Ihave had such burgers ,they have anda,a shami kebab a weird tasting one inside it with chopped cabbage and some salad to the side. The level of hygiene is super poor at those joints , one just have go take a look at the nails of the guys who make them.
In pakistan i dont even eat from fast food restaurants cause even their food gives me an upset stomach, i believe even in our fast food restaurants hygiene levels arent maintained. Infact even in all top notch restaurants in pakistan hygiene standards are not maintained , and going even broader the same happens all over the world tho street food is way more unhygienic.
That's why i give preference to homecooked food no matter what part of world i am in.