CULTIVATING DISTRESS: FARMER SUICIDES AND LOCAL MENTAL HEALTH IN TELANGANA, INDIA NANDA KISHORE KANNURI Thesis submitted in partial requirement for the degree of Doctor of Philosophy DIVISION OF PSYCHIATRY UNIVERSITY COLLEGE LONDON 2014 Declaration I, Nanda Kishore Kannuri, confirm that the work presented in this thesis is entirely my own. Where the information has been derived from other sources, I confirm that this has been indicated in the thesis. Signature: Date: 01/06/2015 2 Abstract This thesis examines the manifestation of global and national policies in rural distress and mental health wellbeing of cotton farmers in India. It draws upon the disciplines of medical anthropology and cultural psychiatry to argue for a re- calibration of health care systems and mental health pedagogy. The thesis addresses three interlinked research questions. Firstly, to examine the social and cultural contexts of farmer suicides. Secondly, how and why do these socio-cultural issues mediate between cotton farming and mental distress? The third question investigates the psycho-social consequences for survivors. Ethnographic field work for 12 months (2011-2012) was conducted in a village in Warangal district, Telangana State, India. A nuanced analysis points at a confluence of global and local forces in defining rural predicament when encountering modernity. Bt cotton symbolises this plight as it demonstrates the transformation of rural landscapes into environmentally and culturally toxic terrains. Such toxic landscapes amplify existing social and cultural marginalities leading to immense distress. Marginalised communities embody their suffering in both psychological and social forms. Furthermore this process generates an unrelenting state of social defeat amongst the despaired farmers. The thesis posits that shrinking state responsibility, inactive civil society and media posturing lead to an erasure of rural distress and renders it socially invisible. This is compounded by state oppression that denies cotton farmers an agency to collectivise and resist reproducing their marginalised identities. The thesis explicates that health and wellbeing of farmers are contingent on rural distress that continues to be unaddressed. The existing cultural gap between the clinic and people poses a challenge for local biomedical health care. The thesis proposes that in order to transform such toxic into ‘healing’ landscapes, a radical rethink of texts and training of professionals and policy makers is required. An interdisciplinary approach that is culturally sensitive and is critical of received wisdom and global models is vital. This applies to disciplines of agriculture, public health and social sciences. 3 Table of Contents Abstract .......................................................................................... 3 Acknowledgements ......................................................................... 5 Preface ....................................................................................................... 8 Acronyms: ..................................................................................... 12 LIST OF TABLES ......................................................................... 13 LIST OF FIGURES ....................................................................... 14 Chapter 1 .................................................................................................. 16 Introduction and Background .................................................................... 16 1.1 Farmers Suicides in other countries: ...................................... 22 1.2 Conclusion .............................................................................. 23 1.3 Outline of the thesis ................................................................ 25 Chapter 2 .................................................................................................. 28 Methodology ............................................................................................. 28 2.1 Theoretical Orientation............................................................ 28 2.3 Ethical concerns: .................................................................... 30 2.2 Research Questions ............................................................... 30 2.4 Methods: ................................................................................. 30 2.4. Identifying the village- meeting the MRO, Police: .................. 35 2.4.1 Justification of the selection of the study site: ................... 40 2.5 Brief History of Telangana Region .......................................... 40 2.6 Farmer Suicides in Warangal district: ..................................... 42 2.7 Entry into the village: .............................................................. 42 2.8 My identity in the village: ......................................................... 45 2.9 Some dilemmas: ..................................................................... 46 2.11 Description of the village- Vangapahad ................................ 47 2.11.1 History of the village ....................................................... 47 2.11.2 Social Structure of the village ......................................... 48 2.11.3 Land ownership and Agriculture in the village ................ 51 2.11.3 Facilities in the village: .................................................... 53 4 2.11.4 Social Mobility: ................................................................ 54 Chapter 3 .................................................................................................. 56 Suicide ...................................................................................................... 56 3.1 Suicide in different traditions ................................................... 56 3.2 Suicide in Hindu tradition in the Indian context ....................... 58 3.3 Sociological theories of suicide. .............................................. 61 3.4 Suicide in modern India: ......................................................... 64 3.5 Suicide from a public Health perspective: ............................... 66 3.6 Conclusion .............................................................................. 69 Chapter 4 .................................................................................................. 70 Cultural History of Cotton: Resistance and Defeat ................................... 70 4.1 History of cotton in India ......................................................... 72 4.1.1 Cotton Production during pre-Christian era in Indian Subcontinent ............................................................................. 74 4.1.2 Trade routes of Indian cotton: ........................................... 76 4.1.4 British interventions to improve the cotton produce in India .................................................................................................. 78 4.1.5 Difficulties in improving Indian cotton ............................... 82 4.1.6 Cotton Production in India – World Wars .......................... 84 4.1.7 Cotton and the Indian freedom movement ....................... 86 4.2Cotton in the post-independent era .......................................... 89 4.3 Genetically modified crops- cotton - India ............................... 90 4.4 Cotton and Multinational Companies ...................................... 93 4.5 Conclusion .............................................................................. 96 Chapter 5 .................................................................................................. 97 Agriculture, Ecology and Wellbeing .......................................................... 97 5.1 Agriculture in India .................................................................. 97 5.2 Pesticides and Wellbeing ........................................................ 99 5.3 Environmental impact of GR and Cotton............................... 100 5.4 Farmers perception of Pesticides & Bt Cotton ...................... 103 5.5 Conclusion ............................................................................ 116 Chapter 6 ................................................................................................ 117 Cultivating Distress: Marginality & Suffering among Cotton Farmers .................................................................................................. 117 2 6.1 Marginality ......................................................................... 117 6.1.1 Geo-Political Marginality ................................................. 118 6.2 Peasant marginalisation and resistance movements in India 118 6.2.1 Cultural history of Peasants movements in Telangana Region: .................................................................................... 121 6.3 Socio-Cultural Marginality .............................................. 132 6.2 Social suffering ................................................................. 145 6.3 Humiliation: Ethnographic cases ................................... 146 Kumar: ........................................................................................ 148 6.4 Conclusion: ....................................................................... 157 Chapter 7 ................................................................................................ 160 State and Media response to farmer suicides ........................................ 160 7.1 Some statistics on farmer suicides: ...................................... 161