Travelling when you have a life-threatening peanut allergy can add an extra layer of concern to any trip, but if you are emigrating the question 'will I be OK?' ricochets around your head just a little louder.
After the usual checks of passport, ticket, toothbrush, adrenalin and a little wish that this trip won't see you in A&E mainlining anti-histamine you can add: Will I ever eat out again? What's the healthcare like? Do they know about allergies? Will I be able to get a new Epipen?
When moving to Singapore nine months ago these were my concerns. I had never visited
the city state. I knew the population was mainly Chinese and I knew that Chinese cooking uses peanuts. However, I also knew that English was the national language which had to make life easier...
The island of Singapore is just 25 miles long and 14 miles wide and is home to an amazing fusion of races. Consequently the standard of English can vary widely. Three-quarters of the island's 4.5 million residents are Chinese, 13% are Malay, 9% are Indian and 2.4% are Eurasians and many often feel more comfortable speaking in their own language.
So the first thing I did was to get a few sentences about my allergy translated into Mandarin Chinese and Malay. I carry this note around in my wallet and get it out to show the waiters where understanding is suspect.
Despite such precautions I have had two incidents since moving to Singapore. Both reactions occurred at the same restaurant and although I cannot say for certain I believe there were issues with cross- contamination. Anyway that restaurant is now off limits.
So are all Chinese New Year goodies, which appear in January and February, as they are peppered with peanut dust.
There is a fantastic choice of food and venues in Singapore from open air hawker centres selling a vast array of food to the decadence of the Sunday brunch buffet with free flowing champagne at Singapore's top hotels. However there is no doubt that you always have to be on the look out for peanuts. The traditional Singaporean cuisine is Nonya or Peranakan and is a combination of Chinese and Malay influences. Peranakan refers to descendants of Chinese migrants who married local Malays and Nonya refers to their cuisine. Peanuts and particularly candle nuts, a waxy nut ground down to use as a thickener, are key ingredients in Nonya cookery. I spoke to two fellow nut allergy sufferers to see how they coped with day-to- day eating in Singapore.
Adrian Querzoli, from Adelaide, Australia, is 31 and a BP trader. He moved from London to Singapore eight months ago. He is allergic to cow's milk and nuts although he does not believe his allergy to be life threatening.
Adrian was also surprised at the level of English in Singapore.
'Even though English is the main language it’s harder work than I thought it would be. You are not sure if you have got your point across or if serving staff understand the consequences. A lot of waiters see it as a personal choice, they think I just don’t fancy peanuts.’
So far he has had two incidents in Singapore, both in
Indian Restaurants. 'I got a bit complacent in London but since coming here I have been caught out twice so I am a bit more careful. I order what I think will be OK and then do a taste test – I try a small amount and wait to see if an allergic reaction is triggered. However with the heat of the spices in curries my warning system gets confused.’
Adrian hesitates before going for an Indian in Singapore, and steers clear of its famed satay – barbecued meat with a peanut gravy dip – and popiah, which is a fried wrap.
'I was eating popiah and asking for no peanuts but I saw it being made one day and there is a problem with cross-contamination so I have stopped eating that,' he said.
However, Adrian doesn't believe a nut allergy should deter people from visiting Singapore. 'It's manageable. Always err on the safe side and if in doubt order something else. Be persistent if you have language difficulties,' he advised.
Lesley Renton is 43 and is head of marketing, public relations, promotions and sponsorship for Harry's, a chain of pubs in Singapore. She found out she was allergic to nuts at age 27 when her allergy came on dramatically overnight after eating the same bag of mixed nuts she had enjoyed the day before without incident.
Lesley is allergic to nuts, olives, olive oil and eggs and carries an Epipen. She manages her allergies by using business cards detailing her dietary needs printed off in the language of whichever country she is visiting. Lesley hands one to the person taking the order and insists it gets handed to the chef. She then ensures the same person who took her order serves her food.
Lesley moved from Indonesia, where satay is a staple, to Singapore five years ago. From her point of view Singapore is 'easy Asia' and so far she has had only one close call.
'I had a problem at a Sunday brunch at one of the hotels. I am usually very careful and I get a special meal cooked. But I took some chicken chili and vegetable from the buffet. I quickly spat it out as it had cashew nuts in it and I took an antihistamine.’
Lesley does not believe a nut allergy should prevent anyone from traveling to Asia, least of all Singapore. 'You can't let the tail wag the dog, you have got to live your life,' she said. 'Singapore is famed for its service. Food and beverage and staff are very knowledgeable about allergies and cross-contamination,' she added. Lesley has used her powers as marketing manager for good making Harry's able to cater for allergies.
Living in Asia with a peanut allergy is a risk and Singapore can lull you into a false sense of security with its western ways and the prevalence of English. However you can't afford to relax as it is then you get caught out. Adrian, Lesley and I believe a nut allergy should not stop you from traveling or living abroad but extra precautions are necessary to prevent you from falling foul of a fatal misunderstanding.
For more information on peanut allergy: www.anaphylaxis.org.uk
First published in 2008
For more articles on travelling with allergies and intolerances see here.
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You can also find articles on anaphylaxis here, cow's milk allergies here, egg allergy here, histamine intolerance here and articles on a wide range of other allergic and intolerance reactions to a wide range of other foods here.