Coeliac India survival guide part II

I'm not sure how any coeliac tourists have survived India, contamination with gluten is rife. Perhaps the blogs I read before I travelled were from the gluten intolerant or elective gluten free perspective. I can only assume the authors were either less sensitive to gluten or ate in well staffed tourist restaurants.

Both in the south and in the mountains of Northeast India gluten is everywhere. After a relatively successful period avoiding gluten with a wonderful host, I haven't stopped wheezing and rasping since. The local curries, thin and unlikely to be thickened, contain gluten. I can only assume it is mixed in with one of the spices as a bulking or anti-clumping agent. In the mountains of Meghalaya and Mizoram it's somewhere in every meal of local food. After enough time getting frustrated at the lack of quality control in India which is letting this contamination happen, it's time to think about survival.

One of the things backpackers and travellers do is eat the local food. I now realise the truth, I can't do this anymore (I wasn't always coeliac). I will not be able to eat in restaurants or share a meal with a host. Eating is now about surviving, and any risk of gluten contamination must be avoided. The mathematics are simple, if there is only a 10% risk of gluten contamination per meal I may get sick every 4 days (several meals per day). It takes me 5 days to fully recover, which leaves me in a permanent state of fatigue and reduced absorption. In reality, the contamination risk per meal is over 50%, it's just too high. The best description of a glutening I read from another blogger is this: you feel like a cockroach and someone steps on you and your insides spill out over the street.

I now eat chocolate. It's gluten free, dense and provides a decent number of calories for the dollar. Fresh fruit is of course a perfect gluten free food, but it's hard to take in enough to make a dent on your daily calorie requirements. Dried fruit is unsafe, certain evil powdered grains can be used to stop it sticking. If it's possible to communicate the idea, a plate of plain white rice is often safe (the rice cooker is dedicated). However rice plate generally means rice-meal/dahl bat/dinner, which will come with a whole selection of dishes. The ultimate survival food is the boiled egg, it keeps for a day, and sitting inside its shell is safely protected from any floury pestilence. Eggs are a crucial source of protein, as it is the Dahl can't be trusted. In my case desert is a calcium tablet to ensure my bones remain healthy.

I find a pricey alternative food, a nutritionally complete food powder, suitable for end-of-life care and tube feeding. The label boldly states it is both gluten and lactose free (I'm both). Just add water... I take as many tins as I can carry.

Revised list of safe gluten free foods
Fruit
Boiled eggs
Chocolate
Coca cola
White rice (with care)
Nutritionally balanced powdered food

All quiet in paradise

I haven't written a word in weeks, it's the effect of sitting around on my backside down in paradise. The village of Nongriat in Meghalaya still has its charm, despite my initial doubts, and what else is there to speak of. I even picked up a sack and cleared the litter from my favourite point without so much as a tweet. This was my line in the sand for India's garbage problem, this place was mine. But even all the heat and frustration from picking up the strewn bottles and food packets evaporated away before it reached the internet. The adventure began again when I left, asked me what I was looking at and smacked me in the face.

I've often entertained a sort of nostalgia for the quaint British touches in Meghalaya. I put the genocides of the British empire to one side and let myself believe the occasional comment that things were better under the British. It's unlikely to be first hand anymore, anyone who remembers the empire themselves would be in their late 70s. Instead it's the stories of parents and late relatives compared against the Indian empire of today, as locals see it. The fondness for Britain is a rejection of Hindi India's dominance over their homeland. Welsh missionaries first made their mark and bound the countries through religion and schools named after famous Joneses. English officials bound the two nations through football, drinking tea, and being socially reserved. Unfortunately the poor Khasi people are now left to follow the fate of the England football team at world cup events, whereas some of their Mizo neighbours have sagely defected to Germany. I've chuckled before at the traditional Khasi, *cough* mock Tudor, house. Even the Khasi rebellion against the Indian empire couldn't be more British. It consists largely of grumbling in private, with direct action in the form of slow and reluctant service of Indian customers.

Britain seems to have exported other things to the 'Scotland' of the east. Women here are liberated, with roots in traditional Khasi culture. Among other things, they can drink! In fact on the day I leave I encounter a group taking full advantage of this on a Saturday afternoon. I first get encouraged onto a hired public bus by one group of daytrippers. Then I'm offered a drink of clear spirit from a white bottle, and I start to notice, it's barely the afternoon and they are plastered. One of the girls stumbles and falls on the road outside, another is busy throwing up on the bus beside me. A short distance away on the grass another girl is also beyond walking. The guys aren't in a much better state, the same invitation to party back in Shillong (the capital) is repeated a dozen times. This drunken mess could be any English Saturday night... The locals look on in disgust.

The same café in Cherunpunji ignores me for as long as they can, before finally serving me food, and I suspect charging over the odds. I'm a glutton for punishment, they were just as keen on foreign customers 3 years before.

Shillong is uneventful, I arrive and within 2 hours I leave on the state bus for Mizoram.(I've been lucky, there are 3 per week).

You could not step twice into the same river

I am not the same man, and the river has continued to flow. I think perhaps it was a mistake to come back to the greatest place of my travels, but I had no choice, the memory of it drove me here like a compulsion. Fatigued and exhausted from 6 days of frenzied journey I burst into Nongriat early in the morning, with only nagging fears in my mind. From this moment nothing sat right with me. The guesthouse was the same, the same friendly talented host, and the same adventurous travelers who have made the walk with their bags. But I could not feel the spark I felt on first arriving in paradise.

My rejection of change must be irrational, after all it is the only constant. But why did more tourists have to come to the place, why is the thrown rubbish greater, why did new buildings have to be built, why did the winding stone path clinging to the valley side need concrete steps, why did the betelnut plantation need to grow into the forest, is the frontier atmosphere less now? I can't put my finger on any one important thing that has changed, apart from it not being my fictional memory of itself.

The first time I arrived I may have been at the peak of myself. Strong after many days on the beach, restless but fulfilled by my travels, and seeing everything new. That time as now I stopped first in the guesthouse 'at the top', in a town called Sohra (British/tourist name Cherunpunji). It has a dormitory which helps to throw travelers together. Meeting one or two others I heard some details about Nongriat, but still had not quite constructed a mental image. Only the basic landmarks were filled in from the stories: some large number of steps into a deep stoney valley, and a guest house beside a root bridge in an otherwise vast blackness of unconstructed backdrop.

To reach the village you have to descend quite a few steps (thousands) down the side of the valley. The old and less-used stone path begins from the plateau where Sohra is located, at Mawmaluh which is 7km down the road, noteworthy for it's cement plant. The views of the valley are something on the way down. About half way you reach Tyrna which is where many people begin the walk, at the cost of a taxi. From here the steps are concrete, a product of the Mahatma Gandhi rural employment scheme or other government program. The concrete is no bad thing, aside from the small size of the steps it's a very steep descent through the forest.

To reach Nongriat you have to cross the bottom of the valley. Two rivers are spanned by distinctly rusted cable bridges, formed of fresh cables and disintegrating cables held together by twisted bits of wire and bamboo. The bridges are around 40m in length and up to 10m above the valley floor, failure isn't a pleasant idea. After a couple of rises on the far side you reach the village, camouflaged by betelnut trees and surrounded by forest. There are many places to stay where there were once two, with the most popular foreign tourist spot right at the start of the village. The owner speaks good English, which makes things simple.

Within a few kilometers of stone (now concrete) paths in each direction are beautiful waterfalls, emerald pools, other villages. The guidebook attraction is the two storey 'living root bridge' which made the place famous. The temperature is pleasant, ranging on hot and humid in the late season.

If I try to describe what makes this place special it all stems from the absence of a road. The locals are hardy, and the tourists adventurous. There is no traffic problem here, and no pollution to speak of. The limited volume of tourist traffic keeps rubbish down. In essence nothing has changed. I realise my memory was a moment in time with a small group of people so in awe of the place we regressed to an almost childlike state. Everything was new. I remember painting with torches on slow camera exposures of the bridge, exploring the valley, accompanying a trip to the village to buy a local machete, riding on the roof of the Jeep, swimming, diving, sunbathing. The euphoria is gone, with just enough visitors now it's no longer a private party.

Naturally the tourist department wants to destroy this one thing that makes the place special. Despite the fact that Indian tourists do visit this place, and make the trek down the valley as part of their holiday... What would really improve this place is clearly a road, and a parking lot for hundreds of white tourist jeeps. This is the view of the people with money, the hotel developers of Sohra who want to turn the place into a government approved tourist site for government approved tourist vehicles to stop at for five minutes, throw their rubbish, and move on. I hope they never achieve this, but fear it is inevitable.

The journey: part 3-5

Part 3-5 of the journey, 1000km to 3820km.

At some point I stop forming new memories. Train sleep isn't real sleep, the occasional station stop, bright lights, beggars. Let alone the fact that always the 'ticket only' coach has about 16 people in the 8 bed compartment. I'd call second class sleeper a form of mild torture, and the train, a rolling cess-pit. This is heightened by the fact the sinks and toilets frequently run out of water.

The other guys in the compartment are all going to Assam bar one, and seem friendly enough. But they are from poor backgrounds, from the size of them they look like perpetual boys, and they don't speak a word of English. We bond a little over the 3 days, and they help me in a little of the negotiation for buying a gamcha. (Some sort of shoulder scarf which holds the head scarf in place). I wanted it to insulate myself from the dirtier parts of my seat-bed.

I don't remember much else from the middle days of the journey. Identical looking station platforms, identical drying cowpats on the walls. In the 56 hours it covers 2988km.

It's a chilly morning in Assam, it's much further north than when I started the journey. I stumble off the train at 7.15am. After 4 nights of train sleep everything is a little hazy, but I'm lucky. I've only lost my lucky charm on the journey. Right outside the station I stumble into a government bus to Shillong, and a very friendly man from one of the northeastern states directs me to a ticket counter. Within 15 minutes I'm already moving towards Shillong. On this bus I'm sat next to a local going to the same town (Sohra/Cherunpunji), and we wait for a shared sumo (Jeep) together. And it's done, I manage not to vomit on the Jeep and I'm there, sort of.

The journey: day 2

Part 2 of the journey, about 700km in

I arrive at Bangalore by 7.15am, almost on-time. It looks like the ticket counters don't open till 8 so I mill around the station. Bangalore city station is fairly developed: working electronic sign boards, some electronic ticket machines.

I pull off my second same-day booking with only a minor hitch. It is possible to book foreign tourist quota tickets from Bengaluru. It's not advertised, but the "senior and physically handicapped"* counter in the main station building can book this overlooked quota of tickets. (Looking at the weekly schedule for my train nobody else has). For the second time I have a train ticket for a service leaving the same day (technically), in about 16 hours. The foreign tourist quota is tiny, just 2 beds of the thousand on the train. But there is a catch, it's a lower bunk. The lower classes of Indian trains have a 3-level bunk, and in the daytime the middle bed folds away to make the seating on the lower bunk. The upper bunk allows 24 hour sleeping, and a little added security. The lower bunk prevents my usual strategy of sleeping in an almost vegetative state for the duration of the journey. It's going to be tough, I'll be on the train for the next 3 nights.

I waste 16 hours in Bengaluru until the train departs near midnight.

*India is at various points in the euphemism treadmill simultaneously. Disabled is the most common, followed by differently abled and occasionally handicapped.

The journey: day 1

Part 1 of a 5 day, 3820km overland journey.

I left the room at 10 slightly ill, this forced my hand, I was to take the AC train to Bengaluru... it also has toilets. I paid the hotel owner and sat down at a ticket booking office next door. I asked for a ticket to Bangalore, today, and much to his surprise there were still 5 AC tickets available (it's more expensive than the AC bus). It's pretty rare to book a sleeper train the same day in India.

This small step solved I then have to get to the start point of the train. While just 60km by road this is no mean feat by the buses of Goa, and will take over 3 hours. I race to the first bus stop in town and catch the bus to Mapusa at 10.45. I've been lucky, I have a seat, and can enjoy the countryside to the rhythm of the thumping complementary Hindi music. I get my money's worth of free music, the bus takes the round the houses route to Mapusa. Pink, green, blue, white with red trim, cream, purple, pink and green. It's easy to forget how bright the Indian houses are after so long in the country. These houses dot a Goa landscape of black rock, dusty red soil and yellow grass. The trees are a mix of palms, bananas, and the broad leaved species.

I get to Mapusa (eventually) and jump on a bus to Panaji which leaves a minute later. The saving grace of the trundling bus service is it's frequency. From Panjim I take a government shuttle bus (they still exist) and reach Vasco (De Gamma) by 1.45. I'm my usual fashionable self as I march around Vasco searching for an ATM which accepts international MasterCard, has Rs500 notes, doesn't charge credit cards, and can give a receipt. Sadly I don't find a machine with all of the above, and go without the receipt. In case you can't picture the British idiot abroad: dark grey baseball cap covering a shiny tanned face with a weeks stubble. Khaki green t-shirt, black rucksack, black backpack over the shoulder. Black shorts, thick grey socks and chunky walking shoes.

The train station has no electronic information boards, but it's pretty standard fare. A multitude of different offices for tickets, catering, waiting rooms, station masters, ticket officers, battery rooms, guards offices, railway protection offices and so on. After a brief panic, that I can't find the train, a helpful ticketing officer directs me to the end of the Delhi train. The last 3 coaches tacked on the end are a separate designation, the train will separate layer. At 15.10 it starts moving, and for at least a minute the vast train (20 something coaches) creeps out of Vasco. I'll save recounting the atmosphere of an Indian train for another day. After 50 minutes the train halts at Madgaon (railway)/Margao (everything else). You have to remember the railway name when dealing with the trains, most places have two names, thanks to the British/ French/ Portuguese. This is the transport hub for Goa and is on the coastal Cancona railway. It's also the home of a crumbling stretch of a 'sky-rail' mass-transit system of the future that wasn't. A few more people board. 6 hours into the journey and I can't be more then 70km from where I started. The edge of Goa is a beautiful hilly nature reserve, the train gives occasional views as it climbs through the hills.

In India the train changes around you. At Londa the three coaches destined for Bangalore are shunted out and back into another perform. They look slightly isolated standing at the platform on their own, a short distance behind another stray coach. At some point we are joined onto the back of the Kolhapur Bengaluru train.

The journey: a preview

I can't charge my phone on the 55 hour train to Guwahati, the blog will have to wait.

In the mean time I'll have to amuse myself, perhaps I could take advantage of the hourly at-seat Rubik's cube service.

Coeliac India survival guide

You try to eat gluten free, you get sick. You eat packaged food with listed ingredients, you get sick. After this you get frustrated, I'm only eating damn white rice and boiled eggs, then you find a Magi (wheat) noodle at the bottom of your bowl of rice. You get sick. I'm starting to think Indian-born coeliacs just die.

Apparently this isn't always the case, see BMJ article, but awareness is recent and the spread of information is limited. It could take a generation of doctors and patients before knowledge about coeliac spreads. Much like Italy in Europe, the first awareness is in the wheat centric regions of northern India. I'm guilty of the same mistakes mentioned in the article, I became coeliac in India and moved from doctor to doctor suspecting recurrent infections. It was only the UK blood test which revealed excess ttg gluten antibody levels, a food intolerance hadn't crossed my mind until this point.

The problem with staying gluten free in India is contamination and the hidden sources of gluten. Gluten can literally be hiding in your bowl of rice, with one careless stray wheat noodle. Simply having a rice based food, or ingredients list which doesn't include flour, is not enough. The worst culprit is 'hing'/asafoetida, which as a spice is ground with wheat flour. This is added to various curries, chutneys and pickles even in otherwise rice-based south India. After 7 days healthy on the beach it was my immune system which detected the hing. The telltale rasping breath, then the fatigue. I didn't know what it was, all I had done was add a bit of chili-lime pickle to spice up my daily veg-curry rice. It was googling a food blogger's work that revealed the hing, and lo and behold when I had a look in the kitchen, the chili pickle listed asafoetida. The same process repeated with the Indian snack containing fried gram flour noodles, which turn out to be not so pure gram (chickpea/lentil). The masala omelette (some masala mixes may contain wheat to prevent clumping/unscrupulous bulking). The stray noodle hiding in my bowl of rice was just to remind me that butch has nowhere to hide.

Fried food is a perpetual risk for coeliacs, this source of contamination isn't worth touching. As is the Indian love of Chinese flavours: fried rice, Manchurian and so on, which may include gluten-rich soy sauce.

There are then the regional traditions, tourist places will add bread to your omelette unless you ask otherwise. Unpalatable sweetened bread to suit the Indian market at that. The only option is to excise a safety zone of omelette which may have touched the bread and hope for the best. If you ask for an omelette without bread, you'll see the same omelette again. The only saving grace so far is that the local train catering has been serving the omelette and bread separately. The local variation on iced tea seems to be adding barley water, which is nice for non-coeliacs. I'll give credit to the local Starbucks which did give me a heads up on this tradition before the 'café coffee day' Apple refresher smacked me in the face.

For a summarised list of foods which are safe for coeliacs in India:
Coca cola
Fruit with skins
Boiled eggs with shell

May be safe, roll a dice, if less than 6 you survive:
White rice
Simple veg curry
Idli/dosage/masala dosa - usually safe but depends on the chutneys (asafoetida) or contamination
Papadum - unless it contains any flour or asafoetida

May be unsafe:
Chapati, roti, naan, pouri, samosa...
Chutneys/pickle. May be unsafe, asafoetida ground with wheat
Fried rice - soy sauce, gluten
Manchurian - soy sauce, gluten
Biryani: may have crispy breadcrumbs added for texture
Ice tea/local soft drinks: may contain barley water
Packaged crispy snacks with gram flour noodles - suspect wheat content (not listed)
Any fried/battered food: contaminated oil or flour.
Rava dosa - one reference for sometimes adding wheat flour.
Any powdered spices/spice mixes/masala (spice)
Masala omelette