A report detailing a medical condition in the Catering Department that worsened, yet the patient was required to continue working in the galley.
What the Reporter told us:
I have been working for a passenger vessel company, as a Commis de Cuisine since 2011. I joined my last ship on 20th September. While working on board my duty was in the cold galley night shift. In March, after six months on board, the fingers on both of my hands got infected with fungal bacteria. I went to the ships clinic and our doctor gave me antiseptic cream to apply to my hands and authorised me to return to work. A few days passed and I kept on applying the cream, but it did not work at all….
I complained to my Sous Chef, and asked my department head, the Executive Chef, to change my work place but they refused and instructed me to keep working. Three months passed and both my hands and 6 fingernails became completely damaged with fungal bacteria. In June, the ship’s doctor sent me to a shore clinic in Italy, and told me that I would not need to pay for any written prescription from the shore doctor because the Company would arrange it for me. After visiting the doctor in Italy eight days passed and the ships doctor still did not give me any kind of medicine. Finally, on 25th June the ships doctor decided to send me home on medical repatriation to receive medical treatment in my home town.
I have been on medical leave since 25th June undergoing treatment with two dermatologists here in India. Both hands have five fingernails that are completely damaged and the skin folds that frame and support the nails on three sides are critically damaged forever. This means I cannot work anymore as a food handler and my total career has been lost due to the negligence of a ships doctor and my supervisor. They never transferred me to a more suitable workplace, while the ship’s doctor misdiagnosed my condition for four months.
The ship’s clinic and doctor failed to provide adequate medical treatment to me. I was suffering with a fungal infection but the doctor, my Sous Chef, and department head kept me working in the knowledge that I was a food handler – if any kind of cross contamination could happen to the food then this was both dangerous and hazardous with respect to the health and safety of passengers.
What the Third Party told us
CHIRP wrote to the managers of the vessel in question but they declined to respond.
CHIRP sought expert advice, and asked if good hygiene practice in the cruise sector indicates that the reporter should have been removed from food contact to reduce the risk of food contamination at an earlier stage? We were advised that approximately 25% of crew visits to cruise ship doctors concern skin conditions, and a large proportion of the people involved are food handlers. Most light or moderate skin conditions, even when they involve the hands, will be permitted in active food handlers, but it is now an absolute requirement that food handlers wear gloves – both to avoid contamination of the food and also to protect their own skin.
CHIRP was advised that fungal and bacterial infections are relatively rare on hands, and usually secondary to other conditions. Most common are wounds (injuries), or contact dermatitis. These are not contagious but can lead to secondary infections from bacteria or fungus. Gloves are to be used while working, but accumulation of moisture during the use of gloves may aggravate the conditions and promote infections. Most skin conditions that are limited to the hands will heal quickly with proper supportive care, (such as not using strong soaps or disinfectants, proper drying of hands, plus the use of moisturizers and mild topical steroids), and above all with proper follow-up and TIME!
Fungal infections can be made worse through overly eager hand sanitation: frequent washing, in particular with strong soaps or disinfectants, removes nature’s barrier protection, thus promoting fungal growth.
CHIRP suggests that the overall lesson is for all companies to ensure that they have robust procedures in place to ensure that recurrent medical conditions are thoroughly followed up. The management of such hand conditions in food workers, including communication between medical staff, the patient and his/her superiors should also be in place. This should improve management of the condition, and clarify what tasks should be avoided if possible and the likely recovery time.