PAKISTAN: Depression, Poverty Make A Deadly Mix

Zofeen Ebrahim

LAHORE, Pakistan, Jul 20 2010 (IPS) – She survived the nightmare, but three of her six children, as well as her husband, did not. In fact, Muzammil Akbar says, it was her husband Akbar Ali who had fed poison to their three eldest children before handing her a handful of white tablets .
Akbar, 32, recalls her husband as telling her: What s the point of dying a little every day? Let s just die once and get over with this dog s life.

Akbar says she was overcome with shock and was soon swallowing the tablets her husband, a rickshaw driver, gave to her. Released from the hospital where she spent more than two weeks in June, Akbar found herself locked out of her in- laws home and denied the custody of her three remaining children. We don t trust her with these three children, says her father-in-law.

The family tragedy, which occurred Jun. 15 in a low- income community about 45 kilometres from the northern Pakistani city of Lahore, was fodder for many news stories for a while. But now that the morbid media frenzy has passed over what was mistakenly reported at first as a mass suicide , there are those who worry that any interest to stop many more of Pakistan s desperate poor from dying by their own hand will disappear as well.

Murad A Moosa, head of the psychiatry department at Karachi s Aga Khan University, finds a strong relationship between poverty and poor mental health. Yet he does clarify: Not all poor kill themselves, only the clinically depressed (see) suicide as the only alternative.

Still, poverty and depression can be a fatal mix. Poverty not only makes people more vulnerable to depression, it also limits their means to seek help once they feel cornered and have little to live for. Some 36 percent of Pakistan s 170 million people live below the poverty line.
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While there is no nationwide study on suicide, Moosa says research done in Karachi shows that 90 percent of those committing suicide turn out to have been suffering from diagnosable psychiatric disorder that would have responded well to timely treatment.

Experts add that many more suicide cases go unreported because of the stigma attached to the act.

The federal minister for human rights, Mumtaz Alam Gilani, told the National Assembly that over 180 incidents of suicide had been reported in different parts of the country over the past year. From its monitoring of news reports on suicides from January to October 2009, the independent Human Rights Commission of Pakistan reported that there were some 1,393 cases of suicide in this country during that period, along with 439 attempts.

The English-language Daily Times also quoted the charitable trust Edhi Foundation as saying that in the first three weeks of June alone, 11 suicides were reported in Lahore. According to the report, severe financial problems was the reason cited in most of the cases.

But senior journalist and rights activist Najma Sadeque believes the tragic trend is nothing new. The effects of deprivation and hunger don t show immediately, and people inexplicably feel so ashamed that they try to hide their hunger for as long as they can, she says. It s been building up for at least a decade.

Karachi-based economist Asad Sayeed, for his part, points a finger at globalisation for the increasing inequalities among Pakistan s people.

It is bad enough that the poor have either stayed static or been pushed further into the cycle of poverty, he says. Globalisation, says Sayeed, has also increased the vulnerabilities of the non-poor but low-income population.

A lot of suicide cases that we hear are those in the latter category, those who were not poor but were pushed into a situation of poverty, he says. This makes intuitive sense also as circumstances and consumption patterns for the poor do not alter much but for those who fall into poverty, the change are psychologically more damaging.

So far, cases like those of Akbar Ali, who was driven to try killing his wife and children along with himself, remain rare. Moosa explains what may have been going on inside Ali s head: Such people feel their families would suffer without them, hence they feel killing would be a favour.

At the time of his death, Ali was earning about 200 rupees (about 2.3 U.S. dollars) a day, which was not enough to support his family even if they were sharing a house with his parents and his brother s brood.

Muzammar Akbar says that her father-in-law scolded her husband daily because she had sold off jewelry to be able to meet the needs of their family, which included a physically and mentally challenged daughter. A neighbour also says that money problems often led to family fights next door. Ironically, what Ali could not manage to earn in his lifetime may finally come to his family because of his death. According to Punjab chief minister Mian Shahbaz Sharif, Ali s widow will be receiving one million rupees (11,904 dollars).

Says a less-than-pleased Moosa: Giving money is not the answer.

He notes that it may even encourage others in similar predicament to take their lives to benefit their families . A far better use of the money, says Moosa, is the setting up of low-cost mental-health programmes.

 

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