Reducing resistance to bacteria in healthcare
Doctor Marina has been in the food hygiene business for the last thirty years. She prides herself in working with all types of businesses in the food industry – and helping them create safer, more hygienic work environments. We were lucky enough to get an interview with this remarkable woman. Take part in Reducing resistance to bacteria in healthcare.
When did you start working in the field?
This is a great story. Officially, I started working as a food regulation consultant in 1996. I originally studied Medicine and became a doctor in the USSR. In 1991, when I came to Israel, it was difficult to receive a license and find work as a doctor. Thankfully, I saw an ad in the newspaper. Can you believe it? This was, of course, before the internet. That little ad changed my life. It said that a new company based in Jerusalem was bringing this innovative idea of food hygiene and food safety consultants to Israel, and that they were looking for doctors! I scheduled a meeting with them, and it really did change my destiny.
Dr. R. Katain, may he rest in peace, conducted the interview, he was the founder of the company, and he really was the first to introduce the idea of private food safety consultants here. He wanted doctors specifically, not only thanks to our expertise and understanding of how germs and transmittable diseases work but also because there were a lot of us coming to Israel at that time without being able to find work here. He really was godsent.
At first, they wanted me to start working in Eilat, which is really far away in southern Israel. I was a single mother of two young girls – I explained how I couldn’t possibly uproot them so far, and regretfully turned the job down. They told me, if I waited, maybe they could find work for me. It took a few months, I called every single week to check if maybe they had worked for me now. One time, one of their regular employees had taken a month off to have surgery done – and that was my chance. That was the start of my career. After substituting for a month, Dr. Katain said he liked my work and wanted me to stay for good.
The initial pay was horrible, I was getting paid in peanuts! But I could see how important this field was, how it would grow in the upcoming years, and how much I could learn from working in it. It really felt like I could see the future in that sense. I worked with Dr. Katain for a few years, and thanks to my basic knowledge and work experience as a doctor combined with his teachings and true professional communication I was able to learn and develop rapidly in my field. It’s really thanks to this that I was able to open my own consulting business. It was just an incredible learning experience.
I’m a perfectionist, I had to know that things were perfect before really starting my own business. On top of this, there was the fact that I grew up Jewish in a foreign country. There was always a lot of discrimination against Jews in the USSR. I always felt like I had to have more academic achievements just to be considered equal, that I had to make up for being Jewish somehow. That’s probably why I doubted myself so much at first, and struggled with deciding to work in my own business full-time.
I knew I was ready to do it on my own when one of the chefs I’d previously worked with called me up, saying he wanted my guidance when he opened his new restaurant. He called me, not my company. That’s when I knew I was ready to open my own company full-time.
That’s an incredible story.
It really is. Within a month the phone calls started coming in, and the business started blooming.
What kind of businesses do you work with?
Anywhere that prepares and serves food. Restaurants – big or small, coffee houses, hotels, food factories – really all types of businesses in the food industry.
As well as providing inspections and microbial tests, I also have lectures that teach employees about food hygiene, I guide businesses through the process of getting their food safety certification, and have recently opened a class teaching how to become a sanitation trustee – a job that every food business needs. My course is approved by the Israeli health ministry, and I am just about to open my fourth cycle.
What is the biggest problem you see when helping businesses out there?
I think it all comes down to a lack of knowledge. A lot of the time, the business owners themselves don’t follow the required hygienic standard. Often business owners in the food industry lack the professional tools needed to create a hygienic work environment – so of course, their employees won’t be hygienic either.
I think that the certifications needed don’t encompass enough information right from the get-go. I think every starting business needs a sanitation trustee. The class is 25 hours and it’s just the basics of food sanitation, and it is so vital for businesses, especially when starting out. When you start out you have no professional knowledge, but you still create habits that you follow throughout your entire career. More can be done to ensure that good habits are instilled earlier on.
Sadly, the norm that is created in many businesses is very lax around hygiene. Saying, “should be fine…” without really looking into it, or “let’s just make it look hygienic so that we pass the exam…” are both sad truths I’ve heard. That’s not how to go about things, certainly not when the wellness of your staff and customers are on the line.
Reducing resistance to bacteria in healthcare
Why does one person get sick from food while another one doesn’t?
This is a vast subject. First of all, you have a microbe, a fungus, or a toxin. Fungi, like some microbes, can actually release toxins into the food. These are the leading causes of illnesses from food. These germs can come from humans or from animals, which is why we have to be so careful when handling food.
People have different bodies and react differently to things. For example, someone who has a weaker immune system is more likely to develop an illness after eating something that contains germs. A person with chronic illnesses has a higher chance of having a weaker immune system, and so they would also have stronger reactions when it came to food-borne illnesses.
Age plays a massive role here as well, as elderly folks usually have their fair share of chronic illnesses, and day-old babies haven’t had the time to develop their immune systems yet. Babies are also quite prone to illnesses, as the only immune response they have is what they got from the mother during pregnancy.
Pregnant women are also immune-compromised because their immune system reacts differently during the pregnancy. Tourists that have yet grown used to our food or the local germs can also react very swiftly to food-borne pathogens.
You’ve heard of Salmonella, right? A person with a strong immune system, for example, a sturdy 20-year-old soldier, will likely not react to salmonella. An elderly person would, however, likely develop an illness.
Two people can go to the very same restaurant and have the same food, and one of them would end up ill and the other won’t.
How do food-borne illnesses get into our food to begin with?
There are several ways. First of all, the produce itself could be contaminated before it even set foot inside your restaurant or factory. The work surfaces could also be unclean – there is a very specific technique to clean them, so some shops may be exerting a lot of effort to keep them clean, but they would still be unhygienic. The food could become infected from the surfaces or the tools used to make it like the bowls and silverware etc.
Hands are probably the most important thing. Unclean hands pass illnesses to both the food, the surfaces, and the tools, that’s a fact. It’s a chain of infection inside the kitchen.
Have you heard of the phrase “cross-contamination” when it comes to preparing food? Something came in infected, and that infects other clean things. That’s why you need complete separation between surfaces, tools, sections, and departments.
Why do people not wash their hands right?
It all really comes down to habits. People aren’t used to washing hands correctly in their everyday life. It’s just not part of the culture, or norm if you will. You know, I give lectures about food sanitation at a famous culinary college. I explained about personal hygiene and hand hygiene. Almost everyone in my class didn’t know how to wash their hands properly – and worse, how to dry them! For example, it’s customary to have one towel for drying hands for the entire family.
Workplaces don’t make sure their employees know how to wash their hands. They don’t teach them. You’d think, okay, they didn’t learn how to do it so far, but coming into this line of work someone will teach them. Wrong!
Hardly anyone takes the time to teach new employees about the hows and the why’s of hand hygiene. You have to constantly teach, your employees are constantly growing and learning. Give them that opportunity. Guidance is the best way to go about this.
What do business owners fear when it comes to hand hygiene? What’s the worst-case scenario?
If someone went to the bathroom and didn’t wash their hands, and then touched raw food materials – that’s trouble right there. Especially if we’re talking salads, veggies, fruit, things that don’t end up being boiled to a temperature that kills a lot of the average germs. Some germs need a higher temperature than usual for them to die off, and cooking doesn’t always do that too. That is the worst-case scenario.
We understand very well that we need to wash our hands after going to the bathroom because it feels very visible and yucky, but people don’t understand we have to wash our hands after smoking a cigarette for example! You touch your mouth, you touch the germs on your face and from the saliva, of course you would have to wash your hands before preparing food again. But most often, people don’t wash their hands after smoke breaks. I asked the cooks at the college I work at why they think they should wash their hands, and they hypothesized that it’s because of the smell of the cigarettes! They didn’t realize how germs could pass to their hands so easily – all just because of a smoke break.
Business owners in the food industry need to understand themselves first of all. If they think it’s fine – that’s half the problem. When you accept a new employee, you need to go through the required hygiene procedures with them, and not just assume that they know things.
Do we hear about cases where things go wrong? Or does it get silenced?
Well, you know, it depends. Today, with the internet and social media, I can let half the world know anything I want by pressing a button. Someone who suffered from food poisoning after eating out will, more often than not, write a scathing review online. That is every owner’s worst nightmare. It’s hard to regain a good reputation once it’s lost.
What happens when somebody falls ill from eating out?
Someone who feels bad after eating out will most likely call to complain. They will be answered by whoever operates the phone in the business, whether we’re talking about a hostess, a secretary, the shift manager, etc. In these instances, there is a series of questions that you must ask the customer.
Telling someone, “I’m a burger joint and I’ve sold burgers all day and everyone else is fine, you’re the only one complaining,” is a very bad answer. It doesn’t mean that your burgers are germ-free! It just means that the product you had that day wasn’t spoiled, at the very least. If somebody with a weaker immune system got sick from your food, it means that the germs were there, to begin with.
You need to start an investigation. It starts with the questions you ask the complaining customers. Some of these questions have to do with the time the illness started, because different germs have different incubation periods. Some toxins can affect you as soon as half an hour from eating! Others take much, much longer. The person answering the phone needs to be aware of the different possibilities and slowly rule them out. I teach exactly what questions to ask on my course.
If somebody was sent to the hospital, that’s a different matter, but this is how it usually goes with the lighter questions.
So tell me a little bit about a place you worked with that managed to turn things around. I think sometimes, especially in the food industry, people tend to focus on all the bad things that could happen. But that’s not true – people can succeed in creating hygienic work environments too!
Ok, I’ve got one. There’s a germ called Staph. Aureus and it lives in the throat, nasal cavities, and in the hands of up to 50% of the population. Under the right conditions, it emits a very dangerous toxin. This germ isn’t automatically considered a pathogen, it really does need the right conditions to become dangerous. In the story I’m about to tell you, it got very, very dangerous.
This company made food for children’s daycares – cooked food and salads. In the salads, Staph. Aureus was found in large quantities – and inside foods, it creates the dangerous toxin we mentioned. Children and adults can react to it from half an hour to 2 hours after eating the food – it has an incredibly short incubation period.
You know, oftentimes, business owners hear that the customer felt ill just 2 hours after eating the food and they say, “well, that’s impossible, you must be feeling ill from something else! How can my food affect you so quickly?” On the other hand, when somebody calls after a day and says they are ill, those same business owners say, “oh, too much time has passed so it must not be from our food!” As if they are never at fault.
So the catering company got a lot of complaints and it was very urgent. An investigation commenced, and finally, we caught it – one of the cooks that prepared the salads had a pimple hidden in his neckbeard. It had puss and everything, but his beard was long so no one – including him – didn’t know it was there. It itched during work, so he scratched it a few times, in which case it doesn’t matter even if he had gloves! He passed on the germ with the puss inside the salads.
That’s just one of the cases. Investigations have to be extremely thorough. You check every little thing in the work process. That’s my job. I check everything, from the moment the product made it to the time the dish left the kitchen. I examine hands, tools, surfaces, refrigerators, hygiene habits, and how the dish was served, there are just so many factors.
Hand hygiene and hand washing are the basics of the basics. With all the surfaces and expensive tools in use in businesses – our hands touch all of them. If our hands are dirty – they will likely be dirty too.
What tips would you give a business owner that wants to turn things around?
I think the minimum amount of effort is to have a sanitation trustee in the business. Have someone that knows he is in charge of these processes, knows what to do, how to train the new employees on hand hygiene and professional kitchen etiquette, and so on. I honestly believe businesses should not be allowed to open without it. Also, teach your staff! Create learning opportunities for them!
How many times do you think people talk to baristas about hand hygiene? None! What about servers? The chefs and cooks are not the only ones with a massive effect on the food! Bring in lectures, teach your staff, and prevent infections through knowledge before they happen.
Businesses can also take hand swabs from employees and test their foods if they want. This is also part of the services I provide. Once the results are in, we analyze them together and I explain what could go wrong in light of these results, and how to prevent that from happening in the future.
New workers in food environments don’t always come with a formal culinary education. Business owners can’t take standard hygiene practices as a given but must make sure to teach every employee no matter how basic it seems.
I think Soapy’s solution is great. If people understand how much soap and water needlessly go down the drain every year, then they need Soapy. The money you could save from resource conservation alone is terrific. Especially for businesses that need to wash hands, and ensure handwashing is thorough – the CleanMachine is a great solution. I know restaurant kitchens are often too busy to wash hands well enough, which is why customizing the wash cycle is vital. They also almost never have warm water for the cooks and servers to wash hands with, and warm water is critical to help the soap froth and decrease germs on hands. The CleanMachine really answers all of that. Food production factories could really utilize the CleanMachine to their advantage, making sure hands are clean whenever approaching the food. They have a lot of staff and a need to wash hands quickly and carefully – especially on the production floor.
What would you tell business owners in the food industry who are reading this article?
I’d tell them that personal hygiene is a must when it comes to making food. It’s basic sanitation. Anyone coming to you to eat food needs to leave happy and healthy. If he came to enjoy your food and he left in an ambulance because somebody didn’t wash their hands – the fault lies with you. Never mind Covid, people have been swarming the restaurants and pubs because they missed it so much during the pandemic. Business owners need to understand that if somebody felt ill after eating their food, they will never come back. They will go to a competitor. Worse, they will write a bad review online. Reducing resistance to bacteria in healthcare is our responsibility.
Teach your staff. Don’t assume they know things. Arm them with knowledge! If they understand why they are doing things, they are more likely to follow them.
Doctor Marina with Chef Danon, Founder of Danon Culinary College