Trouble in Paradise: Suicide Epidemic Claims Lives in Guyana

1978: People lie on the ground dead from forced suicide.
1978: People lie on the ground dead from forced suicide.

By Re

November 18th marks the 37th anniversary of the Jonestown Massacre, when 909 members of an American cult called the Peoples Temple died in a mass murder-suicide under the leadership of Jim Jones in the Jonestown settlement of the South American nation of Guyana.

Jones founded the charitable Peoples Temple in Indiana in the ‘50s, relocated his congregation to California in the ‘60s and then Guyana in the ‘70s following negative media attention. He promised a utopian community amid the Guyanese jungle, but instead confiscated members’ passports and medications and forced them into long days of field labor, monitored by armed gunmen, and punished those who questioned his authority—worsening as his mental health declined with his drug addiction. Letters and calls were censored. Members were plagued by mosquitos and tropical diseases and forced to participate in mock suicide drills in the middle of the night—until those mock drills became a reality.

US representative Leo Ryan visited Guyana to investigate with a delegation that included reporters and concerned relatives, all of whom were murdered by Jones’ gunmen when they and a small contingent of Peoples Temple defectors attempted to leave the country. The same day, Jones ordered his followers to gather in the main pavilion and commit what he called a “revolutionary act.” Parents pricked their children’s throats with syringes full of cyanide, sedatives and powdered fruit juices before consuming poison-laced concoctions themselves at gunpoint.

Almost four decades later, Jonestown has zero connection to the current situation in Guyana—but voluntary suicide among its own community members is rife and plagues the small South American nation beset by witchcraft.

Authorities are forced to cope with what Guyanese Health Minister George Norton called “a suicide epidemic” last month, particularly in the Carib community of Baramita District, where 69 people committed suicide or died by alcohol-related misadventure incidents in the last four years. Guyana was earlier this year classified by the World Health Organization (WHO) as the country with the highest per capita rate of suicide in the world.

Baramita’s categorization as “a community in deep distress” follows the death last month of an 11-year-old Carib child from alcohol poisoning and an attempted suicide by a six-year-old. Officials have said he was given a high proof alcohol drink mixed with wine on an empty stomach.

While data collection on suicide rates remains a challenge—since attempting suicide is a criminal offense and thus the resulting stigma has lead to significant under-reporting of both attempted and completed suicides—a WHO 2012 report (the most recent data available) suggests that there are 44.2 suicides per 100,000 people in Guyana. The global average is 16.

The problem has evidently been festering for months with little intervention from the previous government, which lost elections in May.

Statistics show that while completed suicides are higher among men, suicide attempts are higher among women.

For example, well-known human rights activist Zenita Nicholson, who, for many years, volunteered with The Society Against Sexual Orientation Discrimination (SASOD) against LGBTI discrimination and abuse, died by suicide last month. At the time of her death, Nicholson had been working as Country Coordinator of the Caribbean Vulnerable Communities (CVC) and the Centre of Integral Orientation and Investigation (COIN) under the PANCAP Global Fund Round 9 “Vulnerablized” Groups Project. In 2014, the United States Embassy in Guyana presented her with the Woman of Courage Award, but she took her own life in October from pesticide poisoning by ingesting a number of carbon tablets following reports of domestic violence.

Domestic violence against women in Guyana is not uncommon.

“In rural communities, cultural practices oftentimes result in women being passive and financially dependent on males. As a result, they are sometimes dominated physically, emotionally and psychologically which typically results in a pervading sense of hopelessness, futility and dependence on men. With limited safety net options and scarce support services available, some women see few alternatives to escaping these expressions of dominance—various forms of abuse, partner assault, etc.—and attempt to end their lives,” explained Anthony Autar, The Guyana Foundation managing director.

Guyana’s Second Periodic Report to the Committee on the Elimination of All Forms of Violence Against Women (CEDAW) concludes that “violence against women is widespread in Guyana,” and cites a survey dating back to 1998 of 360 women in greater Georgetown as evidence. The survey found that, “out of more than 60 percent of women who were involved in a relationship or union, 27.7 percent reported physical abuse, 26.3 percent had experienced verbal abuse and 12.7 percent experienced sexual violence…Nearly four of every five respondents perceived violence in the family to be very common in Guyana (76.8 percent). More than one in three knew someone who was currently experiencing domestic violence (35.5 percent).”

Domestic violence is among the most common and dangerous forms of gender-based violence in the country, as women become targets by virtue of their relationship to the male abuser and the violence is inflicted on them usually, but not exclusively, within the home. Abuse is more pervasive in rural communities, and although deaths by suicide are not localized to Baramita or any specific communities, the prevalence of them are generally higher.

Baramita, along with Black Bush Polder in Berbice and the Essequibo Coast, where most people have eked out a living from harvesting timber, subsistence cassava and cash crop farming, have been identified by stakeholders as some of the areas with the highest prevalence of deaths by suicide, affected more likely because of the higher prevalence of risk factors.

“[Risk factors] include higher poverty levels, greater unavailability of support services and systems, absent or minimal safety nets to prevent or deal with the aftermath of various expressions of violence and abuse, cultural practices and easier access to means of ending one’s life,” Autar said. For example, one of the most frequently used suicide methods in the country is the ingestion of pesticide. As many people are farmers, pesticides are readily available and contribute significantly to the high suicide rate. And, of course, for women, there’s oftentimes that larger dependency on the aforementioned physically and mentally abusive relationships.

But in addition to the risk factors, Autar said it’s crucial to understand the role of mental illness, and depression in particular, which is one of the leading underlying causes of suicide in Guyana. Locally, the resources allocated to this sector are grossly insufficient, with less than 10 full-time psychiatrists, fewer than five clinical psychologists, limited options to access quality mental health and psychosocial services and little to no help for those grieving. The situation is compounded by widespread stigma and misinformation driven to a large extent by cultural practices and beliefs about mental illness. Symptoms are all-too-often mistakenly attributed to witchcraft (known locally as obeah). Communities then ostracize sufferers and have, at times, physically assaulted them with the endorsement of highly respected religious leaders—the same leaders who are available to “help” grievers.

“So we have a convergence of factors—a high rate of un-diagnosed and untreated mental illness, easy access to the means to end one’s life and an environment where there is widespread stigma, misinformation, blame and few support services—that has contributed to the high rate of deaths by suicide in Guyana,” Autar said.

Fortunately, efforts of various stakeholders like The Guyana Foundation to educate the population about various forms of mental illness have made headway.  “We have seen over the past year a more vigorous conversation about mental illness, and while there is still a lot of work to do in terms of educating the population about specific mental illnesses and combating stigma, instances of mistaken attribution to obeah are less frequent,” Autar said. “Additionally, incidents involving the physical assault of mentally ill individuals, with the endorsement of religious leaders, are isolated.”

The Guyana Foundation has embarked on a national suicide prevention plan to do its part to combat suicide in Guyana. This includes a series of training workshops to train volunteers in being active listeners and guiding individuals in need to effectively handle the life challenges they are facing.

These workshops are conducted by highly qualified mental health professionals from around the world. The Guyana Foundation recently completed a six-day training workshop in Georgetown for 12 volunteers, and will shortly be conducting three one-day training workshops and a four-day training workshop. Additionally, the foundation will soon unveil their plans to tackle some of the underlying socio-economic factors driving suicide in Guyana, though no further information is available at this time.

In the region overall, the issue is also gaining attention. The Pan-American Health Organization (PAHO) has recognised suicide as a major problem, and is focusing special effort on raising awareness and implementing changes in government policy and in public health services. Between 2010 and 2013, PAHO launched region-wide initiatives to address treatment gaps in mental health, and has integrated mental health in its strategic plan for 2014 to 2019.

Continued global attention on suicide prevention in Guyana is critical. “Most of the methods used to end one’s life do not provide quick, painless, easy and certain death. Many of the individuals who’ve attempted to end their life regret it—some when it is too late,” Autar said.