“Every time I open the door, I see my father’s body,” says 14-year-old Nikita Surwase, pointing at the iron shaft on the ceiling.
In May 2014, Nikita’s father, Ashok, hanged himself to escape the mounting pressure of repaying a loan of nearly ₹2 lakh that he had taken to grow cotton on his 1.5-acre land in Talegaon village, Beed district, Maharashtra. That day, Nikita says, she and her father were home while her mother Sunita (30), grandmother Jaibai (65), and three younger siblings — Ashwini (12), Rohan (9) and Suraj (6) — had gone to visit a relative.
Around four in the afternoon, her father asked her to go out and clean the porch. The unsuspecting child, who was 10 at the time, followed his order.
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Her mother returned around five and found the door locked from the inside. There was no response to their repeated knocking. A neighbour who was passing by noticed the commotion. He peeped in from the window and saw Ashok’s body hanging lifeless. Everyone rushed to break open the door. Nikita’s father had cut a hammock that used to hang from the ceiling and used the same rope to end his life.
‘I feel very tense’
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For the first few months, her weeping was seen as the natural reaction of a grief-stricken child. “All of us were crying,” says her grandmother, Jaibai. But Nikita failed to return to a semblance of her normal self. She stopped communicating and almost gave up eating. She spoke only a few words throughout the day and slept all the time.
“When we would call her for meals, she would eat very little and go back to sleep,” says Jaibai. “She didn’t want to go to school any more. She kept saying she had a headache.” In the following months, Nikita lost weight rapidly. She had fever often. Her crying wouldn’t abate, and she kept having graphic flashbacks of her father’s lifeless body.
Nikita’s father could not repay the loan as Maharashtra had one of its worst spells of drought that year, and it ruined his crop yield. To continue repaying the loan, Nikita’s mother took charge of the farm and also started working in other farms, plucking cotton.
Two of Nikita’s siblings, Ashwini and Rohan, were sent away to Aurangabad to stay at a residential school that adopted the children of farmers who had killed themselves. Nikita, who is now in class nine, continued to battle against her anxieties, her trauma getting little attention from her family.
Last year, an Accredited Social Health Activist (ASHA) who lived nearby took Nikita to the Beed Civil Hospital, where she was diagnosed with extremely low levels of haemoglobin. She was given three units of blood and prescribed several food supplements. Nikita still weighs only 30 kg, way below what’s healthy for a 14-year-old. Though she looks slightly better now, the ASHA worker says that the girl is lost in her own world.
An alien concept
The children of farmers who killed themselves cope with acute mental trauma, but they say very little. Even worse, no one asks. In a place where ‘mental health’ is still an alien concept, the fact that a parent’s suicide can damage the child remains unrecognised.
Senior psychiatrist and World Health Organisation (WHO) consultant Lakshmi Vijayakumar says that Nikita has been experiencing classic symptoms of post-traumatic stress disorder. “In children, these mental disorders don’t show up like they do in adults. Children mostly present themselves with continuous complaints of some kind of body pain (headache, stomach ache) or behavioural problems such as refusing to go to school, refusing to eat, and temper tantrums. Children who don’t have any of these problems may start bed-wetting,” explains Vijayakumar, adding that when a child loses a parent, there is a growing sense of abandonment and separation anxiety.
In Beed’s Arvi village, a dirt track through large cotton fields leads to a residential school called Shantivan. The word translates to ‘forest of peace’. Run by a couple passionate about social work, Shantivan is home to 300 children who have lost either one or both of their parents. Of these, 120 are children of farmers (from the Marathwada region) who have committed suicide. One of the eight districts of drought-prone Marathwada, Beed has witnessed the highest number of suicides in the region.
One resident, 14-year-old Mayur Rasal, lost his father in 2009, a year that saw a great number of farmers end their lives to escape debt. Mayur, his two older brothers and their mother, Vaishali, inherited three acres of land and an unpaid debt liability of over ₹5 lakh. Unable to bear the burden, Vaishali left with another man a year later. Mayur and his two brothers became their grandmother’s responsibility.
“My grandmother got labourers to plough the field and grow cotton, jowar and bajra. But she always complained that we did not have enough money, just like my father,” says Mayur. He says his relatives told him that his father had hanged himself from the ceiling fan. “It was June 1. I remember the date because I was going to join class 1 from June 15,” says the teenager, eyes turning moist as he remembers his father.
Saved by stories
Volunteers from Shantivan visit suicide-affected families and urge them to send their children to the residential school for a proper education and a better life. Last June, when they visited Mayur’s house in Manjar Sumba village, his grandmother immediately agreed to send him away. “He would cry all the time. He would wake up in the middle of the night, calling for his father,” says Kaveri Nagargoje, who runs Shantivan with her husband, Deepak. “He felt that no one cared for him, and both his father and mother had abandoned him. As he gradually opened up to me, I learnt that shortly after his father’s suicide, his mother, unable to manage the three children on her own, had ended up pouring boiling water on him,” Nagargoje says.
Nagargoje is not a trained counsellor but she says she does whatever she can to motivate the children. Storytelling brightens up the kids, she says. “I have made up a fictional character named Dheru who has faced similar hardships after losing his father to suicide,” she says. “In my story, he goes on to become a Collector and fulfills his mother’s dreams, pays off all debt, and has a peaceful life. Most of these children now aspire to become like Dheru.” Mayur, who is now in class 8, wants to appear for the civil services examination.
Nagargoje observes that most children at Shantivan need constant support: “Bed-wetting is a common problem in children as old as 12 years. Some are reclusive, and it takes time for them to mingle with others. But we closely observe each one of them and monitor their emotional as well as educational progress, as it tells us whether the child is getting over her trauma or continues to remain in its grip.”
In Wardha district, which falls in the drought-prone Vidarbha region of Maharashtra, a village named Kurzhadi has reported eight farmer suicides over the past decade. In 2016, Ganesh Thackrey gulped down a bottle of pesticide that he had kept for use on his three-acre cotton farm. When his wife Archana got home from a village gram panchayat meeting, she saw her husband on the floor, barely breathing. A neighbour helped her put Ganesh on a motorcycle and rush him to a government-run health centre 12 km from the village, in Phulgaon.
But Ganesh’s condition was critical. So he was transferred to a rural hospital in Sawangi, 35 km from Phulgaon. For nine days, Ganesh battled for life in the Intensive Care Unit of the Sawangi hospital. But his organs began to collapse one after another, and he eventually succumbed.
Archana then started to work on the farm. But with both father and mother away, the two children, Aniket (11) and Sanchita (9), suddenly found themselves on their own. “While the girl was still too young to understand what had hit the family, something changed in the boy after he lost his father,” says Avinash Ghode, a teacher at the Zilla Parishad Primary School in Kurzhadi where the siblings study.
Ghode says Aniket always ranked first in his class. “After his father’s death, he remained absent for a while. About three weeks later, when he rejoined school, he was no longer his chirpy self,” he recalls, adding that he also developed a severe problem in paying attention. Aniket, the teacher says, would stare blankly in class. He would have no clue what was being taught.
“We spoke to him several times and told him that whatever had happened was not in his control and that he needs to focus on his education,” Ghode says. Gradually, Aniket managed to get his focus back on studies and once again ranked first in class 5 . He is now in Class 6. “But he is not his old self, when he used to be playful and laugh out loud,” says the teacher.
Any question about their father brings tears to the siblings’ eyes. When asked what they would like to do when they grew up, Aniket says he wants to be a police officer, while Sanchita wants to be a ‘madam’, as the teacher is addressed in the school. “These children need more than education. Such an upheaval in life is tough even for an adult to cope with,” says Ghode. He feels that the government has to bring in professional counsellors to reach out to such children.
A 2010 study led by the Johns Hopkins Children’s Centre found that losing a parent to suicide increases children’s risk of developing a range of major psychiatric disorders. “Those who have lost a parent to suicide are at a higher risk of committing suicide too,” says Vijayakumar, who has worked extensively in the farmer suicide-affected Kattumannarkoil district in Tamil Nadu and with the tsunami affected-children from the State. “There is a grave need to evaluate and counsel these children. They should get avenues to vent their emotions in a non-threatening manner,” she says, suggesting group painting and art therapy as possible methods. “The pictures they draw at times reflect the emotions they are going through,” she says.
Survivor’s guilt
Ann Masten, a professor of child development in the Institute of Child Development at the University of Minnesota, says that, in itself, losing a parent is a very stressful event in a child’s life. “Many children experience it as a parent leaving them for something they may have done. They react with anger at times. Some who internalise their feelings may become sad and silent, and can thus be easily ignored. Some children recover with good parenting and good teacher support, while others may require mental health support,” says Masten. “Intervention is needed because it is obvious that these children are silent sufferers,” she adds. But hundreds of children from Marathwada and Vidarbha’s suicide-affected families are exactly that — silent sufferers.
Experts say that survivor’s guilt is most commonly observed in those who have lost someone to suicide. They are tormented with either visual memories of the event or auditory memories. “We use the technique of memory distortion. For example, if it’s a visual memory, we get them to reconstruct it and then ask them to farther the body from them and gradually destroy the image. To reduce the guilt, we use the Rational Emotive Behaviour Therapy techniques to assure them that it was not their fault,” says Mumbai-based counselling psychologist, Binaifer Sahukar. “With continuous counselling, they are able to become resilient. While the counsellor is not going to be around forever, these strategies are developed for them to use whenever needed,” she says.
Sahukar, who has counselled many school and college students, observes that some children may bounce back quickly while others may take time, and a few may never be able to deal with the trauma. “It all depends on the core personality and the stress tolerance threshold. We may have twins going through the same trauma and one of them may recover quickly while the other does not. The time taken to heal varies from person to person,” she says, adding that complete lack of counselling or a support system to deal with the trauma may lead to long-term consequences such as alcoholism and wrecked relationships.
In 2015, the National Crime Records Bureau (NCRB) recorded 8,007 farmer suicides across India. Of these, 3,030 were in Maharashtra, the highest number for any State. While the NCRB is still compiling the data for 2016, media reports peg it at around 3,063.
In February 2015, the government launched Prerna Prakalp, a mental health programme for farmers from suicide-prone Marathwada and Vidarbha. The programme currently covers eight districts of Marathwada and six of the 11 districts in Vidarbha.
A Prerna Prakalp cell theoretically consists of six people — a psychiatrist, a clinical psychologist, a psychiatric social worker, a psychiatric nurse, a community nurse, and an accountant/case registry assistant. But of the 14 cells that exist in the two regions, only eight have psychiatrists. The programme is largely dependent on ASHA workers, who have been trained to visit houses with a Patient Health Questionnaire 12 Somatic Symptom scale (a screening and diagnostic tool for mental health disorders) to assess the family members. But it only covers adults.
The number of positive replies to the 12 questions classifies the person as normal, mildly depressed, moderately depressed, or severely depressed. For the later three, the ASHA worker urges the family members to have a chat with a counsellor on the State’s toll-free mental health helpline, 104. The counsellor then gauges whether the person needs to be directed to the primary health centre or a rural or sub-district hospital. Since 2015, more than 30 lakh households have been surveyed, and 15,528 people were found to be suffering from various levels of depression — 12,850 mild, 2,089 moderate, and 567 severe. “Prerna Prakalp is not age-specific. But when we mean farmers, we mean adults. We try to reach out to children through our District Mental Health Programme (DMHP),” says Sadhana Tayade, joint director of Directorate of Health Services, who is in charge of mental health.
The man of the house
The DMHP was started in the 1990s under the National Mental Health Programme with the aim of upgrading State mental health facilities and reaching out to as many people in need as possible. Its outreach component involves targeted interventions, life skills education, counselling in schools and colleges, and workplace stress management. In Maharahstra, however, the DMHP’s school intervention programme was rolled out only in November 2016. The State authorities are yet to collate data on the number of children they have reached through the programme but the rough estimate is 12,000. So there’s still a long way to go for a targeted intervention to help children affected by farmer suicide.
For many children, the experience of Pawan Parve from Aurangabad’s Bodhwal village may be typical of the aftermath of a farmer’s suicide. After his father drank pesticide and died in 2011, Parve, who was only 14, suddenly realised that he had become the man of the house. Instead of receiving help through counselling, he found himself responsible for an unmarried sister and two younger brothers. “No one cared for me. I became just another farmer who had to pay off the debt,” says Pawan.
Somehow, he managed to repay his father’s ₹1 lakh debt by putting all his efforts into cotton and maize farming. Pawan is now in the second year of junior college, but he only appears for exams. He spends the day working on the three-acre farm or selling the yield, and studies for an hour or two at night. “From the day my father left us, I have never felt like a young boy. Everyone treats me like a grown-up,” he says. He has managed to save up ₹40,000 for his 18-year-old sister’s marriage as well. “My relatives have already started inquiring about her,” says the youngster, who once aspired to join the police force. But now he views the future with little hope. “Nothing has changed,” he says. “Just that I have replaced my father.”