How free school meals gave thousands of children food poisoning in Indonesia

Within minutes of eating a school lunch of chicken, rice, salad and strawberries, Aldo Revaldo started getting very sick.

"After finishing the food, I felt a headache, then a stomach-ache," the 17-year-old said.

"Then I struggled to breathe."

All around him, one by one, his classmates were also succumbing to a painful and overwhelming sickness.

Footage from the school in Indonesia shows teenagers convulsing, vomiting and crying with pain.

Ambulances took the sick children to a nearby sports hall and a town hospital, where some had to receive oxygen.

Aldo's father, Ade Jalal, said there was hysteria and mass panic.

"Parents there were crying," he said.

Mr Ade said he found Aldo in the corner having seizures.

In a video that went viral on TikTok, Aldo was filmed on a stretcher, crying in pain and foaming at the mouth.

"Both his arms were tied to the folding bed," Mr Ade said.

"They had to hold him down to put the IV [intravenous drip] in."

Aldo and his classmates fell ill after eating meals provided by the Indonesian government's Free Nutritious Meals program, known locally as MBG (Makan Bergizi Gratis).

The program was Indonesian President Prabowo Subianto's key election promise.

But since launching earlier this year, it has caused thousands of cases of food poisoning in children.

More than 130 children from Aldo's school in Cipongkor, West Java, were hospitalised in the mass outbreak of food poisoning in September.

Across the region, more than 1,000 children fell sick over the span of a few days.

But across the country, more than 10,000 have been poisoned since the program was launched.

Estimates vary but JPPI, an Indonesian education-focused NGO, believes more than 16,000 children had become sick after consuming the food.

The Indonesian government's own figures, revealed in a parliamentary hearing last week, said 13,370 people had experienced "health problems due to poisoning".

Despite the controversies, the government is pushing ahead with expanding the program.

Plans to double number of free meal kitchens

The president's pitch was very popular: free meals for every school-aged child and pregnant mother, every single day.

The MBG program's goal was to address stunting, a condition where children's height is lower than average, often because of malnutrition.

But the program has been marred by poisonings, as well as concerns over its cost and allegations of corruption.

In some incidents, students in East Java and South Sulawesi found maggots in their meals, while children reportedly found shards of glass in rice in meals in the Riau Islands.

Footage of mass poisonings play on Indonesia's local news regularly, galvanising a strong response across Indonesian NGOs and mothers' groups, who have called for the program to be suspended.

But there are still many supporters.

The free meals are popular with the enormous number of Indonesian families who live in poverty, or those who find feeding their children difficult when faced with the increasing cost of living.

Indonesia's National Nutrition Agency (BGN), which runs the program, said by the end of the month, it wanted to be providing weekday meals to more than 75 million children and pregnant mothers.  

More than 14,000 kitchens across the country have been set up to support the program — and the nutrition agency wants to double that by next year.

Many kitchens are run with oversight by Indonesia's military. 

Local media has also reported that many kitchens are managed by local politicians, members of parliament, or residents near the kitchen sites.

In the wake of mass food poisoning events in September, Indonesia's president acknowledged "deficiencies" in the program. The government then issued kitchens with a range of guidance notes on sanitation, supervision, sterilisation and testing.

Prabowo defended the record of the program, claiming the "percentage of error" of meals that caused sickness was just "0.0017 per cent".

BGN head Dadan Hindayana also apologised, admitting "negligence".

Cases of food poisoning have been blamed on improper ingredients and storage, poor sanitation, poor water quality, and slow meal distribution times.   

At a parliamentary hearing on November 12, Mr Dadan identified another possible culprit: high nitrite levels in food.

"We found that nitrite infection is quite high, possibly because of farmers' cultivation practices providing too much nitrogen," he said.

"This results in high nitrite content in the plants, leading to frequent poisoning."

Over the last few months, more than 130 kitchens have been suspended following poisoning events, with some reopening following testing and training.

But cases of food poisoning do not appear to have slowed down.

Blame on 'kitchens that did not follow the rules'

At a kitchen in East Jakarta, BGN-appointed kitchen head Tommy Afoan said kitchens had been ordered by the president to send in samples for testing, improve food quality, and recruit professional chefs.

"Based on our experience, food poisoning could be attributed to raw ingredients, contamination during storage, production or transportation," he said.

"There are so many factors … so we need mitigation on every level, to follow strict procedures to minimise the risk.

"I feel sad seeing the children suffering in hospital, caused by kitchens that did not follow the rules."

Kitchen nutritionist Achyar Fuadi said lab tests had been carried out for salmonella and E. coli.

"In some cases, small, remote kitchens don't have experience," he said.

"A problem could come from workers that are inexperienced, nutritionists that are less detailed … this could all lead to food poisoning.

"I work here for 12 hours from 6pm to 6am nonstop, to make sure things are correct."

BGN spokesperson Dian Fatwa said that for the agency, food safety was "non-negotiable".

"This is a challenge of growth, not of neglect … this is a living system and we learn every day," she said.

"Every bowl, every plate we serve to the kids, it carries a duty of care, so one case is too many for us.

"This is not a perfect story, but this is a story of progress."

Protesters want program paused and reviewed

The program has also drawn criticism from civil society groups, frustrated at the amount of money the government has allocated for it in the budget.

BGN said it expected to spend more than 99 trillion Indonesian Rupiah ($9 billion AUD) this year.

But the costs could more than triple, with the program reportedly budgeted for 335 trillion Indonesian Rupiah next year.

At a recent protest against MBG outside the nutrition agency's Jakarta headquarters, mothers voiced their anger over the poisonings and the cost of the program.

Nada Arini from the Indonesian Mothers Alliance said the government had sacrificed education funding.

"They need more targeting of children, especially the most remote, poorest and farthest areas from development," she said.

"I want this MBG to be stopped, evaluated and back to the drawing board."

Bhima Yudhistira Adhinegara, executive director of legal and economic think tank CELIOS, said any program aimed at improving childhood development and lowering malnutrition rates should be more specific.

"It should target poor children from the poorer family backgrounds," he said.

"Other alternatives like cash transfers might be better."

Ms Dian said she was optimistic the program would achieve its aims.

"This nutrition intervention is starting when the mother is pregnant," she said.

"From the tummy to high school, we are feeding [children].

"The parents, the teachers, they see the benefits … the kids can study more, in the weight of the kids they can see an improvement."

Kids still 'traumatised' by mass food poisoning

Despite the calls for a moratorium on the program, it is unlikely to be paused, as the nutrition agency is ramping up the number of kitchens and recipients.

At the parliamentary hearing earlier in the week, the nutrition agency's chief said 1.8 billion portions of food had been produced.

The ABC visited the kitchen at the centre of the school outbreak in Cipongkor, which was undergoing refurbishments.

The school said it felt it should be consulted before the free meals program was brought back to its classrooms, as the children were still processing the mass food poisoning.

"We still feel it," Aldo said.

"I don't want to eat the MBG again, my friends and I feel traumatised."