Diet histories in the urban slum

Thursday morning, I headed out with a translator to visit four families in the urban slums. We were to collect 24 hr. diet recalls and food expenditure information from two very poor familes and two not-as-poor families. Definitely not scientifically based, but to gain an observational snap shot of actual child feeding practices relate to socio-economic factors.

My translator was an 18 year old half British/half, Chinese/Indonesian girl who is bi-lingual. And while I don't think she completely understood what we were doing, she was a great source of information on local food and customs. This picture is of the 2nd to the poorest of the four families. They live in this one room house along with the 10 year old daughter and husband. The baby is 12 days old and probably because of the bad Jakarta traffic, was born in a taxi.

The interviews were essentially mini case-studies supporting what is already known - almost everyone spends a lot of money on pre-made food and snacks from street vendors which are essentially very poor nutritionally. However, the mom from the poorest family did not have enough money to always feed her family three meals a day let alone afford snacks for her kids. She rarely was able to provide them with a protein source. The second poorest family at least had cow skin on the menu (though the jury is still out on how much protein that contains). Regardless of income, mothers reported that their little kids were filling up on snack foods and not eating meals - and in a report I read, one reason for giving in is the community pressure to keep your kid quiet in such densely populated neighborhoods. So when they throw a tantrum, the mother's first priority is to make the child happy. Spoiling one's appetite is definitely a world-wide, time-honored practice so hardly surprising it exists here as it does everywhere.

The other habits of the urban poor is to shop daily, and cook every morning all the food that will be consumed that day, and without refrigeration, they keep reheating it for each meal until it is gone. It was really interesting getting to three out of the four families' homes - ranging from one room to perhaps four rooms in total. The mother of the poorest family - 7 children ranging in age from 3 to 24 with only one source of income and whatever the oldest sent home as a maid - came out to the alley to talk with us. She had, I believe, put on her best dress and did her hair nicely to meet with us. My translator became increasingly uncomfortable and then told me that the mother was acting very uncomfortable answering questions about how she fed her family within earshot of all the neighbors. Needless to say, we finished the interview without getting all the information we needed. (Pictures coming soon!)

New accommodations

As mentioned earlier, Monday I moved to an expat staff's apartment while she is away traveling. The apartment is part of a giant complex which includes my building, a series of two/three storey homes laid out very similarly to a western condo/apartment complex and a third area which I haven't seen because it's behind the giant "green door" which cordons off the embassy housing from the rest of us. Along with being behind gates with a plethora of gate-men, there are three swimming pools, three tennis courts, a gym, coffee shop and spa. The complex is next to it's own little neighborhood strip mall complete with grocery store and is a five minute walk to the office.

Now that all sounds well and good - and it is. However, as with any move, your first night can be literally a rude awakening. For starters, there is no TV or internet connection in the apartment. Alright no worries there. What was causing me grief was shortly after going to bed, I had the feeling that I was being snacked upon. Flip on the light and yes I had bites but I wasn't sure what kind. So thinking it might be something in the bed, I switched to the other guest room. Things were going better but the occasional sting followed by burning indicated that yes, I was being bitten by mosquitoes. Very silent, very small but very vampire-esque beasts. In half slumber, I realized that they/it was making a small meal of my face. So a little deet mask later, and I managed through the rest of the night. Upon awakening in the morning, I was puffy-eyed and lip swollen and a bit itchy all over.

My colleague upon assuring me that my lip was more pleasantly plump than a fat-lip, arranged with the housekeeper to install a mosquito net that day. Tuesday night was much nicer. In fact, sleeping under a mosquito net has a certain romantic, out-of-Africa feel to it. AND while working from under it last night, I discovered a free wi-fi signal too. I also tried out one of the pools. It was beautiful but a little eerie having a dimly lit, deserted, night swim complete with prayer call and bats for ambiance.

A "field" trip to the slums

Because I am collecting information on the nutrition/food situation in the urban slums of Jakarta, the nutrition director thought it would be helpful for me to pay a visit for some context. So this morning, I set out with two national staff and our driver for the tour de slums.

Jakarta is divided into a complex system of local governments within neighborhoods. Today was the monthly weighing and the bi-annual dosing of vitamin A of children. We stopped by several centers where this was happening and also visited several Mercy Corps programs where they have helped the communities implement improved hygiene systems like handwashing stations and community latrines and beautification projects. We also visited a composting project that has an income generation component.

While touring the neighborhoods, we ducked down the pathways between buildings where families live in one-room apartments. Cooking facilities that do exit are located outside the room, and there are no toilets or running water. Skirting buildings and pathways is the gutter, where many people relieve themselves and which is absolutely fetid with stagnant water and filth. It was a really amazing experience to see what is a completely normal existence for such a large portion of the world but is unknown to the rest of us.

What I was supposed be taking special note of are the street vendors. The word for them translates into "five legs" because the cart has three legs and the vendor has two. They all sell relatively the same thing and not much of it is healthy. The community and Mercy Corps are concerned with the amount of snacking children do. They don't eat regularly meals but buy snacks from the vendors: fried noodles, chips, candy, soda, ices, sweets etc. The regular consumption of these foods, in place of nutrient dense meals, is said to be causing stunting and micronutrient deficiences in children and obesity is a concern too. One idea is to initiate dialogue with the vendors to find options for selling healthy snacks and then have carts labeled as a "healthy snack" cart. A complex situation which hopefully will have an effective solution.

Living it up in Jakarta

My living situation has changed so that I only have internet access at the office - and this afternoon I have managed to get the IT guy to drop the block on blogspot. That and pubmed. Apparently which sites are blocked is rather random.

So a little catching up is in order. Sunday I spent my last day at the hotel. I took a short walk and stumbled upon a neighborhood of gated houses on tree lined streets - a far cry yet so close to where my hotel is located. A posh hotel but step out on to the street and you can't tell if the sidewalk is coming or going. Gaping holes that would break your leg are everywhere and that's if you aren't run down by a motorbike off-roading to beat the traffic. Also on this street is the most gi-normous KFC I have ever seen. KFC is more prevalent in Asia than any other fast food franchise (by my observation). This one has an indoor playground and a music center. I couldn't get the whole thing in the picture because at rush hour it was impossible to cross the street.

Also on Sunday I treated myself to a spa treatment - 90 minutes of being massaged, scrubbed and slathered with various substances. It was, shall we say, the most thorough and sticky treatment I've ever experienced but oh it was lovely...and about $22.

Inside the ex-pat life

After spending a very relaxing morning working and learning Obama's life story on CNN, I took a taxi to the country director's house to attend his 3-year old son's birthday. Gathered at his very nice house were an assortment of American, British and Australian ex-pats with their children and nannies in tow. In no way do I judge the ex-pat life but I am not used to one that includes maids, nannies and general house help. In most of these families, both parents work and without the daycares of the western world, the nanny is an indispensable position. And from what I've heard, the nannies are far more reliable here than back home.

It was a pretty good shindig. The kids - mostly boys between the ages of 2 and 5 ran around, there was a water fight, lots of great food, a Pooh ice cream cake, and a Pooh pinata. Yes, pinatas are plentiful in Jakarta. A teacher from one of the international schools said that they are a part of most children's parties. The funny thing about this Pooh pinata was that the kids kept taking turns thwacking the poor bear but Pooh refused to yield. Half way through the beating, one parent muttered "It isn't one of the ones with wire is it?". And as the beast started to come apart, it was held in shape by chicken wire. Fortunately, the kids didn't care and when the host finally shook the candy out of the bear, the usual chaos ensued.

A Saturday afternoon well spent. A very friendly crew who all confirmed that Jakarta is a nice place to live as long as you have everything you need nearby because it takes forever to get anywhere at any time in this huge sprawling city. PS Check out this cool party idea - putting jello inside orange slices which then become little boats. Way cool.

It's a small world afterall...

This morning at the hotel breakfast, I found myself looking toward a very familiar face. And since the face was looking at me, I suspected we had correctly placed each other. Of all the hotels in all the cities in the developing world, I had run into my predecessor at Mercy Corps. Sarah had held my position prior to me and I hadn't seen her for nearly two years. But for the same three weeks we are both in Jakarta assisting our orgs' respective country offices (she is based out of DC now). Very bizarro.

And so today proceeded like yesterday sans the exhaustion. Lunch was at a local hole in the wall where you go through buffet style choosing from various platters and bowls of food: fried tempeh, stewed fish, tofu, chicken, beef, vegetables and rice. It was incredibly good stuff and we ate in what could very likely be the family after-hours living room.

The Longest Day

Because you never want to count your chickens before they hatch, I wasn't thoroughly convinced my exit from Singapore was guaranteed. Thus, I was up far too early for my far too early departure time just to make sure I was on that plane. But make it I did and despite having to answer an awful lot of questions at immigration, they let me into Indonesia where the 1 1/2 hrs commute through Jakarta morning rush-hour and my very friendly driver du jour awaited me.

So what the heck am I doing here for the next three weeks? I am gathering as much information as possible on the current situation surrounding child malnutrition in the urban slums of Jakarta. What I can't find via the internet, I'll then have to try to get from other organizations. All the information will then be funneled through a meeting in September where they will transform it into the the Urban Nutrition Strategy to be used for future programming and to entice future donors. Voila!

For my first week I'm staying at really nice hotel which on my first night would have been even nicer if there hadn't been a ruckus dinner event at the pool below my room. The exuberant entertainment however was no match for my sleep deprivation and I managed to pass out early despite it sounding like the singer was belting it out next to my bed.