Clinical Ethnography of Farmer Suicides in Andhra Pradesh

258 Pages·2015·3.41 MB·English

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

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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.

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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
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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
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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
7.2 ‘Data-ed’/numbered by the State .......................................... 161
7.3 Categories of genuine and non-genuine: .............................. 166
7.4 State Definitions: Categories of Exclusion ............................ 167
7.5 Calculative practices of the State: ......................................... 169
7.6 State – mass media as an agent for popular culture ............. 171
7.7 Ethics of media reporting: ..................................................... 173
7.8 Hindi Films and Documentaries on Farmer Suicides as a case:
.................................................................................................... 174
7.9 Conclusion: ........................................................................... 180
Chapter 8 ................................................................................................ 182
Cotton in the Clinic: Farmer Suicides and Health System ...................... 182
8.1 Cotton in the clinic ................................................................ 183
The setup of psychiatrist in the district hospital: .......................... 184
8.2 History of Mental health services in India ............................. 201
8.2.1 Glocal? ........................................................................... 210
8.2.2 New Pathways, New Hope: National Mental Health Policy
of India, 2014 ........................................................................... 214
8.3 Recent debates in mental health: Movement for Global Mental
Health (MGMH) and NMHP 2014 ............................................... 216
8.3.1 Critiques of GMH movement .............................................. 218
8.4 Conclusion: ........................................................................... 219
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Chapter 9 ................................................................................................ 221
Conclusion .............................................................................................. 221
Future research directions .......................................................... 227
Bibliography ............................................................................................ 229
Appendix 1 ............................................................................................. 249
Information sheet .................................................................................... 249
Appendix 2 ............................................................................................. 251
Informed Consent Form for Participants. ................................................ 251
Appendix 3 ............................................................................................. 252
Sample Focus Group Discussion Guide With Community
Members ................................................................................................ 252
Appendix 4 ............................................................................................. 254
Sample Interview guide with mental health Professionals ...................... 254

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Acknowledgements
My debts are many!!
At first, I would like to express my gratitude to the villagers from my field that
magnanimously accepted and welcomed me into their homes, cotton fields and
shared their stories.
This dissertation took shape with active guidance from my primary supervisor
Dr.Sushrut Jadhav and secondary supervisor Prof. Roland Littlewood. Their
commitment to critical scholarship, integrity to the ideas they believe is awe-
inspiring. It is my privilege to have been associated with them. Dr.Jadhav’s
mentorship helped me to evolve as a researcher with a critical perspective. His
constant support and incisive inputs are vital in shaping my outlook towards
research.
I owe special thanks to Prof. GVS Murthy, my India supervisor who extended
support, encouragement and advise without which my dissertation would not
have been possible.
I am thankful to Dr.Audrey Prost my upgrade committee member for her
perceptive comments and suggestions.
Thanks to Prof. David Napier, I could attend very interesting and educating
medical anthropology seminar series.
I am thankful to my friends Sumeet Jain who was always there for me; Maan
Barua, brilliant academic who helped me with his perceptive comments, Jane
Derges, Emilie, Taghrid for sharing my London blues, Gwen Burnyeat
affectionate and committed and Clement and Manuel my fellow research mates,
Nia the cheer leader. I had a nice time with them meeting, sharing my ideas and
deliberating my work. They all made my life easier in London.
I cherish my academic journey at UCL as I have met some wonderful people:
David Goldberg was keen to listen to me and has shared his ideas and
suggestions that helped me refine my thinking. I have thoroughly enjoyed
walking with him. I am extremely grateful for his support. Caroline Selai, large
hearted and supportive friend. Ruth Padel, generous person and an inspiring
poet, Chico and Meena, kind and charming couple, Raficq an engaging intellect,
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Prof. Gyan Pandey who took his time to comment on a draft paper, Satheesh
Bhai, a witty and nice person and Manju da, the rebel!
Thanks to office staff at Division of Psychiatry, Deana and Cleisson were very
helpful.
I’m grateful to Leela and Mallika who affectionately accepted me into their
midst. With their kind gesture, they made their home, my home away from my
home and family. I treasure and value the time I spent with them. I am thankful
to Mallika for reading my work and providing comments and Leela for proof
reading my papers in making.
I am thankful to my friends and colleagues at IIPH Hyderabad.: Raghu is always
supportive and motivating, Sathya who began his journey at UCL, we shared
some good moments in London, and Shailaja, Somesh, Souvik, Hira…
Ever supportive WTP teams at LSHTM and PHFI. My special thanks to Prof.
Pat Doyle, Prof. Sanjay Kinra, Prof. Dandona, and Ms.Palkie, Ms.Parul, Ms.
Neha.

I’m thankful to Prof. Srinath Reddy, Prof. Sanjay Zodpey, and Dr. Ravi Narayan
who were very supportive when I decided to change the topic of my research.
Financial support for this research was provided by PHFI-Wellcome Trust.
Friends and well-wishers: Krishna Reddy who unhesitatingly facilitated my stay
in the village, Dr. Purushotham, Sudarshan, Grace, Pavan, David, Sita,
Shamanna, Ansari and Murali.
My Father-in-law and late mother-in- law were always encouraging my pursuit
of PhD.
Kalappa, Subha, Taman, and Deepu; Vivek, Gangaa and Leora for being a
wonderful extended family.
Vinay, Rajini, Rishi and Mithali for their affection.
My loving family Sowmya, Muthu and Poovi, are a constant source of affection
and support and not to forget, Jerry and Jana. They have endured my long
absences and managed with great aplomb! Sowmya patiently proof read the
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thesis. Sowmya stood by me all through my ups and downs and was
instrumental in motivating me to re-initiate my foray into research and
academics.
My parents gave me everything. What I am is because of their love, vision,
support and confidence in me.
I thank all of them for making it possible.

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