Slow suicides in Samoa

By Ulafala Aiavao

WESTERN Samoan officials trying to combat the country’s high suicide rate want to revive a suicide awareness programme and limit access to the weedkiller paraquat.

Paraquat is the most popular suicide method in Western Samoa, and one of the most agonising, with some taking several days or more than a week to die.

Since the first paraquat suicide was recorded here in 1973 more than 277 Samoans have died by paraquat alone.

Last year Western Samoa (popu lation 160,000) listed 27 suicides, 19 of them by paraquat. Medical statistician Vili Ropati told a seminar in Apia in May that statistics in past years may be under-reported because data from rural medical centres was incomplete. Nurses in charge of' district centres often list of paraquat poisoning as renal failure, because they are only required to list the final diagnosis.

The worst year for suicide statistics

was in 1981 when au thorities recorded 49, (including 39 by para quat). The rate of suicide for young males aged 15 to 24 years was three times higher than the same group in the next highest country.

The suicide rate, and number, has declined since the 1981 high but “It is still too high. ' said Dr David Parkinson, the World Health Organisation (WHO) resident representative in Apia.

Officials are; aware that the high suicide rate is not reflected in the large Samoan communities overseas, but there are no easy answers to explain why. Attention is now being shifted to preventive programmes.

Dr John Bowles, a WHO consultant at the seminar who worked in Western Samoa in 1981 to 1984, has suggested better controls on access to paraquat.

Agriculture officials have resisted calls for a ban on paraquat, widely used as a weed control method by farmers. The Agriculture Department argues that removing paraquat only makes a poten tial suicide seek another method.

Dr Bowles told the seminar that this is not necessarily the case. He said that in England in the 1970 s a popular suicide method was to stick one’s head in a gas oven. The fuel suppliers switched from coal gas to North Sea gas which Dr Bowles said had no carbon monoxide. There was no jump in suicide

It sometimes expresses anger, isolation or a need to escape

by other methods, when the fuel switch was made.

“Western Samoa is the second country to show this,” said Dr Bowles.

Statistics support him at the moment.

When paraquat suicides declined after the 1981 high, there was no appreciable rise in suicide by other methods such as hanging, shooting and

poisoning. Nobody knows how long this

will last.

Suicide prevention programmes will face obstacles. Samoan culture frowns on young people who ask questions of their elders. This causes problems for programmes aimed at encouraging people to seek outside help when they are under great stress. Another problem is that publicity about suicide deaths is sometimes blamed for “copycat” suicides.

Officials know that nearly half those who take paraquat actually survived because they spat out the tiny amount they held in their mouths, or because the liquid was in a very diluted form. But they prefer to leave this fact out of the prevention programmes as it is easy to

miscalculate what con stitutes a fatal dose.

Increasing stress on Samoans has been blamed on various fac tors, including rapid

social changes,

breakup of extended family units via mi

gration, inability to communicate problems. . . even a three-month public servant’s strike in 1981.

The senior nurse in charge of the WS Health Department’s psychiatric ser vice, Sister lokapeta Enoka, listed several categories for those who use, or try to use, suicide as a means of communicating. For some, suicide is a means of expressing emotions of anger or loneliness. Others use it to gain attention or escape marital, financial or social situations.

Some fieldworkers worry that a few potential suiciders view suicide as an acceptable way to resolve a conflict. The theory here is that Western Samoa’s devout Christianity may, by perverse logic, lead a troubled person to view Christ’s sacrifice for the world’s sins as an example i.e. taking a burden with them and being admired for it. The theory fails to explain why such a person ignores the strong opposition of any church to suicide.

Survivors of suicide attempts often say they did not really want to die. The challenge is to convince the small group with suicidal tendencies they can seek help from friends or support groups. □