A unique community based project that engaged rural communities in India in prevention of pesticide suicide has come to a successful end.
The project aimed to understand how rural communities respond to pesticide use and pesticide suicides, empowering them to take action for their own wellbeing and safety.
The project was unique due to its approach. It was designed following extensive consultations with communities and relied on community participation and grassroots action. This made it very different from existing interventions, such as training on ‘responsible’ pesticide management, which follow a top-down approach.
The two-year project began in October 2020 and ended in late 2022. It was implemented by the Emmanuel Hospital Association (EHA) – a network of hospitals and community development projects covering 25 districts in India – and supported by the Centre for Pesticide Suicide Prevention (CPSP).
Community engagement activities
The project was based in India’s Janjgir Champa district in the state of Chhattisgarh. It covered two blocks and included 117 villages, out of a total of 169 villages, with a population of over 200,000.
EHA initiated a range of activities to engage a wide audience group, including survivors of pesticide self-poisoning, community leaders, government officials, and pesticide vendors.
Activities included:
- Awareness and education programs about pesticide hazards and health
- Formation of two survivor support groups (male and female)
- Formation of a local, voluntary task force group, consisting of media personnel, lawyers, social activists, farmers, and survivors
- Advocacy and awareness raising with agricultural, pesticide retailers and police officers
- Engagement with pesticide vendors
- Capacity building and training programs for village leaders, farmers, and women’s groups
- Training for suicide survivors
In total, the project involved over 500 separate activities.
Empowering action
Some notable achievements resulting from these initiatives include:
Action by pesticide vendors – Vendors have started to keep a record of pesticide sales, including the name of the product and to whom it has been sold. This helps identify the pesticide used when an incidence of self-poisoning occurs. Vendors have also stopped selling pesticides over the festival period, a time when suicide incidents rates are particularly high.
Action by agriculture officers – Following meetings between EHA and agriculture officials, officers carried out inspections at all pesticide shops. Those found to be selling illegal pesticides were issued with warnings. These kinds of practices have never been observed in the past.
Action by village leaders – Villages have adopted measures to ‘minimise harms’, through storing pesticides safely and adopting precautionary measures while using them in the field.
Action by support groups – 36 pesticide poisoning survivors joined the two survivor groups (18 male and 17 female). These members acted as role models within their communities and actively engaged in project activities. Existing members invited new participants to the group and made referrals to EHA or the hospital if further support was required.
Action by task force group – Members of the task force group served as a ‘watchdog’ in the community to raise awareness of pesticide-related suicides and high-hazard pesticide effects on human health and its surrounding. They continue to be engaged in ongoing dialogue with several governmental departments.
The project has also stimulated further action across the Emmanuel Hospital Association network. Activities marking World Suicide Prevention Day, which was not previously observed, are now a regular annual occurrence supported by all 20 EHA hospitals and 53 projects.
Overcoming challenges
The project began in October 2020, during the COVID-19 lockdown. This presented a challenge for EHA, who were unable to initiate in-person and mass gathering activities during the initial stages of the project.
The team responded by developing a ‘helpline’ and sharing information through mobile and WhatsApp messaging services.
The semi-urban settings of some communities posed another challenge. While it was relatively easy to make connections and arrange activities in rural areas, it was not as straightforward in more urban areas. This required patience and consistency to build trust and gain insights.
Recommendations
The project team made a number of recommendations to help reduce pesticide suicides in India.
A key recommendation was the inclusion of a defined line item in the public Health Management Information System (HMIS) to record instances of pesticide self-poisoning. This would improve reporting and data collection.
Further recommendations included the scaling-up of education and awareness raising efforts within communities; continuing advocacy with relevant agencies on highly hazardous pesticides; and improving existing medical care.
What next?
Although the project has ended, the survivor support groups will continue to hold regular meetings to self-support within the community.
The task force will also continue its activities, with members planning to accompany EHA staff on a visit to the state capital Raipur. There they will meet with government ministers from health and agriculture. They will present a petition calling for the cessation of the sale of banned pesticides and for the strengthening of systems to monitor the sale highly hazardous pesticides in the state.
EHA will continue suicide prevention activities through their existing community health development projects. They hope to secure future funding to scale-up activity and increase coverage.
‘Succeeded in changing mind-set”
Bangkim Chingsubam, project coordinator at the Emmanuel Hospital Association, said:
“Through this unique, yet simple project, we have seen some admirable work. We are now doing everything we can to link up with district-level organisations to address the rising number of self-poisoning instances and suicide cases.
We have also seen a fall in the frequency of reported suicide attempts in places where the project was implemented, in comparison with data from our most recent EHA research, and our Champa hospital’s suicide reports over the last six months.
If not policy change, the initiative has succeeded in changing the mind-set and raising awareness among the public as well as many important stakeholders such as the farmer’s community, pesticide retailers, police, and the governmental departments. Another significant achievement is acceptance by the farming community and government departments of the challenge and the need to take ownership.
At present, there are very few NGOs working on this important issue, which has long been ignored. This was a new approach to tackling the problem and we hope that activities can be continued, expanding into previously unreached areas.”
Dr Leah Utyasheva, Policy Director for the Centre for Pesticide Suicide Prevention, said:
“We were privileged to work with the Emmanuel Hospital Association on this project. This project is unique in a way that it utilizes the power of the community to make change and address pesticide suicides. We are very encouraged that community leaders were interested and receptive of the project activities.
“The actions taken by community groups, pesticide vendors and agricultural officers is extremely encouraging. As many highly hazardous pesticides are yet to be banned, it is important that people understand the dangers of pesticide use.
“We are hopeful that even after the project’s end, the community will continue to benefit from the knowledge on pesticide management, stronger community support to vulnerable individuals, and community leadership to address negative impact of pesticides.”