Will Israel Wake Up to Food Allergies?

((Originally posted on The Jerusalem Post blogs on July 22, 2011. I ask you to please pass on to your Israeli friends.))

Yesterday, while swimming at the pool with my kids, my friend Daniella called me over to ask me if I heard about the girl who died from an allergic reaction in Tel Aviv.
 
Immediately my heart leapt into my throat.
 
No, I said. What happened?
 
Daniella told me what she understood from the story and the blanks were filled in later when I got home and googled “Girl dies from nut allergy in Israel.”
 
In my mind, the girl was young, like my son, but in reality she was a young adult; independent and out for a night with her young friends. Presumably, she did everything right. She asked the waiter if there were nuts in the Belgian waffle dessert she ordered, including Nutella, a popular hazelnut-based chocolate spread. According to testimonies from her friends, the waiter told her there was not.
 
And so she ate it.
 
It’s a choice each food allergic individual and the individuals who parent kids with food allergies have to make each and every day.
 
Do we live in a bubble or do we venture out into a dangerous world and do our best to keep ourselves safe?
 
I don’t know if the woman had an epi-pen on her or if it was used. The details are missing from the story. I do know that we insist that my 8 ½ year old son carried a green canvas Steve’s backpack with him wherever he goes: to school, to camp, to a friend’s house, to the migrash, to restaurants, to sleepovers at his Saba and Savta’s. Some people have indicated they think it’s excessive. I worry it might someday be a lifesaver for him.

Inside the small pack is his “epi pen pack” a plastic bag with two pens of epinephrine, Benadryl and an instructions note that indicates his allergens (peanuts, walnuts, pecans, almonds, and hazelnuts) and potential reactions to recognize.
 
Despite this visible reminder and verbal requests to keep him safe by keeping him away from nuts, I’m amazed at how often people forget. Or perhaps they don’t forget, but they don’t think that his allergy (or any food allergies) are truly life threatening.
 
I don’t know why, exactly, but Israelis, on the whole, do not take his food allergies seriously. This is in stark contrast to the States, where more and more parents are toting epi-pens as accessories.
 
In the weeks leading up to our aliyah, I anxiously researched schools and communities, but not so much to learn about education or teaching styles, rentals or housing markets. No, the most important information I needed to find had to do with food. And I was dismayed to find out that food allergy awareness, while growing, is still something that is not only severely lacking in Israel, but blatantly off the radar of important government officials and in schools.
 
I was shocked to find there was no school nurse on site to administer an epi-pen should my son need it. (We had to train him how to administer it himself.) I was shocked to find out that unlike in the States where there is some regulation on labeling, in Israel there was none; instead manufacturers slap everything with a “May contain traces of nuts, sesame, or gluten” label in order to avoid liability issues, leaving our food allergic children with no true concept of what they can and cannot eat from the packaged food selection.

Worse yet for us, my two kids with allergies react to nuts and sesame, I daresay two of Israel’s “national” foods.
 
I was not surprised to find out that parents here still served peanut butter-smothered Bamba at every childhood function, from birthdays to Yom Hatzmaut. But I was devastated to learn that most bread products in Israel, including pita, pizza and challah, are covered in sesame; and most ice cream and candy are swimming in nuts, from pesek-zman to kit kats.
 
Nothing terrifies me in this country more than the risk my children face when they eat outside their home.
 
Not terrorism, not kassam rockets, not enemy infiltrations into my small Northern community.
 
No, nuts and sesame scare me a whole lot more.
 
We’re doing what we can to try to eliminate our fear and to continue to empower our children to speak out about their food allergies. To make sure they ask adults to help them when we’re not around. To engage their friends in protecting them by keeping away from them their food allergens. Some of it’s working. I saw it yesterday at the pool when my son’s 5-year-old friend told him to stay away from his sesame covered sandwich.
 
But what can we do when we continue to find ourselves in situations where Israelis pooh-pooh food allergies; even when our child speaks up and requests assistance? Our son has been told by teachers and camp counselors that a food product does not contain nuts without reading the label. When he insists they read the label, they insist back that it’s “fine for him.” This is unconscionable.
 
This is contrary to what we have spent 6 years teaching our son and, while these laid back adults don’t mean my son harm, they do likely think, “Ze lo big deal.” But, I assure you, it is a big deal.
 
I’m sorry to say it, but somewhere in that café in Tel Aviv, someone thought “ze lo big deal” and a woman died. Or someone wasn’t thinking at all.
 
If we, as a country, can take so seriously the issues of kashrut labeling on our foods, we can and should take life threatening allergies just as seriously, if not more.
 
I’m seeing more awareness of Celiac disease in Israel and noticing more gluten free foods popping up even in the mainstream markets. This is great. But it’s just a baby step. In North America, there are eight common food allergens: fish, shellfish, peanuts, tree nuts, dairy, wheat, eggs, soy, with sesame and corn following close behind. And while there are studies that Israeli children seem to be less susceptible to peanut allergies than their Jewish American counterparts, considering the influx of their Jewish American counterparts as new olim to Israel, I suggest that Israel wakes up and starts treating this as a serious issue.
 
What do I mean by that?

1. Start by regulating labeling in the food industry. Require strict guidelines on food labeling and differentiate between CONTAINS and is PREPARED ON EQUIPMENT WITH. The government should monitor this labeling.

2. Hold restaurants accountable for what they serve their customers. Educate restaurant owners about the life threatening nature of food allergies. Some restaurant chains in the US have started preparing and offering food allergy versions of their menus so that guests can know which foods contain what.

3. Be closely in touch with FAAN (Food Allergy and Anaphylaxis Network), a US non-profit that has already made great strides in both creating awareness and supporting parents of food allergic children by creating local and regional support groups.

4. Educate ganim and school staff on the seriousness of food allergies. Suggest they incorporate food allergy awareness into their “diversity” and “good citizenship” programs. Bullying and teasing of food allergic kids is on the rise. 
Right now, there is no magical cure for food allergies. And even worse, the numbers of food allergic children are on the rise. (That’s a blog post in and of itself; if you want to get started, check out AllergyKids.com or read my friend Robyn O’Brien’s book The Unhealthy Truth.)
 
As Naama Katzir from the food allergy advice and counseling association says in the YNet story on the tragic death this week, “The Health Ministry has sadly been dragging its feet for over three years and is tarrying over launching regulations for the marking of food products. Over the last few years there have been a vast number of harsh allergic reactions, mainly with children. Sadly both cases ended like this tragic case – in death.”
 
Does Israel need another tragic death to wake up to a growing public health concern?
 
This very frightened mother of two Israeli food allergic children hopes and prays the answer is no.