Food and water safety concerns in Ecuador is something that every tourist and local know is prevalent. With common sense and having good safety habits with food can help lessen these concerns, but won't alleviate the problem completely. I have traveled a lot throughout Ecuador and I have been lucky enough to have never gotten sick. I make sure to always have bottled water or boil the water myself, I also don't eat any salads from eateries. With that said I don't believe being too caution and experiencing all a country has is important. I've eaten meat at open markets and I have also eaten fruits like, grapes, apples, plums and strawberries that I haven't washed myself… or they probably haven't been washed at all. Fruits that need to peeled to eat like bananas, oranges, avocados, papayas, etc. are the safest to eat because the the edible part doesn't come into contact with water or any outside contaminates.
Meat products are safe in establish grocery stores like Mega Maxi where they have standards for meat products that they sell. But in local open and enclosed markets and also street vendors the quality of meat products are highly questionable at best. Most of the time it's meat that is personally raised like pigs, cow, goats and sheep that are then slaughtered in order to be sold to make money. It is not uncommon to see huge pigs hanging from hooks outside a local restaurant or market. When more meat is needed for cooking they take portions of meat bit by bit from the carcass. Unlike the establish grocery stores, these meats aren't refrigerated or packaged. This meat sits out until it is sold or cooked. Another thing I have noticed is that the quality of the meat in general in Ecuador isn't good. The meats are tough in texture and very chewy. I don't know if it is because I am use to American meat with all the chemicals that maybe used or different feeds that is given to the animals, but a difference in meat is very evident.
Water. There is clean bottled water every, usually for 50 cent to $1. I bought a huge 1.5 litter of water for 75 cents at a local market that lasted me for days. Other alternatives to water is coca – colas, juices and of course beer. In restaurants normally water is sold via water bottles and rarely do you get serviced water in a glass, but it is always safe to ask for bottle water. I have seen multiple locals drink from outside public faucets and other unfiltered or untreated water sources. The difference is that the locals have more of a tolerance to certain bacteria than tourist do, a different immunity.
Tourist and locals as well are at risk at getting sick from the quality of food and water and poor food practices. I personally have not gotten sick from food in Ecuador but I do know many people that have. My friend in Ecuador who is from Ecuador got sick after eating fish at a friend's house. She got so sick that she tried to go to the local clinic to get examined but there were so many people at the clinic waiting to be seen that she ultimately ended up going back home. She was bed ridden for three days straight. A few years back when my dad and I were traveling together we took a local out for dinner at a local restaurant in town. We had chicken with rice and a choice of salad or plantains. I told my dad to get plantains like I chose because the salad had a good chance of getting him sick. He chose the salad instead. The next day he wished he listened to him and chose the plantains. It cost money to boil water to use to clean vegetables or fruits, so most restaurants wash with contaminated water. Even locals know this and will avoid eating vegetables or salads that come with meals at eateries.
Coming to a third country like Ecuador there is always going to be concern for health issues. It cannot be completely avoided but with good practices it can be lessened. Be smart about what and how you eat but at the same time experience new foods. You can't let fear stop you from discovering something new.