Lax inspections and unsanitary environments at popular food centers have led to an increase in foodborne illnesses.
KARACHI:
As thousands flock to Karachi’s vibrant food streets, many are ending up in packed emergency rooms, as doctors increasingly link rising cases of diarrhea, gastroenteritis and food poisoning to mouth-watering and deadly street favorites.
Food is the identity of a city, and few cities in Pakistan are as famous for their street food as Karachi. From samosas, chaat and pani puri to bun kebab, falooda, khow suey and layered biryanis, the city’s food culture is built around affordable roadside stalls that attract hundreds of customers daily. However, behind the aromas and flavors lies the bitter reality: a growing public health crisis that authorities remain unaddressed.
Across Karachi, unregulated and poorly monitored food streets have grown along deteriorating roads and open sewage drains. In areas like Lyari,
Lee Market and Ranchhor Line, stalls selling ready-to-eat foods operated alongside overflowing gutters carrying raw sewage. Similar conditions are visible in some of the city’s most popular dining 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 environments. In several places with street food stalls, stagnant sewage accumulates near cooking areas, producing a strong stench. Despite these conditions, many of the outlets prominently display valid licenses from the Sindh Food Authority, highlighting the disconnect between regulatory approval and actual food safety.
According to the Sindh Food Authority Act 2016, all food business operators must 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 restaurant has done little to improve conditions on the ground.
Under this law, food business operators must obtain separate licenses for each establishment, even when operating under the same brand. Each license is valid for one year and must be renewed annually against a fixed fee. Although the official fee is relatively small, the licensing process often involves additional informal costs. Several operators allege that failure to make these additional payments leads to repeated objections or threats of closure.
As a result, licenses are often issued without thorough inspections and, in some cases, without inspectors visiting the facilities. Even in areas marketed as organized food streets, food is often prepared and served outdoors, without protection from dust, vehicle emissions or insects. Broken sidewalks and overflowing trash bins create an environment where pollution becomes inevitable.
In the absence of effective enforcement, it is clear that licenses have little meaning when it comes to the hygienic element of street food. This is strongly linked to foodborne illnesses. Dr Qaiser Sajjad, former general secretary of the Pakistan Medical Association, warned that food streets set up next to open drains posed a serious danger to public health.
“The stench that comes out of 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 these environments include Escherichia coli, Salmonella and Shigella, which can cause diarrhea, gastroenteritis, dysentery and food poisoning,” said Dr. Sajjad.
“Contaminated water is often used to wash utensils, plates and spoons at street stalls, increasing the risk of disease transmission,” added Dr Sajjad, who further revealed that high levels of air pollution in Karachi, combined with dust settling on food, were also contributing to respiratory problems such as asthma, bronchitis and allergies. “In this scenario, the increase in antibiotic prescribing also raises concerns about antibiotic resistance as a secondary public health challenge,” Dr. Sajjad noted.
Hospitals reported a steady influx of patients, especially during the warmer months, when food spoils faster and bacteria multiply more quickly. The situation has put additional pressure on already overstretched public health facilities. Dr Khalid Bukhari, medical superintendent of Karachi Civil Hospital, said cases of diarrhea increased between May and October and continued to increase every year.
“Inferior quality foods sold on unsafe roadside food streets are causing an increase in diarrhoea. Stomach illnesses in children are largely caused by colorful syrups and drinks sold at street stalls during summer, while adults fall ill mainly due to unhealthy foods,” said Dr Bukhari, who appealed to parents and the general public to prevent children from eating and drinking on unsafe food streets.
It is the hospital emergency rooms that absorb this daily load. For example, at Karachi Civil Hospital, 22 to 25 patients with diarrhea come to the department every day. This translates into more than 750 cases per month and more than 9,000 per year. From January to December 2025 alone, the hospital recorded 6,527 cases of diarrhea and gastroenteritis among children.
According to the records of Sindh’s Liaquatabad government hospital, 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 more than 21,000 per year.
Speaking to Express PAkGazette, Dr Atiq Qureshi, medical superintendent of the hospital, shared: “The rise in cases is directly related to contaminated water consumed in hotels and unhygienic food sold on unsafe streets.” Similarly, in Sindh’s Saudabad Malir government hospital, 60 to 70 patients with diarrhea are reported every day.
Dr Agha Amir, medical superintendent of the hospital, confirmed that the number of these patients almost doubled during the peak summer months of April, May and June. “Patients with diarrhea are treated with drips and ORS,” Dr. Amir mentioned, noting that dehydration remains a major complication in these cases.
Data from Jinnah Postgraduate Medical Center revealed that 80 to 90 patients were treated daily for gastrointestinal problems. Although numbers decreased during the colder months, doctors maintained that contaminated food and water continued to contribute year-round. New Karachi Hospital receives 20 to 28 such patients every day, while 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 PAkGazette investigation.
A 2023 study on the risk of foodborne illness provides scientific evidence of how unhygienic environments and practices lead to harmful diseases. The research was conducted by the Institute of Environmental Sciences, University of Karachi, in collaboration with the Faculty of Public Health, 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 the facilities, including Jinnah Hospital, Civil Hospital and Landhi Korangi Hospital. The study focused on commonly consumed street foods such as bun kebab, chaat, samosa, chicken rolls and pakoray. Laboratory analysis revealed widespread bacterial contamination.
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, indicating contamination after cooking.
The study revealed that water quality played an important role in this contamination. Street vendors depend on water to wash their hands, clean utensils and prepare chutneys and sauces. Due to limited access to tap water, many vendors reuse water throughout the day, redistributing microorganisms among foods. Poor handling practices further aggravate the risk.
The study also found that most vendors lacked basic training in food hygiene. Aprons, gloves and caps were rarely worn, and food was handled with bare hands. Items were often served in polythene bags, old newspapers or reused paper. Improper waste disposal was widespread: food waste was dumped near stalls, attracting flies identified as carrying pathogenic microorganisms. Despite licensing requirements, enforcement of hygiene standards remains weak. Because food inspections are infrequent and monitoring is inconsistent, consumers bear the health consequences. The Express PAkGazette attempted to contact Sindh Food Authority Director General Shahzad Fazal Abbasi regarding the number of licenses issued in Karachi and the inspection mechanism, but did not receive a response despite multiple reminders.
