 KIRAN PANDAY |
People think it's a joke when you tell them that a place as beautiful as Ilam has the highest rate of suicides in Nepal. It's a fact: this corner in the far east of the country famed for 'kadha rang, meetho swad' tea also has the bitter taste of suicide in its soil. The trend has become so common that locals barely spare a glance for the large hoarding board against suicide placed in the centre of Ilam bajar. Nowhere in Nepal will you see another like it. Six years ago, when the district police headquarters organised an 'Awareness against Suicide' program in several towns, Ilam was identified as having the highest rate of suicides not only in the district but in the country.
Suicide almost Normal
Statistics show that in the past eight years there have been almost 500 suicides in Ilam. In a year alone, the district headquarters records more than five dozen suicides in Ilam. DSP Tej Jung Thapa says, "Suicide has almost become normal here."
The list of suicides over the past few years is surprising. An 18-year-old killed himself because his father refused to give him the keys to the motorcycle. A 14-year-old died while experimenting with how people hung themselves. Even a staunch anti- suicide campaigner, Yan Bahadur Siwahoti, chose to end his life. While a suicide prevention workshop organised by Namsaling Social Development Centre (NCDC) was taking place in 2000, Khem Bhattarai, nephew of NCDC psychological department employee Bhopal Khatiwada, killed himself.
The most common way people commit suicide is by hanging, followed by poison, self-immolation and the use of weapons. "Death by hanging is popular because the chances of survival are minimal," DSP Thapa tells us.
25/100,000
The global suicide rate is 16 out of every 100,000 people. In Nepal, according to police statistics, 10 out of 100,000 commit suicide but in Ilam, the number is an alarming 25 for every 100,000.
This is a serious cause of concern for the locals and they are now discussing the reason behind this increase and trying to organise programs to prevent suicides. Pramod Syanbho, a psychiatrist working with the BP Koirala Health Science Academy, believes that anti-suicide programs being run by NCDC are the first in the country. "It is also beneficial for government surveys on the psychological health of the people," he says.
Julie Kush heads a program that monitors mental health within the community through the Youth Ambassador for Development Program from Australia. While suicide has been called a disease of the rich, Julie's study shows that Ilam's suicide rates are no less than that of a developed nation.
So does that mean we inherit a lurking 'suicide gene'? Case in point, the unfortunate Chipalu family– after his wife killed herself by self-immolation, the husband hung himself. Following this, their daughter committed suicide and the only remaining member, a son, has already attempted to kill himself once.
Dr Anupam Pokherel of the BP Koirala Research Academy says that even though mental instability is the main cause for suicide, this is not always the case. Social factors like unemployment, poverty, marital disharmony and love gone wrong are a just a few of many other suicide triggers.
Renowned journalist Dharma Gautam believes suicides are increasing with the demands of a rising middle class. He points to high suicide rates in the district headquarters and the fact that people buckle under the pressure of keeping up appearances while making sure the basic needs are met. He might have a workable theory because Shri Aantu, the second most developed VDC in Ilam, has the second highest rate of suicide after the district headquarters.
Prakash Adhikari of INSEC, a human rights organisation, says socio-economic and cultural disparities affect many young people. "The youth of Ilam are directly influenced by neighbouring Darjeeling and this causes envy and mental anguish that could lead to suicide."
Police statistics seems to support the above theories - 65 per cent of suicides are committed by people from lower middle or middle class backgrounds.
It's a well documented fact that people deprived of sunshine often are depressed. While Ilam has an occasional burst of sunshine, fog is a constant every day all year. Dr Syangbho believes there is a direct correlation between the lack of sunshine and deep depression that could lead to suicide. He adds that more research is necessary.
Help
Ilam has one hospital and three doctors, none of whom are psychiatrists. Nearly a dozen suicides are brought in to the hospital every month but proper post mortems are not being done. The two peons of the hospital, Bahadur Adhikari and Til Maya, do what they can and earn Rs 1,000 per post mortem.
Dr Syangbho says the lack of a proper post-mortem is another reason why the large number of suicides in Ilam remains a mystery. Not everyone leaves a suicide note and there is even the possibility that murders are being passed off as suicides. The police claim that no such complaints have been registered.
Besides NCDC and the Sungabha Club, no other organisations work in mental health. The BP Koirala Health Science Academy has picked Ilam as a research centre and sends a psychiatrist once a month. This is not even close to addressing the needs of the people. Dr Pokharel is convinced that the suicide rates will fall if people had access to appropriate diagnosis and treatment. "Ilam desperately needs a crisis centre and even a telephone hotline to help people in emergencies," he adds. The gaps in the mental health system can be filled by trained social workers, according to Dr Syangbho, "Even if all they could do is tell people that they may be susceptible to mental illnesses, it would help a lot."
Julie Kush says the lack of awareness is the reason behind the rise in suicides and that she doesn't see this trend stopping any time soon. The lack of research further aggravates the situation. "If this carelessness continues then suicide will become a fashion trend," she says.
Ilam has always been famous for its alaichi, amriso, adhuwa, aolan and ankora. It's a pity that now it's becoming infamous for a sixth – aatmahatya.
Suicide's Domino Effect
Gobasti has a bad reputation. This little hamlet of 25 houses has experienced an alarming spate of suicides in the past two years. Hima Shivakoti, 19, killed herself, followed by social worker Man Bahadur Shivakoti, 60, who was fond of telling people that suicide was wrong. A few months later, his 65-year-old neighbour, Poudyal, committed suicide. South of where Poudyal's house stood, 25-year-old Netra Trikhatri hung to death after a quarrel with his wife. Then Bishnu Maya Shivakoti, 57, who consoled the bereaved Trikhati family, killed herself. The saga ended finally with the suicide of Bhattarai, 57.
It's the survivors who are left trying to put back the pieces of their lives. Bishnu Maya's husband recalls, "We talked normally that evening, there was no family dispute or anything – maybe it was just fate. In such a small locality when neighbours kill themselves one after the other it's just like they are daring each other – if he did it, why shouldn't I?" Bishnu Maya is survived by her husband, four daughters, one son and a grandson.
* This article originally appeared in issue #114, June 2005. All statistics are based on research conducted in 2005.
