Original Article Digesting Urban Space: Dietary Wellbeing in Mumbai Slums Briana Gilmore and Nicky Pouw International Development Studies, University of Amsterdam, Amsterdam, The Netherlands

Abstract Policymakers and industrial developers in Mumbai face the mounting social and spatial needs of a constantly increasing urban population. Slum dwellers account for up to half of the city’s inhabitants, and are the socioeconomic group most vulnerable to deficient and exclusive governance practices. This article explores the social and psychological determinants of ‘dietary wellbeing’ from the viewpoint of cultural ideology and temporality intersecting and a relational perspective on the (re)production of urban space. Urban policy directives and a deficient Public Distribution System negatively impact the ability of slum dwellers to access quality food and avoid dietary illness, thus reinforcing shifting cultural norms within dietary preferences and notions of success. The prevailing urban ideal established by Mumbai governance authorities contradicts the real modes of spatial and temporal legitimacy inherent to slum spaces and populations, whose dietary wellbeing is at stake. Les décideurs politiques et les développeurs industriels de Mumbai doivent faire face aux besoins sociaux et spatiaux grandissants d’une population urbaine en croissance constante. La moitié des habitants de la ville réside dans des bidonvilles et est constituée des groupes socio-économiques les plus vulnérables aux pratiques gouvernementales défaillantes et exclusives. Cet article explore les déterminants sociaux et psychologiques du ‘bien-être alimentaire’, en adoptant un point de vue entre idéologie culturelle et temporalité, ainsi qu’une perspective relationnelle sur la (re)production de l’espace urbain. Les politiques urbaines ainsi qu’un système public de distribution défaillant ont un impact sur la capacité des habitants de bidonvilles à accéder à de la nourriture de qualité et à éviter les maladies liées à l’alimentation; cela renforce les normes culturelles associées aux préférences alimentaires et aux notions de succès. L’idéal urbain existant établi par les autorités de Mumbai contredit la légitimité spatiale et temporelle propre aux espaces et aux populations des bidonvilles, dont le bien-être alimentaire est en jeu. European Journal of Development Research (2016) 28, 236–251. doi:10.1057/ejdr.2014.69; published online 19 February 2015 Keywords: dietary wellbeing; urban slums; food quality; urban space; Mumbai

Introduction Rapid urbanization poses new challenges for human development and wellbeing, as urban poverty threatens to parallel rates of rural poverty by 2035 (Ravallion, 2007). By 2030, the percentage of urban inhabitants will have risen to 60 per cent of the global total (UNPD, 2008). An effect of rapid, unplanned growth is the hybridization of urban space into polycentric webs without a traditional core or stable boundaries (Davis, 2007). In Indian cities there are not enough jobs, infrastructure, food and social safety nets to support the growing demand on urban resources and space. And yet people continue to migrate to cities and the city itself is migrating to and enveloping the peoples living outside it (Davis, 2007). Food and nutrition security is a growing concern for the urban poor. Global industrialization has altered the availability of resources for urban inhabitants, leading to an increasingly commercialized diet for populations that no longer grow or produce their own foods (Gupte, 1984). This has changed what is (safely) available in © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251 www.palgrave-journals.com/ejdr/

Digesting Urban Space urban markets in the Global North and South, and has shifted perceptions among urban populations of what constitutes healthy food. Mumbai is the most populous city in India, and the city with the highest number and percentage of slum dwellers. It is also the Indian city with the highest population density, with at least 22 000 people per square kilometre (Census GIS, 2008). The island city is already strained to capacity, yet the arrival of thousands more migrants each month continues to put pressure on the resources and overall wellbeing of the urban population (Davis, 2007). The purpose of this article is to shed light on the social–cultural and psychological dimensions of the dietary wellbeing of Mumbai’s slum populations. This is done from the contention that social–cultural and psychological food needs are embedded within a broader context of material, spatial and symbolic change, affecting the livelihoods of slum dwellers in Mumbai City. The field research was carried out in 2010 in three slum areas of Mumbai and involved a multitude of stakeholders, including slum dwellers, food vendors and policy-related institutions. The next section details the theoretical underpinnings of the research, pointing to the need to recognize social-cultural as well as psychological influences of food choices, and how these choices are embedded in the changing material, spatial and symbolic environment of urban slum dwellers. The section after that explains the research methodology and the research and policy context of Mumbai, including a review of its recent urban policies on slum demolition and the Public Distribution System (PDS).1 The following section presents the research findings regarding people’s dietary wellbeing: what constitutes good food, what the causes of dietary illness are and what livelihood strategies are adopted by slum dwellers to respond to the recent changes. The subsequent section focuses on the research findings concerning the PDS in Mumbai. The implications of these findings are discussed in the penultimate section, where we also formulate recommendations, after which the final section concludes.

Dietary Wellbeing, Culture, Temporality and Urban Space Introducing the Concept of Dietary Wellbeing Nutritional health and food security are of increasing concern to rapidly growing urban populations in developing countries (Food and Agriculture Organization of the United Nations (FAO), 2013a), where both over- and under-nutrition constitute serious challenges to human health and wellbeing. Although food supply may well be more diverse and hygienic in (growing) cities, decreasing the malnutrition of children and adults (Ruel and Garrett, 2004; FAO, 2014), this does not apply to all food categories and outlets. Moreover, healthy foods are not readily available to all urban dwellers. This global health hazard was signalled by the World Health Organization more than 10 years ago (WHO, 1990). However, it remains of great concern today in many rapidly growing cities in the developing world (WHO, 2004; Nugent, 2008).2 This is especially true of Mumbai, where the poor constitute the most vulnerable group, and their dietary wellbeing is jeopardized by other development goals. Medical researchers have warned of an obesity ‘epidemic’ in developing countries and other lifestyle-related health problems, notably in cities, for some time now (for example, Prentice, 2006; Nugent, 2008), next to under-nutrition as a remaining problem (for example, Jamison et al, 2006). The poorer segments of the urban population face daily challenges to make ends meet and fulfil their nutritional needs. Where food and nutrition security focus on food availability, access, utilization and stability (Gross et al, 2000; FAO, 2006), Noack and Pouw (2014) have argued for the inclusion of the sociocultural and psychological/cognitive dimensions of food utilization, to understand what constitutes ‘sufficient © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251

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Gilmore and Pouw culturally adapted food’, and food that is available and accessible to a household or community to meet physiological and social–cultural needs (Noack and Pouw, 2014, p. 5). People use these parameters to assess their wellbeing in terms of food intake and dietary needs. Below we briefly review other concepts and approaches to demonstrate the originality of this approach. For example, the concept of dietary health emphasizes the nutritional aspects of a diet from a purely biomedical perspective (for example, Nishida et al, 2004; FAO, 2013b). The notion of dietary health is dominant in informing local and national strategies on public health (for example, WHO, 2004), and increasingly so in relation to human activity. The concept of nutritional wellbeing is also frequently used and – like dietary health – grounded in a biomedical approach. However, nutritional wellbeing is often used to signify an approach that takes into account dietary habits (cultural aspects) and differences in nutritional status according to socioeconomic and age categories. Given that dietary habits and socioeconomic and generational differences differ by culture and country, the approach is used to inform national or local public health policies, or public strategies regarding specific target groups (for example, SACN, 2008; Kent, 2011). Finally, food and nutrition studies have focused solely on psychological aspects by seeking to explain mental health and wellbeing as dependent on nutrition intake (for example, Hakkarainen et al, 2004; Van de Weyer, 2005). Following Gross et al (2000), in this article we proceed by recognizing the significance of a secure and adequate social–cultural environment in which food is utilized and consumed, in addition to the material and spatial. Dietary wellbeing is here defined as: the achievement of food and nutrition security that satisfies human nutritional, social–cultural and psychological food needs. By defining dietary wellbeing in this way we draw on Sheperd (1999) and Goyal and Singh (2007) for their insights on the social–cultural determinants of food choice, as well as McGregor (2004) and Gough and McGregor (2007) for their insights on the importance of subjective evaluations of human (food) needs being met (or not) as being critical to the experience of human (dietary) wellbeing. Both aspects require knowledge of people’s own evaluations of their food utilization and consumption – including how and where food production, processing, storing and consumption take place and what choices of recipes and ingredients are made (Noack and Pouw, 2014). This has informed our exploratory and qualitative research methodology with multiple stakeholders and actors in the slums of Mumbai City. The exploration of the determinants of dietary wellbeing in Mumbai slums is further contextualized by two epistemological viewpoints: cultural ideology intersecting with temporality, and a relational perspective on the (re)production of urban space. This provides a more dynamic understanding of food production, consumption and marketing practices and innovations taking place, aimed at building resilience in response to social–cultural and economic change. Instances of innovation in slums have been researched in cities throughout the world, but so have the limitations and implications of such resilience (Davis, 2007). Each of these departure points is explained below, and summarized in the conceptual scheme presented in Figure 1 at the end of this section. Cultural Ideology and Temporality: Competing Norms in Modern India Using Thompson’s definition of ideology as ‘a coherent system of meaning, which provides a basis for purposive action’ (Thompson, in McGregor, 2004, p. 4), the wellbeing approach aims to operationalize culture as being meta-ideological; culture transcends single ideologies but is always founded upon them (McGregor, 2004, p. 7). People use cultural tools to resolve inconsistencies between ideologies with other people or groups of people; this can take familiar forms such as public debate or schoolyard bullying (McGregor, 2004). The goal of many hegemonic structures is to create a single, monolithic culture to mediate ideological 238

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Digesting Urban Space

Mumbai as a "World Class City" and the ways this rhetoric influences advertising, discourse, and expressed ideals of respondents

Governance ideology and policy implementation

Culturally inherited norms and traditions. Perceptions of ideal consumption patterns

Objective health indicators

Ideal space

Industrial development in planning and practice

Non-governance institutions and prevalence of respondent utilization of services

Dietary well-being

Access and distribution of quality, healthy, affordable food

Real space

Livelihood strategies, innovation, foodrelated employment, social capital, utilization of government services (PDS)

Temporality of lived spaces in slum markets and ideal neighborhoods

Slum spaces and food markets in slums neighborhoods

Spatial heterogeneity in food distribution norms

Methods of material and objective ownership and legitimacy, comparative spatial utilization

Figure 1: Conceptual scheme of exploring dietary wellbeing.

ambiguities and resolve dissent based on personal perception or emotional responses. This ideal is mythical. However, such structures insist on maintaining this mythical narrative of a cohesive structure in order to maintain an existing order or convince a population of necessary change (McGregor, 2004). Beyond the structures of ideology and culture lies temporality. Analysing temporality, or ‘the way time is’ (Tiemersma and Oosterling, 1996), in contextual research is difficult because the evidence of temporal distinction rests in cultural custom and practices. Materialism is the operating paradigm of many Western societies today (Marx and McLellan, 2008). Materialism is not, however, the temporal structure that thousands of years of South Asian history is based on. The operating paradigm in India is closer to idealism. Idealism, as it exists in India, operates on the principle that the material universe is not the goal of life, but rather an illusion manifested to demonstrate the power of the Creator. Idealism is an ideological focus that forms cultures and structures that are cyclical rather than linear. Cyclical structures – and the people who live by a cyclical temporality – reside in the understanding that time, or life cycles, do not have a beginning or end. Where materialism emphasizes individual progress and social mobility over the course of one’s lifetime, idealism emphasizes existing structures and hierarchies more as ‘facts of life’. To escape poverty or move up the ladder of life may then not be a goal that can be achieved over a single person’s lifetime. Improvements in existing living conditions can © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251

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Gilmore and Pouw be made, but within given structures and social–cultural relationships. The tension these competing paradigms create has caused friction between the institutionalized ideal of modern India, its world class cities, and the lived realities of its inhabitants. The different ways that people define notions of ‘progress’ and ‘modernity’ speak to how they compose ideological positions and how they formulate cultural performance and interaction (for example, with regard to perceptions of endogamy and dietary preferences). Significantly, the way a government and social structures define progress and modernity in urban environments influences how they promote, advertise and evaluate ideal consumption patterns, health indicators and urban policy implementation, leading to contestation over urban food consumption and market places. Contested Urban Spaces Space is a relational concept (Lefebvre, 1991; Harvey, 2009); it does not exist as a ‘thing in itself’, writes Harvey (2009), but exists through the process of relative material existence and legibility. Harvey wrote that it is in the confusion between our conception of cities – our desired and ideal version of them, and the geographic realities of them – that disparity and injustice occur. The sociopolitical priorities of institutions govern the distribution of income, property rights and social objectives. Institutions also govern acceptable forms of cultural dynamics and the distribution of public goods, including space. As the demands of global capital consume urban spaces worldwide, the socio-spatial concerns of institutions are replaced by the inert structures that serve capital. Capital accumulation is supposed to impart spatial freedom; the utopian ideology of globalization strives for fluid, flexible, mobile space that imparts infinite possibilities into our lived spatial realities (Khilnani, 1999). The reality of capitalized space, however, ensures that few people will be able to transgress it; the rest must suffer the geographical conceptualizations of the capitalist production of space (Huang, 2004). Time and space are allowed to exist according to the practised and reproduced conceptualizations of actors (Harvey, 2009), such as slum dwellers. However, the spaces of capital accumulation and their alternatives are not neatly delineated. The spaces in-between (those serving capital but transgressed by the lived realities of separate temporal ideals) are contested for legitimacy and ownership by their inhabitants and users. As Edensor (1998) describes, moving through an Indian street is a sensory experience rich with labyrinths and overlapping openings and passageways. The complex blends between the public and private, religious and profane, the ecstatic and the mundane; most remarkable is the way Indian urban spaces regulate food. Consumption in slum settlements conflicts with spaces of ideal capital, particularly as both spaces rely on integrated distribution systems and social networks. The spatial rhetoric of the Brihanmumbai Municipal Corporation (BMC) in Mumbai is therefore analysed to form a vision of the institutional ideal of urban space; of what is considered legitimate use of urban space (slum spaces, food markets) and what is real; of how the PDS of food functions for the poor; and of how slum dwellers strategize their livelihoods to adapt and innovate in response to this.

Research Context and Methodology Mumbai Slums and Policies The most recent estimate of the Mumbai slum population amounts to between 11 and 12 million out of a total population of 21 million (UN-HABITAT, 2010). The official definition of a slum is a rundown area of a city characterized by substandard housing and squalor, and lacking in tenure security. The term ‘slum dweller’ is a functional term that fails to recognize the details and 240

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Digesting Urban Space differences within and between slum populations; the breadth of slum populations in the world (numbering at least 1 billion people; Risbud, 2003) is so heterogeneous that the term could not mean anything about all them except ‘one whose primary residence is in a slum area’. The respondents in this research took great pride in their homes and communities. Slum dwellers characterized their own slum areas as receiving little of attention from municipal programmes, a lack of public and private services such as health care or schools,3 and a lack of viable infrastructure such as secure housing and solid and human waste facilities. Slum areas often contain pavement dweller huts, zopadpattis (squatter settlements) and chawls (tenement housing). The vast majority of these dwellings are rented or owned; rent is paid to a local overseer or strongman (between US$10 and 40) or bought privately (for up to $16 000). Owning or renting property in a slum area does not imply that the occupant will have a safe or protected structure, particularly if the land and community do not fall under the most recent Slum Redevelopment Scheme4 (Risbud, 2003). Structures are made out of solid material such as brick and concrete, but a quarter of structures are made out of less solid materials such as drywall, insulation and fabrics. Pavement dwellers – who are classified as a subcategory of slum dwellers – are known to have the least solid structures, which are often made out of mosquito nets, cardboard or fabric. The respondents in this research lived in slum areas, but were not pavement dwellers or chawl inhabitants. A very large-scale demolition project by the BMC was carried out between December 2004 and June 2005, with the goal of demolishing upwards of 60 000 homes built after a cut-off period of 1995. Slum dwellers were forced to prove – with written documents or photo identification, such as a PDS card – when they established ‘residency’ within a slum settlement. Local municipal Corporators5 were required to make lists of huts that met demolition criteria and were instructed to build local squads of men willing to partake in the demolition process. The BMC also requested the assistance of local citizens to actively help local Corporators and to report illegal settlement activity to officials. Despite protest from slum dwellers’ organizations, NGOs, citizens groups, prominent activists and international organizations, the demolitions were carried out for a period of seven months. And although huts built before 1995 were to be left alone during the process, thousands of inhabitants made complaints that officials destroyed long-standing homes and stole dweller’s identification cards to erase the evidence of fraudulent practices (Mahadevia, 2008). In 1995 the BMC put forth new policy directives to shape Mumbai into a ‘World Class City’ (Mahadevia, 2008). The policy directives include new tactics in the municipality’s ongoing battle against the creation and maintenance of slum areas. Part of these new methods against slum encampments and spaces of slum livelihood activity was the specific directive to treat slum dwellers as if they do not exist; quite literally, illegal inhabitants are to be treated as invisible (Mahadevia, 2008). The policies of the BMC and the Mumbai Industrial Development Corporation (MIDC) specifically aim to eliminate the value of slum food market in public spaces (public markets) by ideal markets using a private Mall Model. Malls are private entities, and symbolically exclude specific inhabitants of Mumbai through authoritative use of the following devices: ●

●

Physical structure: Malls are indoors and off the streets where slum dwellers typically walk; items are not readily available to view, touch and smell and so remove the complex sensory experience of traditional public market spaces. Regulated customer service: The means of exchange are fixed through price points, advertisements and sales – bargaining is not present. There is no specialization of food vendors ensuring quality through personal interaction, other than luxury markets specializing in high-end products. © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251

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Gilmore and Pouw ●

Density of distribution: Ideal market spaces are spread throughout a neighbourhood rather than packed close together, making it difficult to walk from place to place to do all necessary shopping – customers must have the means of time and/or money to drive or walk long distances between points of food distribution.

The PDS could potentially mitigate two critical problems facing slum inhabitants: the lack of affordable healthy food options promoted by regulated institutions, and the lack of trust and dependence on government provided services by the poor. However, the PDS in Mumbai has been increasingly affected by scandal, mismanagement and waste since its inception in 1942. Despite its systemic imperfections, it is the largest food distribution system of any national government mandate in the world, and since its creation has been committed to mitigating chronic hunger and controlling market fluctuation. The PDS was first operationalized in 1942, when the crisis of World War II prevented reliable trade and prices, and severely undermined the food security of the Indian population. At first the system was targeted to food-scarce regions, and after the emergency the system continued in cities, major towns and to areas with large numbers of food-insecure people. In the 1960s and 70s the programme benefited from an increase in availability of staple cereal grains through the techniques of the Green Revolution, and was able to supply rice and wheat stocks at stable prices, particularly to populations of the urban poor. Since then, the PDS has gone through several revised plans; the largest revision was in 1997 when the Government of India introduced the Targeted Public Distribution System (TPDS). This plan was implemented after studies and critiques indicated that the PDS was biased towards urban dwellers and excluded the poorest populations. Since that time, local populations have been classified by relative wealth, and those below the poverty line are charged prices for goods that are no more than half of the central issue price. Research Methodology The field research took place in three different slum neighbourhoods in Mumbai City in Maharashtra state: Andheri, Byculla and Malwani. These locations were selected on the basis of socioeconomic data, diversity of internal populations, and the presence of non-governmental organizations that could assist in data gathering and community knowledge. The populations were from diverse regional, ethnic and religious backgrounds. More people were from Maharashtra than from any other place, but the majority of respondents were migrants from outside the state or city. It was important for this research to evaluate both migrants and respondents native to Mumbai and Maharashtra in order to look at patterns of food culture and acculturation, as well as the redevelopment of the use of space in slums and food markets over time. The religious or spiritual affiliation of the research population as a whole indicated that while the majority of respondents were Hindu, there were a significant number of respondents who ascribed to other religious practices. Sixty-one in-depth interviews and transect walks were conducted with slum dwellers (with an interpreter). The slum dwellers were sampled through snowballing. Twelve food vendors and distributors were interviewed. In addition, 13 in-depth interviews were conducted with respondents from official institutions, including urban government employees and directors of NGOs.6 Finally, five interviews were conducted with Indian farmers supplying food to Mumbai. These interviews triangulated the findings of the secondary research on the local food system,7 with evidence from primary research respondents on food quality and access through local markets and the PDS. 242

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Dietary Wellbeing of Slum Dwellers The Importance of ‘Good Food’ However impoverished the individual, without exception respondents in this research indicated that food quality was the most important factor in deciding what items to purchase. Food quality was subjectively defined by the respondents as food that gives ‘value for money’, is ‘of good colour and taste’ and ‘fresh’. Migrant respondents often compared it to the value of the same product that they would have been able to purchase in their native place, for the same amount of money. However, respondents indicated that urban markets lack consistent food options of high quality, and that the situation has been growing worse for years. In addition to this, the quality of cooked food is lessened by the poor quality of drinking water in the city. When this water is added to rice, dal and vegetables that are already lacking in flavour and quality, the prepared meals do not taste pleasing. Slum dwellers pay high prices for clean drinking water. Finally, another factor affecting food quality and flavour is the emergence of seasonless food in urban markets; the globalized food system allows for any and all fruits and vegetables to be sold in Mumbai no matter what the local growing season is. These factors are known and highly relevant to respondents, as over 80 per cent of the respondents said that the lack of local quality food affects the recipes they prepare, the overall quality of the food they consume, and their fulfilment after consuming prepared meals. ‘The tomatoes look different; you can see when they travel in trucks for too long. The taste is no flavour, makes too much tension’, said one female respondent (B/21). A rise in rice and wheat production since the Green Revolution has provided access to these preferred grains for poor populations. During the Green Revolution, the agricultural sector replaced traditional polyculture and subsistence farming with high-intensity monocropping. Refining of wheat, rice, corn and soy plants emerged as the norm in industrial food production as a means of utilizing and redistributing food surpluses (Parayil, 1992). The successes of the Green Revolution in India peaked in 1971, and by the mid-70s India declared itself self-sufficient in the production of cereal grains. By the late 1980s the country was exporting large amounts of wheat and rice, and had also started using this for domestic cattle feed (Chakravarti, 1973; Parayil, 1992). Cereal grains such as sorghum, maize, buckwheat, barley and other small millet varieties used to provide the bulk of caloric and protein consumption for India’s poor (Calpe, 1991, pp. 70–84). Today, refined cereal grains are more easily accessible and less expensive to all income levels in India. Thus, so-called superior cereals are not only preferred, but most often consumed. However, the homogeneity of the distributed grains is contributing to an overall decrease in the dietary wellbeing of the poor. Although malnutrition has been significantly reduced in India, a much heard critique is the restriction of food complexities and cultural dietary distinctions (Altieri, 2008; Pingali, 2012). Respondents are aware of their food choices and shifts in distribution of fresh foods. However, they have no education about developments in cereal grain production and what these mean for their health. The shift in affordable carbohydrates has less to do with relative wealth, however, than with an influx of cheap processed grains in the Indian market. ‘I used to make only corn or millet chapati, but now you cannot find it at the market’ (A/9), notes one respondent. The decrease in heterogeneity among available cereal grains has affected the dietary health of consumers. As evidenced throughout the research, such shifts impact the acculturation of youth in slum populations, as a generation is being raised with little or no connection to the dietary preferences of their parents. Access to refined foods and luxury goods creates diverse preferences within families, fuelling disharmony around meal times and straining what limited time working parents are able to spend with their children. As one respondent expressed in frustration about her eleven year old son: ‘… all he wants is pizza. © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251

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Gilmore and Pouw But it cannot be any pizza, it has to be Domino’s pizza – they cost over Rs 150 for one serving! But he is telling now he is embarrassed to bring roti and subje for tiffin. Why would he be embarrassed to have a good meal’ (A/15)? The marketing of global capital within the food market alters expectations and preferences, and with little to no education among slum dwellers on dietary health, quality food is often overlooked in favour of conspicuous items that are desired to fulfil social–cultural (status) needs (for example, see Sheperd, 1999). Social status and social change can alter traditional food habits, despite people’s knowledge of what constitutes healthy food (Noack and Pouw, 2014). Dietary Illness Accompanying shifts in the availability of quality food and water are shifting notions of success and cultural ascriptions, which impact the consumption patterns and preferences of urban inhabitants. An increased availability of non-vegetarian and processed foods, as well as cooking oils, has changed disease profiles in Mumbai. The prevalence of so-called ‘lifestyle diseases’ such as obesity, heart disease, Type 2 Diabetes and Type B Malnutrition (being overweight but undernourished) is increasingly affecting the wellbeing of Mumbai slum dwellers, and is directly related to consumption patterns and lifestyle decisions. On the basis of respondents’ self-reported weight, height and illnesses, this research found that 48 per cent of the respondents were obese or severely overweight (an estimation of a person’s Body Mass Index was used and compared to the official WHO criteria); 8 per cent had been diagnosed with Type 2 Diabetes; and 38 per cent had chronic hypertension, the primary symptom leading to heart disease according to the medical literature (Gupta, 2004; Mohan et al, 2007). Furthermore, 38 per cent had experienced acid indigestion, 16 per cent diarrhoea and 11 per cent constipation. It was also worrying to see many overweight children (15 per cent) at a young age (see Table 1). Considering restricted access and Table 1: Reported and observed illnesses of respondents Dietary illness

Number of respondents

Percentage of Chronic and total respondents acute illness

Percentage of total respondents

6 4 2 5 7 4 11

10 7 3 8 11 7 18

2 2 4

3 3 7

Overweight/Obese Underweight Diabetes Acidity Diarrhoea Constipation Nausea/Vomiting/ Gastritis

29 6 5 23 16 11 10

48 10 8 38 26 18 16

Flatus

9 — 9

15 — 15

3

5

STIs

4

7

2

3

Cataracts

2

3

4

7

No reported illness

4

7

Children with overweight/obesity Children with jaundice Children with distended stomach Children with pellagra

Tuberculosis Malaria HIV/AIDS Cough/Cold Fever Back pain Skin/Hair/ Teeth problems Jaundice Seizures Depression

Number of respondents

Source: Respondent interviews. 244

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Digesting Urban Space a lack of will professed by many respondents to see a doctor regarding health problems, the numbers of respondents suffering from chronic lifestyle diseases was likely far higher than what was reported. The urban poor in India are particularly susceptible to these illnesses because cultural consumption patterns encourage excessive eating; however, once they live in the city, the urban poor are less likely to participate in consistent manual labour or walking long distances. A lack of daily exercise is coupled with a rise in the consumption of unhealthy foods due to their pervasiveness in the spatial and cultural confines of the city. Perceptions of individual wellbeing (which include the notion that ‘success’ translates into the ability to consume foods that are rich in flavour and fat) impacted the decisions of 72 per cent of respondents in regard to daily food consumption. Most respondents indicated that one of the reasons to eat more meat, fried food and prepared snack foods is that friends and neighbours view such habits as underlying success, wealth and happiness. This nutrition transition is one mirrored in developing cities throughout the world, and closely mirrors the decades-long rise in lifestyle diseases in cities like Los Angeles and London (Steel, 2009). While a lack of formal and informal education options regarding healthy food choices is paramount, the access to unrestricted consumption seems to outweigh the ability for relatively educated and developed societies to mitigate the temptations of an unhealthy diet. In speaking of his research into the nutrition transition in China, Dr Hu of the Harvard School of Public Health (HSPH) stated: … the combination of highly refined carbohydrates plus sugary drinks, less fibre, and saturated fat (from animal protein) has created an unhealthy pattern – one conducive to obesity and diabetes once you add in a sedentary lifestyle … Until fairly recently, most people in China did not have all they wanted to eat … When you go from limited food availability to having all you can eat, people tend to overdo it. (Hand, 2009)

The respondents had difficulty talking about dietary illness in ways that reflected the severity of the issue. Most respondents see dietary illness – including diabetes and chronic hypertension – as a fact of life. The prospect of changing their diet and that of their family also seems, for most, to be out of the question. As supported by evidence from the HSPH research, developing societies are more likely to overeat diets rich in refined carbohydrates and saturated fat because they are foods associated with success and luxury. In an urban conglomerate, part of the appeal associated with these luxury foods is fuelled by a culture of conspicuous consumption supported by institutional ideals of progress and modernity. Adaptation and Innovation Within the Urban Diet Instances of adaptation and innovation within dietary preferences and food-related livelihoods are present among respondents. Many respondents indicated that when they migrated to Mumbai years ago, they (or their parents) grew vegetables along the side or on top of their slum dwellings. Space in Mumbai until the 1990s was still plentiful, particularly in the northern reaches of the island city. Today, the pressures of time, space and capital have removed the ability of slum inhabitants to grow their own food. Respondents indicated that it no longer benefited them to grow tomatoes and vines on the roof, because if it is a sturdy dwelling it is prudent to build a second room above the ground level to be rented out. In an Andheri slum, a northeastern Mumbai neighbourhood, three respondents indicated that, years ago, police had taken to destroying any crops grown in slum areas to prevent dwellers from literally ‘rooting’ themselves to a space considered to be illegally inhabited. Some slum inhabitants – particularly Muslims – raise animals for sale or slaughter; women and children are most commonly engaged in these © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251

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Gilmore and Pouw home-based livelihood activities as a means of gaining extra income. Animals raised in urban areas can be capitalized on at market through advertising the meat as ‘free-range’ to meet a growing demand for animal products reared outside of factory farms. Innovations in food processing are also practiced by urban food vendors in response to price changes. For example, one food vendor in the Bandra West neighbourhood of Mumbai has been selling dosas – a South Indian pancake made of fermented rice and lentils – for 19 years. In the past 2 years, however, the rising prices of food and the constant pressure to work longer hours forced him to change the inherited recipe from his place of origin and use white wheat flour instead of the traditional mixture. The price of food had risen so dramatically in the past ten years that he has to buy the flour and fresh produce for his dosa fillings on the black market to keep costs down. He works such long hours to make a profit that he no longer has the time to prepare the correct batter at home: ‘My wife used to help me prepare the batter and chutney for the next day, but now she has to go for earning so we are doing nothing on time, not taking our own meals on time either’ (D/7). Innovation is a critical aspect of livelihood activities in contested slum spaces; however; the consistent pressure of time, space and capital affects the cultural mechanisms and inherited customs of impoverished inhabitants. Coupled with shifts in dietary preferences and notions of success, these pressures alter the spatial competency and cultural relevance of migrated culture(s). Rather than uphold the diverse cultural ambiguities of the booming metropolis, the urban ideal in Mumbai is for the homogenization of time, space and capital into a uniform ideology; this is mirrored through uniformity within cultural nuances of foods and dietary preferences. The institutional and spatial ideals upholding this paradigm modify the spatial competence and cultural dialogue within and between slum spaces.

The Public Distribution System In Mumbai, the rising input costs of food production and sale increasingly force small food operations to seek cheap sourcing options. Because of the mounting prevalence of the black market for food. the efficacy of the PDS has diminished. Fifty-six per cent of the respondents indicated that they were in possession of a ration card. Obtaining a ration card can be difficult for slum dwellers. As most have unofficial residency status it is a lengthy and often expensive process; nine respondents admitted to paying bribes for documents to help secure the card, and four indicated that they were using a friend’s or employer’s card that had been given to them. Some respondents were able to use their status as renters to receive a card, but this was only allowed if the landlord had a different address.8 Otherwise, respondents most often inherited the card from parents who have moved out of the city or moved in with their children. Obtaining a ration card, however, is no longer the most difficult part of the process. The hardest part is finding food to buy. One respondent out of sixty-one indicated that she was buying sugar, wheat, rice and kerosene – all of the allotted supplies from PDS local neighbourhood Fair Price Shops – due to the benefits of a special discounted card for inhabitants over 60 years of age (A/9). Fifty-six per cent of respondents bought their kerosene ration from the shop, while 8 per cent bought both sugar and kerosene from the shop. Apart from that, not one respondent indicated that they were currently buying food rations from PDS stores. Many respondents indicated that in recent years the food had become ‘dirty’: ‘the wheat and rice are not clean’ (B/8); there is ‘nothing but stones and sand’ in the sugar (B/11). Complaints about the quality of the food at the shops were expressed in every neighbourhood evaluated. ‘The quality is too much bad now; we have not been taking in maybe five, six years’ (A/4). 246

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Digesting Urban Space But the complaints did not stop there, because quality was only half the problem. Most respondents have stopped going to Fair Price Shops because there is often no food to buy. According to 87 per cent of respondents, the shop where they are to access rationed food does not consistently have it. Twenty-eight respondents said the shop did not carry any food, nineteen respondents said their shop carried sugar sometimes, and six respondents claimed that the lack of consistency in availability and quality kept them from frequenting the shop except for an occasional ration of kerosene. Because of PDS zoning regulations respondents would often have to go to ration shops different from the one their neighbours went to. One respondent (B/3) lived just 2 m from a Fair Price Shop, yet she had to walk one kilometre to get to the shop she was allowed to buy from: ‘I can buy those things here in the market. Why should I spend that time to go so far? Sometimes they are not even having kerosene in the shop; it is not to bother with’ (B/3). An estimated thirteen Fair Price Shops are used by the respondents interviewed for this study, which indicates a systemic problem that is further disenfranchising people in Mumbai communities who lack a voice for food justice and security. Several respondents have approached shopkeepers for explanations or to complain about the lack of food, or to request that the shopkeeper petition for better-quality food. Some were met with meek assurances and feeble attempts to resolve the issue: ‘When we complain about not getting the food, the shop will get it for a short period, maybe two, maybe three weeks, then it is again no more’ (B/6); this story was common from outspoken respondents who had pressed shopkeepers to be fair and honest with residents. Other shopkeepers could do no more than insist that their own hands were tied: ‘We have complained, yes, but the shopkeeper is a good man, we know this – and he tells us that he is also not getting the food’ (B/17). Some respondents felt that complaining was useless because it was well known that particular shopkeepers would reserve just enough food to sell to people from his place of origin; ‘The man in the store and the officials (BMC Corporators) are from UP – there is no use to complain’ (A/7), said one Maharati woman. Regional, religious and caste-based discrimination was common within small businesses in slum neighbourhoods, and nine respondents indicated that Fair Price Shops were no exception. The lack of regulation at the shop level and the leakage of PDS supplies into the black market are the primary reasons for a lack of food at Fair Price Shops. PDS shops are not franchises, and all shopkeepers are paid as municipal employees: they receive the same wage whether they sell their supplies to cardholders or not. This allows for black market practices to occur out of sight of the regulatory framework, which stops the moment shopkeepers sign off on shipments of rations. On top of a meagre salary, selling reduced-rate wheat, rice and sugar to food distributors and manufacturers on the black market offers a lucrative bonus for PDS employees. It is not only shopkeepers who are purported to resell the cheap goods, but also truck drivers who bribe shopkeepers in order to keep goods and redistribute them. The price of the food is so low that a shopkeeper can afford to offer it to businesses at low prices, undercutting market rates and channelling tons of carbohydrates into the city for use in businesses like hotels, roadside stands and sweet shops. The black market for food is discussed as a banality of life and the food industry in Mumbai, and is regarded by slum dwellers as a ubiquitous practice unworthy of efforts at collective dissent. Some respondents acknowledged that they had friends with connections to the black market or had personally witnessed exchanges in their own neighbourhoods; others confided that they were explicitly involved in the black market trade of goods in what they deemed as a transaction necessary for the maintenance of their livelihood. In conclusion, flaws within the PDS disenfranchise slum dwellers. The quality of provided food is poor when it is available, or is manipulated by shop owners for sale to certain customers or for higher prices on the black market. © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251

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Discussion and Recommendations The PDS is ill equipped to respond properly to the food (quality) priorities of urban slum dwellers. Despite the fact that ration cards are widely held by slum dwellers, it is difficult to obtain quality food – or any food at all – in PDS shops, due to systemic mismanagement. Moreover, some PDS shops contribute to price increases of food through black market operations, making quality food even less affordable for urban slum dwellers. National and municipal government policies pursue an urban ideal that further marginalizes the voice and lived spaces of slum dwellers. In an urban context whereby public food markets in slums are replaced by private malls, with limited to no availability to slum dwellers, market space is becoming more expensive. This prevents food vendors coming from slums to capitalize on their labour and provide for their basic needs. The black market functions because local governance perceives that it is a necessary function of supplying affordable food to the city. But it is this affordable food that is costing incalculable amounts in shifting the dietary health and cultural preferences of inhabitants. If the black market is not tackled, the dietary wellbeing of Mumbaikers cannot be achieved. This is not an easy proposition, and will necessitate an overhaul of the PDS at the local and national level. The technological needs of the system must be met to facilitate communication and tracking systems. Greater integration between different parts of the system – from the administration down to the Fair Price Shops – would eliminate waste and potentially reduce fraud. At the national level, however, we would recommend a change in the functioning of the PDS. A more equitable way to service the dietary needs of the population would be to further integrate the private market through an expansive voucher system. Each card type under the system could be allotted a certain monetary amount of vouchers per period, and these could be used within the private market. Shopkeepers could redeem the amount of the voucher from the local government. Crops that are now allocated to central godowns (storehouses) could be sold regionally on the private market. This suggestion may not be immediately practical for the PDS, though it would be an innovative way to adapt to the changing needs of the growing population. Shifts in the cultural and ideological mechanisms impacting the dietary wellbeing of slum dwellers could be practical immediately and gradual in implementation. Furthermore, in the wake of the urban food transition, nutrition education has an important role to play in building knowledge about food quality and what constitutes a healthy diet. Nutrition education actions can take place in different settings, including the places where food is produced (for example, agricultural settings/fields), sold (for example, retailers, food service outlets, public sector catering in schools, workplaces etc.), and consumed (for example, households), and where information and education on food and diet is provided (for example, health service settings). The source of the nutrition education actions can also vary, involving the public sector, the private sector, civil society and public–private initiatives. Actions may involve a wide array of different foods and nutrients, from fruits and vegetables to dairy, from dietary fibre to fats, or involve generic to healthy eating (Hawkes, 2006). Finally, if the mandate of the Indian government is to pursue more inclusive policies and reduce urban poverty, the perception of ideal, modern living must be shifted to accommodate the cultural diversity in cities. Ideal spaces should also facilitate the dietary health and overall wellbeing of the people responsible for daily producing spaces of authenticity. One way to achieve this would be to uphold a vibrant market model that allowed for cultural heterogeneity to persist through a functional and affordable food system. Furthermore, urban slum dwellers should have continued access to culturally preferred foods and good-quality drinking water at affordable prices in order to pursue their own dietary preferences. Finally, the urban ideal should not label 248

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Digesting Urban Space unlicensed food product vendors as being illegal, but rather seek ways to warrant and monitor good quality and food hygiene being practised in hybrid market spaces.

Concluding Remarks This article has shown that in the process of rapid urbanization and within traditional market spaces, slum dwellers in Mumbai City have been attempting to re-define spatial legitimacy through the sale and consumption of food resources over recent years. In so doing they create new modes of dietary wellbeing based on competing material, spatial and temporal ideals; however, their wellbeing is consistently marginalized by institutional forces that seek to dominate material and spatial capital through the manipulation of food distribution. The PDS in Mumbai is not functioning to the benefit of urban slum dwellers. This material and spatial marginalization not only limits and alters livelihood options for inhabitants, but reinforces shifting symbolic and cultural norms within dietary preferences and notions of success. The marketing of global capital within the food market has changed expectations and preferences, and – with little to no education among slum dwellers regarding nutrition and healthy lifestyles – traditional food of higher nutritional quality is often replaced by socially and culturally desirable conspicuous items. This article has focused on the subjective side of dietary wellbeing only; it cannot make claims about the objectively measured nutritional value of slum dwellers’ diets. This constitutes the study’s limitation: perceptions of ‘good food’ do not necessarily converge with high-quality or healthy food, especially if people are not informed about nutritional value or hygiene. The insights gained highlight social–cultural understandings of ‘good food’, and point to the high occurrence of dietary-related diseases among slum dwellers. However, more research is needed to assess the nutritional value and healthiness of urban dwellers’ traditional food baskets and lifestyles compared to modern ones. New urban food baskets that can satisfy people’s culturally sensitive social–cultural and psychological food needs, as well as being nutritious and healthy, need to be identified if urban populations in the developing world do not want to develop dietary-related chronic diseases. Nutrition education at multiple levels and by a multitude of stakeholders could play a role in providing valuable information about food quality, safe environments, healthy diets and lifestyles, not the least to populations residing in slum areas. Further research is needed to develop nutrition education strategies that effectively reach the poorest of the poor. Since the majority of them are not reached by formal education or medical health care, urban food and health policies should identify innovative methods and actors with a direct connection to urban slum dwellers, possibly through strong public campaigns, and via informal channels and civil society actors and organizations working in slum areas. Hybridity in urban food markets and consumption spaces needs to be seen as an opportunity to pursue urban wellbeing, rather than a threat to the urban ideal.

Notes 1. 2. 3.

The Public Distribution System in India is a food security system whereby subsidized food and basic non-food items are distributed via shops to India’s poor. Post-colonialist authors such as Bhabha (1994) and Freire (1970) note that the temporality of the ‘ideal’ nation or ‘imagined community’, as Anderson defines it (1983), is created through a process of domination and homogenization of oppressed or marginalized social structures. Slum areas are not characterized by a total lack of hospitals or schools (both either Government administrated or private), but rather there is not sufficient prevalence of these services, nor is their management or outreach sufficient. © 2016 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 28, 2, 236–251

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5. 6. 7. 8.

According to the most recent redevelopment scheme, structures built after 1995 are not permitted to be constructed with concrete or bricks. Rather than make these dwellings less permanent or preclude the dwellers from being evicted, the law simply implies that the dwellings cannot be safely built; dwellings made of unstable materials are the most vulnerable to monsoon rains and other inclement weather. Corporators are directly elected local governance officials who control management of the 24 municipal wards. The list of respondents and the semi-structured interview questionnaire are available upon request. For more information, see the Research Master thesis of Gilmore (2011) on ‘Digesting Urban Space’, University of Amsterdam. A 1+1, or an illegal rented dwelling built upon another dwelling, is not a legal residence eligible to obtain the card.

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