Economics and mental health

February 3, 2007 at 8:23 am (Sarah's Posts)

I picked up the paper yesterday to the headline, “11 farmers end lives in 48 hours,” bringing the total to 62 farmer suicides in Jan 2007.  The numbers for the last few years have been catapulting upwards—156 in 2003, 324 in 2004, 412 in 2005, and 1050 in 2006.

A study committee on the causes of the increased suicide rate cites debts and inability to pay them back under increased financial pressure as the reason for many of these suicides.  Why?  In 2005, India decided (with a significant amount of leaning from the WTO) that they were going to open their cotton market with the goal of liberalizing the economy and ending barriers, tariffs and subsidies is crucial fields.  Having to compete on the open market has left these farmers, many of whom are still paying off the land that they work, unable to pay off their loans.  One example that the BBC cited spoke of a man who had an initial loan of $200, with interest owed at an additional $300 (that he was making a loss on), which was five times his annual income. These farmers aren’t making enough money to cope with economic shocks, and many are paying off the debts of their land with profits. 

 “Distress among cotton growers in west Vidarbha has accentuated with the wrong policies of state which is bowing to the WTO norms and free trade policies of globalization.  The Bt cotton seeds promoted by the government, instead of giving better yields or disease-free crop, has added to the woes of farmers as they are inadequately trained or protected from fake seeds,” said Vidarbha Jan Adolan Samiti president Tiwari.  As a result, the cotton economy of the region has collapsed. 

I’m not enough of an economist to speak to how sound this economic policy is (although I’d love to hear what wiser folks say), but I will say that I find these stories extremely troubling, especially because the government’s stance seems to be to blame the suicides on alcoholism and family problems.  India is under such pressure to open up their economy in order to gain more power and sway on the international stage.  But, I have a (perhaps one-sided, but not entirely untrue) picture in my mind of the business technology guys sitting alongside politicians and deciding to open up the economy to bring in more businesses to give them more money while the ones who suffer without any institutional support are the field laborers.  And they make up a darn large part of the workforce here in India.  More realistically, the ones who are suffering now are the wives of these farmers who now have to deal with a farm without anyone to work it, a family, and crushing debt. 

 

How should the public health person help families deal with the effects of globalization?  I don’t think that it is realistic to say that it shouldn’t happen, or that it won’t.  But, there are very clearly people losing out in a big way.  To me, one of the major problems is that nobody is catching the increased suicide rates as a major warning sign that there is a problem in the community that requires some action.  In so many ways, the public health system can be surveillance for bigger political issues.  This is one of many reasons that I think the role of the public health advocate in the future will be riddled with political and economics questions, and it would behoove all of us to add some wisdom about these areas to our arsenals.

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8 Comments

  1. msoule said,

    In order to break the silence on this issue of the connection between open market economics and public health (one that I think is really important and not thought about enough), I’d like to throw out there that this question is really hard. Really really hard.

    Why?

    It gets to the root of the question of what is wrong with health in developing countries and how globalization might be contributing to poor public health. To answer this question will be to take the next big step in improving the conditions for poor people around the world (including the ones who are being left behind by the rampant capitalist growth in the United States).

    So.

    I’ll think some more and come back with a comment. It will be nowhere near an answer. But I will try to pick some things apart.

    And in the meantime, I encourage everyone who’s been reading to throw in what they have. Because together, we might get somewhere. Don’t be shy!

  2. deepika said,

    very disturbing facts, but I am glad that you put it up on your blog. while I sympathize with the farmers, i wonder what is it that I can do to help sitting here. I mean I’d love to help them by donating a couple hundred dollars if it can get them out of the debt but where do you send the money and how do you assure that its going to the right people !

  3. msoule said,

    Deepika

    Your desire to help is wonderful. This problem, to say the least, is big and it ought to have a big solution. I am not aware of organizations who organize debt relief for farmers but there ought to be one. The way that you’re looking at it (getting the farmers out of debt) is more productive than the way the GOI is looking at it (buying cotton from the farmers to give them income). What good is the income when it all goes to these terrible moneylenders? Nothing returns to the pockets of the farmers. They need to own their land and stop paying interest and then maybe they can start to thrive. These moneylenders are the reason that microcredit organizations started (to have a viable replacement for the awful practices of these people) and they have flourished. Helping farmers get out from under their thumbs would be huge progress.

    Is there anyone out there who is aware of a group that ensures that concerned people can help out farmers in debt trouble?

    And if there’s not, maybe we should start one.

    And maybe the Gateses could send a little money thataways.

    More on the bigger issue to come.

  4. aebeacon said,

    Sarah,

    First of all I wholeheartedly agree with your closing remarks on public health activists gaining increased knowledge of economics. Given globalization’s pull on our daily conception of our world, it’s increasingly crucial that we equip ourselves to speak capitalism. I’ll get back to your question of helping farmers negotiate this imposed system after a brief foray into farmers and suicide.

    You are right on suggesting that the economic pressures of globalism are putting considerable pressure on individual farmers. In addition to this economical burden, the psychological stress is probably physically debilitating further compounding the problem.

    On one of my trips abroad I had the chance to encounter an added risk: pesticides. Pesticides, despite their well researched neurotoxic, carcinogenic and teratogenic effects remain largely unregulated in developing countries. In addition to these primary risks, pesticide ingestion is one of the most common methods of suicide in developing countries. Compounding this risk, recent research has suggested that one of the neurotoxic effects of chronic pesticide exposure is heightened incidence of depression and subsequent suicide (email me for citations if desired).

    As economic pressure to raise agricultural output forces the adoption of aggressive (and largely unsafe) pesticides, farmers are subjected to blossoming psychological and biological stress. Combined with the physiologically facilitating effects of pesticides and other occupational risk factors, its no wonder that many farmers are ending their lives.

    Back to what you can tell the farmers. First, safety. Personally I know practically nothing about how to stay safe on a farm but I’m betting there’s a lot of information out there. With a little research you can bring some life saving information to people who wouldn’t otherwise be able to find it. Second, finance. Again, helping people negotiate complex financial systems is key and something that you can definitely contribute. Additionally, during your research you may become privy to alternate financing schemes which would enable many of these farmers to avoid these high interest loans to begin with; think Turbo Tax. Finally, mental and physical health services. While most people are going to know their community pretty well, who knows, you might uncover something new or provide links with an NGO that could.

    Obviously you can’t be everything to everyone but a few suggestions that may help.

    Æ Beacon

  5. misarita said,

    Michael, I’ll be glad to hear your thoughts. These are the issues that make me feel like an economics idiot.

    Deepika–I want to thank you. Sometimes I get so lost in the macro perspective on these issues that I lose sight of the very practical ‘here’s what I can do right now,’ part. I don’t know of any organizations that are helping these farmers’ families, but I can look into it. In addition, a few of my friends have informally told me that, although the families are technically responsible for the debt, they aren’t being asked to honor it because there is so much guilt or awareness of the issue or something.

    More later. I have to do a bit more research.

  6. msoule said,

    I found an article that addresses alternative method of cotton farming (NPM: Non-Pesticidal Management) as a replacement for BT cotton (mentioned in the original post) and the reliance upon pesticides that it induces (risks of which discussed by AE Beacon).
    Here it is: http://india.indymedia.org/en/2005/03/210185.shtml

    Some NGOs in this article are:
    Centre for Sustainable Agriculture, Hyderabad
    Centre for World Solidarity, Hyderabad
    Socio-Economic and Cultural Upliftment in Rural Environment (SECURE)

    We ought to get in touch with them.

    A little bit on this article:

    The article hints (not subtly) at the dominion that agribusiness has in the world. Indian farmers are being encouraged by the government to use bioengineered seeds that carry greater costs and greater risk of pest infestation (and thus even greater costs to pay for pesticides) than regular cotton seeds. The reason that the Indian government may be drawn to biotechnology is that a huge famine in the 60s (I think it was the 60s) was “averted” by the use of American engineered wheat. However, this wheat has brought unforseen consequences. It uses far more water than the traditional pulse crops and has been draining the water tables in India for the last 40 years. However, the loss of water hasn’t hit rock bottom yet and so the government is still regarding bioengineered crops as the best choice. There’s a whole study by the great Amartya Sen (economist, Nobel Prize winner) about this famine that is sitting on my shelf staring me down. Time to pick it up.
    Indian government officials are also extremely eager to be seen as “in line” with the globalizing economy and if biotech is a big part of that, they want to be in on it. Just to be able to sit at the same table. But what they don’t realize is that our method of “advancement” is not really sustainable and it’s not getting us to a good place.

  7. msoule said,

    Ok.

    So here’s a bit of a response to the original post. I think that in my previous comment I addressed the one of the possible reasons the Indian Government is buying into the BT seeds: they want to play ball in the technological ballpark. Traditional = backwards = not developed. This equality runs counter to the desire to appear developed. The trouble is, the impacts of these new seeds (both the ability of parasitic salespeople to sell counterfeits and also the apparent [according to the article linked in my previous comment] increased susceptibility of this cotton to pests) were not adequately looked into.

    The Indian Government, in the wave of tech profits, has abandoned its old Socialist style protectionism. Part of this is a good thing: the red tape involved in starting any industry or making any investment was prohibitive. Ditching chunks of the bureaucracy will help business thrive in India. Part of it is bad: the old sense that the Government has a duty to its poor that Gandhi and Nehru founded the country on has dissolved in the blinding light of the promise of Development. The indiscriminate implementation of plans such as the cotton plan in Vidarbha is proof of this.

    One thing that we as health people can do is what the article linked above talks about: get pesticides out of villages and return to non-pesticidal methods of farming. There are ways of doing it. They may have lower yields (this is not true according to the article I’ve been pointing to) but at least the mental and physical health of the farmers won’t be at risk. So more work needs to be done on the impacts of these chemicals. The article above says that there have been studies illustrating the increased ill mental health of farmers who use lots of pesticides. So the suicides might not just be despair over economic circumstances. We must collect enough evidence to get the government to change its tack and disengage with global chemical giants and do what is good for its farmers. I don’t know who’s doing that or how to do it, but it seems like that’s what we can do.

    We’ll always lose the economic argument with the info that’s currently on the table (these farmers right now are seen as the unavoidable casualties of Development. Ah, human sacrifice). But if we can build up the risks of the current policy, we might be able to tip the scales.

  8. misarita said,

    Two quick thoughts. Michael, you said, “This equality runs counter to the desire to appear developed.” I think that is one of the big issues that is driving public policy right now here in India. There is such a big push to appear like they are The Next Superpower. And a decent amount of that seems to involve shaping policies that look good to the outside world. I read in the paper this morning that the US is stopping all aid to India because they are no longer considered to be “developing” based on recent economic growth. With the paltry amount of money spent on health in this country, I hardly feel like they have the ability to be self-sufficient. Argue all you want that money is being wasted, that they should be self sustaining right now–I don’t agree. Those are certainly issues, but there are a LOT of people in India (ahem, understatement) who rely on governement spending and protection to meet their health (and other) needs.

    And you say: “We must collect enough evidence to get the government to change its tack and disengage with global chemical giants and do what is good for its farmers. ” I’m not sure that the evidehce and information are enough to work here. I’ve seen people blatently look through evidence to make decisions in the interest of appearances. There is going to have to be a lot of nudging and hard elbowing–pressure put on the gov’t if these changes are to be made.

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