A selection of writing from Edward Evans. 

In Kansas, Inspectors Work to Prevent Foodborne Illness

Mark Lackey methodically gets out of his state owned sedan, stretching his muscles after the long car ride. He has driven over an hour from his home in Lindsborg to Manhattan to help cover a gap left when one of his inspectors received a promotion. He walks to the back of his car, opens the trunk and removes his small rolling bag. Inside is his laptop computer, thermometers, sanitary wipes, pens, identification and a small mobile printer.

He walks across the parking lot and opens the door to the Sonic restaurant. He is immediately met with the deafening sound of industrial fans, several fly strips covered in dozens of dead pests and a swarm of living flies that, thus far, had managed to evade the efforts of the staff. He walks into the kitchen, identifies himself to the supervisor and notifies him that it is time for the restaurant's annual surprise inspection.

Lackey has been a health inspector for over 20 years, and in that time has conducted some where near 6,000 inspections. Now he is a district manager who oversees six of the 39 inspectors employed by the Kansas Department of Agriculture's division of food safety and lodging. These 39 inspectors are responsible for monitoring over 14,000 food and lodging establishments throughout the state; without funding from the state government.

"Pretty much the majority of the program's funding has been through licensing fees for at least the past decade," said Adam Inman the Assistant Program Manager for the division of Food Safety and Lodging of the Department of Agriculture. "For at least 15 years we've been fully fee supported, and we have some contracts and grants from the federal government as well, but the majority of the funds are license fees."

"The FDA suggested number of food establishments per inspector is 250 to one," said Lackey. "In Kansas the ratio is about 350 to one. You can't get around as often. We're required by law to inspect an establishment at least once a year, and unless it requires a follow up inspection, which are the problem places, that is probably going to be the only inspection that place gets all year."

If, for example, a restaurant was given a violation for having a malfunctioning refrigerator, but not enough violations were found to require a follow up inspection, the restaurant would not be held accountable for more than a year; even though improper refrigeration is one of the leading causes of foodborne illness.

"Ideally restaurants would go through inspections about once a month," said Fadi Aramouni, a professor in food science with an emphasis in food safety at Kansas State University. "Unfortunately, this is not possible due to lack of manpower."

While inspections are unannounced, restaurants are often able to make it seem as if their facilities are much cleaner than they actually are says Lackey.

"You go into some places and they'll tell you that the manager will be out in a little bit," said Lackey. "Meanwhile you can hear them in the back trying to get everything ready.”

Lackey also cited high rates of employee turnover as a cause for concern.

"I'm guessing [the employees] are not very motivated to go out of their way to keep things healthy," Lackey said. "In the bigger places, they might be working there for six months. Even the managers don't stay for that long. You'll go in to do an inspection and the next time you're there they'll have a completely different staff. It makes it hard for us to go back in there and retrain them."

Not only is there a high rate of employee turnover, but often the pressure of keeping customers happy combined with the typically low wages increases the chances of food contamination through carelessness.

"When it gets busy, I just forget to do things like wash my hands or put on gloves," said one food service employee who wished to remain anonymous. "I'm getting paid on tips and if my tables have to wait for their food, I get paid less."

During a recent inspection in Manhattan, an overworked waitress accidentally dropped a dirty bowl into the trash. She reached in and fished it out, but, in a rush to deliver the food waiting to to be served to customers, simply wiped her hands off with a napkin and returned to work instead of washing them. This went unnoticed by the inspector.

Prioritizing customer service before food safety was a consistent theme at many of the restaurants in Manhattan. Another waitress who wished to remain anonymous recounted a time when a coworker accidentally dropped ready-to-eat food on the floor and, in a rush to serve the rest of her customers, picked it up and served it.

An employee at an Orlando area Golden Corral posted a video on YouTube of the restaurant hiding food next to a dumpster to keep an inspector from seeing it. The video was very popular online, garnered a large response from the media, and resulted in the manager who ordered the hiding of the food to be fired.

The possibility for corruption also remains under the current system. Because inspections are conducted and reported by a single person, often only once per year, no real system of accountability has been established.

"There's been bribes offered in the past, although it doesn't happen very often," said Lackey. "The inspector was handed money, but they handed the money back and told them to put it into fixing the refrigerator that was causing the problem."

While that particular instance was properly reported and largely stemmed from a misunderstanding, it illustrates the potential for corruption in the system.

"We're not where we want to be," said Inman. "We're not seeing the number of outbreaks, but, because food borne illnesses are underreported, we can't say for sure that [we're being successful].”

Foodborne illness was the cause of over 47 million illnesses, 125,000 hospitalizations, and 3,000 deaths nationwide in 2011. 

"Most foodborne illnesses are preventable," said Inman. "Being able to reduce food borne illnesses significantly [is our main goal]. Particularly the serious ones that cause long term health outcomes like E Coli infections which can cause death or lifetime changes, having to have kidney transplants, kidney failure. Those very serious foodborne illnesses are also very preventable."

Mark Lackey sits down at a table to fill out his report. He has finished his second inspection of the day, and plans to finish 4 more before starting the hour long drive home.

"My first job was with the health department," said Lackey. "I've seen a lot of changes over the years, but I think the number of food borne illnesses has gone down and that's ultimately how we show that we're being effective."