In South India, the Way Out Is Often Suicide

Ganesan Babajee was a child of India’s promise, a boy who wanted to sit at a computer, not climb palm trees and cut coconuts for his father.

Babajee was growing faster, it seemed, than life would let him. The 15-year-old chafed to break free of the drowsy rural monotony, to ride his dream somewhere else.

He was going to be a doctor. He studied hard, and as his confidence grew, so did the confrontations with his father, a strict former soldier who demanded that things be done his way.

Babajee’s father wanted the boy doing farm chores, not rushing off to computer class during school break. And he didn’t like some of the lessons that Babajee’s tutors were teaching. The tutors were evangelical Christians who said Babajee should pray to Jesus Christ instead of the family’s Hindu god.

Somewhere else, Babajee’s conflicts might have passed with time, like any growing pains. But the pressures are intense on a teenager in this drought-stricken region of southern India, a suicide hot zone where young people are killing themselves at the highest recorded rate in the world.

Farmers are losing their crops, and then their land, in a downward spiral that has driven several to kill themselves. Young men have trouble finding jobs. And as they have for generations here, teenage girls marry middle-aged uncles and live like servants.

For solace, many villagers turn to a local drink called sarayam, a witch’s brew of fermented bananas, rice or sugar cane, various tree barks and, for an added kick, acid drained from old car batteries.

Babajee escaped his demons by drinking from a can of Demacron pesticide. He died here, alone in a cave, on a sweltering spring day two years ago.

In the Kaniyambadi district of southern India where Babajee lived, which is made up of 62 villages with 108,000 people, suicides account for about a quarter of all deaths in young men, and from 50% to 75% of all deaths in young women, a research team reported in the British medical journal the Lancet last month. But statistics cannot say why so many young people take their lives. Those who would know are dead, and few left suicide notes. Many of the victims were illiterate. Jayaprakash Muliyil, the principal of the medical college that compiled the statistics, thinks that the answer to the mystery lies in the local culture.

“It is very difficult to prove these things,” said Muliyil, who is also a community health professor. “Our own feeling is that people tend to enact what their culture demands them to do. And there is something in our culture that suicide turns out to be an option when conflict arises.”

Most villagers in the district are Tamils, 98% of them Hindus, with a minority of Muslims and Christians. Muliyil stressed that he didn’t see any link between Hinduism and higher suicide rates, and his college’s researchers say they haven’t begun to figure out whether anything in Tamil culture might be the cause.

Record-keeping is often haphazard in India, and police routinely report suicides as accidents to cut their paperwork or spare families any stigma. Kaniyambadi district offers researchers a uniquely clear and accurate look at the problem.

Meticulous records of every birth and death in the district are kept at Muliyil’s Christian Medical College and Hospital, which was founded by an American missionary in 1900. It is one of India’s most respected medical institutions.

Staff members at the college, in the nearby city of Vellore, have trained health workers who live in every village in Kaniyambadi and form the foundation of a comprehensive reporting system that allows doctors and nurses to build an accurate database of births and deaths.

Researchers from the college studied computerized death records from the 1992-2001 period, for people 10 to 19 years old. They discovered suicide rates “several-fold higher than those reported anywhere in the world, especially in young women,” the team reported in the Lancet.

Suicide is the No. 1 cause of death in that age group, with a rate of 148 suicides per 100,000 girls and young women and 58 per 100,000 boys and young men. That’s many times higher than the youth suicide rate in the United States. In 2001, the rate in the U.S. was 7.9 suicides per 100,000 people ages 15 to 19, the National Center for Health Statistics reported.

The Indian statistics shocked experts at the Vellore college.

“Like any other person, at first you don’t believe it,” Muliyil said. “Then you double-check it. And it is confirmed.”

Anuradha Bose, a pediatrician on the suicide study team, suspects that if such meticulous records were kept elsewhere in Tamil Nadu state, they might show equally high suicide rates.

“There is nothing unique, socially or environmentally, about this part of Tamil Nadu for us to believe that something unique is happening here,” she said.

In India, there are few places to turn for help outside the family when people consider killing themselves. Tamil Nadu has only one suicide hotline, operated by 40 volunteers, for a state of more than 62 million people.

Suicide kills more than 108,000 Indians a year, making it the third-leading cause of death, said Pallasena V. Sankaranarayanan, director of a suicide intervention agency in Madras, Tamil Nadu’s capital. Governments do little to help prevent suicide, he said.

“People think it is a personal problem and ask, ‘Why should I get involved?’ ” he said. “But it is a social problem. The government has to recognize it as a national problem.”

Young women are more likely to kill themselves than young men in Kaniyambadi district. That’s the opposite of the norm in most of the world.

Bose thinks that Indian society’s persistent bias against girls and young women is largely to blame. Parents are likely to send boys on to higher grades no matter how poorly they do, but girls usually get pulled out early if they don’t excel, the pediatrician added.

“It’s an end of opportunity. The next step is she will get married,” Bose said. “Nearly all the ones I’ve asked don’t want to get married at that young age. It’s quite sad. I think, to some extent, they realize that once you’ve had a child, your life as you know it -- for yourself -- is more or less over.”

The list of life’s options is shrinking for Devan Punitha and Selvaraj Satya, who cling tightly to each other as they describe how their neighbor, Chinnadurai Kantha, killed herself March 16, 2003.

As 16-year-old girls in Kaniyambadi, they run a high risk of falling into the same fatal trap.

Chinnadurai, 35, walked two miles from her village to the forest where she used to gather firewood and plucked leaves from an adanthalai tree. She took them home, mixed a poison and collapsed in writhing agony in front of her house after drinking it.

Punitha was one of the neighbors who fought to save the woman’s life. They tried to make her vomit by forcing tamarind and water down her throat. It didn’t work. Neither did a raw egg. The poison killed her within half an hour.

There were many possible reasons why she chose to end it all -- her life was a long unraveling. Her only child died when he was 3. Her husband left her. Her mother went mad 10 years ago and now sits alone, slouched and mumbling in the shadows of her mud-brick house. She chases off visitors with a stick.

Chinnadurai’s only brother died after drinking bootleg liquor. The village mailman, repository of local gossip, says she also had an unhealthy taste for the sarayam, brewed by her brother-in-law.

In the police report, the cause of death was listed as “poisoning: prolonged illness.” To the teenage girls who watched her die, the reason means nothing.

“Whatever it was, she should have tried to solve it by speaking to someone,” Punitha said.

Babajee, who lived just up the road, also kept his problems to himself.

Friends and relatives say he was always quiet, and they didn’t see any hint of the storm roiling his mind.

Early on the day he died, Babajee was rushing to harvest coconuts on his father’s small plantation, said his mother, Indirani. He didn’t want to miss any of his morning computer class. So he didn’t cut the coconuts right, at least not the way his father had ordered.

They argued, and for the first time in his life, Babajee’s father hit him. When the boy reached his house, he was as quiet as usual, his mother said.

“He just came home from the farm, had a nice bath, then ate his food and said: ‘Mama, I am going to class and then I will come back,’ ” she said.

Instead, he rode his bicycle about a mile to the gateway of Siluvai Hill, where a statue of Jesus greets visitors, his hands raised in blessing. Babajee climbed a third of a mile up the rocky hill, toward a big white cross.

He stopped at a cave and drank from the can of pesticide. The boy’s body was discovered two days later, by men searching with flashlights, following the sickly sweet smell of death.

Babajee’s conflict with life had been building on different fronts. There were the problems with his father. Exam pressure weighed heavily on his mind. Competing religions complicated things.

He and his father had moved 100 miles away to the village of Minjur, just north of Madras, so Babajee could attend a private high school and get a better education. They lived in a rented house, and his father worked at a truck factory, next to a small evangelical Christian church. Both returned to Palathuvanam after Babajee took his exams.

In Minjur, the pastor, the Rev. Anand Mithiran, invited Babajee for after-school tutoring, which the preacher and a parishioner offered each night. Babajee also attended Sunday services. But his father saw Jesus as just another god, who should not unseat Kali, the black, four-armed goddess with a necklace of skulls.

“His father used to tell him, ‘If you want, you can believe in that god [Jesus], but you must believe in our god too,’ ” Babajee’s mother said.

Every time the family passed the statue of Jesus next to Siluvai Hill, Babajee would bow his head and cross himself. That only angered his father more.

“We never used to bow,” Babajee’s mother said, and then wondered aloud: “Maybe that is why all this happened.”

Not long after Babajee killed himself, his results from the Grade 10 state exams arrived in the mail. He received 420 out of a possible 500.

Top of his class.