What we learned about allergies in India

ghummakadz

I noticed an old thread asking for info from IM'rs with nut allergies to report on their experiences. So, that's what this thread is about! It's kinda long, excuse it please...

I'm allergic to nuts. Not just peanuts, but all tree nuts, and certain legumes like lentils. Another family member is allergic to all nightshades--potatoes, tomatoes, sweet peppers and eggplant! We've been in India now for several months, mostly in Delhi, and the small town of Rewalsar in Himachal Pradesh.

Most important, there is little or no awareness about food allergies, expecially in the remoter places. My family has this apocryphal joke that most Indian cooks don't know much about allergies, because any allergic folks are dead already. Seriously though, many Indian restaurants don't understand the seriousness of allergies, and don't pay much attention to things like cross-contamination from using the same utensils in different dishes. Vegetarians have the same problem with mixed-cuisine restaurants. You're really on your own with keeping allergic reactions down to a minimum.

Here's some of the lessons we learned about having allergies in Northern India. Maybe someone can add something about their experiences in the South...

Before you go...

• Stock up on Benadryl, Epi-pens, inhalers, and other meds. Pack more than you think you could ever use.
• Read up on Indian cuisine, so you're familiar with the main ingredients in common dishes like curries, biryani, tikki, and so on. The Lonely Planet phrasebook has a whole subsection on food that includes a food glossary. Be sure to study up on regional specialties as well.
• Find out the Hindi/Bengal/Tamil names for the stuff you're allergic to. This will come in handy for reading package labels and recipes--many times ingredients lists will be half English, half Hindi.
• A company called Select Wisely sells laminated allergy translation cards for use while traveling. These cards include pictures of the foods with a big red circle on them, as well as questions as to whether stuff has the allergen in it. You can custom order language and ingredient combinations. My card set includes Hindi and Tibetan translations for questions like "Does this food contain nuts or nut oil?" and statements like "I need a doctor".
• You can get carriers for Epi-pens that are rugged, include slots for other meds, and are easily labeled with your name and medical info.

Once you're there...

• Make sure any folks traveling with you know how to get to your meds if you can't. Also make sure they know about Epi-pens and how to use them. You can get 'trainer' pens so you can show folks what to do.
• If you'll be using a cell phone in India, always make a contact entry labelled 'ICE'. ICE stands for "In Case of Emergency". This contact should list the name and phone number of the person to call if something happens to you. If there's a notes or memo field, you can include info doctors need to know like "Asthmatic" or "Allergic to Penicillin". It's becoming a standard practice in many countries for paramedics and ER doctors to check for this entry on patient cell phones.
• In restaurants you cannot be too emphatic about your allergies. Stress that screwing up means a trip to hospital and that you could possibly die from a mistake. Just saying certain foods make you ill might not register, because hey, it's India--tourists get sick all the time. Otherwise waiters and cooks tend to tell you what you want to hear.
• In Northern India, what we've found is that nuts are an expensive ingredient to use for everyday cooking, so many foods with nuts as an ingredient tend to 'advertise' by having a lot of nuts garnished on top.
• We found that cookies and ice creams that were "Butterscotch" flavor tend to include pecans and cashews.
• Familiarize yourself with the local versions of snacks and drinks--know what you can eat, and what you can't. For example, if you buy "Cheetos" in Rewalsar you may end up with a spicy tomato variation that bears no resemblance to what's sold in the States. Sometimes a wallah selling "ice cream" is really selling "kulfi", a frozen treat made with almond milk.
• For long bus or train trips, pack a lunch if you don't think you'll be able to handle the dhabas at rest stops. If you forget, many of the big dhabas along the roadway tend to have several stalls selling different things, usually including one that sells packaged snacks and drinks.
• Street food is tricky, but not impossible. I tend to stay away from mixed treats like bhel puri, because although you can order the stuff to be made without nuts, the possibility for cross contamination is too great. Single-ingredient snacks like roasted corn, fresh fruit juice or fried potatoes work better.
• If you're staying for a long time, you can work things out with hotel staff or a dhaba-wallah to get your needs met. Make friends with a dhaba cook. He can custom-cook something up for you if you buy the ingredients for him, pay a small 'pot fee' and give him plenty of notice.
• Read the labels on cosmetics, too. I discovered that almond milk (also labelled as 'milk badam' or 'doodh badam') is often a major ingredient in creams and soaps.

Nick-H

First rate post! I'll make this thread sticky.

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machadinha

Excellent info! I'm impressed that instead of muttering you just went on and found out how to do it! Great going! Should be helpful to many.

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ghummakadz

Hey, cool--this is my first "sticky" post anywhere!

My motivation for writing all this is to encourage other allergic folks to share their experiences. When I started prepping for my trip, I surfed allergy and medical web sites to check on travel info. While there's lots of info for North America, South America, and Europe, stuff for Asia and Southeast Asia is nearly non-existent. They basically say "India and China are risky," and leave it at that.

While the nut allergy may be a hassle, the nightshades allergy has occasionally had us stumped completely. During the summer, tomatoes, peppers and eggplant are in full season, so that's what cooks are using. For many Indian recipes, once you remove the tomatoes, potatoes, eggplant, and peppers, you're pretty much left with some ghee, onions and spices on the plate. I'm hoping to get in touch with other travelers with allergies of this magnitude, for support and suggestions.

machadinha

I can only imagine. Should be a real pain in the you-know-where I imagine. All the more power to you!

<Walks off feeling slightly embarrassed at never having any eating problems whatsoever>

Nick-H

I wouldn't have a clue what to cook for you!

I think India must be a nightmare for the allergic....

ghummakadz

For us most clues as to what to cook come from the produce-wallah. In Rewalsar, because the food choices are restricted to whatever local farmers are growing, what we do is check out what's new at the wallahs' shortly after they get their main delivery for the week. If something looks really good, we buy a bunch of it and bring it back to the hotel for the cook to cook up. Sometimes it's easier to ask what the kitchen's got than to order off a menu--sometimes a tasty variation can come out of whatever's in stock...Basic indian recipes like dum or masala are pretty adaptable.

mommywizard

I'm the person with the nightshade allergy. It certainly IS an adventure traveling anywhere when you have sensitivities to very common foods. Fortunately, unlike the person with the nut allergies, mine are not fatal if I do happen to ingest an allergen. Although, must say, sometimes it makes me *wish* I were dead LOL! Fortunately, one of our traveling party speaks Hindi quite fluently and can ask easily enough about suspect foods. I've also learned to say emphatically that I don't eat certain things - it's an interesting introduction to new languages, that's for sure! In more traditional areas, I can simply say "Ayurvedic" and they get it as, in the treatment of certain illnesses in the Ayurvedic system (arthritis in particular) tomatoes, potatoes, eggplant and sweet peppers are eliminated from the diet. Enough people understand THAT that usually one can at least claim reasonable health problems.

What is trickiest is when the original poster and I try to go to eat somewhere *together*. It becomes a Monty Python sketch with potential dire consequences. Particularly in those situations where a lot of things are made with coconut or coconut milk (which she can't eat) or garnished with pistachios or almonds (ditto) most of what I CAN consume is lethal to her.

Anyway, up in the north where we're living, I eat rather a lot of fried noodles of one sort or another, and a lot of roti, rice and curd with fruit. I'm nervous about the winter...

machadinha

Haha at least you're keeping your sense of humor I see!

I don't know, what struck me about this thread and what makes a lot more sense to me than the average guidebook, is they'll often be handy to give you the words to "I'm a vegetarian" -- never mentioning that in most places that will get you treated like a leper with some mysterious extra disease. (And never mentioning having studiously mastered the art of saying I'm a vegetarian but I'd like some squid however. I know it's technically wrong, but try learning beef-no pork-yes fish-gladly tofu-always on a 3-week trip). Whereas in most places if you simply ask what's on the menu (long list follows that you can't understand anyway) and you smile and politely ask OK can I have any of that without fish and meat, you'll usually be OK (you may have to scrape out some fishy bits but oh well).

I know it's a bad comparison to an allergic situation which would be far more serious and harder to explain, but you sometimes wonder. About the guidebooks I mean.

Anyway and again, kudos to you. Happy (& healthy) trails!

ghummakadz

Humor is really the best thing to hang onto in these situations, because often the alternative is something called "justifiable homicide."

I still remember a meal at a very expensive restaurant in Los Angeles. Our waiter marched proudly up to our table to report that he'd checked with the chef, and the dessert I wanted to order contained no nuts at all. Just marzipan.

Without screaming, I said, "Thank you. Please bring me a scoop of chocolate ice cream in a glass bowl."

machadinha

ghummakadz

Since it's Diwali, I thought I'd add a holiday update to this thread. The firecrackers and "Hydro-bombs" are still going off as I write this.

The holidays (in just about any country, not just India) tend to be the most dangerous time of year for folks with allergies. There's a lot of food that's homemade, the ingredients won't be listed anywhere, and there are any number of social situations where you just get handed stuff to eat, without knowing what's in it. I don't know how many times I've had to be firm with a host or hostess, because a coy "just try it, you'll like it" is no preventative for anaphylactic shock.

So, Diwali. In Rewalsar, Himachal Pradesh, the treats are turned out by the hundreds by local sweet shops, and stacked in inviting piles in front of the stalls. You can buy a box of just one kind of treat or an assortment, by weight (1/2 kilo, 1 kilo, and so on). The sweets are not wrapped or labelled, and the boxes are generic packaging with no nutritional information. This is one of those situations where it's good to familiarize yourself with the local cuisine beforehand. Too, the sweets are just placed in the box all together, so cross-contamination is highly likely.

Wandering around town today, folks tended to have a box of sweets available for offering to friends who stopped in. There were also people going by offering bites of this home-made treat or that. I had one lady plop a spoonful of some kind of rice pudding in my hand today. Looked delicious but unfortunately was studded with walnuts. I explained in my winning combination of good English and horrible Hindi that I couldn't really eat the stuff, but was happy to eat the 'spirit" of the food. I then mimed putting the food to my mouth and eating, without actually touching the rice-and-walnut mixture, and that seemed to satisfy everybody.

Anyone else have holiday adventures with their allergies? If you did, I'm really interested in hearing from you.

Nick-H

You can be fairly sure that, apart from sugar, milk products and nuts are fairly high on the lists of possible ingredients of those sweets.

I have a sweet tongue. I can eat chocolate all day: I love the look of those sweets. As soon as I put one in my mouth I know I couldn't eat another for three days.

You're much healthier (even apart from the allergies) staying away from them!

ghummakadz

From that perspective, even the treats I can eat are pretty dangerous. Stuff like jelebis (deep-fried sugar syrup) and gulab jamun (deep-fried dough balls soaked in sugar syrup) are yummy, but they're so sugar-soaked I only have them 2-3 times a year....

Among the other treats I can do are a fudge made from cooked-down milk, and some new treat I tried tonight, kind of a splintery-textured golden sweet that melted on the tongue. Didn't get the name of it, though....

Nick-H

I know just what you mean from that description!!! Don't know the name, though.