Documents
Resources
Learning Center
Upload
Plans & pricing Sign in
Sign Out

Suicide Report

VIEWS: 195 PAGES: 23

Suicide Report

More Info
									              Survey Report (Base line)
   Surveillance and Reduction of Women’s Suicidal
Trends in Jhenidah: A Hot Spot with High Suicide Rate
                    in Bangladesh




              Prize winning painting on suicide by Dhruv Suri




                             Submitted by:
          Society for Voluntary Activities (SOVA)
              58 Sahartali Sarak, Adarsha Para
                      Jhenidah-7300.

                                                                1
                      Phone: 88-0451-63843, 0175671535
                         e-mail:sovajh@yahoo.com


                                    Summary

Suicide is one of the three leading causes of death among 15-44-year old people
globally, particularly in women in Bangladesh. A population-based surveillance in
a rural community in southwest Bangladesh was conducted in 2005 among
27,390 population in 25        villages to    collect    baseline    demographic    and
socioeconomic data on suicide attempters that occurred during the past three
years (March 2002 and April 2005). A total of 361 suicide attempters was
identified by home visits, 239 (66,2%) were female compared to 93 (33,8%)
male. Of them 67 (18.6%) died and 38 (56.7%) of them were female. It was more
frequent in age group 11-30 years (69%), and in housewife, farmer and student.
Insecticides and hanging was the predominant means of suicide attempts. The
contributing risk factors were multifactorial and many, that frequently included
family    dispute,     underestimation/negligence          by       family    members,
misunderstanding & dispute between spouse, poverty, illness, dowry, failure in
love and torture (physically and mentally). The triggering factor for suicide
attempts was acute anger in 88.6% of cases. Young, first-time-married women
took easily available residual insecticide kept at house for committing suicide on
many occasions. The social and financial impact of suicide was huge and had
multidiscipline   problems.   Ongoing   and     future    works     involve   preventive
approaches (Village dispute regulation committee, courtyard meeting, income-
generating trainings and means) that include broadly promotion of rational use of
insecticide without storage in the house, public awareness, good governess,
prevention of childhood marriage, empowerment of women and reduction of
violence against women by useful and relevant means in primary target group
(women, students) and secondary target group (family members, resource
persons, community leaders) in the study population in order to reduce the
burden of suicide.




                                                                                       2
1. Introduction:
1.1. Background
       The word "suicide" was first used by Sir Thomas Browne in 1642 in his Religio
Medici. The word originated from SUI (of oneself) and CAEDES (murder). Since then,
the word has evoked constant and continuous debate and has been defined in various
ways for medical, social, psychological, administrative, legal, spiritual and religious
purposes. Suicide is one of the three leading causes of death among 15-44-year old
people globally. As a social phenomenon it is more or less well known to almost all
human beings in the world. Emile Durkheim, a prominent sociologist gave a
theory on suicide to discuss the social facts. After that many social studies have
been done on the suicide issues and at the present time this process is
continuing. It is evident that suicide rate is on the rise not only in Bangladesh but
also all over the world. In Bangladesh it has been termed as a social disease.
Nearly all families in our country have the experience either directly or indirectly
in this tragic event. Bangladesh Mahila Parisad pointed out in their “Study on
Gender Analysis of Suicide in the Contemporary Bangladesh” that in recent
years suicide cases among women and young girl’s increased markedly. Suicide
though appears to be a personal decision can be caused by various factors that
might be influenced by personal, family and social factors. Among three known
kinds of suicide most cases are either egoistic or anomic in Bangladesh, anomic
being the common one. Human have attempted and successfully committed suicide
since time immemorial. The reasons for killing oneself vary with cultures and societies
and in urban or rural settings. Suicide is now being recognized as a major public health
problem in the complex scenario of development and lifestyle changes. It is a very
important issue cutting across diverse disciplines and sectors such as health\, religion,
spirituality, law and welfare. It evokes mixed reactions: varying from anger, distress,
ridicule, anxiety, tension, fear and sadness. Though suicide and para suicides have been
attempted since the beginning of mankind, a sea change has been observed recently in
our understanding of the problem. To understand more regarding suicide we need
analyze suicide with its historical background. Suicide is commonly referred to as
Atmahatya in (Bangla, Bangladesh and Hindi, India), Kha tua Tai in (Thai, Thailand),
Bunuh Diri in (Bahasa, Indonesia), Siya Diivinasa Ganima in (Sinhalese, Sri Lanka) and
by others local terms in different countries. The practice of singing Maromi is prevalent in
South West Bangladesh, where suicide rates are high. Information from Sri Lanka


                                                                                          3
reveals that a large numbers of suicide are among Buddhists even though their religion
doesn’t favour it. The belief in rebirth and the lack of definite statements on suicide by
both Hindu and Buddha makes suicide much less “sinful” than killing another person. In
ancient European cultures, suicide was common, with women using hanging and men
using various tools for deliberate self-harm. Ancient Hindu texts allowed individuals to kill
themselves although in later Upanishad periods suicide was generally condemned. In
general, suicide considered asasin in Islam, Christian, Buddha, Hindu and so on cultural
and legal attitudes towards suicide. The Roman Catholic Church has never altered its
unequivocal position on the subject; however, in practice, the rigid provisions of Canon
Law are often mitigated by individual members of the clergy. In the Chinese cultural
tradition, Confucianism stresses the virtue of family affiliation, teaching that one should
not injure one’s own body because it is given to a person by her/his parents. Implicitly,
attempting suicide is prohibited except in cases where it promotes loyalty to the family. In
Indian Hindu culture, various religious and philosophic writings have enunciated views on
suicide. Some permitted suicide on religious grounds (the best sacrifice was man’s life
itself); others censured suicide. Sati—the self-immolation of a widow – received the
sanction of religion by her self-destruction on the funeral pyre of her husband, the widow
would atone for the sins of her husband, free him from punishment. In general, Hindu
philosophy held rather tolerant attitudes towards suicide based on the view that life does
not end with death; death after all, only leads to rebirth in another body or form. With
regard to Islam, there is interdiction of suicide in the Koran and according to historical
tradition suicide is a violation of a divine command contained in the holy books of Islam.
An acceptance of life’s events is the cardinal factor in obedience to God; suicide,
consequently, is an act of revolt against God and the perpetrator of such an act risk his
wrath.
              However, suicide does not result from a single cause, it is linked
with personality disorders, and many argues that social isolation contributes to
increase rate of suicide. Suicide is often a response of “problem” situations; the
problems may be emotional family problems, bereavement, the ‘unbearable
feeling of loneliness’ financial ruin or poverty, chronic painful disease or mental
disorder. It may not occur as a result of factors purely “internal” to the individual
there is always an interaction between the individual and his/her social
environment. Besides these if a person faces problem such as cheating by
lovers, force marriage or marriage of lover, frustration caused by unemployment,


                                                                                           4
beaten or scolded by elder, not having suitable gifts/rewards against ones
activities or bad results in examination, complied with family decision etc., which
create the ground for motivating spirit of individualism that one could not enjoy
the life any more and such kind of emotional issues play a vital role to initiate this
tragic phenomenon. Suicide is undoubtly a result of extreme desperation, defeat
hatred, shame and craziness. Jhenidah, a district of Bangladesh is situated on
South Western part of this country. This district is progressive in agricultural
sector but very underdeveloped/backward in industrial sector. Rootless and
vulnerable people who don’t have land are proportionately very high. That’s why
they have to struggle with extreme poverty. Because of being poor, education
rate is very low and superstition is a part and parcel of daily life of our target
population. Suicide rate is generally high among the middle class people and this
is the common scenario in the world. This situation prevails also more or less in
other districts of Bangladesh except Jhenidah. Suicide rate is comparatively high
among the poor people who are suffering from extreme poverty. Both visible and
invisible poverty create different kinds of social and familial disputes that
encourage the victims to kill themselves. Rahman MH (1998) in his research
study “Atmohottyar Artho samajik O monostattik karon (in Bangla)” identified
causes of suicide in a sample survey carried out in Jhenidah district. The
common determinants of suicide were the poor economic condition (50%), family
problem and feud (26%), problems between spouse (23%), lack of socialization
(11.1%), dowry and lack of educations (10%), deterioration of social value (8%),
polygamy and easy availability of poisonous chemical substance. In another
study on suicide by Islam AMMF (1999) it was observed that the average age of
suicide was 27 years with a range between 10 to 85 years. Common age group
includes people of age ten to thirty years. Suicide cases were comparatively
higher (55%) among people who were married, illiterate and poor. Poisonous
substances were the popular means for suicide. Karim J (1995) in his study
pointed that suicide cases are on the rise and most of cases are mainly socio-
economic and ideological.

      Population-based surveillance in a rural community in southwest Bangladesh
revealed that suicide is a major cause of mortality, especially in young females. Mortality
from suicide occurred at a rate of 39.6 per 100,000 population per year from 1983-2002.
Among young people, 10-19 years old, suicide accounted for 42% of deaths; 89% of

                                                                                         5
suicide-associated deaths in this age group were in females. Suicide-associated death
rates from this surveillance area are substantially higher than rates reported elsewhere in
Asia, warranting further studies aimed at identifying risk factors for suicide and strategies
for prevention.

In Jhenidah limited attempts were taken to study and analyze this important
matter that has significant social, psychological and economic impact. And
almost no appropriate attempts were to taken to reduce suicidal trends among
the target population. To aim at identifying the important issues on suicide such
as contributing risk factors, impact and real situation of occurrence, it is essential
to start the preventive approaches by which the rate of suicide might be reduced.
However, a conservative estimation reported that a total of 494 people, mostly
woman, committed suicide in the 2003 as recorded in local hospitals. However,
this figure represents only a fraction of real number of cases. According to police
records, a total of 661 persons committed Suicide in 2001 and 584 in 2002. On
an average two persons committed suicide per day. According to statistics of
police, 70% suicide victims were women and most of them committed suicide by
taking pesticide. The majority of suicide victims were from Jhenidah Sadar
Upazila (Dynamic Daring Daily, January 10, 2004). A preliminary survey
conducted by SOVA during 2001-2004 (July) in Jhenidah district Thana Health
Complexes showed that nearly 4054 people took suicide attempts and many of
them died in the hospital. According to studies carried by various research
organizations, it’s clear that the number of women tried to commit suicide and
the number of suicidal cases is gradually increasing in the recent years. It is
evident that only a fraction of suicide attempters attended hospitals if they were
alive. Not all such cases of suicide attempts are published in the newspapers,
however reports indicate that the suicide occurs frequently in this district. Now
the question arises: why so many people in the region took attempts to terminate
their lives in this way. To the best of our knowledge, this has never been
addressed thoroughly and precisely in any study. Such study and analysis are
important to know about the main causes of the occurrences in order to save
lives of many innocent people, especially young woman, in the region. It is
therefore, necessary to conduct a base line survey to study and analyze
contributing causes of suicidal attempts and take an appropriate remedial



                                                                                           6
measure to save the victims in the future in order to reduce these preventable
causes of death.


2. OBJECTIVES OF THE RESEARCH
         The objectives of this research are:
   • Retrospective collection of base-line data of suicidal attempters during the
         past 3 years (2002-2005).
   • Analysis and identification of causes/risk factors for suicide attempts
   • Develop a specific strategy to reduce the women suicidal trends.
   • To promote knowledge regarding human rights specially women rights,
         justice and socio-economic improvement factors.


3. SURVEY METHODS
   a. Design: Retrospective data collection on suicide cases or cases of
         survival of suicide attempts during the last three years (2002 -2005).


b. Study area: Furshondi and Dogachhi union of Jhenidah Sadar Upazilla
under Jhenidah district was included in the study area.


c. Study population area: Total population of study area is 27,390.


d. Data collection: Structured questionnaire was used to collect relevant data.
In our survey we interviewed people who were directly victims, relatives of
victims and family members of those victims. To point out real information our
survey team interviewed two persons including victims in case of survivors and
for suicidal death-case information was collected from two persons who are
relatives or family members. Mainly primary level sources have been used in the
study.
e. Data Analysis: Data were analyzed by SPSS 11.


f. Expected outcome: Using the findings we could be able to develop specific
strategies such as preventive measures including development of gender
sensitive policy and planning, increase awareness and knowledge for anti-


                                                                                  7
suicide campaigning, strengthening local government, reducing violence against
women and empowering women by which suicide rate might be reduced.


4. LIMITATION OF THE STUDY
Both primary and secondary target people were not keen to deliver right
information because of fear for legal action by law-enforcing authorities. Local
people ideology seamed to us as like as give and take system.


5. RESULTS
Suicide attempters: A total of 361 (Table 1) attempters was identified in two
unions by our data collectors during the past three years (April 2002- March
2005). Of them 239 (66,2%) were female compared to 122 (33,8%) male.


Table 1. Suicide deaths among suicide attempters (N = 361) in Jhenidah (2002-
2005)
Type of suicide                                Sex of suicide attempters       Total
  attempters
                                                 Male            Female
 Suicide death               Count                29               38            67
                    % within Type of suicide    43.3%            56.7%         100.0%
                          attempters
                           % of Total           8.0%             10.5%         18.6%
Surviving suicide            Count               93               201           294
  attempters
                    % within Type of suicide    31.6%            68.4%         100.0%
                          attempters
                           % of Total           25.8%            55.7%          81.4%
     Total                   Count               122              239            361
                    % within Type of suicide    33.8%            66.2%         100.0%
                          attempters
                          % of Total            33.8%            66.2%         100.0%



Age: More than 69% of the suicide attempters were in the age group of 11-30
years and the highest concentration were reported in 21-30 age group (45.7%).
And the lowest in less than 10 years of age.55%.
 Table 2. Age distribution of suicide attempters

    Age group                       No.                           Percentage
     0-10 years                       2                             0.55%
    11-20 years                      84                             23.33%
    21-30 years                     165                             45.7%
    31-40 years                      58                             16.0%

                                                                                        8
     41-50 years                      31                                   8.6%
     51-60 years                      12                                  3.32%
     61-70 years                       7                                  2.14%
         70+                           2                                  1.43%
        Total                         361                                 100%

 Sex: About 66.2% of suicide attempters were female in our study.
 Educational status: More than 60 percent of suicide attempters had no formal
 education and more than a quarter (28.8 percent) had primary education. The
 level of formal education is almost equally distributed in both sexes. Secondary
 school education rate (32.24%) is higher in female suicidal death cases than
 male death cases (17.2%) whereas in case of primary education it is just
 opposite.
          Table 3. Educational status and sex of the suicide attempters

                                                     Educational status of suicide attempters       Total

   Sex of                                          No      Primary Secondary    SSC    Master
  suicide                                       education education education complete degree
attempters
    Male       Type of     Suicide     Count        12       12          5                              29
               suicide      death
             attempters
                                     % within Type 41.4%   41.4%      17.2%                         100.0%
                                      of suicide
                                      attempters
                                      % of Total    9.8%    9.8%       4.1%                         23.8%
                           Surviving     Count       47      21         21         3            1     93
                            suicide
                          attempters
                                     % within Type 50.5%   22.6%      22.6%       3.2%     1.1%     100.0%
                                      of suicide
                                      attempters
                                      % of Total   38.5%   17.2%      17.2%       2.5%     .8%      76.2%
               Total                     Count       59      33         26          3        1        122
                                     % within Type 48.4%   27.0%      21.3%       2.5%     .8%      100.0%
                                      of suicide
                                      attempters
                                      % of Total   48.4%   27.0%      21.3%       2.5%     .8%      100.0%
 Female        Type of      Suicide      Count       17      6          15                            38
               suicide       death
             attempters
                                     % within Type 44.7%   15.8%      39.5%                         100.0%
                                      of suicide
                                      attempters
                                      % of Total    7.1%    2.5%       6.3%                         15.9%
                           Surviving     Count       104     38         53         6                 201
                            suicide
                          attempters
                                     % within Type 51.7%   18.9%      26.4%       3.0%              100.0%
                                      of suicide
                                      attempters
                                      % of Total   43.5%   15.9%      22.2%       2.5%              84.1%


                                                                                                    9
                    Total                        Count      121                        44                  68               6                239
                                             % within Type 50.6%                     18.4%               28.5%            2.5%             100.0%
                                              of suicide
                                              attempters
                                              % of Total   50.6%                     18.4%               28.5%            2.5%             100.0%




Marital Status: Nearly 77.8% of suicide attempters were married. Significant
variations in marital status by sex (male 29.5% vs. female 70.5%) were observed.



                                           M arrital status of suicide attem pters (n=361)
                                          U nmarried

                                          80.00 / 22.2%




                                                                                                   Married

                                                                                             281.00 / 77.8%




     Marrital status of Surviving suicide attempters (n=294)                     Marrital status of suicide deaths (n = 67)

        Unmarried                                                        Unmarried

                                                                         25.4%
        21.4%




                                                                                                                                 Married
                                                                                                                                  74.6%
                                                               Married

                                                                78.6%




Marital age of suicide attempters: Majority of suicide attempters got married by
the age of 15 years and 46.26% were married between ages 15-20 years.


Table 4. Marital age of suicide attempters
   Age group                                       No.                                                   Percentage
  11---15 years                                    134                                                     47.69%
  16---20 years                                    130                                                      46.26
  21--25 years                                      14                                                      4.98%

                                                                                                                                           10
  26--30 years                      03                                  0.1.07%
  31--40 years                      00                                    0%
      41+                            0                                     0%
      Total                         281                                  100%



Number of marriage in suicide attempters: Majority (80.43%) of victims were
married for the first time and only 13.43 % were married for the second and
5.43% for the third time.



Table 5. Number of marriage in suicide attempters

   No. of marriage               No. of attempters                       Percentage
          1st                           226                                80.43%
          2nd                            38                                13.52%
          3rd                            15                                 5.43%
         th
        4 ---+                           02                                0.71%
        Total                           281                                 100%

Occupation: As a whole agriculture (43.4%) is the frequent occupation in male
and housewife (79.5) in female (Table 4). Students, and daily labour are next
common occupation.


Table 6. Marital status and sex of suicide attempters

                                                                         Sex                      Total
 Marital                                                                 Male     Female
 status
  Married    Type of      Suicide death               Count               20        30       50
              suicide
            attempters
                                             % within Type of suicide   40.0%     60.0%    100.0%
                                                   attempters
                                             % within Sex of suicide    24.1%     15.2%    17.8%
                                                   attempters
                                                   % of Total           7.1%      10.7%    17.8%
                         Surviving suicide            Count              63        168      231
                            attempters
                                             % within Type of suicide   27.3%     72.7%    100.0%
                                                   attempters
                                             % within Sex of suicide    75.9%     84.8%    82.2%
                                                   attempters
                                                   % of Total           22.4%     59.8%    82.2%
              Total                                   Count               83       198       281
                                             % within Type of suicide   29.5%     70.5%    100.0%
                                                   attempters
                                             % within Sex of suicide    100.0%    100.0%   100.0%


                                                                                                    11
                                                    attempters
                                                    % of Total           29.5%    70.5%    100.0%
Unmarried    Type of       Suicide death              Count                9        8        17
              suicide
            attempters
                                              % within Type of suicide   52.9%    47.1%    100.0%
                                                    attempters
                                              % within Sex of suicide    23.1%    19.5%    21.3%
                                                    attempters
                                                    % of Total           11.3%    10.0%    21.3%
                          Surviving suicide            Count               30       33       63
                             attempters
                                              % within Type of suicide   47.6%    52.4%    100.0%
                                                    attempters
                                              % within Sex of suicide    76.9%    80.5%    78.8%
                                                    attempters
                                                    % of Total           37.5%    41.3%    78.8%
                  Total                                Count               39       41       80
                                              % within Type of suicide   48.8%    51.3%    100.0%
                                                    attempters
                                              % within Sex of suicide    100.0%   100.0%   100.0%
                                                    attempters
                                                    % of Total           48.8%    51.3%    100.0%




                                                                                                   12
Occupational status suicide attempters: As a whole agriculture (43.4%) is the
frequent occupation in male and housewife (79.5) in female. most of them were
unemployed (81.5 per cent). However, significant variation was found by sex and
employment. Among the female, only 8.4 per cent were employed (if we do not
consider housewives as employed). on the other, 57.1 per cent male were
employed who committed suicide (fig.) (see annex table 31 for more details).

Table 7. Occupation of suicide attempters


                                                                                      Sex of suicide attempters

                                                                                                    Total
                                                                               Male   Female
Occupation    Agriculture                      Count                         53          2          55
                               % within Occupation of suicide attempters   96.4%      3.6%        100.0%
                                  % within Sex of suicide attempters       43.4%       .8%        15.2%
                                             % of Total                    14.7%       .6%        15.2%
              Daily labour                     Count                         21          1          22
                               % within Occupation of suicide attempters   95.5%      4.5%        100.0%
                                  % within Sex of suicide attempters       17.2%       .4%         6.1%
                                             % of Total                     5.8%       .3%         6.1%
             Small business                    Count                          4                      4
                               % within Occupation of suicide attempters   100.0%                 100.0%
                                  % within Sex of suicide attempters        3.3%                   1.1%
                                             % of Total                     1.1%                   1.1%
             Van/rickshaw                      Count                          6                      6
                puller
                               % within Occupation of suicide attempters   100.0%                 100.0%
                                  % within Sex of suicide attempters        4.9%                   1.7%
                                             % of Total                     1.7%                   1.7%
                House                          Count                          6        190          196
             wife/activities
                               % within Occupation of suicide attempters    3.1%      96.9%       100.0%
                                  % within Sex of suicide attempters        4.9%      79.5%       54.3%
                                             % of Total                     1.7%      52.6%       54.3%
                Others                         Count                         17         20          37
                               % within Occupation of suicide attempters   45.9%      54.1%       100.0%
                                  % within Sex of suicide attempters       13.9%      8.4%        10.2%
                                             % of Total                     4.7%      5.5%        10.2%
                Student                        Count                         14         25          39
                               % within Occupation of suicide attempters   35.9%      64.1%       100.0%
                                  % within Sex of suicide attempters       11.5%      10.5%       10.8%
                                             % of Total                     3.9%      6.9%        10.8%
                Beggar                         Count                          1                      1
                               % within Occupation of suicide attempters   100.0%                 100.0%
                                  % within Sex of suicide attempters        .8%                    .3%
                                             % of Total                     .3%                    .3%
              House hold                       Count                                    1            1
                chores
                               % within Occupation of suicide attempters              100.0%      100.0%
                                  % within Sex of suicide attempters                    .4%        .3%
                                             % of Total                                 .3%        .3%
  Total                                        Count                         122        239         361
                               % within Occupation of suicide attempters   33.8%       66.2%      100.0%
                                  % within Sex of suicide attempters       100.0%     100.0%      100.0% 13
                                             % of Total                    33.8%       66.2%      100.0%
Determinants of suicide attempts: The present study identified a number of
determinants of suicide among both male and female. We detected approximately
22 determinants (risk factors) that played a role to go for a suicide attempt that resulted
in deaths of many people. We identified more than one determinant in many cases. The
key determinants are as follows:


Table 8. Determinants of suicide attempts in Jhenidah (2002-2005)


      No.                  Determinants (Causes)         Number Percentage
       1.     Familial dispute                             298     31.50
       2.     Underestimation/ Negligence by family        188     19.87
              members
       3.     Misunderstanding & dispute between           162     17.12
              spouse
      4.      Poverty                                      120     12.68
      5.      Illness                                       35      3.70
      6.      Dowry                                        28       2.96
      7.      Failure in love                              25       2.64
      8.      Torture physically and mentally               21      2.22
      6.      Disable & abnormal physically and mentally    19      2.01
      7.      Illicit love                                  13      1.37
      8.      Polygamy                                      12      1.27
      9.      Debt                                           6      0.63
      11.     Biological & physical harassment               4      0.42
      12.     Resisting love affairs by family               4      0.42
      13.     Economical scarcity                            3      0.32
      17.     Childhood marriage                             3      0.32
      18.     Fear                                           1      0.11
      19.     Accused without committing fault               1      0.11
      20.     Kabin Nama related                             1      0.11
      21.     Loss in business                               1      0.11
      22.     Unknown                                        1      0.11
      23.     Total                                        946     100%


Frequency of determinants/ risk factors of suicide attempts: Among the
suicide attempters the key determinants or risk factors were family dispute/feud
with family members were 31.50 per cent, dispute with husband 17.12,
underestimation/negligence by family members 19.87, poverty 12.68 per cent,
illness 3.70 per cent, dowry 2.96 per cent and failure in love 2.64 percent (Table
6).
Modes (Means) of Suicide: Insecticide (58.7) was the most popular means
closely followed by hanging (37.7). These two consists of more than 90 per cent

                                                                                        14
of the modes used. Similar pattern was observed in both sexes.                                                                                         Suicide
attempters took insecticide as a means of suicide because it is easily available in
the house as mentioned by 65.4 percent of the respondent. It was also easy to
die by taking insecticide.


                    Means of suicide attempts in surviving cases                                        Means of suicide attempts in dead cases
              180                                                                                  50
                                                       Means of suicide in
              160                                      surviving cases                                                                  Means of suicide in dead
                                                                                                   40                                   cases
              140
                                                       Means         Frequency (%)                                                      Means         Frequency
                                                       Hanging       114 (38.8)                                                         Hanging       22 (32.8)
              120
                                                       Insecticide 171 (58.2)                      30                                   Insecticide 41 (61.2)
              100                                      Sleeping pill 3 (1)                                                              Sleeping pill 1 (1.5)
                                                       Others        6 (2)                                                              Other         3 (4.5)
               80                                      Total         294 (100)                                                          Total         67 (100.0)
                                                                                                   20

               60




                                                                                       Frequency
               40                                                                                  10
  Frequency




               20
                                                                                                   0
                0                                                                                             Hanging    Insecticide   Sleeping pill    Other
                           Roap/shari   Insecticide    Sleeping pill   other

                                                                                                        Means of suicide attempts in dead cases
                    Means of suicide attempts in surviving cases


Figure 1. Means of suicide attempts in all cases
Time of Suicide: More cases (37.31%) choose morning time followed by night
(22.39%), afternoon (17.91%) and noontime (11.94) for committing suicide
attempts.
Triggering factors for suicide attempts: Anger is the commonest triggering
factor for attempting suicide in 88.6% of surviving suicide attempters flowed by
helplessness, shyness and protest against something Table ).

Table 9. Triggering factors for suicide attempts
     Factors                                    Frequency                            Percent                               Cumulative Percent
   Helplessness                                     13                                 4.5                                        4.5
     Shyness                                        9                                  3.1                                        7.6
  Protest against                                    5                                 1.7                                        9.3

              Anger                                   257                              88.6                                              97.9
              Others                                   6                                2.1                                             100.0
                                                      290                             100.0


 Status after suicide attempts and treatment approach in suicide death cases:
 Majority (62.69%, 42 of 67 cases) of the suicide death cases were alive after their
 attempts and all most all of them were hospitalized for the treatment. However, All
 died in the hospital.


                                                                                                                                                                15
Violence against Women and Suicide: Violence against women was common in
suicide attempters like all other studies.
Socio-Economic status: It is also appeared from the present study that socio-
economic condition such as poverty and skill significantly affects the number of
suicide attempts. Thus, 21% of suicidal attempters were very poor and can’t afford
three meals per day. Person skilled in their profession or activities took more suicidal
attempts than diseased and disabled persons (Table 7).


Table 10. Physical and poverty status of suicide attempters


      Status          Frequency                          Percent
   Not very poor         285                               78.9
    Very poor             75                               20.8
    Unknown               1                                 .3
       Total             361                              100.0
  Skilled person         295                               81.7
     Disabled              5                               1.4
    Diseased              34                               9.4
      Others              23                               6.4
  Mental disorder          4                                1.1
       Total             361                              100.0




Fate of suicide attempters: Of 361 suicide attempters, 67 (18.6%) died. Of them 38
(56.7%) were female.


7. DISCUSSION/COMMENT
SOVA just completed base line survey on rural people who committed complete
suicide & attempted to commit suicide in a period of three years in southwest part of
Bangladesh. Many interesting points were observed. During the last three years 361
persons attempted to commit suicide, 62.33% of them are women. In case of
complete suicide 56.7% were women. The study area is a very densely populated
area (588 people/per square kilometer). Most of the people are poor and a many of
them are really unable to have three meals a day. The rate of complete illiteracy was
very high (50.41%) among victims. Most of the primary stakeholders were engrossed
in superstition and the rate of them was 42.06%. It is especially mentionable that
about 78.95% people are directly related to cultivation of land, daily labour and




                                                                                       16
household works, of them 21.05% are day labour. Of all the attempters, the majority
was married showing the vulnerability of married women.


Bangladesh like countries of the South-East Asia Region (SEAR) is witnessing rapid
changes in population growth, socioeconomic development and health profiles.
Suicide is now being recognized as a major public health problem in the complex
scenario of development and lifestyle changes. In the socio-culturally diverse
communities of this region, suicide is a very important issue cutting across diverse
disciplines and sectors such as health, religion, spirituality, law and welfare. Suicide
evokes mixed reactions: varying from anger, distress, ridicule, anxiety, tension, fear
and sadness. Often, one wonders: "Why did it happen?"; "Could this have been
prevented?"; "Can young lives be saved?"; "Was there an alternative solution to the
problem?" Though suicides and para-suicides have been attempted since the
beginning of mankind, a sea change has been observed recently in our understanding
of the problem. Cumulative research, media reports and anecdotal evidence over the
past three decades reveal that suicides are an emerging epidemic the world over.
Research in different regions of the world has focused on understanding the problem
in its various dimensions. Today, it is not impossible to predict and prevent suicide.


The findings of this report suggest that suicide is an important cause of death within
this rural surveillance area, indicating that self-inflicted death represents a public
health concern, especially for young females. The rates of suicide-associated death
were higher within the surveillance area than rates recently published from China and
from Hong Kong (Special Administrative Region), Turkey and Sri Lanka. Rahman MH
(1998) in his research study “Atmohottyar Artho samajik O monostattik karon (in
Bangla)” identified causes of suicide in a sample survey carried out in Jhenidah
district. The common determinants of suicide were the poor economic condition
(50%), family problem and feud (26%), problems between spouse (23%), lack of
socialization (11.1%), dowry and lack of educations (10%), deterioration of social
value (8%), polygamy and easy availability of poisonous chemical substance. In
another study on suicide by Islam AMMF (1999) it was observed that the average age
of suicide was 27 years with a range between 10 to 85 years. Common age group
includes people of age ten to thirty years. Suicide cases were comparatively higher
(55%) among people who were married, illiterate and poor. Poisonous substances


                                                                                         17
were the popular means for suicide. Karim J (1995) in his study pointed that suicide
cases are on the rise and most of cases are mainly socio-economic and ideological.
Population-based surveillance in a rural community in southwest Bangladesh revealed
that suicide is a major cause of mortality, especially in young females. Mortality from
suicide occurred at a rate in female. Suicide-associated death rates from this
surveillance area are substantially higher than rates reported elsewhere in Asia,
warranting further studies aimed at identifying risk factors for suicide and strategies for
prevention. The reasons for the high rates are not clear and warrant further study.


While suicide represents a substantial and under-appreciated problem in South Asia
insufficient data are currently available to know whether high mortality rates described
in this report are representative of suicide rates elsewhere in Bangladesh, particularly
within urban areas where factors linked to suicide may be dissimilar from those in
rural areas or occur with different frequency. In China, suicide rates appear to be
three-fold higher in rural areas than in urban areas (2). Population-based data from
health and demographic surveillance systems (like that in Abhoynagar and
Keshobpur) elsewhere in Bangladesh will be helpful to ascertain impact of geographic
location and population density on suicide incidence and risk factors for suicide, and
to make it possible to reliably estimate country-wide burden of disease for suicide.


Prevention of suicide, while potentially effective, is challenging, requiring multifaceted
approaches and adaptation of strategies to locally relevant cultural factors.
Demographic characteristics of victims suggest the need for a variety of prevention
strategies. Issues that will need to be addressed are likely quite different for
adolescent females, who accounted for a substantial proportion of mortality, than
older, employed males. For instance, violence against women and suicide attempts
may be interrelated; thus, it may be necessary to address fundamental factors
responsible for the former in order to successfully prevent the latter. For cases
referred to as suicide in this report, information collected during post-mortem family
interviews clearly indicate self-inflicted death; however, the possibility that some
deaths might represent homicide (for instance, deaths falsely described to
interviewers as suicides) cannot be ruled out with available data—this complicates the
interpretation of the data and broadens the scope for future studies and potential
interventions.


                                                                                          18
Young, first-time-married women took easily available residual insecticide kept at
house for committing suicide on many occasions. The social and financial impact of
suicide was huge and had multidiscipline problems. Ongoing and future works involve
preventive approaches (Village dispute regulation committee, courtyard meeting,
income-generating trainings and means) that include broadly promotion of rational use
of insecticide without storage in the house, public awareness, good governess,
prevention of childhood marriage, empowerment of women and reduction of violence
against women by useful and relevant means in primary target group (women,
students) and secondary target group (family members, resource persons, community
leaders) in the study population in order to reduce the burden of suicide. Further
studies will be needed to more closely examine underlying factors responsible for
suicide and characteristics predictive of suicidal death, and to identify opportunities for
contact with a physician or mental health services before suicide is contemplated or
attempted.




  An approach for the prevention of suicide




8.0 Use of Study Findings:
     In light of findings some strategies need to be develloped such as:

                                                                                          19
Preventive measures including- a. Courtyard meeting, b. Distribution leaflet, poster,
sticker, c) Organizing and arranging rally and drama, d) Village dispute regulation
committee (VDRC) formation with an aim at reducing familial and social disputes by
which suicide rate might be ultimately reduced.
Training Session: All VDRC members will be trained up and the committee is to made
self-sustainable.
Legal aid support: It is to be ensured that legal aid support on basis of findings should
be provided by establishing liaison with Madaripur legal Aid an NGO that provides
legal aid support in the study area in collaboration with Local Government.
Income generating trainings and means for women
Awareness campaign students who form a large proportion suicide attempters


9.0 Recommendation
Ensuring education (especially vocational and technical) equally for both sex.
Economic empowerment of women through more women specific income generating
works, skill training handicrafts, weaving, starching and marketing of products.
Stronger local govt. specific role of women leaders members in the local govt. leaders
separate portfolio for them.
Closely monitoring and follow up the marriage process through proper registration,
controlling child marriage force marriage, polygamy in our project area.
As a grand member of people use poison as a means all poison dealers need to be
conscious or make them conscious about to whom this poison is being sold.


10. Future Activities:
We have a plan to make a trainer motivator and counselor for all community /para.
To raise strong voice and to reduce the suicide trends of mass people VDRC
members will know more information about laws to prevent the violence against
women, child rights convention and human rights.
Prospective data will be collected.
Case study will be done in order to publish in the daily newspaper to create interest on
life and greater awareness for mass people.
A TOT course will be developed by a core training team (from VDRC groups) on
human rights and violence against women and empowerment of suicide attempters.


                                                                                        20
We think it will be helpful to cover and support for smooth functioning of greater
awareness raising program at the union level.
Income generating trainings and means for women
Awareness campaign students who form a large proportion suicide attempters




                                                                                 21
 14 February 2006


 To
 Ms. Bansree Mitra Neogi
 Program Officer
 Manusher Jonno
 House # 122, Road # 1, Block J
 Banani Model Town
 Dhaka

Subject: Base line Survey Report on Project “Surveillance and Reduction of Women’s
Suicidal Trends in Jhenidah: A Hot Spot with High Suicide Rate in Bangladesh”

Dear Sir,

Please find the Base line Survey Report on Project “Surveillance and Reduction of
Women’s Suicidal Trends in Jhenidah: A Hot Spot with High Suicide Rate in Bangladesh”
for your kind information and necessary action. It contains results of retrospective survey
data of our study area with broad ideas on future activities.

We hope to submit a complete report once our project is complete. Your valuable
comments and suggestions will enhance our activities in future.

Thank you,


Yours sincerely




Dr. M. Rahman
Chairman




                                                                                        22
23

								
To top