut butter to school. Why peanut butter and not nutella? It bothered me that the head who is a friend dismissed my protest with the words -- it is not a cultural issue, it is only a snack and he is having to give up tracker bars. Actually peanuts and peanut butter is used extensively in African,West Indian, Asian cooking in addition to American cooking. In Middle Eastern cooking, pine nuts are often used. Pine nuts and sesame are related to peanuts and people with peanut allergies need to actively avoid these. How can he understand the significance to me when it has never come up in conversation before?
And how can he claim to be trying to save a child's life when he has not done the basic medical research and is not employing best practice?
Every few years or so, I encounter this. It is not that people mean to be unkind. It is simply that people failed appreciate that someone's culture and food might be different. Multi-cultural is not dismissing other people's concerns with a few glib or emotive words.
My heart goes out to the child and its parents, but the school has to make this child safe rather than paying lip service. The only way the child can be made safe is through proper hygiene and avoidance procedure by that child. That child has to take responsibility for his/her own allergy. IMHO. Ultimately their life depends on it.

I am interested in food allergies because I am allergic to ketchup. If I consume even a little bit, I break out in a rash. Luckily I am not contact allergic and so can allow my children to enjoy ketchup on their chips and hamburgers and other products containing ketchup. But I have to be careful. Also as a teenager, I worked in A GirlScout camp kitchen where we had several campers with allergies. This is back in the days when allergy meant an actaul reaction rather than an intolerance.Back then we had to be careful about how we prepared the food, and the camp nurse gave us specfic instructions. We prepared most foods from scratch because of the problems. And because processed was too expensive. Peanuts due to Jimmy Carter having been president were in plentiful supply from the US government. Jimmy Carter was a peanut farmer and the peanut lobby was strong or so I was told.

FWIW I also think the British government's plan to use more chill-cooked foods in schools will ead to more food allergy incidents as no one will be able to vouch for exactly how food was prepared and IF there is any cross-contamination during preparation. It surprises that no one has objected on those grounds.


Donna Alward said...

My daughter's best friend is severely allergic to nuts. Notes have gone nuts of any sort in food. It still happens and the parents of the student bringing the nuts get a call. At lunch all students wash their hands and all tables are washed with disinfectant after. THe problem with this particular girl is that even the smell can trigger a reaction. THe other day she was eating a fruit snack and her tongue started to swell. Another child in the room brought nuts.

It is also hard to make a 5 yr old responsible for that big of an issue. She is only in Kindergarten.

Incidentally notes have also gone home about buying "nut free" labeled products and also about not bringing bakery goods such as cupcakes to class celebrations. I know they had an ice cream thing they other day and bought Chapman's brand because it is from a nut free facility.

This is such a touchy issue and I hate not being able to send my kids to school with the odd PB&J sandwich or put nuts in my baking, but if it were my child I'd hope someone would do that for me.

Donna Alward said...

Michelle I should also comment that we have no microwaves for hot lunches at the school so few "entrees" are eaten at lunch. Also the cultural thing is a big issue with us since our school is about 70% English second language. HUGE middle eastern population.

Michelle Styles said...

I suspect the fruit snack the child had been eating was contaminated with nuts or nut oil. It is possible the table was not cleaned properly (ie only soap and water were used). But contamination of the food stuff happened, rather the smell of the nut causing the severe allergic reaction. The recent medical research at John Hopkins published May 2004 showed that NO detectable allergens were put in the air through consumption of peanuts, or peanut butter. See the FAAN
I would also suggest the affected child's parents investigate Xolair -- it is current being investigated in phase II for the possible use with severe peanut allergies. It is already licensed for use with asthma.

Anonymous said...

Michelle - I love your zest for research. You might want to pass along an easy to read and negotiate website to your school's head

I'm so thankful that my anaphylactic reacation to dairy is moderate (or at least it has been to date. I've been warned that it can get worse so to not treat it casually. Thankfully I do learn from pain!!)

By the way, what age is the kid with the allergy at your kids' school. I agree with Donna - young children are not mature enough to manage a life threatening situation on their own.

When my son was in his school for kids 18 months to 3 and one little girl was deathly allergic, a ton of stuff was banned. You know how kids are at that age - everything is in their mouths.

Good luck with this.

Lori :)

Michelle Styles said...

Lori --
We are talking middle school aged children here 9-13).
Many of the children attending are purchasing snacks/lunches on the way to school. Some are from disadvantaged homes.
It is a very different kettle of fish from preschool, or even early primary. But at this point, the child in question knows how to read and should know what or what not to eat.
I do so agree the FAAN website is great. It is their school policy that I want my school to adopt.