SuicideDesperate measures

GUYANA tends to do disappointingly, but not disastrously, in global rankings. It comes 121st out of 187 countries on the UN Development Programme’s human-development index; in the World Economic Forum’s latest competitiveness rankings, it comes 117th out of 144. But when it comes to suicide, Guyana is at the worst extreme (see chart).

A World Health Organisation (WHO) report published this month gives Guyana an age-standardised suicide rate of 44.2 per 100,000 inhabitants. That compares with a world average of 11.4, and a figure of 6.1 per 100,000 for low- and middle-income countries in the Americas (neighbouring Suriname, with a similar history and ethnic mix, does very badly, too).

The WHO numbers are adjusted to take account of countries’ differing age structures. Children are at less risk of suicide than adults, the elderly more so than the young. But using the unadjusted rate makes little difference to Guyana’s ranking—it lies third (after North and South Korea) for both sexes, and second (after Lithuania) for male suicides.

Statistics on suicide are notoriously unreliable. For religious and cultural reasons, many go unrecorded. But Guyana clearly has a big problem.

Men everywhere are more likely to kill themselves than women are, but the ratios in Guyana are heavily skewed towards males. Many drink weedkiller, a particularly distressing and protracted death. Most live in rural areas and are middle-aged or elderly (despite heavy media coverage of teenage suicides).

The Guyana Foundation, a recently created non-governmental organisation, this month released findings from a study based on in-depth interviews by Serena Coultress, a student at the Global Health programme at Maastricht University in the Netherlands. She talks of hopelessness and frustration among men who are unable to fulfil their expected role as provider, and who turn to domestic violence, alcohol abuse and, sometimes, suicide. The numbers show that Indo-Guyanese people are more at risk from suicide than Afro-Guyanese but that, she says, may simply be because most of the rural population is of Indian origin.

Chemistry has a role to play, too, says Professor Gerard Hutchinson, a psychiatrist who heads the department of clinical medical sciences at the University of the West Indies Trinidad campus. Guyanese agricultural workers and farmers may be overusing organophosphate herbicides and insecticides, which international studies suggest can lead to impulsive suicidal behaviour.

Guyana’s suicide rate has fallen by 8.5% since 2000, but much more needs to be done. Training workshops have been held to help identify people at risk, but there has been little follow-up activity. There is no functioning telephone helpline for people in distress, although the police have announced plans to set one up using civilian counsellors. Attempted suicide is a criminal offence in Guyana. The law is rarely used, but its existence helps set a pattern of stigma that the country can ill afford.