Nalini (not her real name) is a 22-year- old housewife with a young daughter. Two months before we met her, she had drunk from a bottle of pesticide in a bout of sudden anger towards her husband. At the time, she had not thought of her child or husband and had not wanted to die.She wanted her husband to know how hurt she was by his words.

She was admitted to hospital after drinking the pesticide. The nurses and doctors had cared for her and she was discharged after psychiatric assessment and help.

Nalini knows of other people who have died from pesticide poisoning. She is aware how lucky she was to survive.

Self-poisoning is often done with little thought, as a way of communicating anger or pain. Studies from both Sri Lanka and China have shown that the majority of people who drink pesticides do it after little thought, less than 30 min after first thinking about the action. The toxicity of highly hazardous pesticides - where they are widely used in agriculture and therefore for self-harm - means that many of these thoughtless acts result in the person's death and severe stresses for family and community. Replacing highly hazardous pesticides with less toxic pesticides can make these sudden acts of self-harm much less dangerous.

The great majority of people who survive drinking pesticides go on to lead a successful life; few go on to kill themselves by other means.

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