By Guest Blogger James Perry
During the past week in Thailand there has been some concern about food safety. The sad and unfortunate death of a young New Zealander, Sarah Katherine Carter, while vacationing in Chiang Mai has spawned fears about the safety of food in the country. While this case is a serious one, it seems that it has been prejudged by the media. A few sources have jumped to conclusions regarding the death, assuming that Mrs. Carter consumed tainted seaweed. Initially, the suspected culprit was adulterated seaweed, but public health officials have not completed their investigation. It is important that the public not prematurely assume anything until this investigation yields a conclusion.
Let’s take a look at some facts that need to be considered with regard to eating safely in Thailand. In cases such as the one aforementioned, this is an extremely rare incident. We sometimes hear that Thai people will not get sick from consuming street food, but a westerner may experience food poisoning.
In some instances this may occur, but is not as common as perpetuated in traveler’s lore about eating out in the streets of Thailand. If it does occur, it’s usually true for minor food-borne illnesses, not for cases in which something is toxic enough to cause death. The unfortunate victim in Chiang Mai could have just as easily been a Thai national.
Is street food safe in Thailand? There is a large body of information and research out there stating that it might not be the healthiest option, but laws do exist in Thailand directed at food safety. Thailand also recently initiated a global food traceability initiative, demonstrating that food safety is becoming more of a priority for the nation, particularly as Thailand depends on a percentage of income earned from exporting its livestock and agricultural products.
This might be stating the obvious, but if you feel concerned about your health and safety while vacationing or residing in Thailand, the best thing you can do is take some precautions and use common sense.
Here are some basic safety measures you can use:
1) Try to avoid ice that isn’t in cube form, especially at roadside food vendors. If the ice is crushed or shaved ice, the risk of contamination is higher.
2) If you eat at street vendors (the type that you sometimes see at markets), try to find one that cooks the food in front of you. That way you can see if the food is being cooked long enough and at a sufficient temperature.
3) Go to places where you see a lot of people eating. Thai locals usually know the best places.
4) Avoid places that have pre-prepared food kept in metal trays or other containers. If it looks like it has been sitting there for hours, it probably has. You should eat food that is prepared when you order it.
5) Do not eat raw forms of seafood that you find at a market, on the street, etc.
6) At a restaurant, inspect the forks, spoons, knives, chopsticks, etc. Also observe the personal hygiene of the person working there or preparing the food. If the workers appear to have good personal hygiene and practice hygienic measures with food handling and preparation, it’s a good indication your food will probably be clean.
7) Vegetables should be washed well and fruits should be peeled to remove any pesticide residues.
Related Resources:
Thailand Street Food documentary
Note by Thailand Lawyer Blog moderators: Our thoughts and best wishes are with the family and friends of Sarah Katherine Carter, and we extend our warm wishes to both Emma Langlands and Amanda Eliason while they recover from their own bouts with the illness.
{ 14 comments… read them below or add one }
Readers need to be aware that an American died in Chiang Mai on 1/11/11 as a result of food poisoning. The Thai media failed to report this death. There are dots not being connected by the media or the local health officials. Or if the dots ARE being connected, the public is not being properly informed of the food safety risks in Chiang Mai.
How can you possible tell if a “worker appears to have good personal hygiene”?
Very few Thais have good personal hygiene. I know because I lived in Thailand for 5 years. Ever wonder why there is very seldom toilet paper, soap, and hot water in the restrooms? Because most Thais grew up using only their hand to wipe themselves and then they rinse that hand with the dirty cold water bucket.
Proper handling of raw meat? Forget about it in Thailand!
Refrigeration of meat dishes after they’re cooked? Forget about it in Thailand! These dishes are left out on the counters for hours or days.
This is true. There was in fact another death of a 33-year old American lady, who according to reports, had “food poisoning symptoms” in the hours prior to her death. But it seems there has been no official autopsy report from the authorities. Two months is entirely too long.
I had a bit of suspicion when I wrote this article, simply because I had never known of any food poisoning case like Ms. Carter’s. That is why I indicated caution about “jumping to conclusions”. Upon reading the subsequent news of two UK citizens that died of “heart attacks” less than two weeks after Ms. Carter, I felt that any toxin involved (if it were involved at all) had likely not originated from adulterated food. An additional death has surfaced of a Thai staff member from the same hotel a few days prior to Ms. Carter’s.
You have a good point about authorities not being more assertive. I don’t think these cases are necessarily related to the food itself. It’s very difficult to conclude anything if the health department isn’t talking.
Harrell, I don’t know where you lived or what types of restaurants you saw; but I have seen some as you described. But, I never ate at a place like that. There are many restaurants and food vendors that take adequate food safety measures.
I have to disagree that “very few Thais have good personal hygiene”. Again, I suppose it may depend on where you lived and other things. But the majority of Thai people have very good hygienic practices. In fact, it’s important to keep a good appearance in Thai culture. Toilet paper is not used in some places because the water sprayer is available. This can actually reduce the risk of transferring bacteria to the hands or other places on the body. I don’t think anybody uses their hand. There are certainly bathrooms in any country that are very unsanitary. Just go to a roadside gas station in America (no soap, no toilet paper, bathroom hasn’t been cleaned in weeks or months, etc.). I think it would be both unfair and inaccurate to believe that MOST Thais don’t have good hygiene.
“An additional death has surfaced of a Thai staff member from the same hotel a few days prior to Ms. Carter’s. ”
Are you referring to Waraporn Pungmahisiranon, who was staying as a guest in the Downtown Inn in a room close to the other victims?
Or are you mean yet another person– an actual staff member from the hotel? If so, this would make the number of dead 6.
Sorry, I was referring to Warapon, who was staying there (not a staff member, as one report stated). Five total.
I lived in a Thai rice farming ‘village’ (small town) and observed Thais for at least 5 years, up close. I never saw a Thai wash his or her hands after walking into the kitchen. I never heard the bathroom sink water turned on after they used the toilet. My Thai wife explained to me how she was raised to go to the bathroom and she is insistent that many if not most Thais in the countryside still use only their hands (with no toilet paper) to wipe themselves after defecating and then, as I said, pour dirty water over their hands as their version of cleaning. Think about it: in most bathrooms in Thailand you don’t see toilet paper and you don’t see sprayers (which have their own problems, see below). All you see is a bucket of water. How do you think the person gets the feces off of their bodies using simply a water pan with a handle? Answer: they use their bare hands.
If sprayers are available, then spraying the private parts after defecating is a great way to splash fecal material everywhere, including hands, legs, clothes, shoes, the bathroom. I urge you to try spraying yourself–as I have–and find out for yourself just how messy this method is. I know it sounds good in theory–it sounded good to me, too…until I tried it.
In the United States, the restrooms–even at roadsides–are usually (but not always) relatively clean. Dirty bathrooms are the exception in the U.S. In Thailand, they are the rule. Even when Thai bathrooms don’t appear dirty, you still can’t find soap in them, or hot water (but I’d be happy with just the soap).
There is a reason the fecal-to-oral route is the number one cause of disease transmission on the planet. Because most people on the planet don’t practice good hygiene. I know many people in the West who fail to practice good hygiene, too.
I’m not trying to criticize Thailand unnecessarily. One of the reasons I love Thailand is because it is still a little ‘wild’.
Yes I understand what you’re saying. Yes in the rural areas, I’m sure there are quite a few examples of what you described. This is probably an indirect result of the long-term neglect of rural Thailand. I think it’s certainly no secret that rural Thailand has had little support from the government or Bangkok prior to the election of Taksin Shinawatra in 2000.
The case above is no longer a suspect food poisoning case, as there are now 6 or 7 total deaths that could possibly be connected in Chiang Mai.
Looks like this is now a case of poisoning.
Chemical poisoning
The deaths at the Downtown Inn in Chiang Mai have now been connected to the poison used to get rid of bed bugs. And serious food poisoning is rare in Thailand, even from street vendors.
Serious food poisoning may be rare, but it still does happen. When I went to Thailand I foolishly tried the fried bugs from a Bangkok street vendor on the last day of my holidays. I had practiced good food safety practices until then, but let my guard down. I was very sick for two days with diarrhea and vomiting and then another five with diarrhea. I ended up in hospital for a short stay on a drip as I was so dehydrated. Seven days of misery. People sometimes tell me it’s only the foreigners who get sick as the locals are ‘used to’ the bacteria. Well, my Thai tour guide had a case of food poisoning during the trip as he loved to graze streetside vendors. Thailand is a great country and the people are very friendly, but food handling in such a hot and humid country really needs to be upgraded a few notches.
Hi Harrell,
I have to agree with you on some points and disagree on others.
As you said you lived in a small rural village during your 5 years here. It seems like the rural village does not have proper education on hygiene being taught. Also as described by your wife who was taught to wipe herself with bare hands after defecating. These people are poor and have a lack of education, etc etc which is understandable.
As for places without toilet papers. Most public toilets don’t have toilet papers because owners are stingy, and is not required by law like in many places in the US. As a matter of fact, the average Thai uses TOO MUCH toilet paper! Hence this is another reason why many places don’t provide toilet paper – it doesn’t mean people don’t use it.
Hot water or not – it doesn’t make a difference in reducing bacteria. As long as you wash your hands with soap and DRY – DRYING is the key to prevent bacteria growth, which most don’t do.
Yes, I do agree spraying does get a little messy and can actual spread the bacteria around.
Also Thais like to scoop water out of a water basin to flush, water basin is a growth spot for bacteria, so is the wet floor when water splashes all over the place. Reason why they scoop water from water basin / bucket to flush because it is cheaper in construction!
I also observed many Thais don’t wash their hands after going to the toilet, I hear cases of girls not washing more than guys. I would predict 3/10 people don’t wash their hands.
I would say the majority of Thais 70% wipe and wash after going to the toilet properly, not as low as your portrayed.
As for food hygiene, I would give it a 3/10 on average for street, and 6/10 for restaurants. I have seen block ice factories. Ice are dragged on the floor and loaded onto 10 wheels with dirty plastic / cloth covering. Very dirty indeed, eating block ice is like licking the ground.
Street stalls are unhygienic as well, most washing method consists of 3 buckets. 1 for scrubbing the food, 2nd washing with soap, 3 for rinsing. The water is seldom changed. Rinsing bucket is always still soapy – meaning dishes are still soapy when they put it up for drying.
I great example of unhygienic food is raw crabs – thais love raw crab with papaya salad. Raw crabs are never refrigerated when waiting to be prepared. Almost half of the people eat it have diarrhea afterward, they don’t think its unhygienic – they just think their body can’t handle the raw crab, weird logic of theirs – they still eat it all the time.
@ Harrell, James P. Michael and DP.
I read a lot of posts in various sites , but I found your post the most educational. Thank you.
Harrel- The little sprayer that you see in asian bathrooms –” Bottom Shower” or ” Bidet Sprayer ” as it’s known– should be used with your bottom still inside the toilet bowl. From your description of events I get the impression that you have used it incorrectly.