Suicide’s link to poverty likely a fallacy –says PAHO/WHO official

PAHO/WHO Country Representative Dr William Adu-Krow

By Ariana Gordon

SUICIDE being tied to poverty may very well be a fallacy, says PAHO/WHO Resident Representative Dr William Adu-Krow, who spoke with the Guyana Chronicle recently from his Brickdam, Georgetown office.One of Dr Adu-Krow’s areas of expertise is public health, and he says that while Guyana’s suicide rate is indeed high, judging from statistics made available to his office, he does not believe that the reason behind the majority of cases is poverty.

He, however, cautions that this does not mean he is disputing that there may be cases of poor people committing suicide.

“People may say that it could be a case of poverty, but it is not just poverty; it is more than that,” the diplomat said, noting that global studies have shown that the countries with the highest rates of suicide are surprisingly middle-income countries.

He is of the opinion that had the boot been on the other foot, whereby lower-income countries were shown to have the highest suicide rates, then the argument of poverty being the main cause of suicide would have held currency.

Guyana has been grappling with the issue of suicide for a number of months; and as of recent, the number of deaths by suicide has skyrocketed. Unfortunately, public health officials have, to date, not been able to say what are the factors responsible for the rising incidence of suicide here.

In an effort to determine this, the PAHO/WHO Local Office will be soon embarking on a project that will see a consultant spearheading a number of studies here.

“PAHO is going to hire an ethnographer, or somebody who is doing a PhD in Suicide, to look at it for us,” Dr Adu-Krow said, adding that the person will be working with a team of locals on compiling the data.

Noting that the high incidence of suicide here is cause for alarm, Dr Adu-Krow says something needs to be done, and urgently, to arrest it.

Hon. Dr George Norton, Minister of Public Health
Hon. Dr George Norton, Minister of Public Health

Not knowing the cause of the problem, he says, is the real worry, as it means that the issue will prevail. “We have to learn a little more about suicide,” he said. “Is it racial?”

Perhaps anticipating the question ‘What does race have to do with it?’ Dr Adu-Krow said PAHO/WHO statistics have shown that an equal number (30 per cent in each case) of Indo-Guyanese and Afro-Guyanese tend to attempt suicide.
However, upon closer examination of those who go through with the act, statistics have shown that in 80-90 per cent of the cases, it is the Indo-Guyanese.

“Why? We don’t know,” Dr Adu-Krow said. “Is it cultural; is it something that is done? Is it religion?” he pondered.

Dr Adu-Krow said, “When you look at religion, Muslims are the least (likely to commit suicide). They have the least numbers in terms of suicides, followed by Seventh-day Adventists. Now, if you look at Christians alone, the worst happens to be Pentecostals.”

As to what else PAHO/WHO has been doing to help combat this problem, Dr Adu-Krow said the organisation has been assisting the Ministry of Public Health with formulating a mental health strategy. This has already been finalised and adopted, he said.

“We have also gone a step further to help the country to write up a suicide strategy and a work plan…. Now, the challenge is the Ministry of Public Health doesn’t even have a unit to work, so we are now working with it to set up a viable unit that would also champion the work of (combating) suicide,” he explained.

Once that unit has been established, he said, with the help of the strategy guides that are available, coupled with the work plan, “We will begin to see some amount of progress”.

“We have so many people doing different things…but there is no coordination,” he said, adding: “Once we help the Ministry of Public Health to set up a coordination unit, that should probably take care of that.”

To fully answer the question about what the PAHO/WHO been doing, Dr Adu-Krow said there are a number of interventions in train, and that, hopefully, the Ministry of Public Health will follow the advice of PAHO/WHO on the setting up of the unit.

He said his office (at the time of the interview) was awaiting a document from the Ministry of Public Health, so that efforts to strengthen the capacity of the unit can progress.

“I was to receive something two days ago. Up to now, I haven’t received it for us to look at it and advise whether it is plausible or not. Once we receive it, we will give our comments, then it is up to Government to set up the unit, and hopefully take it up,” he added.

Asked what was the latest position with the document at reference, Minister of Public Health, Dr George Norton, said the Chief Medical Officer (CMO) “was instructed to complete and submit it”.

Other than that, he said he could not say with any certainty whether or not the document was completed, as he was out of the country this past week. He, however, said that as far as he knew, the Coordinating Unit has been established, but a coordinator is yet to be appointed. That unit, he said, was set up following a stakeholders’ meeting on suicide held approximately two weeks ago.

“The unit will meet again to organise a larger stakeholders’ conference, to involve all the different organisations to decide on a collective way, both in Georgetown and all the regions,” Dr Norton said.

He also noted that an eight-member committee has been selected to look into the matter, and that a coordinator will be chosen from the lot to head it.

As for the Georgetown Public Hospital Corporation’s (GPHC’s) Mental Health Unit, Dr Norton said that department is functioning. It is headed by Dr Bhiro Harry, who is a qualified psychiatrist. “So, all are involved in the process,” Dr Norton said.

Dr Adu-Krow believes that, in order to effectively tackle suicide, the root cause or causes need to be found. He said that for every one case of suicide that is committed, there are 25 more attempts. He noted that all groups and all possibilities must be examined.

According to him, statistics show that the elderly also commit suicide, though in small numbers. “When I looked at the data,” the minister said, “I was shocked! Those over 60, they also commit suicide, but the numbers are small. But because the numbers are small and the percentage in the population is also small, it gives them a very high per capita rate.”

He said there are many reasons why elderly persons commit suicide, and those range from chronic pain to the absence of family members and loved ones. And though unproven, Dr Adu-Krow believes that with technological advances, it is becoming increasingly difficult for some to cope with challenge.

“All these are in play, and we are hoping that the consultant who is coming to look at the issues from either racial, religious or cultural perspectives will be able to provide the answers.”

President David Granger convened an emergency meeting earlier this year to deal with this scourge. At that meeting, the President declared his intention to have a hands-on approach to addressing the issue of suicide, and he said he would be looking to implement a national programme that has assessable outcomes.

“I am concerned, as President, that Guyana has a higher rate of suicide than other countries. It is not as though there is an average around the world and we are just average…” said President Granger. He also said that implementation of Guyana’s National Suicide Prevention Strategy, launched by the Ministry of Public Health in September, is critical.

“I intend to find out why we have so many suicides, and once we identify those factors, try to use Governmental action and try to get the efforts of civil society and households to put this scourge to an end. We are above normal, and I want to find out if it’s social, if it’s cultural, or if it’s economic; and (I intend to) bring an end to it… We know what the disease is, let’s find out what the cures are.” the Head of State said.