A means to an end

Rarely have poverty-reduction structures that solely depend on political patronage worked in the developing world. Sri Lanka is no exception except that a much-abused poverty reduction programme here seems to have its good side too.

Samurdhi, criticized by the World Bank as only marginally helping the poor, earned praise recently when the efforts of its officers were singled out as the main reason for the suicide rate in Sri Lanka dropping by almost half two years ago.

Nalini Ellawela, director of Sri Lanka Sumithrayo, a local unit of Befrienders International, said that the number of suicides (8,500 deaths in Sri Lanka in 1995, the highest in the world) dropped sharply to 4,995 in 2001 apparently due to a series of government interventions.

"Although I have no researched document to prove that the change in the suicide statistics were because of these interventions, I have good reason to believe that the commitment of the majority of trained Samurdhi officers has indeed made the difference," she told a recent national convention on suicide prevention in Colombo.

Sumithrayo is part of a global network that befriends troubled people and helps them cope with crises. Ellawela has been working on suicide prevention measures and other issues for more than 30 years and is a member of the Task Force on Suicide Prevention set up by President Chandrika Kumaratunga in 1995 to find ways of reducing the suicide rate.

Most suicides are precipitated by love affairs, poverty, parental pressure on marriage, unemployment, unwanted pregnancies, failure at examinations, fear of punishment, inability to pay loans and in recent years, women going to the Middle East to work leaving behind a host of unresolved social problems.

Other experts however said that though the death rate had fallen, the number of suicide attempts was still high and alarming. "The death rate has fallen possibly due to better transport when taking victims to hospital and good hospital management of the problem. But the problem is still acute," noted Lakshmi Ratnayake, former head of Sri Lanka Sumithrayo and now heading the agency's unit dealing with rural communities.

She said although there was no national data on the rate of attempted suicides (because the police -the collector of such data in the country- only record the number of deaths from suicides), suicidal behaviour in rural communities still remains a problem.

Ratnayake, currently involved in a study on the relationship between suicidal behaviour and alcohol use in the Panduwasnuwara village in the country's north-central region, said poverty was one of the reasons for attempting suicide.

"I am talking of the poverty where one lacks the basic needs to sustain life, like food, water and shelter that is to be seen in many rural communities. It is difficult for urban dwellers like us to understand this because our concept of poverty would be different," she told the second national suicide convention organized by the Sri Lanka Foundation Institute.

According to the ongoing study, Ratnayake said researchers interviewed 50 villagers who had attempted suicide, and the families and friends of those who had died, and found that women suffered the most. Of 23 attempts by women, none died. The attempts were triggered by physical and sexual assaults by husbands. The women were named and shamed in public.

Twenty-seven men attempted suicide and four subsequently died. The research team found that almost all these attempts were alcohol related. Ratnayake said that alcoholism amongst women was not seen as a factor for women attempting suicide.

Researchers from Lankan universities, studying the phenomena of suicides, found that the community as a whole believed that suicide was an accepted way of solving problems. "We often hear the comment 'there's no point in living' by individuals in society when confronted with problems," noted Dr. Damani de Silva, a psychiatrist at the University of Colombo, who was in the three-member team leading the research study.

More than 200 people were interviewed in the sample and it was found that some of the ideas and values that encouraged this behaviour (apart from the community endorsement) were; verbal or physical aggression being seen as a way of resolving differences and societal explanations for suicidal behaviour in instances where a psychiatric disorder was a likely cause.

De Silva said they found that women, who considered their role as homemaker a key element of their duties, justified the abuse hurled by spouses, as they felt responsible for everything that happened at home. "Some women are trapped in gender related beliefs. They feel they are objects to be used by men," she said adding that the suicide rate among women is higher than in men.

She said some of the interventions the study has recommended are de-institutionalizing violence within structures like the family unit, schools and political parties, urging mass media to promote the view that suicide is not a way of solving problems and empowering women.

Mass media was also blamed for inadvertently promoting suicide by sensationalized reporting and eye-catching newspaper headlines that create a copycat syndrome. Here young people read and learn of ways of committing suicide through newspaper reports. When faced with a personal crisis they copy these methods of suicide.

Sunanda Deshapriya, well-known rights journalist and director of the media unit at the Centre for Policy Alternatives (CPA), said that Sri Lankan media seem unable or unwilling to explore the root causes of suicide.

This has resulted in a media that is numb to the effects of irresponsible reporting, he said, adding that in a study carried out with editors of newspapers it was found that newspapers had no guidelines for reporters on how to report suicides. "Every single article (that we monitored) clearly showed the method used in the particular suicide. Mainstream media show no interest in exploring the series of events that led to the suicide and instead explain the suicide as a result of a single event or at best, a simplistic chain of events," he said.

The Samurdhi programme was recently criticized by the World Bank citing poor targeting. It said there were many "affluent" recipients in the programme because of their political affiliations while many poor people were left out from the social welfare net, again due to political reasons.

But Ellawela said some 450 Samurdhi officers showed exceptional commitment after they were trained to implement the national suicide prevention policy enunciated by the presidential task force.

With pesticides being one of the biggest means of suicide, these officers were asked to reduce easy access to poison whereby they visited chemical sales outlets sensitizing traders and alerting farming communities on safe storage. Kaneru, a poisonous fruit that grows wild in villages and considered after pesticides as the most common means of suicide, came under their scrutiny. They persuaded people to keep Kaneru bushes well trimmed so that this fruit would not be readily available.

Education and awareness programmes engaging the support of the media - by minimizing irresponsible reporting through regular contacts with provincial journalists - were some of the other initiatives taken. Medical intervention was also important with Samurdhi officers creating awareness among hospital staff to treat victims with care and not appear judgmental.

"When we started working with Samurdhi officers, we were faced with a problem. The community had little respect for these officers, as they were political appointees. Our task was therefore to introduce them to concepts of personal growth and help them to develop their own coping skills and efficiency levels," she said.

In time these officers responded to these goals and the people’s sense of disillusionment and dissatisfaction in the recruits was seen to recede.

Ellawela proposed the setting up of an independent centre for research and training of educators for social well being that can deal with common social concerns like suicide, child abuse, drug use, violence against women and children, physical and mental disabilities, etc.

She said the way forward was through research and it was time that "we" move away from the compartmentalized approaches that have been adopted in the past to tackle these issues.

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