Swaziland has a very high suicide rate. According to statistics
released by the Royal Swaziland Police, 160 people committed suicide from
January 2014 to January 2015. Of these, 126 were men. One hundred and sixty
people in 12 months effectively mean about 13 people commit suicide in a month,
and that’s a staggering figure. One of my friends, a beautiful woman called
Siphelele Mngomezulu, is a Psychotherapist. I had wide-ranging discussion with
her regarding why Swazis commit suicide at such an extensive scale, whether
they are receptive to counselling and what can be done to curb this scourge,
among other things. She’s a woman of many words, but an absolute pleasure to
listen to. Please note that she spoke in her personal capacity, not on behalf of the organisation she works for. This is what she said:
The high suicide rate in Swaziland is mainly cause by socio-economic
issues, broken families, and lack of support in the family, but mainly it’s a
result of financial meltdowns. People are not coping with finances, and then
they commit suicide. Suicides also have a lot to do with relationship
breakdown. You find that when women commit suicide, usually their husbands have
cheated or left, and there’s no more money for school fees and other expenses.
HIV is also a major factor leading to depression which in turn leads
to suicide. People are struggling to accept suicide as just a chronic ailment
that you can live with. Right now our system is such that we initiate
counseling for everyone that comes to the hospital. On arrival you are told to
test. If as health workers we say, “We
want to know your status before we treat you,” we are practically saying
test or you won’t be treated. It doesn’t necessarily translate to readiness for
testing for the patients. The comebacks are terrible. We get a lot of psychosis;
people are failing to accept because they were not ready in the first place,
mental meltdowns. People will think, I went to the hospital with stomach problem
and I came back HIV positive, how do I even begin to tell my husband.
Doctors are increasingly resistant to treating people whose status they don’t know
because they don’t want to treat the symptoms and instead of the source.
HIV is donor-funded. First they came with “voluntary counseling”, now
we have provider-initiated HIV counseling. How do you say no to someone you
need services from? When someone declines to get tested, ideally we should say
it’s OK, but now the doctor will start explaining to you why it’s important for
you to test and will demand the HIV results. So ready or not, the patient has
to test. We cater for low to medium earning people who can’t afford to walk
away from our institutions where very little is charged, R20 for consultation
and treatment. Some, however, will accept that the test was a push in the right
direction because they will get the right treatment and engage in more
responsible behaviour.
It goes back to cope under difficult or new situations.
Rarely, you also get suicide when there’s abuse in the family, for
instance children that are being abused by parents or teachers. Women in
relationship ages like 17 – 40 have a lot of problems with their husbands and
they feel they have to die as a result of those problems. Very few women commit
suicide for financial reasons. They sometimes come for counseling because of
stress and headaches, but seldom want to kill themselves for that. The majority
of suicides are over relationships that break down, and most of them breakdown
because there’s no money and they are not coping with the pressure. So the
reasons are interlinked, somehow. They all have an effect on the other.
For men it’s usually because of financial pressures. They’ll think,
“This woman cheated on me because I don’t have a job, I have so many debts and
am not meeting family expectations.” I have also noticed there is a trend,
there’s a season for a reason. In January we get a lot of attempted suicides
because of school fees issues, finances are bad after the festive season. At
some point in March you get a lot of school-leavers that have not done well in
matric and then attempt suicides. Of course relationship-related suicides are
all year round. But I find in the majority of cases, it’s a cry for attention
more than a genuine wish to die, or fear of how will I be received having
failed, more than wanting to die. If I’ve cheated and my husband has caught on,
I’ll attempt suicide and go and lie on a bed somewhere while a social worker
harmonises the situation, whereas if I had just gone home, the husband would
have probably just picked up a sjambok, run after me and tell me to pack my
bags and go. So I’m going to pretend I want to die. This is also evident in the
types of methods people use to try and commit suicide. They’ll take Blue Death,
for crying out loud it doesn’t even kill ants, how is it going to kill you, a
whole human being? They’ll take an OD of a few Panados. Those who really want
to die go for the weevil tablet, try to hang themselves, take very strong
pesticides. Those who use the very small things, I always think they don’t
really want to die.
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| Siphelele Mngomezulu: Psychotherapist |
During counseling sessions, they want to call in the husband and
harmonise the situation. They are not content with just being counseled and
changing their mindset. The women are determined, “No! I want to come here,
then you’re going to call my husband and make it a big issue and sit us down. And
you’re going to make us ok. That’s what I want!” They feel getting counseling
and advice on how to make their lives better isn’t enough. The man will say, “I
want my wife here. I want you to tell her to forgive me, to tell her that I
tried to kill myself because I love her.”
In situations where the woman tries to commit suicide because the
husband is having an extra marital affair, she just wants to hear him on the
hot seat saying, “I’m sorry, I’ll repent, I’ll make things better, I love you.”
But two weeks down the line she’s back again after another suicide attempt
because the husband is still not back. Sho it’s like forcing someone to change.
They won’t change. You need to change your mindset. You need to be the one
that’s better equipped to deal with it, than try to kill yourself, that’s my
theory. Why must I die when I’m not in the wrong? You cheat, I die? How does it
work? Why can’t I just move and start again? Most of the time we have women
saying, if I move I don’t have anywhere to go, I can’t afford rent, I’m not
working…” – socio-economic factors
linking again to relationship breakdowns. Root cause was the meltdown. The
person will be attached and will say, “You took me out of school, I don’t have
a qualification, you made me your wife, I have four children with you now,
where must I go, so I’d rather die.”
These are even better than boyfriend and girlfriend scenarios. A lot of girls try to kill themselves because
their boyfriends are with someone else. Sometimes it’s about school fees. I
know a child who went to pay fees at the bank. On her way back she lost the
deposit slip and was afraid of the parents hitting her. She kept quiet. At exam
time she was told she couldn’t write as she hadn’t paid. They couldn’t trace
the money from the bank. She attempted suicide because she couldn’t face
telling her parents that you’ve paid fees for the whole year and I’m not going
to write exams because I lost the deposit slip. She really didn’t want to die.
She just wanted someone to go and break the news to her father and make her
look like the victim.
We live in a society that glorifies suicides. Our media sells with
negative reporting, for some reason. Headlines like “Woman and man found naked
doing witchcraft” get all the attention, but if a group of women stands up and
goes to the rural areas to donate blankets, no-one wants to cover them. Reporters
don’t want to cover you for doing good. They want to cover you for bad. Suicide
is glorified. Also, in society when someone commits suicide, we talk about it. It
becomes such an issue. And if we talk over and over about, it makes an
impression on immature mind. Suicides
are then mimicked. Sometimes our children just wants to be centre of attention
for a while, they don’t really know what they’re doing or why they’re doing it.
A child committed suicide at a primary school and it was widely spoken about at
the school. During that period I got a lot of children from that same school
attempting suicide. Do you even know what it feels like to die? No. did you
really want to die? No. Do you know where you go when you die? No. In about 8
out of 10 cases of children attempting suicide, there is someone known to them
who committed suicide.
People that commit suicide might lose interest in things that they
previously liked, suffer from lack of sleep, tiredness, and isolate themselves
from other people. Some will become tearful with constant crying and general
depression. But when you dig into a person’s problem and find the common trends
of people who wanted to die but didn’t die, they have this underlying
depressing issue, like, “I’m failing to come to terms with the fact that my son
is autistic.” That’s real, they really wanna die because you have this feeling
of not being a perfect mom, there’s turmoil in your soul. But some people that
commit suicide are people that you sit down with and chat, and find tomorrow
they’ve committed suicide. It’s not real, it’s a cry for attention, you don’t really
wanna die. It’s difficult to pick up signs from a person who is doing it to get
attention, because usually the signs just aren’t there. They think, “I might not die, I don’t wanna die, so what
can I take to make me almost dead but not dead.” That’s when you get your
Panado overdose, who’s gonna die from Panado? And they make sure they do it
when they know they will be found before they die, like around the time the
husband comes home from work. People that really want to commit suicide will
send people away, they’ll be found dead for hours. They will create an
environment that is conducive for committing suicide.
These methods also help us to assess the realness of the urge to
really wanna die, because we could be spending a lot of time on counseling for people
who don’t really need it. They just want your intervention to harmonise the
situation they are in. We spend a lot of
time on those that clearly really want to die. Those that shout, “I’ll kill
myself, I’ll kill myself, stop me before I do!” usually don’t really want to
die but it is important not to ignore them. They should still be helped with
whatever is making them even want to talk about suicide before they try. If you
ignore them, they’ll attempt to take their lives to get attention and they could
actually die. Even though we think it’s a cry for attention, we still don’t
take it lightly. It’s only called attempted suicide if you survive. If you
succeed, it’s suicide! You’re gone and we’ll never have answers. We’re left
with questions and thinking if only I’d listened, if only I’d helped when she
said it. Suicide is like a mental block and the only solution that stands is
suicide. Those that commit suicide or try to do so for attention don’t get
that. They deliberately go at it. That is the difference between someone who is
suicidal and one who does it for attention. Those that keep things to
themselves are really dangerous. Those are the ones you wake up to find dead
with a packet of weevil tablets by their side.
That person, who is suicidal in more cases than one, suffers from a
mental illness like depression, schizophrenia, bipolar disorder, or Attention Deficit
Disorder, and at some point their brain shuts down. There is a relationship
between suicide and mental illness. Those that attempt suicide for attention
don’t have that, and during psychotherapy you discover that you can’t treat it
because it’s not there in the first place, they just want your intervention.
I believe we all are mentally ill to a certain extent. I always say
it’s a thin line between sanity and insanity. From time to time we cross over
to insanity and then we cross back to sanity, just that some people don’t have
the opportunity to come back. When they go, they go for good. And if you allow
emotions, feelings, depression, and situations
to lead you to insanity too many times too much, you don’t have an accepting
spirit, you don’t talk about things, you’re not going out there to get help,
chances of crossing and not coming back are very high. People with addictive
behaviour cope with situations in different ways. Some drink alcohol, in turn
they become alcoholics because they’ve allowed problems to push them to the
other side and have not come back from time to time to check if they’re still OK. So yes, our brains do get to a point where we do things that we don’t
understand, that we wouldn’t do under normal circumstances. We should be able
to trace back and say, “This is where it came from, this is the source,” and
you should be able to deal with the source, not the symptom. Like if it pushes
you to club a lot, understand why you’re clubbing, what’s pushing you away from
your home so much. Deal with the root cause because you can’t solve clubbing
for as long as the problem at home is still there. Set standards for yourself
and keep checking if what you are doing is still normal.
People have a lot of mental illnesses, lots and lots and lots that go
unnoticed. I was telling people the other day that so many people are
functioning normally yet not so normally. We put it down to them having an
attitude problem or taking out their stress on others at work. It’s a mental
challenge and the only way to curb it is to confront the source. As long as you
don’t solve it, it will eventually surface as abnormal behaviour.
Counseling helps a lot but people only come when they are referred. It’s
a guided conversation that helps you think out of the box, someone talks to you
without judging you, and helps you look at your situation from a different
angle. Unfortunately Swazis are not receptive to counseling. They believe in tibi tendlu – you don’t air your dirty
linen in public. You keep it to yourself. If
my wife is cheating, I can’t go and talk to someone about it, I’m going to be
mocked. And they don’t believe in telling their problems to a stranger or
to each other. It makes it worse that counseling is a new profession in the African
context and it’s mainly practiced by younger people. If an old man walked in
and found me in a chair, he’d say, “What
can you tell me about life, what do you know?” At the moment people are
almost being forced to come for counseling, “Your
BP is uncontrollably high, go for counseling.” If you ask them to come back
again in a week for another session, they never do. Because of limited resources, our follow-up
system is almost non-existent. If you’re lost to follow-up, you’re lost.
Counselling works best when it’s voluntary. To force something down
someone’s throat doesn’t mean they will swallow. We still leave people to
exercise the freedom of choice in that regard, so that we know whatever advice
or guidance we give will be received, it will be used and it will help.
Life generally presents a new situation every day. How do you handle it?
You can pick up a child’s coping abilities from an early age. When you say, “No
you can’t have sweets,” does your child throw a tantrum, does he cry, does he
accept it? Like when I was about to have my baby, my mother said you can’t go
through labour, you have to get an elective C-section. You don’t deal well with
pain, taking out a tooth is a mission, labour will make you lose your mind.
Lack of knowledge makes us miss a whole lot in understanding those around us.
You know when you hit your child, does he sulk for a week, do they feel
inadequate? If they do, then you know when you say to that child, “Ngifuna ukukushaya wena (I want to hit you) when you come
back from school,” they might go and not come back because they are afraid. You
should find ways of punishing your child that will not push them over the edge.
Sometimes we push people around us over the edge because we don’t take time to
understand each other.
Sometimes people don’t know that the walls are caving in on them until
it’s too late. Others around them also don’t realise it until it’s too late. We
hardly do mental education in schools. We need to educate parents and teachers
on being observant of their children. You know there are children who, when the
teacher says, “Who was making noise, I
going to give you all three strokes,” they could wet their pants in fear.
That is genuine. You don’t just wet your pants. To say to a child like that, “Tomorrow, I’ll get you,” that child you
have put in suspense for the whole day and night won’t sleep nor eat. If that
child has heard of suicide or knows how to commit suicide, won’t they try it
before the next day? People need to be taught how to look out for the signs and
know how far you can go with whom. We take things lightly and want to push
people, keep pushing people, for what?
Previously counselors were found at the psychiatric hospital, so
people have not come to terms with that. People still associate counseling with
mental illness which is still discriminated against in our communities. The
Ministry of Education needs to have counselors in schools in order to nip the
problem in the bud.
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