Tuesday, July 6, 2010

Surging suicides in Pakistan

VIEW: Surging suicides in Pakistan —Dr Mahjabeen Islam

It is true that there have always been suicides and always will be, in any society. But to relegate it all to mental illness in current day Pakistan is representative of the mental insulation that typifies any party that acquires power
Fauzia Wahab, the PPP information secretary, and her government are fast becoming the Pakistani versions of Marie Antoinette. The Queen of Louis XVI of France, when told that the population could not afford bread, is reported to have said, “Then let them eat cake!”

Suicides are surging in Pakistan and now there is an increase in murder-suicides. Surviving relatives detail their financial desperation or crushing debt. And when fathers, like the rickshaw driver, poison their entire family and then kill themselves, it seems to take the whole nation’s breath away. The many stories are essentially the same, the characters and details a bit different. The refrain is invariably poverty and the frank inability to feed, clothe and shelter a family.

But Ms Wahab’s take is different. When asked about this issue, she felt that it was related to “despondency, mental illness and the media glorifying suicides”. She went on to say that “these people need to understand that there is no namaz-e-janaza for the one who commits suicide, that suicide is haram and that suicide is cowardice!”

This is a classic case of mental insulation; how can one live, drive, watch and hear and still not sense the screams of desperation of a populace? The poor kismet that I have of living thousands of miles away and just watching the news, even I can sense the pervasive economic desperation in Pakistan. It is adding insult to injury for the many dead of so many households that the powerful in Pakistan speak in such contemptuous terms of such a grave situation and offer no solutions except finger-wagging admonition.

The Quran does say in Surah Isra and Anam (17:31, 6:151), “Kill not your children for fear of want: We shall provide sustenance for them as well as for you: verily the killing of them is a great sin.” In the vicissitudes of life though, the most comforting is Surah Zumar (39:53): “Do not feel disconnected from the Mercy of God, for God is Oft-forgiving, Most-Merciful.”

And yet, to understand this sad scourge of suicides, one must understand that it is not abrupt but rather very slowly sequential. The onset of trouble is with a situational depression, precipitated in this case by economic burdens. The person tries to deal with it and if there is relief, the situational depression resolves. If there is none, the person’s depression progresses, thought processes start to fuzz out and major depression sets in. The hallmark of major depression is suicidal ideation.

It is only in the very early parts of a person’s emotional decline that they are able to understand and value the importance of Quranic injunctions and societal condemnation. After major depression sets in, the decline begins so precipitously that unless there is immediate removal of the precipitating factor as well as medical treatment of the depression, the person is liable to proceed down the path of suicide.

The actual rate of suicides in Pakistan is not available or accurate for suicides are not always reported due to the attendant shame. It is true that there have always been suicides and always will be, in any society. But to relegate it all to mental illness in current day Pakistan is representative of the mental insulation that typifies any party that acquires power. I have named it the ‘Kursi Syndrome’ in past articles; even if a Sufi acquired power in Pakistan they would become arrogant, delusional and disconnected from the very people that elected them.

Major depression, or like Ms Wahab puts it, “despondency”, is an equal opportunity disease. If, in their Marie Antoinette supercilious arrogance, the ruling elite seriously believes that they are somehow inured to the ravages of depression, or the turning of fortune, a reality check is immediately in order. It would be the ultimate irony if, God forbid, one of them had to be declined for a namaz-e-janaza.

The insensitivity of calling such a tremendous societal tragedy an act of “cowardice” is beyond my ability to condemn adequately, especially when the government has devoted more money to the war against terror than economic and educational uplift.

The dichotomy of the ultra-right in the face of these suicides is also sad. The Tehrik-e-Taliban Pakistan and other similar groups brainwash teenagers to commit suicide, convincing them with perverse and unfounded logic of reward in the afterlife. In Islam, a male is classified as an adult when he comes of age biologically and a woman when she menstruates; and both at adulthood become responsible for their actions. “Killing one person is as if he has killed all of humanity,” (Surah Maidah 5:32) says in the Quran rather directly. And regardless of the brainwashing by men who themselves stay away from suicide vests, the young perpetrators of these heinous crimes are in full control of their mental faculties.

The only individuals who are exempted from accounting for their five daily prayers are the insane and mentally challenged. When a person has crossed over from the blues to major depression with psychosis, they would not be considered mentally competent in a worldly court of law. So what is one to think of the Oft-Forgiving and Most-Merciful?

Ijtihad, or re-interpretation of Islam in the light of modern knowledge, is dead. It is no wonder that religious scholars in Pakistan do not have the vaguest clue of what depression is except 'a weakness of faith’. The government gives monetary support to families of murder-suicides. Should not this monetary help have arrived sooner?

Rapid and effective economic and health relief needs to be provided to the people of Pakistan. Suicides as a whole are preventable and those based on financial desperation, completely so. Food, clothing, shelter, education and health are basic rights and need to be provided urgently and across the board. Human rights activist Tahira Abdullah said rather forebodingly: “Some of the hungry are committing suicide now. The government needs to fear the day when the rest of the hungry come onto the streets and demand justice.”

Mahjabeen Islam is a columnist, family physician and addictionist with a practice in Toledo Ohio. She can be reached at mahjabeen.islam@gmail.com