World Food Day
In recognition of World Food Day on October 16, this conversation showcases solutions that address urban food issues in the Global South — including hunger and malnutrition, but also obesity and unhealthy lifestyles. The solutions are even more varied than the challenges, extending to national campaigns, school lunches, plugging food gaps, urban agriculture, food donations, and public-private partnerships.
Alimentação saudável e "consciente" em São Paulo
Catalina Gomez, Coordenadora da Rede em São Paulo
O Estado Nutricional dos residentes de São Paulo foi desenvolvido em 2010 pela Prefeitura para conhecer o estado nutricional da população e orientar as politicas públicas na matéria. Segundo o relatório, a prevalência de adultos com sobrepeso foi de 34 por cento e de obesidade 13 por cento. Este último dado representa mais de 800 mil pessoas obesas na cidade. Os mais afetados são homes casado maiores de 50 anos. O relatório não achou nenhuma relação direita entre nível socioeconômico e o sobrepeso; com referência à obesidade achou que ela é sofrida um pouco mais pelos cidadãos de menores ingressos, mais a diferencia não foi considerável.
O relatório também destaca que em torno de 56 por cento da população apresenta insatisfação com o peso atual, sendo que a metade dos pesquisados responderam "não fazer nada para emagrecer", por em quanto 24 por cento respondeu fazer exercícios e outro 24 por cento cuida da alimentação.
Aquelas informações do Estado Nutricional somadas às pesquisas recentes que tem achado um aumento do sobrepeso entre crianças e adolescentes em São Paulo, evidenciam a urgência de desenvolver intervenções que promovam uma alimentação adequada e hábitos saudáveis, incluído o aumento dos exercícios físicos.
Atualmente a Secretaria Municipal de saúde lidera vários esforços na melhora da nutrição além da casa, envolvendo as escolas e lugares de trabalho. Para atender as crianças e jovens, a Secretaria tem uma parceria com a Secretaria de Educação para garantir alimentação adequada nas escolas públicas. Como algumas escolas terceirizam os serviços, as secretarias desenvolveram guias para os fornecedores de serviços consigam garantir menus adequados e balanceados. Para aquelas escolas que tem cozinhas, elas tem apoio regular de nutricionistas que ajudam na construção dos menus e supervisam a qualidade dos alimentos y sua variedade. Em quanto aos exercícios físicos, as escolas agora oferecem mais de uma aula de educação física e promovem atividades físicas depois do horário escolar para garantir envolver as crianças e suas famílias na pratica de esportes e de atividade física periódica.
Para melhorar o estado nutricional das pessoas que trabalham e não conseguem se alimentar em casa, a Secretaria de Saúde achou que embora existam opções de alimentação saudável, muitas vezes os mesmos clientes fazem decisões pouco saudáveis. O melhor exemplo é o consumo excessivo do sal, que tem se relacionado com enfermidades cardiovasculares. Para responder a esta situação a Secretaria desenvolveu uma serie de materiais didáticos e lançou uma campanha de "consume consente do sal", que tem contribuído na mudança para o consumo de menores porções do sal.
Outro mecanismo para melhorar a nutrição na cidade, são os concursos de culinária saudável que organiza a Secretaria de Saúde. Alguns dos concursos atraem públicos bem diferenciados; um dos concursos que merece destaque foi aquele de culinária hospitalar que conseguiu uma participação massiva e culminou numa publicação de receitas inovadoras. A publicação tem sido adotada por vários centros públicos de saúde e tem incentivado a outros a criar suas próprias receitas saudáveis.
Foto: Secretaria Municipal de Saúde
Eating healthy and "consciously" in São Paulo
Catalina Gomez, São Paulo Community Manager
The São Paulo Nutritional Status Report was developed in 2010 by the local government to learn about the status of nutrition and health among its residents and to inform adequate policy-making in this field. The report found that 32 percent of adults are overweight, and 13 percent are obese, meaning that there are 800,000 obese people living in São Paulo. Married men 50 years and older are most affected. Interestingly, the report found no significant relationship between income and being overweight. In the case of obesity, lower-income and less-educated populations showed slightly higher numbers than the better-off group, but the differences were not drastic.
The report also found that around 56 per cent of the city's residents are unhappy with their current weight. More concerning is that half of these respondents mentioned that they "don't do anything to actively lose weight," while 24 percent exercise and another 24 percent watch their diet.
The findings of the Nutritional Status Report, along with more recent research, show that growing numbers of São Paulo's children and teenagers are overweight. These numbers evidence the urgent need to develop better interventions that teach city residents about adequate nutrition and healthier lifestyles, including more frequent exercise.
The Municipal Secretariat of Health has been leading various efforts to support the shift towards better nutrition and healthier lifestyles beyond the household, including in schools and workplaces. To target the young population, the Secretariat collaborates with the Secretariat of Education to improve the quality of food that is provided at each municipal school. Since many schools outsource food preparation, both Secretariats have issued guidelines for service providers to ensure food quality and balanced menus. Schools that have cooking facilities in-house receive regular visits from nutritionists that help plan menus and ensure both quality and variety of the meals. Exercising in public schools has grown from involving just a physical education class to more after-school activities that involve sports and physical activities with friends and family.
When it comes to adults, the Health Secretariat realized that although many restaurants offer balanced diets, residents were making unhealthy choices like consuming excessive salt, which has been associated with cardiovascular disease. The Secretariat therefore developed a series of didactic materials and launched a massive campaign to raise awareness about "consuming salt consciously." Although people still continue to eat salt, the campaign has been positively accepted and has contributed to a decrease in consumption.
Another effort to promote better nutrition is the healthy recipes contests organized by the Health Secretariat. This project aims to encourage residents to share their ideas and explore the possibilities of healthy cooking. Some of the contests attract specific target audiences. One worth highlighting was the contest on healthy cooking for hospitals, which promoted balanced meals offered to patients while in treatment at public hospitals. The contest collected so many contributions that it ended up in a publication of recipes that has been adopted by various facilities and has encouraged others to develop their own healthy recipes.
Photo credit: Municipal Secretariat of Health
Reducing waste and getting food on the plates of Nairobi's poor
Katy Fentress, Nairobi Community Manager
That food goes to waste in the Northern Hemisphere is common knowledge. Grocery stores, bakeries, supermarkets, all throw out large quantities of edible goods simply because health and safety rules dictate that they are past their sell-by date.
Countries like Kenya, with increasingly affluent middle classes that shop in malls and eat in restaurants, have jumped on to the waste bandwagon and now also produce large quantities of food that ends up rotting in its cities' extended dumpsites.
Many in the "industrial" North are experienced in finding ways to access the excess food. They reach agreements with retailers or locate where it is disposed of and scavenge it from there. While some do this for their own personal consumption, others have made a form of activism out of it and use excess food to create "feeding centers" in which the less fortunate can come and get a free plateful of whatever is on the menu.
One such organisation is called Food Not Bombs (FNB) and was created in the USA in 1981 during an anti-nuclear protest. FNB began as a bake sale to raise money for members that had been arrested, but soon developed into a larger movement dedicated to putting unsold food into the stomachs of people who could not afford to feed themselves.
As the FNB movement expanded, its members went further afield to see how their vision could be incorporated into international contexts. In 2007, during the Nairobi World Social Forum, FNB founder C.T. Butler hosted a workshop for the Nairobi Indymedia branch. During the workshop, Butler connected with Douglas Rori, a young Nairobian who was dedicated to setting up photojournalism trainings in his neighborhood, Kangemi.
One of the problems Rori had encountered during his trainings was that many of the attendees had not eaten all day. As a result, attendees found it difficult to focus on the classes for any significant amount of time. Inspired by Butler's explanation of FNB, Rori proposed they merge the two projects.
Following the forum, Butler and Rori approached various Nairobi grocery stores and food producers to explore the option of arranging weekly collections. Although the two initially managed to secure some food and conduct a few successful "feeds," these were mainly one-offs, and it wasn't until this year that Rori managed to up his game and make FNB Kenya activities a regular occurrence.
Currently Rori conducts four different feeds each month: in Kangemi he focuses on keeping his workshops going, while in Korogocho, Mathare, and Kibera slums he works with different schools and youth groups feeding between 35 and 40 children each session. Rori currently funds the project from his own pocket and from well-wishers' donations and has only just begun to create a fund-raising infrastructure.
In order to raise money and increase the impact of FNB Nairobi, Rori now works with an organisation called A Well-Fed Kenya, a spin-off of A Well-Fed World, which seeks to promote "sustainable, plant-based solutions in response to global food security, health, and hunger." A Well-Fed Kenya has a bank account, and although the proceeds are not used for FNB Nairobi, Rori is applying the experience to gain knowledge in fundraising, which he hopes to transfer to the project.
Until recently, the idea of food waste was virtually unheard of in Kenya: packaging was inexistent and goods were not mass-produced and processed. However, as the country falls in line with its wasteful Northern counterparts, projects like FNB will become increasingly important as a way to make sure that food reaches the plates of the less fortunate.
Photo: Food Not Bombs
A community food garden in Orange Farm, Johannesburg: toward sustainable, socio-economic 'r-urban' systems
Tariq Toffa, Johannesburg Community Manager
With the projected world population increase of over two billion people by 2050 to be felt mainly in urban areas in developing countries, the future looks urban. This will increase pressure on the larger metropolitan centres to supply not only services such as housing, but also food security. For this reason, urban food gardening has begun to receive increasing attention from policy makers and government officials around the world.
Urban agricultural models can also allow numerous other advantages. Urban agriculture is already a source of income and employment for many households globally, including micro-enterprises (compost, packaging, processing, sales, etc.) and informal sector activities (street hawkers, organic waste collection, recycling, etc.). Agricultural initiatives can also be associated with rehabilitating the environment (and, in so doing, addressing the 'political ecology' of cities, where the poor are often unsafely located on low-lying flood plain areas); and it also has a role to play in fighting malnutrition resulting from poverty. When approached as an interconnected system, these different dimensions of urban agriculture (economic, ecological, social, etc.) — in a European context — have been termed 'r-urban' systems. 'R-urban' refers to a broad strategy of urban resilience involving the creation of locally closed ecological and production-consumption cycles, which link diverse urban activities (economy, habitat, mobility, urban agriculture, culture).
Although in South Africa over a quarter of the population experiences hunger and over a quarter more lives at the risk of being hungry, urban agriculture as a specific policy intervention is promoted only in a fragmented way. As a case in point, recently the City of Cape Town Council controversially released 300 hectares of farmland to developers, at the same time as construction of a pilot agricultural project site was completed in Johannesburg by Johannesburg City Parks and Zoo in partnership with the Neighbourhood Development Partnership Grant, a national fund which aims to stimulate investment in underserved neighbourhoods. The latter, the 'Lakeside Community Food Gardens', attempts to develop a flexible urban agriculture model with a view to feeding local markets; and follows the City's new co-operative 'hub-and-spoke mode' of food production, which combines several small providers into a single supply chain.
The Food Gardens is built in Orange Farm, Johannesburg, in one of South Africa's largest informal settlements. Building upon an agricultural base that already exists, and part of a broader wetland rehabilitation project, the Food Gardens upgrades an existing community farming site and begins to encourage 'r-urban' networks. Designed by Newtown Landscape Architects, the Food Gardens consists of 31 raised vegetable plots (also allowing for fair distribution of produce amongst community members), with supporting irrigation and composting infrastructure. Aided by information signage, the facility also allows for skills dispersal.
Since land on the peri-urban fringe will increasingly come under pressure, identifying sites with agricultural potential for such projects is crucial. However, another, perhaps greater, challenge is for the City is to create farming opportunities for people who live in urban areas, but may still need some form of small-scale farming. The omission in either context (formal or informal), would be a serious one not only for food security and diverse income-earning activities, but also for its social function in assisting the most vulnerable members of communities, such as the aged, child-headed households, or the HIV-affected.
While the future may be urban, the urban may be forced to become more rural, transforming our notions of both.
Fig. 1: Local small-scale farming. Fig. 2: A rehabilitated park, with the Food Gardens behind. Fig. 3: On site (from left): the Ward Counsellor, a Community Food Garden leader, and the Site Foreman. Fig. 4: The Food Gardens. All photos by author.
Mumbai's hidden truth: hungry stomachs grumble for the city's most vulnerable children
Carlin Carr, Mumbai Community Manager
Mumbai's bursting-at-the-seam population growth is often all too easily explained: rural migrants come to the big city because "no one goes hungry here." The land-starved peninsula presents many other challenges, but food is everywhere: markets overflowing with vegetables are interspersed with street food vendors, who often sell their snacks for pennies. While access to food is less of an issue than in rural areas, affordable, nutritious food for the city's most vulnerable communities remains elusive.
A forthcoming study by Rachel D'Silva, a researcher at the Observer Research Foundation in Mumbai, looks at food access and nutrition for children both in an unstructured and a structured slum. The results are startling, but the issue is solvable. D'Silva presents key target areas for intervention by government and civil society.
What does your study tell us about the prevalence of malnutrition in Mumbai?
The study found a higher and more severe prevalence of under-nutrition among children from the unstructured slum sample. This population represents slums that are unregistered and may not have access to water supply, sanitation, and permanent shelter structures. While these barriers may be responsible for their exclusion and deprivation at various levels, they are also potential entry points for effective interventions.
What has been most surprising about your findings?
I was surprised to find children having distended abdomens — about 32 percent among unstructured slum samples — an occurrence that I had never expected to find in the city. A number of clinical findings surprised me, including the high rate of morbid conditions such as poor appetite, pain in limbs, and skin infections seen among children of the study population. Families and children also reported having to face food shortages on certain days that I found hard to believe.
What is unique about urban malnutrition vs. rural?
I have very limited understanding of rural under-nutrition in children as my understanding is only based on secondary reading. But one thing that is clear is that in urban areas, people have to depend purely on food available at market price in the absence of strong social safety nets like public distribution system (PDS) or food from agricultural produce.
It's a complex issue, but can you identify three to four root causes?
Chronic poverty is the overarching cause. Along with this, women and growing children have inadequate diets lacking in nutrition. Personal hygiene and environmental conditions contribute as well.
What are some immediate steps that can be taken to improve food access for families in need? What are some longer-term strategies?
One immediate step to improve food access is to ensure quality midday meals for all school-going children. Another focus area is to strengthen food charity networks, both religious and others in the city. Pulses (legumes) can be given through PDS, since grain alone does not ensure adequate nutrition.
Long-term strategies can focus on improving not just access to food but also access to water supply, sanitation, coverage of health services that will lead to nutrition security.
Photo: Rachel D'Silva
Kolaborasi bersama menangani masalah gizi Indonesia
Widya Anggraini, Jakarta Community Manager
The South East Asia Nutrition Survey found that nutritional problems in Indonesia include both malnutrition and over-nutrition: approximately 22 percent of children in Indonesia suffer from malnutrition, and around 14 percent are obese. This phenomenon encouraged the government to launch a national movement called the "First 1000 Days of Life," because intervention in the first few years of a child's life is crucial in avoiding nutritional problems. This public health movement is not limited to the government: partners include for-profit businesses, NGOs, academia, international development partners, and the public.
Temuan menarik tentang permasalah gizi di Indonesia disampaikan oleh Friesland Campina Institute bekerjasama dengan Persagi (Persatuan Ahli Gizi Indonesia) yang melakukan studi gizi anak yang dikenal dengan nama SEANUTS (South East Asia Nutrition Survey) yang menyatakan bahwa anak Indonesia menghadapi beban ganda yaitu kekurangan gizi dan kelebihan gizi.
Hasil SEANUTS menunjukan bahwa jumlah anak Indonesia yang mengalami pertumbuhan terhambat atau pendek (stunting) mencapai 34 persen dan malnutrisi dialami oleh 22,3 persen anak. Jumlah ini ternyata lebih buruk dari yang dialami Vietnam. Sedangkan, meski tidak banyak, namun kasus kelebihan gizi juga dialami oleh anak Indonesia sebesar 4 persen. Efek dari beban ganda gizi ini beragam misalkan adanya gangguan perkembangan otak, kecerdasan, mudah terkena penyakit, gangguan pertumbuhan fisik dan metabolism dan dalam jangka panjang akan menyebabkan masalah-masalah seperti diabetes, kegemukan, penyakit jantung dan jenis penyakit lainnnya ketika mereka dewasa.
Berdasar fakta ini, pemerintah mulai mencanangkan Gerakan 1000 HPK (Hari Pertama Kehidupan) yang dimulai sejak tahun 2012 hingga 2015. Mengapa 1000 hari pertama? Sebab masa ini adalah periode emas pertumbuhan anak yang dimulai sejak berada dalam kandungan hingga berusia dua tahun. Intervensi di 1000 pertama ini sangat krusial untuk menghindari permasalahan gizi tertentu. Gerakan 1000 HPK sendiri merupakan bentuk keterlibatan Indonesia dalam gerakan Global Scaling Up Nutrition (SUN Movement) yang bertujuan meningkatkan efektivitas program gizi di negara berkembang.
Gerakan ini secara umum melakukan intervensi gizi kepada ibu hamil, anak umur 0-6 bulan dan anak umur 7-23 bulan. Jenis intervensi menyesuaikan kelompok sasaran dan harus bersifat jangka panjang atau sustainable. Pemerintah juga telah mengeluarkan sebuah buku pedoman Perencanaan Program 1000 HPK berisi jenis-jenis intervensi dan indikator keberhasilan intervensi yang bisa digunakan secara umum oleh semua pihak yang ingin terlibat. Tersedianya buku ini sebagai penjabaran operasional, maka diharapkan dari pusat hingga daerah memiliki persamaan persepsi dan perencanaan yang matang dalam pelaksanaannya.
Menariknya dari Gerakan 1000 HPK adalah program ini mencoba merangkul semua pihak bukan hanya pemerintah dan para pelaku kesehatan, seperti yang selama ini terjadi, namun juga melibatkan 11 kementerian/lembaga terkait, dunia usaha, mitra pembangunan internasional, lembaga sosial kemasyarakatan, perguruan tinggi dan media. Gerakan ini juga diharapkan mampu mensinkronkan berbagai program perbaikan gizi yang selama ini cenderung sektoral dan tidak efektif.
Salah satu perusahaan besar yang terlibat adalah GlaxoSmithKline (GSK), perusahaan farmasi yang berpusat di Inggris, yang melalui brandnya Scott’s Emulsion mendukung penuh gerakan sadar gizi pemerintah. Salah satu kegiatannya adalah dengan mengadakan Roadshow Puskesmas se-Jabodetabek. Roadhow ini diisi dengan memberikan penyuluhan dari Kementerian Kesehatan dna GSK kepada ibu-ibu mengenai pentingnya kecukupan gizi anak di 1000 hari pertamanya. Selain itu juga dilakukan lomba cerdas cermat bagi ibu, lomba foto bayi dan demo masak makanan sehat. Masyarakat juga menyambut baik kegiatan ini, terbukti dalam acara yang dilaksanakan oleh GSK ini dilakukan secara sukarela oleh Kader Sadar Gizi Puskesmas bersama dengan ibu-ibu di sekitar puskesmas.
Consolidating foodstuffs to plug the supply drain and bridge the access gap
Olatawura Ladipo-Ajayi, Lagos Community Manager
According to a survey carried out by the Financial Derivatives Company, prices in Lagos are rising largely due to increases in food prices, because of food supply shortfalls. Increases in prices make access to food difficult for the urban poor, so to tackle the problem of food supply, organizations are working to find out where the shortages come from, and who suffers from these breaks in food supply. To this end, Food Bank Nigeria organizes research to better understand its environment and to help design effective food relief program in various Nigerian cities, including Lagos.
Food Bank Nigeria (FBN) is a non-governmental organization that focuses on mending the food gaps in Nigeria. Their mission is to effectively address identified food gaps in Nigeria through sourcing and distribution of food, appropriate innovative programs, education, and advocacy. The organization serves as a central pantry for other organizations working to fill the gaps created by inadequate food supply, lack of affordability and during emergency situations, through soup kitchens, shelters, group homes, senior centers, and emergency food pantries. FBN's programs are wide reaching, catering to different social groups and age grades in need of food supply, including children, senior citizens, single parent families, the homeless, the unemployed, disaster victims, and many other special needs groups.
The organization provides food to relief programs through a reliable source, created by partnerships with food retailers, manufacturers, and wholesalers to acquire, store, and redistribute food to agency programs, working as a central bank for food. They help other non-profit operations extend the impact of their food budgets, so that their scarce resources can be redirected to their programs. FBN programs include food drives and outreach campaigns. The organization has set up a system of sustaining food supply to other agencies catering to the hungry in the city through its food drive program. This program promotes and supports food and fund drives which allow private citizens as well as societies to organize food drives. They also solicit food stuffs from local companies, schools, and neighborhood associations to create a steady flow of food supply to the poor and hungry families. FBN is also responsible for a pilot program at the Makoko Children School which introduces lunch packs as a way to keep students in schools, while ensuring a regular meal each day for the pupils. The pilot was deemed successful and the organization is now working on extending it and on finding sponsors.
During this year's Hunger Action Month (October), FBN will host booths at neighborhood stores and markets to spread the word about FBN's mission and to inspire people to get involved with food/fund drives and with volunteering. The public will be informed about food security issues and the effort of FBN and its partner agencies in addressing such issues. FBN currently works with four agencies in Lagos and are looking to register more. Some of their agencies feed at least 100 people twice a day, every day. Project coordinator Paul Achem estimates that the program has fed roughly 22,500 people since it started. FBN has big goals to help close the food supply gap, aiming to feed about five million people a day across the nation. While the program is just gaining ground, it is definitely on the right track.
Photo: Food Bank Nigeria