Description: Let's do more to end poor living conditions in rural areas. The mental health of up to 80% of the world population is at stake. This is a short essay about suicides in rural areas.

1. 1
Rural development as a cornerstone for mentally healthy populations:
the example of suicides in rural areas among farmers in India and
indigenous people in Australia
An Essay by Tom Kafczyk (B.Sc., M.Sc., PhD cand., tom.kafczyk@hotmail.de), February 2017
Background: This very short essay is based on a short presentation I delivered in 2014 at the Centre For Rural
Development at Humboldt University, Berlin, Germany. Looking back in time, that short presentation and the persons I
have met triggered some very important thought processes. I was deeply humbled by the opportunity. Many thanks!
Worldwide, rural areas are home to up to 80% of the population. Of these 80%, up to 75% live in
absolute poverty, the majority of them women (German Federal Ministry for Economic
Development and Cooperation, 2001). The living conditions in rural areas are not comparable to
the conditions in urban areas. Rural areas are often characterized by:
 poor infrastructure,
 the exclusion of people from political processes,
 poor educational opportunities
 limited access to health facilities,
 and high income insecurities (e.g. due to the dependency on the next harvest and
market fluctuations).
As a result, individuals, groups and communities living in rural areas can feel excluded,
neglected, unsecure, hopeless and stressed. These feelings can result in a decreased quality of
life and, moreover, lay a breeding ground for a reduced mental health and (sometimes) as a
consequence mental health diseases. In some instances their consequences are fatal.
Suicide rates were reported to be higher in rural than in urban areas, especially in marginalized
and vulnerable groups (Fontanella, Hiance-Steelesmith, Phillips, & et al., 2015). There is
evidence that higher suicide rates can partly be explained by the living conditions and factors

2. 2
that are more dominant in rural areas (as mentioned before, these include: economic distress,
poor employment opportunities or poor health infrastructure).
Two examples from India and Australia illustrate this point.
1) India’s suicide rates were according to a recent Lancet study among the highest in the
world; but even more surprisingly, suicide rates in rural areas were almost double of
those in urban areas (Patel et al., 2012). Among all occupations, suicide rates of farmers
were the highest, not only in India, but worldwide. The University of Cambridge is
speaking of a suicide epidemic among farmers (Cambridge, 2014).
2) The suicide rates in very remote areas in Australia are double of those of urban areas
(Commonwealth of Australia, 2010). Especially the rural youth suicide rates in Aboriginal
people are of increasing concern. The suicide rates of Aboriginal people worldwide are
up to 100 times higher than the national average. In the rural areas of the Northern
Territory of Australia, the highest suicide rates in the world can be found among
aboriginal children (Georgatos, 2013).
Mental health problems and at worst suicides hamper sustainable rural development and are a
very powerful indicator saying ‘something is wrong here’; yet few (successful) measures are
taken.
There is no health without mental health and there is no development without health. Healthy
populations live longer, are more productive, safe more, contribute more to economic progress
and poverty reduction (World Health Organization, 2017). Therefore, health could lead to
development what could lead to more health-friendly determinants of health such as
employment opportunities. Mental health problems, with suicide as its most fatal consequence,
are therefore a vicious cycle that needs to be tackled to lay out the basic foundations for
development – namely the health of the population. Health and particularly the mental health of
people are the most fundamental ingredients to allow being creative, positive, resilient,
persistent, in other worlds: to allow people to flourish and excel in what they like.
Human rights are one way to frame this issue.
“Everyone has the right to a standard of living adequate for the health and well-being of himself
and of his family, including food, clothing, housing and medical care and necessary social

3. 3
services, and the right to security in the event of unemployment, sickness, disability, widowhood,
old age or other lack of livelihood in circumstances beyond his control.” (Universal Declaration
of Human Rights, 1948, Article 25).
Article 25 of the Universal Declaration of Human Rights mentions the universal human rights1
of
an adequate standard of living and the right to health. However, whether in rural India or in rural
areas of the Northern Territory of Australia the fulfillment of these rights has yet to be achieved.
For example, mental health care and social security is rudimentary at best. As of now, mental
health care is not an integral part of primary health care in most areas worldwide. For many
farmers, there is no social security system in case the market price for their product drops. For
many children in rural areas there is no proper and adequate education nor employment
opportunities and future prospects. If these factors are not improved, we will continue to see high
rates of suicides among the most rural and marginalized populations in the world and continue to
pedal the wheel of poor health, poor socioeconomic status, and simply negative feelings,
emotions and actions that are not reversible.
It could be concluded, that these circumstances are human rights violations.
In all development dimensions, political, social or economic, we need to put the needs and
thoughts of the people at the center of our efforts. Mental health problems can be treated and
suicides can be prevented. But concerted efforts and solutions are required, now!
Literature
Bielefeldt, H. (2000). "Western" versus "islamic" human rights conceptions?: A critique of cultural
essentialism in the discussion on human rights. Political Theory, 28(1), 99-121.
Cambridge, U. o. (2014). New ecidence of suicide epidemic among India's 'marginalised'
farmers. Retrieved from: http://www.cam.ac.uk/research/news/new-evidence-of-suicide-
epidemic-among-indias-marginalised-farmers
Commonwealth of Australia (2010). The Hidden Toll: Suicide in Australia. Canberra, Parliament
House.
1 It should not be unheard that the Declaration of Human Rights as it was laid out in 1948 is a document
(or a concept) that can be referred to as “western” (e.g. Bielefeldt, 2000).

4. 4
Fontanella, C. A., Hiance-Steelesmith, D. L., Phillips, G. S., & et al. (2015). Widening rural-urban
disparities in youth suicides, United States, 1996-2010. JAMA Pediatrics, 169(5), 466-
473.
Georgatos, G. (2013). Australia’s Aboriginal children – The world’s highest suicide rate, The
Stringer, Independent News. Retrieved from: http://thestringer.com.au/australias-
aboriginal-children-the-worlds-highest-suicide-rate-926#.WJ3edm_hBhF
German Federal Ministry for Economic Development and Cooperation (2001). Rural
development. A reference framework. Bonn, Federal Ministry for Economic Cooperation
and Development.
Patel, V., Ramusundarahettige, C., Vijakumar, L., Thakur, J. S., Gajalakshmi, V., Gururaj, G., . .
. Jha, P. (2012). Suicide mortality in India: A nationally representative survey. Lancet,
379, 2343-2351.
United Nations (1948). Universal Declaration of Human Rights. Retrieved from:
http://www.ohchr.org/EN/UDHR/Documents/UDHR_Translations/eng.pdf
World Health Organization (2017). Health and development. Retrieved 22/01/2017 from:
http://www.who.int/hdp/en/
“[…] And the world will live as one.”