Dear Editor
IN January this year, an article in the local media stated, “The Pesticides and Toxic Chemicals Control Board (PTCCB) continues to execute its mandate through the holistic and comprehensive management of pesticides and toxic chemicals in Guyana with key support at the national level.” Strangely, that mandate makes no mention of addressing pesticide suicide.

Strangely, because in Guyana suicide deaths by poisoning was said to be 36% of all reported suicide deaths from 2009 to 2015. Poisoning was the ‘preferred’ method due to the easy availability of agro-chemicals. One researcher (Henry, 2015) noted that the increase of pesticides availability in the 10 administrative regions in Guyana, with “very limited controls for procurement,” could be one of the contributory factors to such a preferred method. This is compounded by storage that leads to easy accessibility in homes where such pesticides are used, as well as easy accessibility at places of sales as there are no stringently enforced conditions of purchase.

Regarding the PTCCB mandate, while some controls are in place with respect to sales/usage of agro-chemicals, there seems to be no monitoring to ensure that these controls are consistently and fully applied across the board, nationally. As well, one wonders whether enough emphasis is placed on information dissemination, so that the public is made aware of the developments and its own roles in pesticide safety.

For example, have the poison control centres been established? If so, how many? Where are they located? Exactly what services do they offer and to what extent are these services being utilised? Is their efficiency being evaluated, so that they can be data-driven and continually evolving to meet current and emerging needs? Also, a few years ago, the Guyana government was represented at a forum on pesticide suicide in The Cayman Islands, organised by the International Association for Suicide Prevention (IASP). To date there has been no mention of any action outcomes resulting from our representation at that forum.

In any case, as The Caribbean Voice (TCV) has continually pointed out, information provision by itself would create very little requisite action. This is why we have been lobbying for implementation of an adaptation of Sri Lanka’s Hazard Reduction Model relating to agro-chemicals, which saw the total number of suicides being reduced by about 50% from 1996-2005, compared to 1986-1995 – a reduction of approximately 19,800 suicides, after this model was introduced. There is no such proven track record for poison control centres.

In early 2015, TCV and a number of other stakeholders had met with PTTCB and an agreement arrived at that the PTCCB would unveil an adaptation of the Sri Lankan model later in that year. Nothing has since been heard about that unveiling.
The Sri Lankan model encompasses:

1. Introducing a minimum agro-chemicals list restricting the use of pesticides to a smaller number of pesticides least dangerous to humans.

2. Placing import restrictions to ensure that more dangerous chemicals do not enter the country.

3. Restricting the availability of agro-chemicals by ensuring they are stored safely in locked boxes in rural households, along with all equipment with which these pesticides are used.

4. Ensuring that empty containers are safely and effectively disposed of.

5. Restricting sale of agro-chemicals only to licensed premises and to licensed farmers.

6. Implementing administrative controls to ensure that sales outlets safely store all agro-chemicals.

7. Implementing an ongoing safe-use policy to educate people about safe handling, use, storage and disposal. Concurrently, for small-scale farming, non-chemical methods, including organic farming, should be encouraged.

8. Improving medical management of pesticide poisoning: an important facet of control, because better management will reduce the number of deaths. Requirements are the better availability of antidotes (both in central referral hospitals and ideally in peripheral health units) and ventilation facilities, better training, and better evidence for interventions.

9. Constantly monitoring all measures to ensure ongoing conformity, including random home visits to check for locked-box storage and field visits to ensure that only licensed premises and licensed farmers have access to chemicals and that safe handling, use, storage and disposal are in effect.

In this context, the policy of sharing out cabinets to farmers makes sense. However, given that there are tens of thousands of farmers in Guyana, the few hundred cabinets doled out so far is simply a band-aid approach. It is thus time for government to reach out to the World Health Organization and other potential international and local partners to come up with an effective, long-term plan to tackle pesticide suicide.

This plan must, of necessity, include a widely publicised list of all banned agro chemicals. Additionally, potent agri-poisons such as gramozone, the choice of poisons in Guyana, must be added to that list. Gramozone contains the lethal ingredient paraquat, a substance banned in many nations across the globe. There is no known antidote and it has one of the highest death rates for poisons once ingested.

While there has been no study on its usage in Guyana, a 1997 study by Dr Daisley and Dr Simmons on forensic analysis of acute poisonings in south Trinidad, showed that of 105 deaths analysed, almost 95 per cent were cases of suicide, and almost 80 per cent of deaths were due to paraquat.

An analysis of international literature, especially a study in South Korea, shows that the introduction of national policies regulating and banning paraquat led to a significant decrease in pesticide-associated mortality. Yet, access to this poison in Guyana is as easy as access to candy. And, considering that those who attempt suicide generally do not want to die, ingestion of gramozone effectively takes away from them that option to survive.

Regards
The Caribbean Voice