Lax inspections, unhygienic surroundings in popular food hubs have led to a rise in foodborne illnesses
KARACHI:
As thousands flock to Karachi’s bustling food streets, many end up in overcrowded emergency rooms as doctors increasingly link rising cases of diarrhoea, gastroenteritis and food poisoning to mouth-wateringly deadly street food favourites.
Food is a city’s identity, and few cities in Pakistan are as famous for street food as Karachi. From samosas, chaat and pani puri to bun kebabs, falooda, khow suey and layered biryanis, the city’s culinary culture is built around affordable roadside stalls that attract hundreds of customers daily. Yet beneath the aromas and flavors lies the bitter reality, a growing public health crisis that the authorities have not resolved.
Across Karachi, unregulated and poorly monitored food streets have grown along broken roads and open sewage drains. In areas like Lyari,
Lee Market and Ranchhor Line, stalls selling ready-to-eat food operated next to overflowing gutters with untreated sewage. Similar conditions are visible in some of the city’s most popular food destinations, including Burns Road, Boat Basin, Tariq Road and MA Jinnah Road.
While these places are often promoted as organized food hubs, large sections continue to operate in unhygienic surroundings. In several places with street food stalls, stagnant sewage collects near cooking areas, giving off a strong stench. Despite these conditions, many of the outlets prominently display valid Sindh Food Authority licenses, highlighting the disconnect between authority approval and actual food safety.
Under the Sindh Food Authority Act, 2016, all food business operators are legally required to obtain a license before selling food to the public, ensuring minimum hygiene standards, safe food handling practices and routine inspections. However, the presence of a license displayed at a stall or eatery has done little to improve conditions on the ground.
According to this law, food business operators are required to obtain separate licenses for each business, even when operating under the same brand. Each license is valid for one year and must be renewed annually for a fixed fee. While the official fee is relatively small, the licensing process often involves additional informal costs. Several operators claim that failure to make these extra payments results in repeated objections or threats of closure.
As a result, licenses are often issued without thorough inspections, and in some cases without inspectors ever visiting the premises. Even in areas marketed as organized food streets, food is often prepared and served in the open, without protection from dust, vehicle emissions or insects. Broken sidewalks and overflowing trash cans create an environment where pollution becomes inevitable.
In the absence of effective enforcement, it becomes clear that licenses have little meaning in terms of the hygiene element of street food. This is strongly associated with foodborne illness. Former Secretary General of Pakistan Medical Association, Dr. Qaiser Sajjad, warned that food streets established next to open sewage drains pose a serious danger to public health.
“The stench rising from these drains carries bacteria and harmful particles that settle on exposed food and enter the human body through both ingestion and inhalation.
Dust from broken and unpaved roads further contaminates food, while vehicle emissions add another layer of exposure. Pathogens commonly found in such environments include Escherichia coli, Salmonella and Shigella, which can cause diarrhoea, gastroenteritis, dysentery and food poisoning,” said Dr Sajjad.
“Contaminated water is often used to wash utensils, plates and spoons at roadside stalls, increasing the risk of disease transmission,” added Dr. Sajjad, who further revealed that Karachi’s high levels of air pollution, coupled with dust settling on food, also contributed to respiratory problems such as asthma, bronchitis and allergies. “In this scenario, the increased prescription of antibiotics also raises concerns about antibiotic resistance as a secondary public health challenge,” noted Dr. Sajjad.
Hospitals reported a steady influx of patients, especially in the warmer months when food spoils faster and bacteria multiply faster. The situation has put additional pressure on already overburdened public health facilities. Dr. Khalid Bukhari, Medical Superintendent of Civil Hospital Karachi, pointed out that diarrhea cases increased between May and October and continued to increase every year.
“Substandard food sold at unsafe roadside food stalls is causing an increase in diarrhoea. Stomach ailments in children are largely caused by colorful syrups and drinks sold at roadside stalls in summer, while adults fall ill mainly due to unhealthy food,” said Dr. Bukhari who appealed to parents and general public in eating street food and prevent children from eating street food.
It is the emergency departments of the hospitals that absorb this daily burden. For example, at the Civil Hospital Karachi, 22 to 25 patients are brought to the ward every day with diarrhoea. This results in more than 750 cases per month and over 9,000 annually. From January to December 2025 alone, the hospital recorded 6,527 cases of diarrhea and gastroenteritis among children.
According to Sindh Government Liaquatabad Hospital records, 50 to 60 patients suffering from diarrhea and gastroenteritis arrive daily, especially from areas like Nazimabad, Golimar and other parts of the central district. This adds up to more than 1,800 cases per month and over 21,000 annually.
Dr. Atiq Qureshi, medical superintendent of the hospital, told The Express Pakinomist: “The rise in cases is directly linked to contaminated water consumed in hotels and unhygienic food sold on unsafe food streets.” Similarly, at the Sindh Government Saudabad Malir Hospital, 60 to 70 diarrheal patients are reported every day.
Dr. Agha Amir, medical superintendent of the hospital, confirmed that the number of such patients almost doubled during the summer months of April, May and June. “Diarrhea patients are treated through drip and ORS,” said Dr. Amir and noted that dehydration remained a major complication in such cases.
Data from the Jinnah Postgraduate Medical Center revealed that 80 to 90 patients with gastrointestinal disorders were treated daily. Although numbers dropped in the colder months, doctors maintained that contaminated food and water remained year-round contributors. The new Karachi Hospital receives 20 to 28 such patients every day, while the Lyari Hospital reports 30 to 32 cases of diarrhea and gastroenteritis daily. Across hospitals, school-going children are identified as particularly vulnerable, according to The Express Pakinomist’s investigation.
A 2023 study on the risk of foodborne illness provides scientific evidence of how unsanitary environments and practices lead to harmful illnesses. The research was conducted by the Institute of Environmental Science at the University of Karachi, in collaboration with the School of Public Health at Dow University of Health Sciences, and examined the microbiological quality of street food sold near major public hospitals.
Food samples were collected from stalls within a 0.5-kilometer radius of facilities including Jinnah Hospital, Civil Hospital and Landhi Korangi Hospital. The study focused on commonly consumed street food such as bun kebab, chaat, samosa, chicken rolls and pakoray. Laboratory analysis revealed widespread bacterial contamination.
Both Gram-positive and Gram-negative bacteria were isolated, including E. coli, Enterobacter, Pseudomonas, Salmonella, Bacillus subtilis, Staphylococcus aureus and Enterococcus faecalis. E.coli was the most prevalent organism and was detected even in fried items, suggesting contamination after cooking.
The study showed that water quality played a significant role in this pollution. Street vendors depend on water for washing hands, cleaning utensils and preparing chutneys and sauces. Due to limited access to tap water, many suppliers recycle water throughout the day, redistributing microorganisms across foods. Poor handling practices further increase the risk.
The survey also found that most suppliers lacked basic food hygiene training. Aprons, gloves and caps were rarely used, and food was handled with bare hands. Items were often served in polythene bags, old newspaper or recycled paper. Inadequate waste disposal was widespread, with food waste being discarded near stalls, attracting flies identified as carriers of disease-causing micro-organisms. Despite licensing requirements, enforcement of hygiene standards has remained weak. With infrequent food inspections and inconsistent monitoring, consumers bear the health consequences. The Express Pakinomist tried to contact Sindh Food Authority Director General Shahzad Fazal Abbasi regarding the number of licenses issued in Karachi and the inspection mechanism, but received no response despite several reminders.
