Food, nutrition, and the urban poor

The issue of nutrition is essential in the developing world: malnutrition, undernutrition, and unsafe food are pervasive problems for the residents of informal, impoverished, and marginalized communities, the consequence of poverty and of high food prices. Examples from Jakarta and Bangalore demonstrate solutions to child malnutrition and unhealthy snack options. Soup kitchens in Mexico City feed the hungry and skills trainings in Dhaka help the poor pull themselves out of poverty and hunger, while in Rio de Janeiro, food is used as a way to promote the positive aspects of favelas. Read on to learn more, and then join the discussion below.

 

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Nanda Ratna Astuti, Jakarta ContributorRencana Aksi Nasional Jajanan Sehat Anak Sekolah

Nanda Ratna Astuti, Jakarta Community Manager

Students in Jakarta usually buy food from street vendors to sustain themselves throughout the school day. Unfortunately, street snacks are often unhealthy, and sometimes even dangerous: snacks have been found to include harmful substances like clothing dye, MSG, and preservatives. The national food and drug agency of Indonesia created the National Action Plan for Children's School Snacks to improve the quality of snacks served at school, and to reduce the distribution of snacks containing harmful ingredients.

Tidak seperti di negara-negara maju, anak sekolah di Indonesia umumnya tidak mendapatkan makan siang disekolah melainkan lebih sering membeli jajanan (street snack). Padahal usia anak sekolah adalah usia yang memerlukan gizi dan nutrisi yang cukup untuk tumbuh dan berkembang. Sudah menjadi rahasia umum bahwa jajanan di sekolah bukanlah makanan sehat, bahkan cenderung berbahaya bagi kesehatan, namun tetap saja jajanan ini digemari dan dibeli hampir setiap hari oleh anak-anak sekolah tersebut. Jajanan yang digemari anak-anak ini umumnya berwarna mencolok, rasanya gurih atau sangat manis dan harganya murah. Namun sayangnya para pedagang kurang memperhatikan kebersihan dan kandungan nutrisi dalam jajanan-jajanan tersebut, sehingga tidak jarang mereka menggunakan zat-zat yang berbahaya seperti pewarna pakaian, MSG dan pengawet.

Melihat keadaan ini, Badan Pengawas Obat dan Makanan (BPOM) mengadakan program Rencana Aksi Nasional Pangan Jajanan Anak Sekolah (RAN PJAS) yang merupakan gerakan untuk meningkatkan mutu jajanan di sekolah sekaligus mengawasi beredarnya jajanan yang mengandung bahan-bahan yang berbahaya. Program ini dilaksanakan di Jakarta dan kota-kota besar lainnya di seluruh Indonesia sejak awal tahun 2012 yang difokuskan kepada jajanan anak di tingkat sekolah dasar (SD) mengingat sebagian besar kasus keracunan makanan terjadi di tingkat SD. Dalam program ini dioperasikan mobil laboratorium yang berkeliling ke sekolah-sekolah di Jakarta setiap hari Selasa, Rabu dan Kamis. RAN PJAS dilaksanakan melalui penerapan lima strategi, yaitu perkuatan program PJAS, peningkatan awareness komunitas PJAS, peningkatan kapasitas sumber daya PJAS, modeling, dan replikasi kantin sekolah, dan optimalisasi manajemen Aksi Nasional PJAS. Secara nasional melalui program ini Badan POM telah mengoperasionalisasikan mobil laboratorium keliling ke 1.291 sekolah dasar, dan melakukan pembinaan kepada 80.000 orang guru SD, 80.000 orang pedagang PJAS di sekitar sekolah, dan 24.000 pengelola kantin, serta memberikan 100 Piagam Bintang Keamanan Pangan untuk SD/MI di 20 provinsi.

Program ini telah menunjukkan hasil yang cukup menggembirakan, karena hingga akhir 2012 angka keracunan akibat jajanan tidak sehat turun dari 44 persen menjadi 27 persen. Program ini juga menunjukkan hasil berupa peningkatan persentase keamanan pangan jajanan anak sekolah yang memenuhi syarat, dari 56 persen hingga 60 persen pada kurun waktu tahun 2008 hingga 2010, menjadi 65 persen pada tahun 2011, dan 76 persen pada tahun 2012 lalu. Di tahun 2013 ini, RAN PJAS menjangkau lebih luas lagi daerah-daerah di luar pulau jawa seperti Nusa Tenggara Timur.

Meskipun anak-anak Indonesia harus jajan di sekolah, paling tidak mereka membeli jajanan yang bergizi dan sehat. diharapkan di masa mendatang tidak ditemukan lagi jajanan anak sekolah yang berbahaya bagi kesehatan. Jajanan anak sekolah penting diperhatikan, karena jajanan yang sehat sangat mempengaruhi pertumbuhan anak untuk menjadi generasi muda yang cemerlang di masa depan.

Photo credit: Himatipan Unpad


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Comments

Hi Maria Fernanda, I just read your article and learned about the many things Mexico City is doing in order to expand access to food to the poorest populations, especially through community dining halls and food banks. But although Mexico still has people who cannot afford to buy food, the country is starting to have a much worst problem: overweight and obesity. Apparently this national phenomenon is related to a sedentary life and the excessive consumption of junk food, which many times is cheaper than any other food.

In the Mexican Survey of Health and Nutrition 2012, it is mentioned that about 33% of people living in Mexico City are obese. Could you complement a bit of what the city is doing through policies and programs to fight the terrible epidemic of obesity, especially among the poorest populations who are the most affected?

Catalina, gracias por el comentario, tienes toda la razón sobre la problemática que planteas. El Gobierno del Distrito Federal afirma que la Ciudad de México, es hogar de los niños con más sobrepeso y obesidad del país. Una de las razones detrás de esto son los hábitos de consumo, pero que además afecta en mayor medida a la población más vulnerable respecto a la educación y recursos económicos. Por ejemplo, un estudio del Consejo Nacional de la Raza (NCLR) en Estados Unidos, demostró que los niños latinos viviendo en hogares con muy poca seguridad alimentaria son el 61 por ciento más propensos a tener sobrepeso que los niños que viven en hogares en condiciones alimentarias más favorables; puesto que las familias adoptan estrategias para administrar el presupuesto al adquirir alimentos de bajo costo y con alto contenido calórico para satisfacer su hambre.
En este sentido, diversas estrategias se están implementando en la ciudad en alianza con diversos actores. Una de ellas es el programa piloto de “11 jugadas por la salud” implementado por la FIFA, la Federación Mexicana de Fútbol (FEMEXFUT) y la Secretaría de Salud del Gobierno Federal. El objetivo es promover hábitos saludables en los niños y jóvenes a través de sesiones de fútbol en escuelas públicas y privadas, que enseñan habilidades de fútbol acompañadas de once mensajes de salud. De esta manera comprometen a los niños a involucrarse en una actividad física y cambiar estilos de vida. Así mismo, durante los partidos de la liga de fútbol mexicana, se establecen stands en los estadios que miden el índice de la masa corporal y el peso de los aficionados que asisten al partido para informar sobre el rango en que se encuentra su estado de salud.
Otro ejemplo es la regulación por parte del Gobierno Federal sobre el contenido de azúcares y calorías en los alimentos a la venta en escuelas primarias y secundarias, los productos no deben de rebasar 130 calorías por porción así como la prohibición de bebidas gaseosas en los establecimientos.
Por parte de la sociedad civil, la Fundación Mídete emplea campamentos urbanos en los barrios y colonias del DF, en el cual se desarrollan espacios para que los niños cuenten con apoyo de especialistas en nutrición, pedagogía actividades físicas y de salud. Se busca desarrollar hábitos de consumo saludables a través de actividades lúdicas y talleres, así como de la provisión de alimentación sana y nutritiva a bajo costo.
En México es un tema preocupante que ha llamado la atención de gobiernos, organizaciones y de los consumidores por lo que han surgido diversas estrategias desde varios frentes.

Catalina thanks for the comment, the issues you raise are very important. The Federal District Government claims that Mexico City has more children with overweight and obesity than other state in the country. One of the reasons behind this is consumption habits that affect more to the most vulnerable population. For example, a study by the National Council of La Raza (NCLR) in the United States, showed that Latino children living in households with very low food security are 61 percent more likely to be overweight than children living in homes in more favorable food, since families adopt strategies to manage the budget to buy inexpensive foods and high-calorie to satisfy their hunger.
In this regard, various strategies are being implemented in the city in partnership with various stakeholders. One is the pilot "11 plays for Health" implemented by FIFA, the Mexican Football Federation (FEMEXFUT) and the Ministry of Health of the Federal Government. The aim is to promote healthy habits in children and young people through football sessions in public and private schools that teach soccer skills accompanied by eleven health messages. In this way the children undertake to engage in physical activity and change lifestyles. Also, during games of Mexican football league, the government establishes stands in the football stadiums that measure body mass index and weight of the fans attending the game in order to inform their health status.
Another example is the regulation by the Federal Government on the content of sugar and calories in food sales in elementary and secondary schools, products should not exceed 130 calories per serving and the banning of soft drinks in establishments.
From the civil society, the Foundation “Mídete” employs urban camps in the neighborhoods of the City in which they develop spaces for children to have support from nutritionists, physical education and health activities. It seeks to develop healthy habits through fun activities and workshops, as well as the provision of safe and nutritious food at low cost.
In Mexico it is a concern that has caught the attention of governments, organizations and consumers, in this sense various strategies have emerged from several fronts.

Maria Fernanda, many thanks for reporting on how Mexico City is combating overweight and obesity. It seems the city is making an effort in addressing this problem. I think that one important lesson in this week’s discussion is that food and nutrition issues need to be treated in a much more integrated and comprehensive way, bringing together different sectors beyond health, such as education and social assistance. In addition, as Nanda points out, it is also important to bring together government representatives and civil society.

In this respect, I understand that Mexico City’s local government has established a Council for Prevention and Attention of Obesity and Eating Disorders, which is made up of the local head of government, the district’s secretary of health, the district’s secretary of education and six representatives from civil society and the private sector (three each). This is an important step towards working integrated strategies and approaches to the obesity problem in the city.

It's sad seeing that in Mexico City has more children with obesity and overweight, while in the other side of the globe there are thousands of children with hunger and malnutrition. I think we all agree that healthy and nutritious food should be provide every day, especially for the children. And to make that happened, we need a good cooperation between the government, NGOs and the society. The children is the future of the nations, so we should do the work to make it happen and create the sustainable development.

Regards,
Nanda Ratna A
Jakarta Community Manager

Nanda, even though Mexico has a huge number of children with obesity, it is also related with poverty and food insecurity; they cannot acquire healthy food due of the high prices and inflation. It is curios but poverty in children causes malnutrition and obesity as well.
I totally agree with you that cooperation among actors is needed in order to address this problem. However, innovation and alternatives enable the people to cultivate their own food through urban agriculture in order to have access to healty food, as fruits and vegetables. In Mexico City the organization "Urban Gardens" (Huertos Urbanos in spanish) trains people to enable them to develop agricultural techniques accesible in their homes.

Catalina, I loved that there is a book on favela food--another reason to come explore Rio soon! It seems to me, though, that while it's great that there is such a variety of (healthy) choices, can the poor--the very poor--really afford to eat at restaurants? I'm thinking about Mumbai, for example, where the poor survive off of very basic vegetarian food, mostly lentils, vegetables and rice. The immediate difference is that the Indian diet is mostly vegetarian, though often once a week or so, the poor might have some sort of meat. While their basic food is actually quite healthy and tasty, it is also very inexpensive and nearly all families cook at home. The restaurants in the slums are often for the men, laborers who are either living in the city on their own or who are working during the day far from their families. Even then, they likely have a "tiffin," which is a homemade lunch that is delivered by dabbahwallahs (tiffin delivery men). They pick up the thousands of homemade lunches at home each day and deliver them (with an incredible accuracy rate!) to workers throughout the city. They were even the subject of a Harvard Business School study! http://hbr.org/product/a/an/904D11-PDF-ENG?cm_sp=doi-_-case-_-904D11-PDF...

I guess I'm curious to know who is eating at the restaurants in Rio's favelas? Is there a lot of economic stratification within Rio's slums?

Carlin, very interesting to learn about the Dabbawallahs of Mumbai! I wish all deliveries were as good and efficient as these ones.

Answering your question of who is eating at the restaurants in Rio’s favelas, I must clarify that within the favelas there are families with different income levels and therefore the ones with a bit more income can afford to eat at local restaurants. In general, the demand from the referenced restaurants is mostly from women and men who live and work in the favelas, not from outsiders.

The good news is that beyond the restaurants that are covered in the book, there are many other cafeterias and restaurants opening up, demonstrating a great entrepreneurial activity and also demonstrating greater purchasing power in many favelas. This also evidences improvements in access to electricity, water and sewerage in some of these areas, as well as improvements in security, allowing new business, such as restaurants to open up.

For the families who cannot afford to eat at restaurants, meaning the poorest of the poor, here is a link on a previous URB.IM article I wrote on “Food security and the promotion of healthy habits for Rio's poorest”. http://urb.im/ca130408rje

Similarly to Rio, Nairobi informal settlements and poor neighbourhoods abound with cheap places where people can get a plate of ugali (maize meal), cabbage, rice and beans, meat stew or grilled meat (often off-cuts, entrails and other animal parts that do not find their ways into more up-market establishments). By and large it is possible to get something to eat off the street for under a dollar. Because of this, single people (i.e. people who do not have a whole family to cook for) will almost always eat out. It is far cheaper to do so than to invest in buying a stove, charcoal and all the separate ingredients that one needs to be able to cook something.
There have been a few initiatives that have focussed on creating community kitchens in Kibera but to the best of my knowledge these have yet to become a big success.
The idea of producing a book that identified the best little eateries across Nairobi did cross my mind a few years ago but the limited variety of food on offer slightly dampened my enthusiasm. However if you were to ask me where the best place to eat in Kibera slum was, I would not hesitate to point you in the direction of Arusha Foods which offers the best meat stews (the liver is particularly nice) and chapatis in the whole area (and for a large plate with everything on it you would pay little more than a dollar).

Katy Fentress
URB.IM - Nairobi Community Manager
@whatktdoes

On a sad note I was very upset when I read the recent report by Save the Children Italy, that highlights how one child out of three in the "Bel Paese" is at a risk of poverty and one and a half million children live in areas in which the land has been poisoned (this would mainly be in the south which has for decades been a repository for unwanted toxic waste) and hence the food affected.
The report goes on to describe how in the country there are about 720,000 children suffering from malnutrition and that Italy now ranks very low on a series of Europe-wide scales that measure government investment in children and families, levels of social exclusion, material deprivation and education.

Save the Children Italy is currently undertaking a country-wide shock and awe campaign [http://is.gd/7vRlJz] - in which children parade life size cutout puppets that declaim how their future has been stolen - in order to raise awareness of the issue and to encourage the government to act soon and fast.

The irony here is that it is still the case today that in Italy, when people think of Africa, the image of a malnourished child is still one of the first things that spring to their minds. However across Africa - a continent that overall has experience far more economic growth than its European counterparts of the past half decade, there has been so much done to try to prevent the famines that made worldwide news in the late 1970s and 1980s. While everyone was worried about erasing malnutrition in Africa, the children of Europe's fourth largest economy seem to have slipped through the net...

Katy Fentress
URB.IM - Nairobi Community Manager
@whatktdoes

Catalina, that is a wonderful idea of a book to be written. It was handy and I hope that people living in favelas are able to buy the book and try out those restaurants. May I know if it is cultural thing where people in favelas enjoy dining out at the restaurant? Isn’t it cheaper for them to cook? I really interested because in case of people who live in poor neighborhood in Indonesia prefer to cook which is cheaper as they bought ingredients from traditional market, even though now traditional market face challenge as many mini markets show up with better over of shopping experience. But it’s totally different issue.

I am also surprised that obesity and overweight becomes an issue in Mexico especially for the vulnerable population. If I compare to Indonesia, again, junk food such as Mac* or Burger K* are only affordable for mid to high-income families. It is a totally different situation from which these foods came from. So there is small chance that children from poor family will eat this. But at the moment, mid income family in Indonesia is bigger and this lifestyle (who thinks that eat at junk food restaurant is cool) is growing and growing, and I am afraid in coming years Indonesian kids will also experience overweight problems. I think my government should learn from Mexico on how to handle this problem.

Carlin, I really like the idea of mobile food program. It is wonderful idea and I would like you to elaborate more like how many times in a week this truck serve food? Or how many employee they have and how it works? Or do they provide food to all children or just some of them? I had involved in some government program providing better nutrition for school children in remote and poor area. The fund was from government. It was running for three years and when it was done, people do not know what to do because they don't have fund to continue and the government, I must say that their weakness is that they don't think about the sustainability of the program. So, I was wondering what happen with school lunch program in India? Does it has long term plan after the project end? Maybe Carlin could update me with this. thanks

widya anggraini

Widya, you and Carlin are right; eating out is not an activity that all favela dwellers can afford. But actually the number of people who can afford it is growing, if you judge from the fast pace new cafeterias and restaurants are opening up in some favelas; and if you happen to be there at lunch time you will be surprised they are all packed.

The main clients of these restaurants are men and women who work around the area and sometimes they don’t have the time to cook themselves lunch, so they look for quick, healthy and convenient options around them. On the cultural side, I would say that cariocas (people from Rio) like very much socializing, so if they can, they won’t miss a chance to have a bite or a drink outside with colleagues, family or friends.

On a final note, I don’t think locals will purchase the book, as they already know the suggested places. The main intention of the book is to promote the very best of food in favelas to outsiders and also to highlight the amazing work of some cooks who are producing good, tasty and affordable meals in their communities. I consider this a fantastic opportunity to raise interest to visit places outside the known areas, and also to learn about the many positive aspects favelas have, including food. So, Kathy, why not promote it in Kibera? Seems you have spotted some places with high potential…

I think what it boils down to is that it will always be cheaper to buy food in bulk than piecemeal. Also it is important to remember that informal settlements are heterogenous places inhabited by different people with different work patterns.
In Nairobi for example while there are many families that live in informal settlements, these are also places that receive a large influx of rural migrants who arrive on their own and are forced to provide for themselves alone. Hence in a family-type context where a woman needs to feed upwards of three mouths, it will generally be easier to buy the food and cook it from scratch. However for people who live on their own it is not economical, both from a monetary perspective as from a time one, to cook for themselves when they can fill their bellies for a small sum in a fraction of the time it would take to light a coal stove, cook the sauce and then cook maize meal (which given that there is only one stove will happen sequentially and not at the same time hence making the process quite time-consuming).

Catalina with regards to the book: I think the question here is not about nutritional benefits for residents because, as you say, they already know where the good local places to eat are. However by producing a book like this, these eateries are transformed into places of cultural importance which will add to a sense of pride of place for residents who know that their local place can now be viewed across the world. Cultural outputs that get produced in/about marginalised places like this, can help reinforce a sense of identity and worth that may previously have been limited.
With regards to a book on eateries in Kibera and other Nairobi settlements, the problem one might encounter however is that the food there is by and large the same. Hence any book that covers them would probably end up being more about the pictures than the actual food they produce. But I can assure you that the meat bbqs I mentioned above are not really places that are in any way attractive to eat in for people on the outside, hence a book of this kind might become some form of negative food porn where people focus in on the unhygienic conditions and the unappealing foodstuffs instead of the cultural importance of places like this.

Katy Fentress
URB.IM - Nairobi Community Manager
@whatktdoes

Widya, very good questions, and you're right, sustainability is almost always the issue with keeping alive programs. Without long-term government funding or a steady flow of private donors, NGOs have a difficult time sustaining even the best interventions. That's why many foundations--Gates, especially--are looking toward market-based solutions. Of course there are "issues" that lend themselves to market-based solutions more than others. Water, for example, is one of those. Others, like labor issues and food programs less so.

YuvaLok seems to have a strong reputation in the Bangalore area and receives funding for the nutrition program from organizations like the Mother Teresa Foundation. However, given that they've been around a long time, but seem to operate locally in a couple of neighborhoods, it seems that funding or lack of resources may be hindering their ability to grow.

That being said, ISKON, the Hindu organization that runs the school lunch programs, is on the other end of the spectrum. Also known as the Hare Krishnas, the group has high visibility throughout India and abroad and receives many donations that way. We have a huge ISKON temple near us in Mumbai that has a hotel and restaurant, and always has many foreign tourists around. They have been able to grow the school lunch program with both these resources and a scalable model using centralized kitchens. A quote in the Economic Times says "Meals for 24,000 children can be prepared, in two shifts per day, by only five persons. The kitchen was so spotlessly clean that I wondered if it was yet to become operational." The organization says that the investment is really in the future of India, since children with hungry stomachs will never be able to learn and then prosper. Their operation is certainly an interesting model to look at.

I read all of the above comments and the article with interest, but also with suprise. All these initiatives sound very impressive, but I think if I were living in some of these settlements I would feel very much more food secure if I was involved in producing some of the food rather than relying on others to do it for me. Granted, some can afford to do this, however, I think long term food security comes from people owning the means to produce their own food as a community or at household level. This will increase their resilience to shocks and, just as importantly, mean that they have sovereignty over their own food production rather than relying on a stop/start funding model in many cases. I will be interested to read about more examples of informal settlement communities growing and consuming their own food, and maybe even selling some too.

John, many thanks for your comments, they add special value to our discussion. I agree with you about guaranteeing the food security of the people that lack of resources or srategies to cope their needs. In a marginal zone in Mexico City, Iztapalapa, the community organized itself in order to create an association to develop different strategies in order to improve their context. This organization, Asamblea Comunitaria Miravalle, is implementing an urban agricultural project in order to teach the community to produce their own food. This project is technically supported by another NGO named Hierbabuena Urbana, which together gained the Deutsche Bank award in 2010 to scale their strategy. Nowadays they have a soup kitchen which cooks more than 200 meals for the community with the inputs that they cultivate. This community does not depends in the provision of food from other actors but they guarantee their nutrition.

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