There are never going to be zero health risks from eating street or market food in S. E. Asia but then there’s never a zero risk anywhere. (One of our customers ended up in hospital with food poisoning after dining at a Sheraton Hotel in Bangkok and Les in our UK office famously ended up ‘sick as a proverbial’ after cooking herself pasta at home in Portsmouth!)
However there are a few precautions to take and factors to bear in mind that may reduce the risks. Rule number one – a noodle soup in Khao San Road or a noodle soup in Cholon Market may look the same but they aren’t necessarily prepared the same way and so do consider where you are, there can be big differences from one place to another. (For the purposes of this post we’re talking mainland S. E. Asia). Now we get around a bit in S. E. Asia and being partial to the real McCoy like to eat in markets and street stalls. In this respect the S. E. Asian countries fall roughly into the following categories for us: Thailand and Malaysia generally ok – will eat pretty much anywhere, Vietnam a bit more careful, Laos considerably more careful and Cambodia – very careful, only in certain spots. In other words Thai and Malaysian food-stalls have reasonable hygiene levels, access to electricity and water, Vietnam and Laos ones may well have conceptions of hygiene and cleanliness but not always the facilities whilst Cambodian lack most facilities, access to decent quality ingredients and are frequently are oblivious to minimal ‘western’ hygiene concepts. (These are obviously generalizations and we are well aware of the recent tragic occurrence in Chiang Mai.)
Furthermore it also depends a lot on which particular town or specific market you’re eating in. The multitude of street stalls, obviously catering to tourists, in central Siem Reap are a different proposition to Psa Tuol Stomachpump in the suburbs of Phnom Penh. Poisoning customers is never good for business and the problem with the latter is that they are not used to catering for westerners with their more delicate stomachs. Thais and Malays however probably don’t have such cast iron digestive systems these days as the Khmers either and are fussier about eating somewhere ‘clean’ so, as a general rule, any street stall popular with locals in those 2 countries is a good bet whereas stick to ones that tourists frequent in Laos or Cambodia.
Stick also to what the locals are eating and the stalls are used to preparing and avoid obvious danger areas such as seafood or local attempts at western food. Fish may well be freshwater but if in doubt forget it. Though most prawns these days are freshwater ones from prawn farms most prawn farms are typically located on the coast so a long way from Mae Hong Son for example. If you do order meat make sure it’s well cooked and the stir fry wasn’t too brief and when your meat is dipped into stock for a noodle soup make sure it was dipped in long enough! Be especially careful in the hot season when products go off quickly.
When it comes to pre-prepared food popular in Thai food halls and some markets you’re probably fine in the mornings but by the evening it may have been sitting there a long time so keep to the cooked to order dishes.
Anyway as we say some of the best local food can be found in markets and street stalls so go ahead but just use your common sense and if in doubt, don’t take any risks and above all bear in mind if it’s fine/dodgy in one spot doesn’t mean it’ll be the same in other parts of the region!