In UK, a 22 year-old patient died because he wasn’t given sufficient water in the hospital. The UK hospital food is so bad that more than 30 million hospital meals are left uneaten each year and 67% of the hospital staff won’t eat the food they serve their patients (source). In USA, however, efforts are made to improve the quality of hospital food, such as farming on the hospital’s rooftop to provide fresh ingredients. Inspired by these articles, we want to find out about hospital food in Singapore: are our hospitals providing the best nutrition for the convalescents? Hospital food has to be nutritious (for patients’ swift recovery) and delicious because sick people usually don’t have a good appetite therefore hospital food has to be tasty to entice them to eat. Are our hospitals giving nutritious and tasty food?
Out of the seven hospitals we contacted–Alexandra Hospital, Changi General Hospital, National University Hospital (NUH), Khoo Teck Puat Hospital, Singapore General Hospital, Tan Tock Seng Hospital and KK Women’s and Children’s Hospital–three rejected our request to visit the hospitals without stating any reasons, three completely ignored us and only NUH acceded to our request and brought us on a tour on how the meals are prepared.
Carrot Cake from NUH Hospital Food
NUH outsources the preparation of meals to a global company, Sodexo, because, as Jean Chang, Assistant Director of Environmental Services, said it, the food should be left to the experts so that the hospital can concentrate on treating the patients. As a global organization, Sodexo has the resources to scout for fresh ingredients from Singapore and the region. The ingredients are not only safe, certified by AVA, they also abide to ethical laws of not endangering any species. Sodexo also works very closely with NUH dietitians to ensure that the meals are balanced in terms of carbohydrates, proteins, fats, vitamins, etc.
Wednesday Menu from Normal Diet. Reproduced with Permission from NUH and Sodexo.
In addition to the three “No”s of NUH hospital food (no MSG, no coconut milk and no saturated oil), the menu is split into four main groups: normal meal; meals for diabetics; for two types of meals for people with kidney problems because these are the most common illnesses for hospitalization. Within the four main groups of menu, there are more categories such halal food, western, halal vegetarian, Chinese, and Chinese vegetarian, accumulating to 34 pages of menu. Some storybooks are shorter than the menu. The menu changes daily for a week and then repeats but since an average stay in the hospital is six days, a patient probably and hopefully won’t get to eat the same food twice. There are also special festive menus such as turkey for Christmas.
Low Salt and Low Cholesterol Wednesday Menu for Diabetics. Reproduced with Permission from NUH and Sodexo.
Orders are taken daily and the patient can choose any category of food regardless of race. However, if a patient is naughty and decide to order something she or he shouldn’t eat, good luck trying. Everything is computerized. Upon hospitalization, what a patient cannot eat has already been keyed in into the computer.
I was very fortunate to be taken on a tour of the spotless NUH kitchen. Upon entering, everyone has to wear hairnet, gloves, mask, and safety boots. I’m sure I looked sexy in them. The kitchen is similar to a one-way production line in a factory: the raw ingredients enter at the door, where the fridge is. Vegetables are delivered daily in the morning and meat twice or thrice a day depending on the demand. And next to the fridge are four rows of kitchen so that the halal and non-halal food don’t mix. The food is, of course, cooked in such a way that no or minimal nutrients are lost. And after cooking, there is a group of people to pack the meals. A food service dietitian or dietary assistant stands at the end of the packing line to check each and every 850 meals to ensure no mistakes are made. The food is then placed on a special tray, which is placed in a special trolley from a technology from France. What is so special about the trolley is that it keeps one side of the tray hot at above 60 degrees and the the other side of the same tray chill at below 8 degrees (for milk, fruits and desserts). The heat and cold can be maintained at their respective temperatures up to two hours. One tray, two temperatures!
Grilled Dory with Yogurt Parsley Sauce, Zucchini Parmesan, Whole Meal Roll, and Mixed Vegetable Soup – From Western Normal Menu
The photos of the food illustrate the portions you should eat in a day (about 1800-2000 calories). If you’re eating healthily on your own, this is a sample: breakfast (a sandwich or porridge or even mee siam), lunch at cai-fan stall (a bowl of rice with a serving of meat and two servings of vegetables and fruits), a teatime snack (sandwich), dinner (same as lunch), and a supper snack (a cup of milo). I cheekily asked, “Why do hospitals always serve Milo and biscuit for tea-time snacks?”
Lady-fingers Stir-fried with Onions, Green Peas Subzi, Angel Luffa Soup from Vegetarian Halal Normal Menu
NUH Chief Dietitian Lim Su Lin answered that the snacks are just to pack sufficient calories in patients who don’t have appetite for food and to ensure that they have enough fluids, so any snacks will do. In fact, NUH serves sandwiches, green bean soup, red bean soup, tea, coffee, and even Horlicks!
According to Lim, 30% of the patients are malnourished on admission partly because of misinformation. For instance, people who suffer from kidney problems mistakenly believe that they should stay away from proteins, and hence they suffer from malnutrition. For these malnourished patients and women after parturition, the daily calories are increased to 2300-2500, which is about half the calories I have for each food tasting.
In terms of hygiene and proper healthcare towards patients, NUH exceeds my expectation by maybe 4000%. But what about the taste? Taking into consideration that the food is without MSG, it was ok. Although low-fat milk is used as a substitute for coconut milk, the curries were pleasant, especially ladyfingers from the halal vegetarian menu that was assam-sourish, and hence appetizing. The meat, in general, was a little tough but that is because they have to ensure that meat is cooked thoroughly. The rice could be softer with more moisture and the fish could have been less limp. While the textures could be improved, the taste was decent. I do wish that I had tried something from the low fat, low salt menu, a litmus test of the savoriness of the food.
PS: Thank you to the kind people at Sodexo and NUH for taking their time out to show me their kitchen. Special thanks to Michelle for organizing and coordinating our schedules.