On Feb. 16 this year, much of urban Nepal woke up to the headline news about three members of a family in Rukum who committed suicide.  According to the news reports, the impoverished parents had done everything they could to treat the epilepsy of their 27 year old daughter only to find that they had lost everything as they scrambled through the maze of health care — local shamans, private medical shops, and medical doctors. Most of the reporting stressed their ‘poverty.’ The story lines were simple. However, we have failed to ask two interrelated questions: what is the cause of their poverty and why are medical services are so inaccessible? We cannot make sense of the swathes of distress spreading across Nepal without asking those questions and many more.

The fact that these tragedies have been unfolding across Nepal was brought to the public’s attention in January when a multi-institutional report on the state of the health of women of reproductive age was published. This Nepal Maternal Mortality and Morbidity Study 2008/2009 was the second of its type produced in the last ten years. Based on research carried out between April 13, 2008 and April 13, 2009 in eight districts, covering both geographical as well as ethnic diversities, this report shows the trends of the health of women of a reproductive age - defined as the health of all women between the ages of 15 and 45.

Perhaps the most shocking finding of this survey was that suicide as a cause of the death of women of reproductive age has climbed from third place in 1998, when the first survey was conducted, to first place in 2009. According to the new report, 16 percent of the deaths of women of reproductive age occur due to suicide, up from 10 percent in 1998. So what happened during the last 10 years? The survey only expresses shock and points towards some findings based on verbal autopsies. The report states:

“Analysis of verbal autopsy data indicates mental health problems, relationships, marriage and family issues are key factors. It is also noteworthy that 21 percent of the suicides were young women, aged 18 years and under, indicating that youth is a factor to be investigated.”

The agencies that produced this report have been mobilising a lot of resources not only in setting up health services, but also in setting health agendas through research and surveys like this one to ensure new research will be carried out to further probe this abysmal situation. If we go by this report’s data, there is a danger that the focus will be on what P. Sainath calls “the last cause recorded.” What kind of picture will emerge if we begin to ask questions about the conditions in which desperate people find themselves? 

Between 1997 and 2005, one and half lakh of farmers committed suicide in India according to officially classified data. In his speech to Indian Parliament on Sept. 6, 2007, veteran Indian journalist P. Sainath described how those numbers were gross underestimation of the actual calamities facing Indian farmers. More than one and half lakh farmers committing suicides in eight years is already a huge tragedy. Add to this the fact that this number doesn’t even include the swathes of suicides committed by those who are not officially landowners.

Sainath is perhaps the most knowledgeable journalist on this subject, having reported from the front lines of these catastrophes for several decades. As he made clear in his speech in the Indian parliament, he has personally visited 700 households where at least one member of the family had committed suicide. His meticulous reports on the immense distress, selling of kidneys, suicides, and the massive flow of people from the Indian countryside to India’s burgeoning metropolises have maintained the conscience of Indian journalism, which is otherwise increasingly reducing itself to reports of the riches.

By the official criteria, some people who run farms and commit suicide don’t officially count as farmer suicides, he told the Indian Parliament. For instance, most of India’s women farmers do not have land in their own name. This automatically disqualifies their suicides as farmer suicides. In many families, only the eldest family member holds land ownership titles, although many others work the same farm. Any suicide committed by those in the family who do not have land in their own names do not fit the official criteria of a farmer suicide, and are excluded from the data.

In Nepal, we have not investigated farmers’ suicides, barring the occasional news report about distress killings. The report on women’s mortality and morbidity is perhaps the only survey that has documented this tragic trend. Given that most of these women come from rural areas and most of our rural areas are also agricultural areas, it is impossible to investigate the conditions of growing suicides if we only focus on “women as women”, instead of focusing on both “women as women” as well as “women as farmers.”

We won’t be able to find meaningful answers unless we ask the right questions. In 2006, the government of Maharashtra, where most of the farmer suicides have been occurring, set up a task force called a manobaigyanic dal (or experts of mental science, for want of clearer phrasing), comprised of psychiatrists, psychologists, together with others possessing expertise on mental conditions or counseling. They went around the distressed villages giving advice to farmers. Sainath recounts an incident in a village where, after listening to the advice of these experts of mental science, one farmer stood up, two palms joined into dutiful Namaste to these experts. “You have given us good advice. You have said: Do not drink too much. Do not fight with your wife. Do yoga. Remove your stress.” He continued, “Ask us one more question. Ask us why the farmers of this country, who place the nation’s food on its table, are starving?”

“There was total silence,” Sainath said. “One of the doctors told a journalist much later: “We shut up. There was nothing to say. We had all the answers but he had the right question.”

Now that we have discovered this wave of distress unfolding across the country, are we going to ask the right questions or dump every tragedy on the backs of “poverty” or “bad behaviour?” In other words, are we willing to go beyond the last cause reported? Let us also take a look at ourselves in the mirror.

(Confession: Reading all the reports on suicides while writing this essay had been one of the most harrowing experiences of my life and I thank many who listened to me when I shared what I was going through)

Anil Bhattarai

anilbhattarai@gmail.com

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