Those local authorities in this country who have been carrying out extensive training courses for food handlers must, at this time of the year with annual estimates fresh in their minds, together with frequent exhortations for economy, give much thought to the ultimate results of their efforts. In order to proceed further with this analysis, it is necessary to divide the authorities into three main groups: (1) those that have had a comprehensive system embracing lectures to all types of food handlers in hotels, food shops, fishmongers, bakers and greengrocers, etc.; (2) those who are content with one or two public lectures, or those whose campaigns take the form of a Clean Food Week; and finally (3) those who have no organised training programme, do not intend to have one and rely entirely on visits by Health Officers to advise and enforce the necessary Acts and local bye‐laws. It is imperative that a system of regular and thorough inspection of these premises be carried out at least once every three months, irrespective of what type of auxiliary training and lectures are put into force. Those officers who have spent a great deal of time in taking these courses and lecturing have found that there are many people who will not ask questions in front of an audience and to these advice during inspection is of the utmost importance. Particular difficulties in relation to equipment and layout can often be solved on the premises which would not be possible at a lecture even if the food handler would put his questions forward at that time. In order to check improvements, division into the three groups above will assist in assessing the achievements in any training programme. The consensus of opinion among health authorities in this country shows that comprehensive training programmes do pay good dividends. Later inspections show that there are improved conditions in food shops and improved working relations between the food industry and the local health department and, most important of all, increased public interest in, and support for, the cleaner food ideal. This assessment has also been borne out by the experience of authorities in the United States of America. In one large city in Columbia, 70 per cent of the staff of the licensed restaurants had completed training courses and one was interested to learn that in the “ A” restaurants the Health Department had issued tabs to be attached to menus which read: “ Our dishes and utensils are sanitised; our employees are trained; our kitchen invites your inspection”. Of particular interest in this respect is the attention paid to catering at fairs, a very thorny problem in this country. The Missouri Division of Health have stated that, during the past four years, there has not been a single reported case of food poisoning and that this has been accomplished, not only by means of regulations, but with constant supervision and a mobile laboratory that follows the fairs. It also stresses the value of dispensable paper cups and dishes that obviate the necessity for washing and sterilising facilities, often most difficult to obtain with mobile fairs and peripatetic catering. In one county in Kansas courses are planned by the Public Health Department and the Adult Education Sections of the Schools. All food handlers are required to have a card saying that they have successfully completed the course and this card is valid for one year only and personnel must complete a refresher course before obtaining a new card. The rates of improvement vary considerably but in all authorities in the United States of America, where comprehensive programmes have been carried out over a few years, definite improvement has been found in food handling. This is not the only aspect that must be considered at the present time. The potentiality of highly trained staff is of the utmost value in case of emergency. This was demonstrated in the very serious flooding that occurred in Kansas inundating hundreds of houses and disorganising public services. This problem arose at very short notice and the fact stressed by the State Board of Health was that, although the crisis lasted from a period of weeks to several months, not a single case of disease was traced to water supplies or to food. These emergency measures are undoubtedly the most stringent test of public health organisation and of the efficiency of those who handle and distribute food. In such cases, there is never sufficient time to start any scheme of training, but, with skilled staff, the spate of illnesses, such as typhoid, dysentery, etc., that invariably accompanied such occurrences could be reduced, if not eliminated, where efficient schemes of training have been carried out. When assessing the value of food training courses in such an emergency, one is forced by present conditions to think again of how it will fit in with Civil Defence requirements. The experience of the last war showed that the task of feeding large numbers of evacuees is a tremendous problem. It is not sufficient merely to have stores of food at strategic points, but trained people must be available who can not only make the most use of the food, but will know how to reduce the incidence of food poisoning or transference of infection when dealing with communal feeding of this type. To the foregoing must be added the risk that power and fuel might be cut off and also other main services. Then washing and sterilisation of equipment would not be possible. Experienced workers in this sphere will, prior to such conditions, have plans in hand that will cover all these contingencies. It may be necessary to feed homeless exacuees, Civil Defence workers operating in devastated areas, and even distribute food for the remaining citizens in towns where normal services have ceased to exist. It is in these circumstances that the food handler who has had thorough training will be able to carry on, well knowing the risks and taking every precaution to avoid the spread of infection and consequent epidemics.
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