20 January 2013

Rwanda: With Suicide Cases On the Rise, Prevention Is Required

In Nasho sector, Binyagu Ndaribonye, 36 was found dead by neighbors, his body hanging from the ceiling of his house. The police report an alleged history of alcohol abuse. By the time he hanged himself he was about to celebrate 37 birthday.

One of his intimate friends Jean Damascene said he was shocked by the death. "My friend was rather depressed but he was so secretive, he had built a wall around himself and he really spent much time drinking alcohol," he said.

A newly-released police report indicates that 290 cases of suicide were reported in 2012 across the country. The report says causes include family conflicts, land conflicts, as well as social and economical problems.

Yet Police spokesman Superintendent Theos Badege said that cases of suicide are still relatively limited, and that if counsel is sought in time and provided many deaths cases could even be avoided.

Globally, every year, almost one million people die from suicide, one death every 40 seconds. Already in 1993, the eminent Dutch sociologist Diekstra stated that the most dramatic increase in suicide mortality in the next decades will be observed not in the developed world but rather in the developing countries.

"People need someone to facilitate their healing by listening to them with empathy not sympathy. When they feel supported and loved, they can once again find a reason to live."

Humphrey Mutezimana, a psychologist and a lecturer at Mount Kenya University, defines suicide as the act of intentionally causing one's own death. "It is often committed because of factors such as despair which may be caused by depression, alcoholism and drug abuse. It could also be caused by poverty or financial difficulties, poor interpersonal relationships, loneliness, unemployment and poor mental health," he said.

Mutezimana also mentioned that in developing countries, warning signals are frequently overlooked, due to ignorance but also because families and subjects do not know how to read the symptoms.

He added that symptoms can consist, among others, of feelings of guilt and self pity, especially when people are suffering from depression, when they feel that life has nothing to offer to them. A specific tell-tale sign, the psychologist said, would be someone who always speaks in the past tense, as if to remove himself from the picture. "Some do it to try to punish their parents or loved ones," Mutezimana explained.

He advised that whenever someone is in a state where he could take his own life, it is important that they can talk to someone they trust or a healthy officer. "People need someone to facilitate their healing by listening to them with empathy not sympathy. When they feel supported and loved, they can once again find a reason to live," he said.

Mutezimana observed that there is an urgent need for a program of suicide prevention to address the high prevalence of psychological distress among people. "The concerned authorities need to carry out awareness country-wide and sensitize the people, and the few psychologists we have in the country ought to volunteer," he remarked.

Dr Yvonne Kayiteshonga, the head of the mental health division at the Rwanda Biomedical Center (RBC), said that that suicide cases in Africa in general and Rwanda in particular are not very common compared to Europe, America or Asia.

"In the ministry of health report 2011, we received 94 such cases. This represents 0.82 per 100,000 people," she said, adding that police reports frequently highlight domestic disputes and financial problems as the underlying cause of most suicides, while mental illness is rarely mentioned or is involved in only a small number of suicides.

As for prevention, Kayiteshonga explained that that this is not something the ministry of health can do single-handedly. "It is widely accepted that suicide is a societal issue and that no single government department can tackle this issue on its own," she explained. "The government has a cross-departmental approach reflected in the national social protection services that fight poverty, involving supporting organizations in delivering positive mental health and wellbeing messages and providing community-based health checks in rural areas."

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