FEMA & Food Allergies

In all my years of employment and volunteer work with government agencies, I don’t know that I’ve ever heard the words “food allergies” mentioned in disaster planning. Reality is, if there is a disaster and people with special dietary considerations need food, the government may not be able to help.

I recently contacted FEMA about this. Here is part of my communication to them:

My concerns have to do with people with celiac disease and other severe food allergies. A standard cache of emergency food that most people consume without hesitation could harm or even kill us. If we don’t have access to food that we’ve stockpiled—if we’ve even done that—we could starve while everyone else is eating emergency rations.

There are many people like myself with multiple food allergies. A true food allergy is an autoimmune response to a food that in some cases can be life-threatening. People with this condition generally have to cook for themselves with carefully checked ingredients and can’t eat at restaurants.

For some of us, there is no such thing as a canned, boxed, or microwavable meal because we have to be gluten-free, egg-free, dairy-free, etc. Many foods that claim to be allergen-free are manufactured on shared equipment with allergens. We usually have to buy a lot of our groceries from specialty stores because regular grocery stores don’t carry suitable products.

As a CERT and longtime public sector employee, many times I’ve thought, “how are we going to feed people with allergies in a disaster?” That includes those with blood sugar issues. It’s a very sobering thought when you can’t eat what everyone else can.

My concern was taken seriously and I was connected with a Disabilities Integration Specialist. Food allergies can be considered a disability because for some people they are life-limiting.

I was informed that the term disability is being phased out and the new terminology is “functional needs and support services.” FEMA has just published a “Guidance on Planning for Integration of Functional Needs Support Services in General Population Shelters.”

As the specialist I spoke with told me, page 28 of this publication discusses providing shelter services to people with special diets. This is the document: http://www.fema.gov/pdf/about/odic/fnss_guidance.pdf.

While it is refreshing to see this subject becoming a part of emergency management training, which is an improvement, there is still an unsettling aspect to this. It is unlikely that anyone but a food allergic person at a shelter is a hundred percent sure of what they can eat and how to prepare their food.

Cross-contamination is a huge issue when an allergic person’s food is being prepared in the same facilities or with the same equipment. There are hundreds of vaguely worded ingredients in common foods that can cause severe reactions in allergic people.

A good-hearted person fixing food may have no idea that caramel coloring, maltodextrin, or modified food starch could hurt someone. Using the same knife to cut bread and lettuce can have dire consequences. Washing dishes with the same sponge can bring on anaphylactic or bowel hell.

As I’ve mentioned before, it is not the quantity of an allergen that sets off a reaction, it is whether the allergen is present at all. Trace amounts can be life-threatening to some people, and many people can become noticeably ill from very small amounts of an allergen. Some people become sick in a way that would tie up a shelter’s bathroom facilities.

Here is the text from the FEMA guidelines. FEMA’s stance is that local communities should be in touch with the special needs people among them to provide them with the best response. I was told that they can’t mandate rules for allergic people from the federal level.

Since FEMA is the agency providing most such training to government agencies, though, I’m going to stay on this issue and support those who are generating awareness of it. FEMA appears to have the most power to bring this to the public’s attention as an emergency response issue.

The FEMA employee I spoke with has been very helpful and is willing to pursue this issue as well. It’s great to get this kind of response and I look forward to reporting on progress in this area in the future.

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Here is some of the text from the document mentioned above:

4.2.1. Dietary Plans should include provisions to ensure meals and snacks are provided to all shelter residents, including children and adults with specific dietary needs and restrictions (e.g., people with diabetes or severe allergies to common food ingredients and baby formulas). Plans should also include a process for responding quickly to unanticipated, but legitimate, dietary needs and restrictions that are identified when a resident is admitted to the shelter. It is critical that information about any special dietary needs or restrictions be obtained, documented, and communicated to the entity responsible for meal and snack preparation immediately. Food preparation may need to be adjusted (e.g., food may need to be pureed) to meet resident needs.

In order to meet all the needs of all people in the shelter, menus that are low sodium, low fat and low sugar should be developed for general population shelters and should include specific instructions regarding what to purchase in order to prepare each meal. Organizations contracting to prepare meals and snacks should also anticipate and be prepared to provide meals for persons with other dietary restrictions (e.g., vegetarian, gluten-free meals, kosher meals, meals for people who are allergic to peanut oil and by-products).

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What is food to one man may be fierce poison to others. -Lucretius

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