Poor handling of food in roadside eateries raises concerns about foodborne illnesses

It's not unusual for one or two family members to occasionally experience diarrhoea, but recently, Cynthia Namatsi and her family of six were alarmed when the entire household started showing symptoms of diarrhoea, chills, and vomiting — an experience she had never encountered before.

Despite always taking precautions to ensure proper food handling, they couldn’t figure out the cause until they noticed an unusual smell coming from the tap water, which resembled the stench of sewage.

"At first, I thought it was just due to Christmas and people overindulging in food. But when everyone in the household started experiencing the same symptoms, I couldn’t understand what was happening because we always boil our water," Cynthia explains.

She stresses that she is very cautious about cleanliness and the preparation of food. However, the smell of the water caught them completely off-guard.

"I think many of us only noticed the foul smell after we had already used the water, and by then, it was too late. We just treated the symptoms with antibiotics and reported the matter to the county."

Although Cynthia keeps a close eye on what her family eats and how meals are prepared, there are times when it’s difficult to monitor everything, especially when they are not at home. This situation was a reminder that even with careful supervision, unexpected issues can still arise.

Roadside eateries

Food poisoning is becoming an increasing concern in Kenya, largely due to poor food handling in roadside eateries and contaminated water. While county officials have exposed some of these issues, many Kenyans still fail to take the matter seriously, often ignoring the long-term consequences.

While Anne Mburu doesn’t know much about food poisoning, she knows that her environment is far from clean, and she feels helpless.

Living in Nairobi’s Majengo slums, she faces the constant challenge of managing diarrhoea in her children every month. This is made even harder by the lack of medication at public hospitals, despite government promises to restock supplies. The sight of her children falling ill fills her with dread.

"When diarrhoea strikes, the hospital bills can be overwhelming, especially since the local dispensary is often out of medicine. Sometimes, I’m left with no choice but to let them suffer and hope it passes," Anne explains.

She often treats her children for diarrhoea more than three times a month. The ongoing cycle of illness and rising costs is a heavy burden, revealing the harsh realities of life in the slums, where basic healthcare is a luxury few can afford.

“There’s a sewer line right outside my house, and sometimes I catch my kids playing in that filthy water. It terrifies me. I try my best to clean the area, but it feels like an endless battle,” she says, her worry evident.

With overflowing sewers and stagnant water in constant presence, Anne knows her home poses serious health risks. The weight of living in such conditions serves as a daily reminder of the challenges they face.

Ongoing concern

From contaminated water to constant exposure to filth and sewers, Anne’s environment makes food and water poisoning an ongoing concern, adding to the many struggles she endures.

While many people follow proper hygiene practices at home, many neglect these habits when they’re outside, often touching roadside food with their hands without using sanitiser or washing their hands.

Most roadside food vendors lack water or even sanitiser, putting the public at risk of food poisoning. Many fruits sold in these areas are only sprinkled with water, with little to no effort to properly wash them.

Similarly, vegetables are often not cleaned thoroughly, which continues to strain the healthcare system.

Recently, the Nairobi City County government discovered that some food handlers were storing their equipment in toilets, highlighting the poor conditions in which food is prepared and stored. Despite these revelations, the assumption that food from such vendors is safe continues to persist among many Kenyans.

Dr Esther Mwaura, a doctor in Eastleigh, explains that food poisoning is a common issue she encounters regularly, especially due to the widespread habit of eating from unhygienic food vendors or consuming contaminated water.

“When we take the history of the patients to understand the possible cause, eating fast food at local joints is a major contributor. Many people don't take precautions when consuming this food,” she notes.

Children's health at risk

The situation becomes even more concerning when it comes to children.

Mwaura says that some parents purchase fast foods or snacks from unregulated joints, where the food is often poorly packed, putting children's health at risk.

Food poisoning, a type of foodborne illness, occurs when people eat or drink something contaminated with harmful germs or substances. Common symptoms include an upset stomach, diarrhoea, vomiting, abdominal cramps, nausea, loss of appetite, mild fever, weakness, and headache.

These pathogens are found in almost all the food we eat. However, heat from cooking usually kills the harmful microorganisms before the food reaches the table.

Foods eaten raw, however, are more likely to cause food poisoning as they haven't been cooked to eliminate potential pathogens. Additionally, food can be contaminated if it comes into contact with faecal matter or vomit, often due to improper hygiene practices by the person preparing the food who hasn’t washed their hands.

Common foods that are frequently contaminated include meat, eggs, dairy products, and water.

What to do when you have food poisoning

Mwaura advises focusing on effective remedies for alleviating symptoms and supporting recovery from food poisoning.

Here are three key steps to take, along with the use of antibiotics and seeking medical attention when necessary:

Activated charcoal

Activated charcoal is a natural remedy that can help absorb toxins in the stomach and intestines, preventing them from being absorbed into the bloodstream.

However, one should avoid taking charcoal with other medications as it may interfere with their absorption. It is most effective when taken early in the course of food poisoning.

Hydration and oral rehydration solutions

Dehydration is a common issue caused by vomiting and diarrhoea during food poisoning. It's essential to stay hydrated and replenish electrolytes.

In such situations, one should drink plenty of water.

One can also use an oral rehydration solution (ORS) to restore lost electrolytes and prevent dehydration.

If symptoms persist or worsen, such as high fever, prolonged vomiting, severe diarrhoea, or blood in stools, seeking medical attention is crucial. In some cases, a doctor may prescribe antibiotics to treat bacterial infections responsible for food poisoning.

Antibiotics may be prescribed if the food poisoning is caused by bacterial infections such as Salmonella, E. coli, or Shigella.

Raising awareness

Mwaura emphasises the importance of raising awareness about food safety and its long-term impact on health. If left unchecked, frequent cases of food poisoning could lead to a weakened immune system.

“When you notice frequent episodes of food poisoning, it’s important to seek further tests. You could be dealing with underlying conditions like tuberculosis or H. pylori infections. If untreated, these conditions may even lead to gastrointestinal cancers,” she warns.

The World Health Organisation reports that approximately 600 million people – nearly 1 in 10 people globally – fall ill from consuming contaminated food, with 420,000 dying each year.

Unsafe food results in a loss of US$ 110 billion annually in productivity and medical expenses, particularly affecting low- and middle-income countries.

Children under the age of five are especially vulnerable, carrying 40 per cent of the foodborne disease burden, which leads to 125,000 deaths annually.

These diseases also impede socioeconomic development by overwhelming healthcare systems and negatively impacting national economies, tourism, and trade.

Contaminated food, which may contain harmful bacteria, viruses, parasites, or chemicals, can cause over 200 different diseases, ranging from diarrhoea to cancer.

A study by the Kenya Medical Research Institute (Kemri) revealed concerns about the contamination of raw pork and poultry meat in supermarkets. The research, conducted in collaboration with experts from World Animal Protection, the Centre for Microbiology Research and Kemri, indicated the potential risks of bacterial contamination and the spread of foodborne illnesses from consuming such meat.

Several challenges have been undermining food safety in Kenya, including weak coordination and oversight among institutions, poor harmonisation of standards and regulations, insufficient consumer protection, inadequate laboratory and surveillance systems, and a lack of awareness and capacity-building initiatives for consumers.