Buyer beware: What you eat here might just kill you

You can catch Caroline at the bus station near Kayole Primary School at 5.30am every morning, waiting to catch a bus to Muthurwa Market on the fringes of Nairobi’s Central Business District.

Caroline has a stall at the second entrance just opposite the bus station, where she prepares and serves tea, chapati and mandazi, and she has to be there early to get a hold of lorry drivers dropping off farm produce in the wee hours of the morning, and their early bird customers.

Next to her stall are heaps of rotten cabbage and sukuma wiki leaves, with raw sewage flowing farther down. Next to the decomposing heaps of garbage, the lorries offload carrots, green maize, cabbages, sukuma wiki and Irish potatoes, which will end up in the stomachs of Nairobi residents.

Caroline cooks her chapatis and sets them on a table uncovered, where hungry traders can come and select a chapati of their choice with bare, unwashed hands.

At 8am, it is time to begin lunch preparations. One of Caroline’s employees picks up cabbages spread out on the ground, takes a knife and, without washing them, begins to chop them. She does the same for tomatoes and onions, then fries the vegetables for a stew, which will be served with ugali, set on the table next to the chapati. The ugali is covered with a polythene bag.

There are 10 such open-air hotels, serving the traders who operate from Muthurwa Market every day. Next to Caroline’s stall is a woman selling fruits. One of the oranges she is putting in a pile rolls into a stream of brackish water. She picks it up, wipes it with her wrapper and puts it back on the pile.

In Wakulima Market up the road, the smell of decaying vegetables and urea makes noses twitch, and it gets worse at the section next to Nairobi River.

In Kangemi Market – known for fresh farm produce and fruits – the situation is not any better. The road next to the market is under construction and traders jostle for space with matatus and pedestrians. As they cut and sell sliced watermelon and pineapples, heavy trucks turn, blowing dust onto the ready-to-eat fruits.

EXHAUST FUMES

In Nakuru’s Top Market, piles of plastic and unwashed food containers litter the market, as customers eat lunch while swatting flies outside the numerous food stalls. A trader rolls chapati as black matatu exhaust fumes blow into the frying pan and into a sufuria of tea boiling on the fire. He hands a hot chapati to a waiting customer who wolfs it down.

In Kongowea Market in Mombasa, Mwende Mutua, who sells tomatoes, says that poor drainage and negligence by county cleaners have made the market dirty, with heaps of dirt and decomposed leftover produce littering the market.

Ms Mutua spreads her tomatoes next to a shallow tunnel filled with dirt. When it rains, the leftover produce mixes with mud. At another part of the market, Maureen Moraa, who sells dried cereals next to a heap of garbage, says she is now used to the situation.

Many of Kenya’s public markets are filthy, lack water and have unclean toilets, something that Dr Jalab Ashraph of Kisima Health Facility in Mombasa says poses a risk to both the traders and their customers.

FOODBORNE DISEASES

“They are exposed to foodborne diseases such as typhoid, dysentery and cholera, and the unhygienic conditions attract rodents and fleas,” he said, adding that markets should have improved hygiene standards, toilets and clean water, and that traders should be vaccinated and sensitised on public health standards.

A 2015 food safety study by Dr Simon Ndiritu, the head of agribusiness at the Strathmore Business School, found that Kenyans from low socio-economic households are most vulnerable to unsafe foods.

Dr Ndiritu noted that the respondents bought their food from open-air vendors, and that they did not care where the food came from, as long as it was cheap and looked healthy.

Where water access is problematic, traders might use contaminated water to wash fruits and vegetables, exposing consumers to foodborne diseases.

Foodborne illnesses can affect anyone, contributing to a growing disease-burden that continues to clog health facilities and derail economic development.

The symptoms of food-borne diseases range from mild (nausea, vomiting, and diarrhoea) to debilitating and life-threatening (such as kidney and liver failure, brain and neural disorders, paralysis and cancers), leading to long periods of absenteeism and premature death.

CONTAMINATED WITH BACTERIA

Kenya has no definitive statistics on food-borne illnesses, but according to the World Health Organisation, food contaminated with bacteria, viruses, parasites, toxins or chemicals causes more than 600 million people to fall ill, and 420,000 people to die worldwide, every year.

In a report released during a recent food safety conference in Addis Ababa, the global health agency noted that illness linked to unsafe food overloads healthcare systems and damages economies, trade and tourism. The impact of unsafe food costs low- and middle-income economies around Sh9.5 trillion in lost productivity each year.

“Food should be a source of nourishment and enjoyment, not a cause of disease or death,” said WHO Director-General Tedros Adhanom Ghebreyesus, adding that food safety must be paramount at every stage of the food chain, from production to harvest, processing, storage, distribution, preparation and consumption.

“Unsafe food is responsible for hundreds of thousands of deaths every year but has not received the political attention it deserves. Ensuring people have access to safe food takes sustained investment in stronger regulations, laboratories, surveillance and monitoring.”

According to the 2015 Global Burden of Foodborne Diseases, the highest burden is felt in Africa, which accounts for a third of the death toll attributed to 31 main food hazards, something that got the African Union Chairperson Moussa Faki Mahamat to note that unsafe food is a threat to food security.

“Safeguarding our food is a shared responsibility. We must all play our part. We must work together to scale up food safety in national and international political agendas,” he said at the conference that noted that urbanisation poses a new challenge to food safety.

HYGIENE STANDARDS

Nakuru public health officer Samuel King’ori said that the county conducts random medical checks on food handlers to ensure that they conform to hygiene standards.

“Past experience has shown that mass closure of eateries is not the best solution, because when you do that, the traders end up cooking in the public toilets which is even more dangerous,” said Dr King’ori.

According to the Centers for Disease Control in the US, raw meat and chicken products are associated with harmful organisms such as bacteria, salmonella, campylobacter, listeria and parasites, and though cooking destroys these harmful organisms, the food can be contaminated again if not handled and stored safely.

Fresh produce including vegetables, fruits and juices may come in contact with harmful bacteria from many sources – from contaminated soil and water in the fields to a contaminated cutting board in the kitchen. Many studies have found that fruits and leafy vegetables contain high levels of pesticide residue and heavy metals, because of unscrupulous farming practices such as using contaminated water and failing to wait out the requisite period of time between spraying and harvesting and proper washing before eating.

FOOD SAFETY REGULATIONS

Even as Kenyans buy food sold in unhygienic markets, Kenya lacks a comprehensive food safety and nutrition policy, as a document introduced in parliament to set the framework has not seen light of day. Without clear food safety regulations, traders in market operate without official guidance.

According to Director of Public Health Kepha Ombacho, the department has released several circulars to highlight cases of food contamination, but a lot of work remains to be done to teach the public about handling food safely.

“Food safety is a shared responsibility. We can enact policy and raise awareness, but the public must also play a role by reporting (to the authorities) when they come across suspect food and observe hygiene and proper cooking,” said Dr Ombacho.

Additional reporting by Francis Mureithi and Cece Siago.