Guyana has earned itself another dubious world record. According to PAHO/WHO this country had the world’s highest estimated suicide rate in 2012. The press release issued by the international health body did say that the average estimated suicide rate was 7.3 per 100,000 inhabitants for the Americas as a whole, which was lower than the global average of 11.4 per 100,000.
This country, however, is bucking the Americas trend, as is Suriname which had the sixth highest estimated rate globally in 2012. The figures for Guyana are 44.2 per 100,000 of the population, considerably above the rate for perhaps the bleakest nation on the planet, North Korea, which was in second place with 38.5. Interestingly it is followed by South Korea at 28.9; Sri Lanka at 28.8; Lithuania at 28.2; Suriname at 27.8; Mozambique at 27.4; Nepal and Tanzania at 24.9; and Burundi at 23.1.
Four years ago the Ministry of Health in Guyana said in a press release that the suicide rate here was 25 per 100,000 inhabitants, so if the figures are correct, in a period of two years there was what can only be described as a significant increase. The ministry at the time identified Region Six as the area where the highest number of suicides took place, with 50 deaths from suicide per 100,000 of the population. Region Two followed with 36 per 100,000; Region Three with 24; Region Five with 22 and Region Four with 20.
At a workshop in Region Six in June 2010, it was also said that 80% of the deaths were accounted for by males, and that 60% of all suicides were by pesticide poisoning. Other statistics provided were that suicide was the leading cause of deaths among youths aged 15 to 24, and in the 15 to 19 age group, it was the leading cause of death among females and the second leading cause of death among males. Even among those aged between 25 and 44 it was the third leading cause of death.
It seems reasonable to extrapolate that still today in this country the majority of suicide cases are accounted for by males; that the highest rates are among young people; that pesticides remain the means of choice of a majority of those who take their own lives; and that the administrative region with the most shocking rate of suicide is still Region Six, followed by Region Two.
Now one might have thought that with these kinds of figures the government at the time would have put in place measures which would start to address the problem, and in fact, it did – at least in theory. The workshop referred to above, for example, was related to the topic of “Gate-keeper[s] for suicide prevention,” and it was held at the Albion Community Centre, Mibicuri Community Developers and the Corriverton Civic Centre in Region Six, and was facilitated, according to a Ministry of Health press release, by three persons who had trained as suicide prevention gatekeepers.
The intention was to train 110 people, including religious leaders, teachers, farmers, police officers, community workers and agriculture workers, while the sessions were conducted by President of the International Association for Suicide Preven-tion, Dr Brian Mishara.
The problem is, nothing was heard of this again. What happened to the 110 people who were trained? Are they still around working to reduce the incidence of suicide in Region Six? Or did the whole plan fizzle out because there was no follow-up, no monitoring, no centre of some kind for the gatekeepers to liaise with and give them reinforcement?
A little over a month later then Minister of Health Leslie Ramsammy launched a study intended to offer researchers a “post mortem of a person’s life” in relation to suicide cases. In the presence of a Canadian consultant he told his audience at the Project Dawn building that the study would help health officers “understand the footprints – the special characteristics to look for in a person who will attempt or commits suicide successfully.”
He went on to say that ten health workers were undergoing training to determine the factors which contribute to suicide and possible means of intervention. When they had finished their training, the health workers were expected to go into the communities to train other gatekeepers to prevent suicide. Gatekeepers, it was said, could be family, friends, community, church leaders, or the closest person to someone who is contemplating suicide. Whether these were the same as the 110 gatekeepers who had been mentioned the month before as undergoing training is not absolutely clear, but presumably they were. If they were not, nothing has been heard about them since either.
Furthermore, to the best of anyone’s knowledge, the findings of the study which was launched have never been made available to the public, presuming it was indeed completed. It would certainly have been a very useful document if it was, but if it was, there is no evidence it ever informed strategies for preventing suicide and was not left on a shelf gathering dust. Then there was the suicide hotline which was to be set up in September of 2010, an important intervention, although nothing has been heard about it either recently, leaving citizens to wonder whether it is still in operation. If it is, it is not generally known about and someone with suicidal thoughts would probably not know who to turn to.
Of course, the Minister had mentioned that alcohol abuse would have to be addressed as well, and mental illnesses such as schizophrenia, bipolar disorder and depression examined. However, only the year before in 2009, he had conceded that mental health had been sidelined in the health sector here because of minimal investment and general neglect, and he said he was seeking a paradigm shift. This was in the context of yet another workshop on suicide prevention, this time in the Pegasus Hotel.
While this newspaper had reported that the focus of the workshop was on building mental health capacity, Dr Ramsammy, in a candid comment expressed his concern that the talks would amount to nothing but “talk.” It was he who observed that a string of workshops had been held in the past, but that mental health had not benefited in any significant way. He is certainly right about that. The same, it might be said, is true of alcohol abuse as well. This country must be the leader in the holding of workshops on worthy subjects from which nothing eventuates.
There is too the matter of pesticides, used in a high proportion of suicide cases here. This again has been recognized locally for a long time, and four years ago the Ministry of Health was said to be working closely with the pesticides board with the aim of creating a system which would restrict access to chemicals. In addition, an antidote for Gramoxone was being sought to give to hospitals for the treatment of pesticide ingestion, although there has been no news on whether anything has been identified.
It has to be admitted, however, that the pesticide problem is a difficult one, because this is an agricultural society and pesticides are used widely in the various crop sectors. Furthermore, restrictions on access are no more likely to be adhered to than any other rules and regulations in this society – which does not mean to say that serious thought must not be given to the issue.
The most recent WHO report on suicide identified various measures which can help to prevent suicide. Many of them are already known in this country, and have been introduced to a range of personnel at a series of workshops over the years. Some of the latter have also had training. What this country lacks, however, is the ability to follow-through, sustain and monitor any strategies which have been decided upon. Until that is done, nothing much will change on the suicide front here.
