Monday, July 13, 2009

ஏன் இஸ்லாமிய நாடுகளில் தற்கொலை மிகக்குறைவாக இருக்கிறது?

என்ன காரணமென்றால், அவர்கள் தற்கொலை செய்துகொண்டார்கள் என்று எழுதினால், அது ஹராமாக ஆகுமாம். அதனால், இதய அடைப்பினால் இறந்துவிட்டார்கள் என்று மருத்துவமனையிலேயே எழுதிவிடுவார்களாம்.

ஆனால், பாகிஸ்தானின் எல்லா நகரங்களிலும் ஏராளமானவர்கள் தற்கொலை செய்துகொள்கிறார்கள் என்று பாகிஸ்தானிய நிபுணர்கள் கூறுகிறார்கள்.

ஒன்று தற்கொலை குண்டுதாரியாக இன்னும் ஏராளமானவர்களை கொல்லலாம். அல்லது யாரையும் கொல்ல விருப்பமில்லாதவர்கள் தானே சாகலாம்.

இதற்கு காரணம் இஸ்லாமாகத்தான் இருக்கும் என்று கருதலாம்.

More of our men are committing suicide: experts

Daily Times Monitor

KARACHI: Suicide has become a major public health problem in Pakistan but despite this there are no official statistics and national rates are unknown. Rates for men are consistently higher than women; the highest rates for men were between the ages 20-40 years in Larkana. Given the stigma, experts believe these figures to be an underestimate.

To determine rates experts carried out an analysis of suicide reports from six cities in Pakistan. Their findings were put together in an article ‘Epidemiology of Suicide in Pakistan: Determining Rates in Six Cities’ that appeared in the ‘Archives of Suicide Research’ in April.

Suicide is one of the ten leading causes of death in the world today, accounting for almost a million deaths worldwide annually. Along with neuro-psychiatric disorders, suicide contributes 12.7% to the global burden of disease. Information on suicide from Islamic countries is lacking, including those with populations exceeding 100 million people such as Bangladesh, Indonesia, and Pakistan.

There are no official data on suicide from Pakistan. Data on suicide is not included in the national annual mortality statistics. As a result, national rates on suicide are neither known nor reported to the WHO.

Pakistan’s population of 162 million makes it the sixth most populous country in the world. Ninety-seven percent of its people are Muslims, while Hindus, Christians, and Zoroastrians form smaller but important minorities. Official unemployment stands at 12% of the eligible workforce. Health spending is 0.7% of the national annual budget. Mental health does not have a separate budget but is believed to be 0.1% of the health budget.

Under Pakistani law both suicide and deliberate self-harm (DSH) are illegal acts, punishable with a jail term and a heavy financial penalty. Every case of suicide or attempted suicide must be taken to one of the government hospitals designated “medico-legal center” (MLC), where the police register a case and conduct an enquiry into the circumstances of the act. In practice, although prosecution is rare, harassment and extortion of money from survivors and their families is not uncommon. People avoid going to the MLCs and many seek treatment from private hospitals that neither diagnose such cases as suicide nor report them to the police. There are also strong social sanctions against suicide and families are often ostracized. For these reasons suicide is under-researched and under-studied in Pakistan.

Despite this there is compelling evidence that incidences of suicide have increased in Pakistan in recent years. The lay press in Pakistan regularly report on suicide incidences in Pakistan. These news reports are based on surveys of police stations of different cities and reports of NGOs that collect information on suicides. There is therefore need to gather evidence to inform policy for development of preventive programs.

The absence of suicide rates in Pakistan is a major impediment in informing policy, monitoring suicide incidences or estimating effectiveness of suicide prevention programs. The six cities include capital cities of three provinces, i.e., Karachi (Sindh province), Lahore (Punjab province), and Peshawar (NWFP province), while the other three cities (Faisalabad, Rawalpindi, and Larkana) have populations in excess of a million people. Only one province, i.e., Balochistan (capital Quetta) is not represented in our study.

Suicide rates in Islamic countries are considerably lower than other countries. In 1989 experts carried out a 71 nation cross-national analysis and showed when factors such as social, economic, and demographic modernity are controlled, Islam has an independent effect on lowering suicide rates. However, there is good evidence from a number of Islamic countries such as Iran, Turkey and Bangladesh that suicide occurs regularly in Islamic countries. In a recent study of suicide and undetermined deaths in 17 Islamic countries, experts argue that in many Islamic countries culturally unacceptable suicidal deaths may be hidden in the “Other Violent Death (OVD)” category, thereby artificially lowering suicide rates in these countries.

The study highlights that suicide not only occurs regularly in Pakistan but rates are not as negligible as generally believed. When age- and gender-specific rates are calculated, they show much higher figures. It is important to note we used denominator of 20-59 years age group, as population percentage was available for this, rather than 20-40 age group. Therefore, rates are lower than would have been obtained with a lower denominator, i.e., 20-40 years age group.

Currently, when a death of a person occurs, the head of the family is supposed to report it to the municipal administration within four days. For this a register is maintained in the town council office. Although there is a column for cause of death, this is filled according to the statement of the person notifying the administration of the death. Death certificates issued by hospitals usually state “cardio-respiratory arrest/failure” rather than suicide.

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