Volunteer intervention in suicide-prone communities brings positive results
I will attempt to share with you my work experiences at the grass roots level, in suicide-prone remote rural communities. These communities live under stressful conditions where most of the recognized suicide risk factors are a constant presence. These factors include poverty, extreme poverty at times. Poverty, I know, is relative but the poverty I refer to is the absence of the essential pre-requisites to sustain human life, such as food, clean water and safe shelter. There are also very few social support systems in remote rural areas.
Sumithrayo: Where help is always at hand
Other factors present in these communities are unemployment, pressures from loan sharks, alcohol abuse, physical and sexual abuse of women and children, social isolation, mental health problems such as depression and other mood disorders with very little specialized help available, physical disabilities and ill health such as cancers, kidney disease and congenital heart and respiratory problems in children. In addition to this, there is easy access to the commonest means of suicide in the country – very lethal means, such as agricultural poisons and the Yellow Oleander (Oleander Nerium) seed, (known locally as Kaneru). Pesticides are freely available in most village homes, as most of the villages are agriculture based and the deadly poisonous Yellow Oleander grows in every village garden and along most village paths. In the past few years, hanging has become the most common method of suicide where lethality is 100%.
A high literacy rate in the country of almost 92%, encourages high expectations, and this coupled with no employment opportunities in the villages, and exposure to the supposed existence of greener pastures in the electronic and other news media, acute awareness of their own poverty and lack of hope of a better future, all contribute towards extreme frustration, alcohol abuse, depression and suicide.
Considering suicide in the rural communities, poverty and gender inequality stand out as important community and societal factors. In rural communities there are marked inequalities between men and women. Rural women and children have no voice; cultural norms demand this. What is surprising is that in spite of this, on an average 4 to 5 times as many men as women kill themselves in these villages, presenting a higher ratio than shown in the National suicide figures. But when it comes to attempts, men and women are on par. As many women as men attempt suicide, though deaths are much fewer.
Volunteer intervention in these suicide- prone communities brought in unexpectedly positive results, far beyond our initial hopes. The paradox is that the volunteers did nothing more than offer emotional support to the sad, the lonely, the distressed and despairing in the village communities. They visited the rural hospitals in their work areas and befriended those who had survived attempts at suicide. They followed up with home visits wherever possible on a regular basis and mingled with the other villagers at random, building up friendly trusting relationships, talking about common difficulties people are faced with, and the feelings of not being able to cope with life. The volunteers’ attitude was always non-judgmental and accepting of all situations and all peoples. Suicide and suicidal feelings were freely discussed without embarrassment or reservation and also how one could cope with these feelings with the help of an understanding person. The crisis intervention services available to them were discussed and where and how they could reach out for help.
On the prevention side, the volunteers hold regular suicide awareness meetings, for the villagers as well as for specific target groups such as village school children, rural youth and farmers.
Twenty years of volunteer intervention in the suicide-prone rural communities in Sri Lanka has paid very good dividends. Completed suicides and acts of self harm in the suicide-prone villages where we work (over 110 villages in 2 provinces of the country), have reduced by 75% and in some villages where we have worked the full twenty years, success is over 90%. Once again volunteer intervention is invaluable. The greatest advantage the volunteer has with those who are distressed is that he or she chooses to be physically there and this somehow gets through to the people we are trying to help. They instinctively trust us. Volunteers are there, not because they are paid or materially rewarded in any way, not because they feel morally obliged to help, nor because they are forced in any way to do so. They are there because they care about their fellow human beings and what they are going through.
WHAT REALLY MATTERS IS: “When the soul seems dead and all the world a wilderness, when our hearts are dry and brains barren, what brings us hope and solace is not analysis or criticism but love and friendship.”
(S. Radhakrishnan, Hindu philosopher and writer)
The lack of suitable human resources and adequate financial help remain the biggest constraints that limit the extent of the work of volunteers in suicide prevention and their invaluable work in the suicide-prone rural communities. If rural suicides are to be reduced and suicidal behaviour in the remote villages contained, we will need more attention paid by the state and adequate financial help from the public and mercantile sectors towards meaningful suicide prevention measures to be taken. Is it the fact that choices are limited that makes us blind to this terrible tragedy?
While suicide is a non-acceptable cause of death, it is common and many within our country are affected by it and the impacts are widespread and devastating. Suicide and suicide prevention are topics of public interest and the print and electronic media can play an invaluable role in creating general awareness on suicide and the need for society to play a more active role in crisis intervention and the prevention of suicide.
According to the WHO, almost a million people die by suicide every year. Roughly one person dies by suicide every 40 seconds, making suicide one of the leading causes of death in many countries in the world. More people have died by suicide in Sri Lanka, within the last two decades than those the separatist war killed in twenty years.
Sri Lanka Sumithrayo is a volunteer based organization dedicated to the primary objective of preventing suicide. Sri Lanka was reputed to have a very high suicide rate of 47/100,000 in 1995, the highest in the world, but over the last twenty years the national rate has slowly come down to 15/100,000 by 2016. Unfortunately, the suicide rates in the rural areas have not shown a similar decline, and it has been found that over 75% of the suicides in the country occur in these rural communities.
For contact details of all Sumithrayo facilities, please call 2682535 or e-mail slssumithrayo@gmail.com
-Lakshmi Ratnayake (Founder Director, Sri Lanka Sumithrayo Rural Programme)