Cotton production is painstaking work that requires long hours of cleaning, seeding and hauling water to fields. Each bloom must be cross-pollinated by hand then plucked. Workers can suffer respiratory and other health problems caused by exposure to pesticides, extreme heat and physical stress. Most earn barely enough to lift them out of poverty.

Freshly picked cotton is stuffed into a bag before it is taken to the ginning mill where it will be processed and compressed into bales. The next stop will be storage yards, textile mills or even other countries where the cotton will be processed into yarn or cloth to make clothes. Clothing consumes 60% of the world's cotton production; European and North American shoppers account for about 75% of these imports.

Most cotton farmers are barely able to cover their output costs, let alone make any profit to support their families. India – which competes with the likes of the US, where cotton is heavily subsidised – is grappling with the rising costs of genetically modified seeds, fertilizers and pesticides, as well as the impact of unpredictable weather patterns. GM seeds account for 95% of cotton farming in India.

Workers unload cotton from lorries at the ginning mill, where the fibre will be separated from the bolls and dust particles before it can be compressed into bales and shipped to storage yards. Workers are paid about £65 per month – well below the recommended living wage.

India is experiencing its biggest wave of suicides among cotton farmers. Some observers have linked the deaths to the introduction of costly genetically modified seeds, fertilizers and insecticides. Many farmers turn to loan-sharks to pay for these items, however unfavourable weather conditions, or even a mere dip in the global price of cotton, can spell disaster for growers.

A shopkeeper displays a box of GM cotton seeds. Bollgard, developed by Mahyco-Monsanto Biotech, is genetically engineered with the Bacilus thuringiensis (Bt) gene and a protein that is toxic to the bollworm, a pest that is particularly harmful to the cotton plant. Bt seeds can cost up to four times more than traditional varieties and require irrigation (about 80% of farmland in Maharashtra is rain fed), as well as greater quantities of pesticides and fertilizers.

A list of Bt seeds for sale in a shop in Yavatmal. Bt cotton, introduced in India in 2002, was the first GM crop to be grown in the country. Every year, farmers must purchase fresh seeds as retailers sell them only as hybrid cultivars, which prevents growers from replanting them the following year.

A cart loaded with pesticides and a tank used for spraying the fields. Bollworm has developed resistance to Bt cotton, so the plants need to be doused more heavily with chemicals that are extremely toxic to farmers and the environment.

Cotton plants are sprayed with pesticide. Many of the chemicals in these products are banned in the west, yet most Indian workers toil barefoot and without masks.

Usha's husband, Marotrao, killed himself only a year after their wedding. She found him lying dead in their cotton field in Yavatmal. They had just three hectares of land, which was given to them by Usha's family. Usha says her husband had borrowed money to pay for Bt seeds, fertilizer and pesticides, but the rains did not come and his crops failed. After Marotrao's death the government sold his land and used the money to pay off his debt. Usha says she was left with nothing.

Vinod Kale, a cotton farmer and Kalamb village chief, displays a list of workers who have killed themselves in recent years. Most of the local women are illiterate, so Kale is helping widows apply for the relief package the government has set up in response to the deaths. The rules are strict: widows are entitled to up to 100,000 rupees (£985) in compensation, as long as the land was registered in the name of the deceased who had been in debt when he took his life, and there is proof that the debt was the cause of his suicide. Kale says of the 37 cases he has worked on, just three have been successful.