Indian Cocktail

Sep 30, 2012 Features / Columnists, Ravi Dev

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Over the years, I’ve thought a lot about the phenomenon of suicide. It’s not that I’m morbid. As an Indian in Guyana, I’m not sure how one can avoid such thoughts. With almost 200 suicides a year and more than three-quarters of them being Indians, there’s hardly a week you don’t get a call from some friend or acquaintance about someone they or you know who took their life. Who hasn’t been touched?
It’s been so ever since I can remember. Friends from other communities would joke: “What’s the name of an Indian cocktail? Malathion!”
But interesting enough when I started looking into the epidemic, I found that in the villages of the Bhojpuri belt from where most of us had migrated from, suicide had been a rare occurrence. The figures of the 19th century showed that Uttar Pradesh had a rate of 6.3 per 100,000 while in the countries to which we had been exported to labour on the sugar plantations the numbers had skyrocketed to at least ten times that number. From Fiji to South Africa to the Caribbean, the authorities compiled meticulous records, even as they took no measures to deal specifically with the problem. It was just another factor that convinced them Indian immigration had to continue – to fill the gaps so to speak.
Matters haven’t changed much since, as far as the numbers go. Two years ago, Guyana hit the international news with a piece on Al Jazeera, reporting from Black Bush Polder, that we’d placed among the countries with the highest suicide rates in the world. Officially, by WHO figures, we’re # 3. We don’t need Jim Jones to place us on the suicide watch any longer. But that # 3 position was earned as a country as a whole – with a population of 780,000 – producing a rate of 25/100,000. If, as the studies show, we disaggregate the rate for Indians (over three quarters of the victims) then we take the undisputed #1 spot with about 50/100,000.
We’ve been highlighting this fact for the last decade and a half to emphasise that whenever the authorities designed a suicide intervention program, they’d have to ensure that the cultural responses of Indians to the triggering mechanisms for suicide be taken into account. There has unfortunately been a studied refusal to take the hint. Last year, noting that “Multicultural societies require cultural sensitivity in all suicide prevention efforts,” the International Association for Suicide Prevention (IASP) designated the theme for World Suicide Day as: “Preventing Suicide in Multicultural Societies.”
It was emphasised that, “Risk factors for suicide vary across cultural groups. Knowledge about common risk factors in a society often stems from research in majority populations. However, in a multicultural context we need to be aware that some risk factors may play different roles in the suicidal process as well as in suicide prevention for some minority groups compared to the majority population…
“In addition, other factors that might have a different impact on minorities compared to the majority population are attitudes towards suicidal behaviour and suicidal people (e.g. taboo, stigma), religion and spirituality, and family dynamics (gender roles and responsibilities).” It is therefore not surprising that as a result, as is the case in Guyana, “The strategy/program is often aimed at the majority population and a specific cultural perspective or focus is missing.”
One problem arising with the traditional approach in dealing with suicide has been its strong linkage with mental health services. It’s not that the latter are failing people, but that they are not always the right service in the first place. If you are deeply distressed and feeling suicidal, then visiting a place seen a dealing with ‘mad people’ would be the last place you’d want to go. Very few persons who committed suicide sought out available mental health workers.
The government in the last five years has made an attempt to get ordinary individuals within communities trained in a ‘gatekeepers’ program to be available to counsel individuals contemplating suicide. But the initiative appears to have been mothballed for reasons that are not clearly apparent. The former Minister of Health had confessed that funding had always been a constraint but we had hoped with the enormity of the problem, this would have been rectified.
Earlier this month, there was a report of a Peace Corps volunteer working with a local group in Black Bush polder, the Mibicuri Community Developers. He surveyed the community’s specific conclusions as to why they’ve become the ‘suicide nest’ of Guyana. In descending significance these were “the inability to cope, domestic-relational problems, parents disapproving of their children’s boyfriends or girlfriends, alcoholism as a pattern, impulsivity, insufficient money to live on or to repay loans, easy access to agricultural pesticides/poisons, poverty/limited opportunities, manipulation to get what they want from parents and Satan/the Devil tempting them to do it.”
These may be compared to some general factors identified by the IASP – for instance depression, unemployment, poverty, oppression, marginalisation, stigmatisation, or racism. We have to connect the specific and general triggering factors but more importantly identify why the particular response in elicited. Other groups probably face these same challenges but their response is different. An effective intervention program has to answer this ‘why’ and offer alternatives to the “Indian Cocktail”?

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