As Ahmad takes the final bite from his sandwich, he smiles and utters “I don’t complain of any illnesses”. Every day, Ahmad, a salesman at the vegetable market, has his lamb sandwich for lunch from “Abu Abed”, one of the oldest of four remaining meat stalls in the “Al Hal” markets in Aleppo. Ahmed is one of the many workers in “Al Hal” market, who buy their lunch from “Abu Abed’s” street stall. The workers also buy grilled meat sandwiches from a young man whose stall is located at the forefront of the market. The young man inherited this stall from his father six years ago. Next to Abu Abed’s stall there is another one owned by Omar who also inherited the stall from his father, which is the case for most stall owners. The street stalls consist of a large flat piece of wood that is placed over an empty barrel. The knives, spices, vegetables and uncovered meat sit on top of the wooden plank. A piece of glass is sometimes placed on the tip of the plank standing between the buyer and the seller, imitating that of a restaurant window.
From Aleppo to Damascus
Street stalls like those owned by Abu Abed, Omar and two others in “Al Hal” market and the main bus station in Aleppo, are very similar to those located in Damascus. Most street stalls are found where large groups of people gather. You will find one street stall at the bus platforms, one at the “Abbaseen”, one at the industrial site, one at the Pullman garage, and two at the “Al Baramika”. The two stalls at “Al Baramika” are distinctive from the others because they are active throughout the night. They sell sandwiches from sun-set to sun-rise. Close to the area of “Tadamun” there are two street stalls and one located at the door of the “Jarmana” area. Overall there are eight street stalls in Damascus. Each stall sells around 100 sandwiches, thus a total of 800 sandwiches are sold and eaten every day in the streets of Damascus.
The street stalls are identical in the way they operate and sell uncovered meat in the form of coal-grilled meat sandwiches. The source of the meat is unknown and is not under the supervision of any quality control regulations even though between 2008 till mid-2009 meat topped the list of contaminated foods.
The streets of Homs ,however, are free of stalls which cannot be found even in the popular markets and bus stations where they would have usually been found. This is because shops are now located in these busy locations and have limited the spread of stalls. This strategy used in Homs is not popular in Aleppo or Damascus even though street stalls are considered illegal, according to Director of Health Affairs in the Governorate of Damascus, Dr. Tarek Sarsar. He believes that meat stalls are “forbidden altogether” adding that if any patrols from the Ministry of Health come across any of the stalls in the streets, they will be confiscated immediately under the supervision of specialized committees. Exposed to bacteria and pollution, the meat in these stalls has to be disposed of according to Circular No. 100 issued on 28 October 1997 by the Ministry of Supply and Internal Trade, currently the Ministry of Economy and Trade.”
A study was conducted by “Al Watan” newspaper on four samples taken from different locations where meat is sold in Aleppo. These samples were tested under Syrian specifications with the results coming back as “acceptable” levels of bacteria found in the meat. In Damascus however, the results were unpleasant. Two meat samples taken from sandwiches sold in street stalls were “unacceptable” for human consumption and were not in compliance with Syrian specifications. One of the samples contained a higher level of bacteria than is acceptable and according to the report from the Central Laboratory of the Ministry of Economy and Trade, the sample “contained more than one million bacterial colonies per gram, which does not comply with standards that specify that for every gram of food bacterial colonies should be less than one million.”
Head of Analysis at the Laboratory, Thaer Hassan, explained that “the analysis gives an overall idea of the presence of bacteria in 10 grams of food. If a bacterial content in 10 grams of food exceeds one million colonies per 1 gram, then the sample is considered unfit for human consumption. The actual number of bacterial colonies is not mentioned in the laboratory report, because as long as it exceeds the specified level, it is not accepted. The second sample was not accepted because of the increased level of air bacteria and Coliform bacteria”.
Dr. Tayseer Al Buni from the Department of Microbiology at the Faculty of Medicine, University of Damascus states that the likelihood of bacterial contamination “starts from the early stages of preparing the meat into a sandwich, up until it reaches the mouth of the consumer.” Dr. Buni explained that air bacteria are identified “in numbers only and not by type, which further complicates the issue.”
Regarding the samples that were positively analyzed for bacteria and had been taken from other stalls identical to the above-mentioned one where the contaminated sample was found, Hassan stated :“when 100 samples are analyzed and one or more don’t conform to specifications, then the whole batch is identified as unfit for human consumption.”
Hassan gave the example of canned meat: “If the laboratory took 10 samples from one batch of canned meat and only one of the samples came back positive for exceeding the specified bacterial content, then the laboratory does not certify 9 samples as “acceptable” and one as “unacceptable”. The laboratory will consider that the whole batch is unacceptable.” He further explained that scientifically if illness-causing bacteria were detected through analysis then the whole batch would be discarded without testing each item in it.
According to Mahmoud Al Mibyad, Director of Internal Trade in Damascus, in the case of such violations, “the restaurant owner will face a legal sentence. The number or type of bacteria found is not the issue in these cases because samples taken from a restaurant should be completely free from any type of harmful bacteria to avoid being brought to justice.”
In the event of contamination that does not affect customers’ health; the owner is sentenced to a ten-day – one-month prison term. However, if contamination affects customers’ health then the restaurant owner is sentenced depending on the severity of the case. According to law 123 of 1960, and amendment 2 in 2008, and law 158 of 1960, the case is considered as both a case of public and private rights.
Mibyad explained that movable street stalls are forbidden by law. Since they do not have a legal status and do not fall under the jurisdiction of the Internal Trade division, the division cannot send such cases to court. Therefore the course of action left is confiscation by district police and destruction of the street stalls by a specialized committee.
Restaurants, on the other hand, are tested for overall hygiene whenever a complaint is made from a member of the public. The Department of Trade investigates “harvested food samples from the restaurant and analyzes them. In the event of a violation, the case is forwarded to the relevant judicial authority. Individual complaints are supported by medical reports issued by the supervising physician or the hospital that treated the case. Therefore these cases are dealt with within the jurisdiction of civil courts that look into disputes between citizens”, stated Mibyad.
In some cases, an agreement is reached between the restaurant owner and customers who file a complaint. One such agreement took place between the owner of a well known restaurant in Mezze in Damascus. He compensated all clients who ate the contaminated food (four of whom had medical reports asserting their food poisoning) by paying each 10,000 Syrian Liras, and the case was closed.
Thaer Hassan, Chief of the Department of Microbiology at the Central Laboratory considers that “uncovered food stalls violate one of the basic principles of health and safety. The preparation and sales of the product are done in the open air which exposes it to general pollution in the streets as well as car exhaust fumes.” There is no guarantee that “the salesman has washed his hands or trimmed his nails before handling the food. We also don’t know if he has taken any other hygienic measures like removing his rings, wearing a special outfit or a hat while preparing the food.” With this in mind, Hassan finds that the food is already “contaminated without the need to take a sample.” He insists that something needs to be done to stop these street stalls and to “halt their operations without delay. We cannot wait till the problem happens or more people have food poisoning.”
The presence of these stalls “can create an epidemic, because the probability of getting sick after eating is high, simply because the product is unfit for human consumption”, he said. Hassan stresses the fact that “analyzing samples is the last resort to close these stalls.” He calls for a solution to “stop the cause before cases of poisoning occur.” Dr. Al Buni agrees with Hassan and calls for a solution to the problem of street stalls saying “the mere fact of selling food in the street means that it is totally unhealthy and unhygienic, the dirt and dust carried in the air is enough to guarantee food contamination.”
Uncontrolled Street Stalls
All these complaints remain out of the legal jurisdiction of the Directorate of Internal Trade since their authority includes “restaurants and not street stalls” explained Mibyad. He adds that “the street stalls are under the jurisdiction of district police who confiscate these stalls and their contents because they are causing chaos on the streets and not because they are unhealthy.”
The Directorate of Trade attempted to contain the street stalls but failed because the stall owners ran away when they were asked for their ID card and therefore the report is filed against an “unknown” according to Mibyad, who also confirmed that the Directorate “does not have the right to confiscate, arrest or prosecute the street stall owners.”
Higher Immunity among Syrians
With the failure of Aleppo and Damascus to end the food sale from street stalls, there is only Syrian immunity to depend on! In the case of Ahmad, Dr. Al Buni explained that “the reason he was not poisoned after eating a sandwich from a street stall is because Syrians have more immunity against the harmful bacteria. Foreign visitors sometimes suffer from diarrhea after drinking our water. This is because the water contains a certain percentage of Escherichia coli bacteria which we Syrians are already immune to.” Hassan agreed with Dr. Al Buni.
Dr. Al Buni added that there are no cases of Salmonella in the samples because “the street stalls do not use mayonnaise in general, and especially the home-made type that is processed manually without inspection and this is the most common type of food that is likely to carry Salmonella.” Dr. Al Buni further explained that “cases of infection from salmonella may be due to salad rather than meat that is cooked on the fire and heated through, however, vegetables may carry these bacteria and although a person eating it might have developed immunity, they may still be able to transmit it to others.” He is certain that the possibility of catching salmonella is a common threat because: “the vegetables are not disinfected using vinegar or other disinfectants, and the salesman does not adhere to minimal personal hygiene standards, which makes the whole operation unacceptable, illegal and totally unhealthy”.
Poisoning: the numbers
According to the statistics from the Department of Toxins at the Ministry of Health, 80 cases of food poisoning were recorded in the different provinces in Syria during the first ten months of 2007. Out of 3171 food poisoning cases, only 80 were referred to the Toxin Center, forming only 2.5% of total cases.
Control of food products in the country is the responsibility of the Ministry of Health and other concerned ministries including Economy and Trade, Local Administration and Environment. Technical staff from each Ministry make regular visits to food manufacturing plants and local markets to take random samples which are analyzed in the laboratories to test for bacteria and chemical contents to ensure compliance with Syrian specifications. When samples do not conform to specifications food batches are confiscated and owners are prosecuted according to law.
When a complaint of food poisoning is received or outbreaks of food-borne diseases occur, teams from the Ministry of Health follow up on the cases of patients. These cases are addressed in coordination with other related entities which take appropriate action against the offenders.