Salsa, also known as kachumbari in Kenya, made from raw tomatoes, onions, lemon juice, and salt, has become a popular street food and is even served in restaurants.
However, with its rising popularity, the risk of foodborne illnesses, particularly Helicobacter pylori (H. pylori), is increasing.
Doctors say with its increased uptake, vendors and chefs are serving up a heightened risk of H. pylori, an infection that is growingly becoming common and causes stomach ulcers (peptic ulcers).
The hawkers with carts on the streets lack basic kitchen equipment and handle the kachumbari often left unchilled and unheated, ideal for the growth of germs. And some vendors wash their hands so seldom and touch the food with the same hands that they use to pick money.
Others pull on a pair of soiled rubber gloves, while others reuse.
Why kachumbari is riskier
Dr Ajua Nkeng Alemanji, a gastroenterologist at Gastro Hub Clinic in Nairobi, explains that foodborne diseases are a significant concern in urban areas where street food is common.
“The inherent risk is the possibility of contracting foodborne diseases such as cholera, amoebiasis, and typhoid. H. pylori is a common disease that you can pick up from eating street food, especially when proper hygiene is not observed,” he says.
Dr Ajua explains that the raw nature of kachumbari makes it particularly risky. Once the tomatoes, onions, and cilantro (coriander) are chopped and served, it’s impossible to clean them.
“Even if the vendor tries to wash the vegetables, if the water is contaminated, it’s as if the vegetables were never washed at all,” he says.
Some kachumbari lovers can also come in contact with an infected person’s hands whose vomit or stool has the germs.
Rising demand
Despite the health risks, Kenyans continue to flock to their favourite street food vendors or open-air restaurants.
One such vendor is Hassan Ibrahim, who operates a food stall in Nairobi’s Central Business District (CBD). Hassan serves boiled eggs, sausages, potatoes, chapatis, and, of course, kachumbari.
When asked about his preparation method, Hassan quickly shares: “I make it by hand. Customers love it!” he says. “I buy very ripe tomatoes because they’re juicier and easier to cut. I also go for big purple onions because they give the kachumbari a richer taste.”
A food vender prepares Kachumbari in a Nairobi street in this picture taken on January 29, 2025.
Photo credit: Dennis Onsongo | Nation Media Group
Hassan buys around 12 kilos of tomatoes, two kilos of onions, 500 grammes of red pepper, and some coriander leaves daily for his kachumbari.
He admits he has no running water at his stall, so he relies on a 20-litre container, which he uses sparingly. From all the washes, he says, he changes the water twice.
“Water is scarce in the city centre; sometimes we reuse the water, but we wash the food thoroughly,” says Hassan, whose typical workday involves long hours from Monday to Sunday.
Hassan used to prepare the kachumbari at home but noticed customers were sceptical. “Now, they can see everything is fresh,” he explains. “I don’t have leftovers anymore; everything gets sold out.”
While Hassan does not earn a fixed salary, he estimates his weekly earnings range from Sh8,000 to Sh10,000, depending on customer traffic.
Street vending has changed markedly in recent years as vendors have expanded their menus in search of better profits, adding kebabs and chapati to boiled sweet potatoes.
Next to Nairobi’s River Road, another vendor, Shadrack Mwenje, shares his experience. Shadrack sells eggs, chapatis, sausages, and kachumbari, and on a good day, he can earn up to Sh6,000, selling six to 15 trays of boiled eggs and other items. “Kachumbari is more than just a side dish; it’s part of the experience,” he says.
While consumers should exercise caution in choosing where they eat, Dr Ajua adds that the burden of ensuring food safety largely falls on the government and public health systems.
“It’s difficult for the average person to mitigate the risks of street foodborne diseases. The responsibility falls on county health and public health officials to regularly inspect street food vendors and ensure they are adhering to sanitary standards,” he says.
However, even if the government were to consider training the vendors on the required safety training, a majority lack permits.
Training on hand washing, for instance, is critical because it also prevents food handlers from spreading hepatitis A and Staphylococcus aureus, a bacteria spread by sneezing or coughing and causes infections such as boils.
For consumers, Dr Ajua, says, “Look at the environment where the food is being prepared. If you’re buying kachumbari from a vendor near a sewer line or a garbage dump, that’s an obvious red flag.”
Dr Ajua says because, as consumers, you cannot tell whether the food you are buying is safe just by looking at it, he recommends opting for whole fruits and vegetables that can be washed or peeled at home rather than pre-sliced or pre-prepared items.
“If you’re buying an apple, orange, or mango, it’s safer because you can take it home, wash it properly, and then eat it. But with pre-sliced foods like kachumbari, the damage is already done if the vegetables were not washed properly,” he says.
MaryAnne Wanza, a registered nutritionist and dietitian, raises concerns about the method of preparation for kachumbari, especially the chopping and mixing of vegetables in open-air stalls.
She explains that improper handling can expose the food to bacteria like E. coli and salmonella. Bacteria can multiply whenever food, whether raw, partially cooked, or fully done, sits out at temperatures between 45 and 140 degrees.
“I’ve seen patients develop serious gastrointestinal issues after eating contaminated kachumbari,” she says, “the utensils, cutting surfaces, and even the hands of the person preparing the food all contribute to the overall safety of the kachumbari,” she says.
Kachumbari offers nutritional benefits, such as the lycopene found in tomatoes, which is known to reduce the risk of heart disease and certain cancers, but Dr Ajua adds, “But if you’ve already had your fill of vegetables for the day, the small portion in kachumbari won’t make much of a difference.”
