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HIDDEN HUNGER HIDDEN HUNGER Gender and the Politics of Smarter Foods Aya Hirata Kimura CORNELL UNIVERSITY PRESS ITHACA AND LONDON Cornell University gratefully acknowledges receipt of a grant from the Women’s Studies Department of the University of Hawai’i, which assisted in the publication of this book. Copyright © 2013 by Cornell University All rights reserved. Except for brief quotations in a review, this book, or parts thereof, must not be reproduced in any form without permission in writing from the publisher. For information, address Cornell University Press, Sage House, 512 East State Street, Ithaca, New York 14850. First published 2013 by Cornell University Press First printing, Cornell Paperbacks, 2013 Printed in the United States of America Library of Congress Cataloging-in-Publication Data Kimura, Aya Hirata, 1974– Hidden hunger : gender and the politics of smarter foods / Aya Hirata Kimura. p. cm. Includes bibliographical references and index. ISBN 978-0-8014-5164-5 (cloth : alk. paper) — ISBN 978-0-8014-7859-8 (pbk. : alk. paper) 1. Nutrition policy—Indonesia. 2. Women—Nutrition—Indonesia. 3. Malnutrition—Indonesia—Prevention. 4. Enriched foods—Indonesia. 5. Trace elements in nutrition—Indonesia. 6. Food habits—Political aspects—Indonesia. I. Title. TX360.I5K56 2013 362.1963'9009598—dc23 2012029708 Cornell University Press strives to use environmentally responsible suppliers and materials to the fullest extent possible in the publishing of its books. Such materials include vegetable-based, low-VOC inks and acid-free papers that are recycled, totally chlorine-free, or partly composed of nonwood fibers. For further information, visit our website at www.cornellpress.cornell.edu. Cloth printing 10 9 8 7 6 5 4 3 2 1 Paperback printing 10 9 8 7 6 5 4 3 2 1 Frederick H. Buttel (1948–2005) Koyoshi Nakano (1917–1999) Contents List of Tables and Figures ix Acknowledgments xi List of Abbreviations xiii 1. Uncovering Hidden Hunger 1 2. Charismatic Nutrients 19 3. Solving Hidden Hunger with Fortified Food 39 4. Bound by the Global and National: Indonesia’s Changing Food Policies 62 5. Building a Healthy Indonesia with Flour, MSG, and Instant Noodles 81 6. Smart Baby Food: Participating in the Market from the Cradle 111 7. Creating Needs for Golden Rice 139 8. Conclusion 162 Notes 173 References 191 Index 219 Tables and Figures Tables 2.1. Examples of protein-rich food projects 25 3.1. Examples of international organizations’ nutritionalized projects in Indonesia as of 2004 43 3.2. National fortification projects in developing countries 45 5.1. Indonesian milling industry 85 5.2. Flour production capacity in Southeast Asian countries 91 5.3. Top ten flour mills in the world by capacity 91 5.4. Wheat flour mandatory fortification standards 93 5.5. Chronology of fortification projects in Indonesia 96 6.1. Comparison of baby food marketing strategies, 1979–2005 123 7.1. Indonesian public’s perception of different biotechnology applications, % respondents who said each application was “useful” 154 Figures 3.1. The number of publications with key word “micronutrient malnutrition” 42 3.2. The number of newly approved World Bank projects with Health, Nutrition, and Population code 48 3.3. HNP sector commitments by the World Bank 48 4.1. Illustration of the link between nutrition and development 73 5.1. Market share trend of the wheat flour market in Indonesia 87 5.2. Indonesian wheat imports, 1960–2010 90 5.3. Market share of imported wheat flour in Indonesia 94 6.1. Indonesian baby food market, 1999–2004 118 6.2. Indonesian baby food market share, 2003 118 ix Acknowledgments This book has come about through the encouragement of many people. At the University of Wisconsin–Madison, Frederick H. Buttel gave enthusiastic sup- port for the project. Unfortunately, he died while I was doing my fieldwork in Indonesia. This book is dedicated Fred, who was not only a brilliant scholar but also a true teacher. Jane Collins has been a great mentor who always provides thoughtful suggestions and advice. The book would not have been possible with- out rich conversations and guidance from Jack Kloppenburg Jr., Samer Alatout, Daniel Lee Kleinman, and Clark Miller. Other students and faculty members in the departments of Rural (now Community and Environmental) Sociology and Sociology, and the Center for Southeast Asian Studies, provided a supportive atmosphere, friendship, and companionship. I also appreciate the willing assistance of the many Indonesian researchers, policymakers, and NGO workers with whom I spoke. Pak Soekirman kindly shared his knowledge of nutritional policy in the country as well as his vast social network, which was critical for my research in Indonesia. Professors Aman Wirakartakusumah and Adil Ahza at Bogor Agricultural University in Bogor gave institutional support. Nelden and Yosef Djakababa’s kindness, hospitality, and friendship were key to my survival during the fieldwork. I am also grateful to people whom I interviewed in the United States about their work in international nutrition and development, including Alfred Summer and staff members at the World Bank, USAID, the International Life Sciences Institute, and the Interna- tional Food Policy Research Institute. I also benefited from the intellectual and personal support from my col- leagues at the Women’s Studies Department at the University of Hawai’i–Manoa. In particular, Susan Hippensteele was wonderfully welcoming to me when I first came to Hawaii. Kathy Ferguson was generous with her time and read early drafts of the book. Her thoughtful comments helped me to articulate the gendered dimensions of food politics. Meda Chesney-Lind provided indispensable sup- port for the project as chair of the Women’s Studies Department. I also appreciate the encouragement from Phil McMichael and Michael Dove, and feedback from Christine Yano, Jane Freeman Moulin, and Pensri Ho, who read early drafts of the book. Carol Colfer at the Center for International For- estry Research and an anonymous reviewer for Cornell University Press offered insightful comments. Roger Haydon, executive editor at Cornell University Press, xi xii ACKNOWLEDGMENTS skillfully guided me through the overall project. Special thanks are also due to Ange Romeo-Hall, senior manuscript editor, and Katy Meigs, copy editor, at Cornell University Press for their helpful comments and thorough editing. This research was financially supported by grants from the National Science Founda- tion, the Rural Sociological Society, and the Center for Southeast Asian Studies at the University of Wisconsin–Madison. I wish to thank my family as well. My mother, Ryoko (Nakano) Hirata, and my father, Masahiro Hirata, always let me pursue my dreams with strong faith and love. I owe my deepest gratitude to my partner, Ehito Kimura, who has endured all stages of this project with a big heart and soul. Our children, Isato and Emma, remind me even in the most mundane way that all children deserve a world with- out hunger. Their great grandmother, Koyoshi Nakano, to whom I also dedicate the book, raised generations of confident and empathetic women and inspired me by her resilience and strength. Finally, I am deeply grateful to the many Indonesian women who let me into their homes and shared their mothering stories. Now that I am a mother of two, I consider what they had to tell me with deeper appreciation. It is my hope that these mothers find the book reflects their experiences. Abbreviations ACC/SCN UN Administrative Committee on Coordination, Sub-Committee on Nutrition ADB Asian Development Bank APTINDO Indonesian Association of Wheat Flour Producers BAFF Business Alliance for Food Fortification BAPPENAS National Development Planning Board, Indonesia BIMAS Mass Guidance program, Indonesia BKKBN National Family Planning Coordinating Board BULOG Food Logistics Agency, Indonesia CF complementary food CGIAR Consultative Group on International Agricultural Research CYMMIT International Maize and Wheat Improvement Center DALYs disability adjusted life years FAO UN Food and Agriculture Organization GAIN Global Alliance for Improved Nutrition GMO genetically modified organism HKI Helen Keller International HNP Health, Nutrition and Population ICN International Conference on Nutrition IDA iron deficiency anemia IDD iodine deficiency disorder IFPRI International Food Policy Research Institute ILSI International Life Sciences Institute IRRI International Rice Research Institute ISAAA International Service for the Acquisition of Agri-biotech Applications IVACG International Vitamin A Consultative Group KFI Indonesian Fortification Coalition (Koalisi Fortifikasi Indonesia) MDG Millennium Development Goal MI Micronutrient Initiative OMNI Opportunities for Micronutrient Initiatives Persagi Indonesian Nutritionist Association (Persatuan Ahli Gizi Indonesia) xiii xiv ABBREVIATIONS PAMM Program Against Micronutrient Malnutrition PATH Program for Appropriate Technology for Health PAG Protein Advisory Group RDA recommended daily allowance Repelita Five-Year Development Plan (Rencana Pembangunan Lima Tahun) SAP Structural Adjustment Program SF supplementary food SKRT National Household Health Survey, Indonesia SNI Indonesian National Standard SUSENAS National Social Economic Survey, Indonesia UNICEF United Nations Children’s Fund UPGK Family Nutrition Improvement Program (Usaha Perbaikan Gizi Keluarga) USAID US Agency for International Development VAD vitamin A deficiency WFP UN World Food Programme WHO UN World Health Organization 1 UNCOVERING HIDDEN