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Preventing Suicide

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Dr. Frank Anthony's Suicide Motion Presentation

 

 

Guyana's Suicide Epidemic

Guyana is ranked first in suicides per capita worldwide. According to the World Health Organization (WHO) report released in June 2014, Guyana suffers 44.2 suicides per 100,000 persons per year. In effect there are about 333 suicides per year in a population of about three quarters of a million persons. But it is also estimated that at least 25% of suicides go unreported. This would mean that there are at least 425 suicides per year in Guyana. However, empirical evidence gathered over the last ten months reveal that unreported suicides are higher than 25%, thus actual suicides could well be higher than 425 annually.  Also, at a globally estimated 25 attempts per suicide, Guyana would have almost 11,000 attempted suicides a year.

Also suicide is the leading cause of death among young people ages 15-24 and the third leading cause of death among persons ages 25-44, while in the 15-19 age group, it is the leading cause of death among females and the second leading cause of death among males.

In fact, Guyana has the second highest rate of teenage pregnancy in the Caribbean with an estimated 97 teenage girls between the ages of 15-19 out of 1000 becoming pregnant each year. Also, the average Guyanese drinker consumes 13.7 liters of pure alcohol each year with 6.1% of the population considered heavy drinkers (2010 figures). With respect to domestic violence, of the more than 60 percent of women who were involved in a relationship or union, 27.7 percent reported physical abuse, 26.3 percent had experienced verbal abuse and 12.7 percent experienced sexual violence (media reports, year not given). Yet it is noteworthy that all these figures could be higher, because of under reporting.

In 2000, a landmark study – The Shadow of Death: A recent study of suicides in Guyana, Incidence, Causes and Solutions - reported that the majority of those committing suicide were young males below the age of 35 years. They were likely to be poorly educated, employed in a low-income occupation, reside in the same community all their lives and to be less likely to have children. A ‘suicide cluster’ was identified in Black Bush Polder, a community of the East Berbice-Corentyne, Region Six.

In Guyana almost all suicides are committed by ingesting poisons, especially agri-based and by hanging and are the results of abusive and dysfunctional relationships; teenage affairs and pregnancy; rape and incest; an inability to deal with problems (lack of coping skills) and/or unbearable pain – physical or emotional - which generally give rise to awful agony and depression and feelings of helplessness, hopelessness, powerlessness and loneliness.  Suicidal mindsets are prone to copycatting, a practice referred to as the Werther Effect and catalyzed by alcoholism; lack of empathetic communication and low levels of self-acceptance and/or feelings of inadequacy.

 

Myths & Misinformation on Suicide

Since The Caribbean Voice launched its suicide prevention campaign, we have been appalled by the biases, prejudices, misinformation and disinformation that character attitudes towards suicide. In fact we have arrived at the distinct understanding that suicide prevention can only be effective when attitudes become more enlightened and sympathetic.

When a post was placed on a Facebook page requesting contacts to help organize the Black Bush Polder outreach, one commentator wrote, "All the names I want to give you have all committed suicide."

And when his comment was pointed out to be in bad taste, he responded that he was not joking but trying to emphasize the magnitude of the problem. This lack of sensitivity is perhaps the number one misguided attitude. Also, based on feedback, it seems that sensitivity creeps in only when someone has been personally affected by suicide.

Furthermore we receive a lot of comments to do with God, religion and temples. Yes, faith-based counselors and individuals with deep religious convictions do believe that faith in God can help. In fact, one commentator posted, "Stop begging and send them to church to pray to God."

So yes, we are certain that some suicidal individuals might have been brought out of that mindset by faith-based counseling. But faith-based counseling does not work with all, is not available to all and faith-based leaders are not generally equipped for clinical counseling.

Besides, people who deeply believe in God, still commit suicide. So while we endorse faith-based counseling as a strategy that may work for some, we believe that there must be a range of strategies and access so all can be reached.

Furthermore, a number of individuals also simply dismiss suicide as the victim's personal choice and business, and feel there is no need to get involved in suicide prevention since nothing can really be done. Yet there is a tremendous body of literature and shared experiences that prove that something can indeed be done and that suicide is preventable.

So as we move forward, it becomes important to dispel some of the prevailing myths and misinformation about suicide. For too long suicide and factors the drive this crisis have been viewed as 'taboo' and not an appropriate topic to be discussed in public. That taboo must now be laid to rest.

Myth # 1:  People who commit suicide want to die.

Fact: Suicide is seen as a way to end the pain. A suicidal person does not see any other option but those who have survived attempted suicide say they never wanted to die.

Myth #2: People, who talk about killing themselves, are just looking for attention and won't do it.

Fact: If someone is talking about suicide, regardless of how it is expressed, it must be taken seriously.  That person is in pain and crying out for help.  If you're in doubt, keeping talking to the person and listen carefully. Unless this is done that person could end up carrying out the threat.

Myth #3: If people are determined to kill themselves, then nothing is going to stop them.

Fact:  Various studies indicate that showing someone you care and giving that person just five minutes of your time has proven to reduce suicidal attempts. A person's urge to kill him/herself, regardless of the reason, is only temporarily. A study of those who survived the jump from the Golden Gate Bridge stated they would not have jumped if someone had just spoken or even smiled at them during their period of crisis.

Myth #4: People who commit suicide never tell or show any signs of distress.

Fact: In various studies it was noted that up to 80% of victims leave clues, either verbally or through their change in behaviors. That is why, it is important to learn about and become familiar with the warning signs.

Myth#5: Discussing suicide with someone will put the idea in his or her head.

Fact: Talking about suicide lets the person knows you care and that he/she is not alone. It gives a sense of relief and promotes a greater chance that the person will unburden himself/herself.

Myth #6: Only Indo-Guyanese commit suicide.

Fact: Guyanese of all ethnic backgrounds commits suicide.

Myth #7: Only the poor commit suicide.

Fact: Suicide does not discriminate and it can affect the lives of anyone regardless of social status or financial background, as has been seen over and over.

Myth #8: Telling someone to cheer up when he/she is depressed will stop him/her from acting crazy.

Fact: Telling someone to cheer up will cause more distress because it will appear as if that person's feelings do not matter and the person is not being taken seriously.

Myth #9: People commit suicide on impulse or a whim.

Fact: People do not commit suicide on an impulse. Those who end their lives would have thought about it over and over in their mind; it's this process that allows them to carry out the act.

Myth #10: Only cowards commit suicide.

Fact: It's not a question or being a coward or being brave. The reality is that it is difficult to imagine the agony someone goes through before committing or attempting the suicide.

Myth #11: If you go to church you will not commit suicide.

Fact: Regular church attendance, by itself has not stopped individuals from committing suicide. And while belief and faith based counseling may help some it takes more than that to help others.

Myth #12: Only people who drink commit suicide.

Fact: Alcoholism or being under the influence of alcohol is not a reason for suicide, but may provide Dutch courage to the already suicidal.

Myth #13: People who commit suicide are selfish.

Fact: Actually its almost the opposite - people commit suicide because they think they are saving their loved ones from having to disrupt their lives to deal with the own pain and agony of the suicide victim.

Myth #14: People who commit suicide are stupid.

Fact: Stupidity has nothing to with it.

Myth #15: All the barrels and money sent by overseas relatives to their Guyanese families cause the families to become lazy and drink a lot of rum. This then lead to suicide.

Fact: As pointed out above alcohol is not a cause of suicide. Nor is laziness or the combination of the two.

Myth #16: Too much cell phone use cause users, especially the young to maybe be depriving them of opportunities to 'offload' their problems in face-to-face communication, making them more vulnerable to suicide.

Fact: Cell phones do play a part in suicide bu there is no research or evidence to support this contention.

In the final analysis please remember that 'Suicide Prevention is Everybody's Business' and if each of us plays a part, we can save lives and enable potential to flower. Also do remember that suicide is never an answer, no matter what the problem or issue is; suicide simply leaves too many unanswered questions. Finally suicide does not eradicate pain, it leaves behind a circle of agony that embraces those left behind.

 

Empathetic Communication for Suicide Prevention

An inability to communicate empathetically has been identified as a factor that catalyzes suicide.

What is Empathic Communication?

• Also know as active communication or reflective communication, empathetic communication is a way of listening and responding to another person that improves mutual understanding and trust.

• It enables the listener to receive and accurately interpret the speaker’s message/words, and then provide an appropriate, non-threatening, affirming response.

• Through empathic communication the listener lets the speaker know, “I understand your problem and how you feel about it. I am interested in what you are saying and I am not judging you.”

• The benefits are as follows:

1. Builds trust and respect  2.   Enables the person to release hidden emotions

3. Reduces tension/conflict  4.   Encourages free exchange of information

5. Creates a safe environment that is conducive to collaborative problem solving.

Guidelines to Empathic Listening:

Do’s:

• Be attentive. Be interested. Be alert. Create a positive atmosphere through nonverbal behavior.

• Be a sounding board-allow the speaker to bounce ideas and feeling off of you while assuming a non-judgmental , non-critical manner.

• Act like a mirror-reflect back what you think or hear the speaker is say and feel.

• Provide brief, noncommittal acknowledgment responses, e.g., “I see,” or  “Uh- huh.”

• Give nonverbal acknowledgements, e.g., head nodding, facial expression matching the person, eye contact and a relaxed body posture.

• Invite the person to say more, e.g., “tell me more about it,” or “I’d like to hear more about that.”

Don’t’s:

• Don’t discount the person’s feeling by saying, “it’s not that bad “ or “you’ll feel better soon.”

• Don’t let the person “hook” you. This can happen if you get angry or upset, by allowing yourself to take sides and or pass judgment on another person.

• Don’t ask a lot of questions. That can give the impression that you’re being “fas” or intrusive.

• Don’t interrupt or attempt to change the subject being addressed by the person.

• Don’t give advice, teach or rehearse how you will respond to the person.

 

What is Self-Acceptance?

• It is being able to embrace all facets of one’s life, not just the positive. Each person must recognize his/her own specific weaknesses, limitations, and foibles but this awareness should not prevent full understanding of oneself as a person. Remember everybody possesses these qualities also.

• Accepting the person you are is the first step. This enables you to identify with your great qualities - things that make you unique – as well as the not so good parts and can help alleviate feelings of guilt, lack of self-esteem and unhappiness.

• It helps to stop you from comparing yourself to others, which brings about a sort of inner peace, lightness and happiness in your life and prevents continual dissatisfaction, disenchantment and frustration.

Practical Approach

➢ Set an intention-move from the world of blame, doubt and shame, to one of tolerance, acceptance and trust.

➢ Forgive yourself-everyone makes mistakes; view it as lesson learned.

➢ Consider the people around you-focus on those who are a good influence in your life.

➢ Create a support system- those who want better for themselves and can help you be better; network and reach out.

➢ Quiet your inner critic-we can be our own worst enemy; learn to ignore doubts, be less self-critical.

➢ Celebrate your strengths- identify them; write them down, use them, build on them.

➢ Perform charitable acts-when you give to others, it helps you to value what you have, to accept who you are, to develop additional skills and inner satisfaction.

➢ Be kind to yourself-embrace everything that is you (the good, bad and ugly) and remember you’re unique, not lesser than anybody else.

➢ Grieve for lost dreams- sometimes what we want out of life is not possible, mourn the loss but don’t obsess over it, then get back to the life you have and move forward.

➢ Set realistic goals for you- 3, 6, 9 and 12 month goals, celebrate them.

➢ Take time to know you- set aside a few minutes a day for yourself to introspect, enjoy who you are as a person and celebrate your strengths and achievements.

 

What is Self-Esteem?

Self-esteem is your opinion of yourself. High self-esteem is a good opinion of yourself, and low self esteem is a bad opinion of yourself. The way we feel about ourselves has a huge affect on the way we treat ourselves, and others, and on the kinds of choices we make. it affects how we think and act and how we react to challenges. It has a direct bearing on your happiness and wellbeing.

HOW TO ENHANCE YOUR SELF-ESTEEM

Here are some things you can do to protect, raise, or reinforce your self-esteem.

• Spend time with people who like you and care about you.

• Select god role models

• Ignore (and stay away from) people who put you down or treat you badly.

• Focus on your achievements rather than on your failures.

• Prepare thoroughly for any task so that you can be sure you are ready.

• Focus on who you are and what you like about yourself. Why do your friends like you?

• Do things that you enjoy or that make you feel good.

• Do things you are good at.

• Reward yourself for your successes.

• Develop your talents.

• Be your own best friend - treat yourself well and do things that are good for you.

• Make good choices for yourself, and don't let others make your choices for you.

• Take responsibility for yourself, your choices, and your actions.

• Always do what you believe is right.

 Be true to yourself and your values.

• Respect other people and treat them right.

• Set goals and work to achieve them.

 

 

Self Esteem (SE) Test

Circle your choice:

1. Other people are not better off or more fortunate than me.

     True   False

2. I accept myself as I am and am happy with myself

     True   False

3. I enjoy socializing.

     True   False

4. I deserve love and respect.

     True    False

5. I feel valued and needed.

     True    False

6. I don’t need others to tell me I have done a good job.

     True    False

7. Being myself is important.

     True    False

8. I make friends easily.

     True    False

9. I can accept criticism without feeling put down

     True    False

10. I admit my mistakes openly.

     True    False

11. I never hide my true feelings.

     True    False

12. I always speak up for myself and put my views across.

      True    False

13. I am a happy, carefree person

      True    False

14. I don’t worry what others think of my views.

      True    False

15. I don’t need others’ approval to feel good

      True    False

16. I don’t feel guilty about doing or saying what I want

      True    False

 

TEST SCORE:

Total number of TRUE answers giving EACH ONE POINT:

15-16 Points – You have a high level of self esteem!

12-14 Points – Not bad but room for you to improve

8-11   Points – Low self esteem is holding you back

Below 8 Points – Your esteem is drastically low!

 

 

Suicide Prevention Strategies

The following are strategies for suicide prevention.

What is Self-Acceptance?

• It is being able to embrace all facets of one’s life, not just the positive. Each person must recognize his/her own specific weaknesses, limitations, and foibles but this awareness should not prevent full understanding of oneself as a person. Remember everybody possesses these qualities also.

• Accepting the person you are is the first step. This enables you to identify with your great qualities - things that make you unique – as well as the not so good parts and can help alleviate feelings of guilt, lack of self-esteem and unhappiness.

• It helps to stop you from comparing yourself to others, which brings about a sort of inner peace, lightness and happiness in your life and prevents continual dissatisfaction, disenchantment and frustration.

Practical Approach

➢ Set an intention-move from the world of blame, doubt and shame, to one of tolerance, acceptance and trust.

➢ Forgive yourself-everyone makes mistakes; view it as lesson learned.

➢ Consider the people around you-focus on those who are a good influence in your life.

➢ Create a support system- those who want better for themselves and can help you be better; network and reach out.

➢ Quiet your inner critic-we can be our own worst enemy; learn to ignore doubts, be less self-critical.

➢ Celebrate your strengths- identify them; write them down, use them, build on them.

➢ Perform charitable acts-when you give to others, it helps you to value what you have, to accept who you are, to develop additional skills and inner satisfaction.

➢ Be kind to yourself-embrace everything that is you (the good, bad and ugly) and remember you’re unique, not lesser than anybody else.

➢ Grieve for lost dreams- sometimes what we want out of life is not possible, mourn the loss but don’t obsess over it, then get back to the life you have and move forward.

➢ Set realistic goals for you- 3, 6, 9 and 12 month goals, celebrate them.

➢ Take time to know you- set aside a few minutes a day for yourself to introspect, enjoy who you are as a person and celebrate your strengths and achievements.

 

Suicide Prevention Mechanism for Guyana

• We appeal to all stakeholders to join in on organizing walks and rallies in various communities in collaboration with other stakeholders. Regional administrations, NGOs, regional health institutions and community-based organizations, religious institutions and schools can take the lead in his respect. We want to emphasize that that any accompanying address should not focus on awareness (since there is hardly anyone in Guyana who is not aware) but rather on coping skills and prevention strategies, collaboration and ongoing activism.

• We urge the media to be more responsible and sensitive in reporting suicide so as not to foster copycatting on the one hand and to become more proactive in providing coping information and suicide prevention strategies as well as to publicize all the efforts taking place to tackle suicide. Also the media must keep pushing the government to transform all their talk into action.

• Also we urge the government/Ministry of Healthy to restart the Gatekeepers' Program. We believe that media can help to bring this on stream by continually focusing on this need. Additionally we strongly suggest that there be a standard training manual provided to all entities that engage in this kind of training so that the right information and strategies are provided and so that any possibilities of myths and misinformation being included in the training are eliminated.

• The Minister of Education had announced that counselors would have been placed in schools by February 5th. The deadline came and went and so we appeal to the Ministry to please get going on this promise. Here again we strongly believe that the media can help to bring this on stream.

• Meanwhile laud the self-esteem workshops done in some schools in Berbice by the New Jersey Arya Samaj Humanitarian Mission and the Peace Corp with the blessing of the Ministry of Education. We believe that these workshops should be taken nation wide and we urge other NGOs, as well as schools themselves, to establish the requisite partnerships to get this done. Furthermore we strongly urge that the right focus is placed regardless of which entity/individual engages students – self esteem, self worth, self acceptance, coping strategies, how to access help – useful, practical, pragmatic, concrete information and strategies that can actually be used.

• Also we urge the all high schools to follow the lead of Queens College students and set up mentoring programs. Perhaps the Ministry of Education can take the lead in this endeavor.

• We appeal to all businesses everywhere to include suicide awareness messages and prevention strategies in their advertisements, especially outdoor billboards. Even local businesses and other entities can join in this by creating heir own ‘suicide prevention’ billboards within their various communities, such as was done recently in Essequibo.

• We emphasize collaboration, and holistic approach that must include focus on related issues such all forms of abuse, sex crimes and drugs and alcoholism.

• Also we urge MOH and MOSP (Health and Social Protection) to map all that is happening so that an overview can be in place, duplication can be avoided and the gaps can be plugged. And to ensure this mapping perhaps a stakeholders' committee should be set up.

• We also appeal to farmers and users of agro chemicals to safely and securely store, use and dispose of agro chemicals and their containers and to ensure that only responsible persons buy and handle these chemicals. We know that Pesticide Board has distributed 150 cabinets and plans to give out another 150 but this amount is woefully inadequate. So we urge all farmers and other users of these pesticides to create your own cabinets/strong boxes or to collaborate with others in doing so.

• As well we appeal to sports in general to include suicide prevention awareness and coping info in their various plans and events. We know that at least two sports competitions have already taken the lead in this respect and we believe that sports is a very critical avenue to create awareness and foster prevention.  But so too is culture and so we implore entities and individuals who organize cultural events and programs to also include coping skills suicide prevention strategies within these endeavors.

• Finally we appeal to the phone companies to add awareness messages and prevention and coping info to the messages they send out to their cell phone subscribers on a daily basis.

 

Suicide Impacting Factors

The following are critical factors for suicide prevention.

Warning signs:

➢ Talking about: wanting to die or to kill oneself; being a loser; wanting to end it all or give up; having no reason to live, being a burden to others and the like.

➢ Feeling hopeless, helpless, trapped, frustrated.

➢ Feeling unbearable pain – physical, mental or both.

➢ A sudden increase in use of alcohol or drugs.

➢ Sleeping too little or too much.

➢ Being withdrawn or feeling isolated.

➢ Showing rage or talking about seeking revenge.

➢ Displaying extreme mood swings.

➢ Visiting many people all of a sudden and seeming very friendly/happy.

➢ Seeming to be lost but denying that there’s a problem.

➢ Suddenly giving away or selling off personal items and wastefully spending money.

Risk Factors:

• Sexually transmitted disease.

• Abuse (sexual, physical and mental).

• Mental illnesses (depression is a key factor) and associated taboos.

• Previous suicide attempts and/or family history of suicide/suicide attempts.

• Teen pregnancy, incest, rape.

• Relationships: dysfunctional, triangular, teenager. separations, break ups.

• Alcoholism and drug abuse.

• Alternative sexual lifestyles – gays and lesbians.

• Problems that seem insurmountable - poor socialization and coping skills.

• The Werther Effect – copycatting

• The Bollywood Effect – cultural sanction

Preventative Factors:

• Do not sit on a problem; find someone you trust to talk to – family member, priest, teacher, close friend or relative, village elder…

• Never see suicide as the answer…think of your dreams and all you can achieve in life. Remember things will get better; they usually do.

protective Factors:

• If you observe suicidal warning signs, take action and get the person help…suicide prevention is everybody’s responsibility.

• Communicate in such a way to build trust and show that you care. Don’t judge harshly and drive people away or make them feel alone, unwanted, unloved.

• Always safely secure pesticides and poisons with access granted to the most responsible family member.

 

Shri Lanka’s Hazard Reduction Model: Suicide Drop by 50%

According to Guyana’s Chief Medical Health Officer (CMO), Dr Shamdeo Persaud, the Ministry of Health will set up Poison Control Centers throughout the country to provide immediate, free and expert treatment, advice and assistance over the telephone in case of exposure to poisonous or hazardous substances. The CMO explained that the operations of such centers across the country can help curb the issue, or at least, reduce the amount of successful suicides by providing immediate life-saving information for suicide attempts.

However, The Caribbean Voice hopes that Dr. Persaud is aware that information by itself, is useless, unless it is acted upon. So we look forward to the unfolding of other measures aimed at ensuring that information disseminated by the Poison Control Centers is utilized to the fullest, that utilization is monitored, and that follow up is mandated. In this context we would like to point out again, that Shri Lanka’s Hazard Reduction Model relating to agro-chemicals, has proven to be highly successful in reducing suicide in that nation. In fact, the total number of suicides in Sri Lanka fell by 50% from 1996-2005 compared to 1986-1995 – a reduction of approximately 19,800 suicides, after this model was introduced.  There is no such proven track record for Poison Control Centers.

The Shri Lankan model encompasses:

1. Introducing a minimum agro-chemicals list restricting the use of pesticides to a smaller number of pesticides least dangerous to humans.

2. Placing import restrictions to ensure that more dangerous chemicals do not enter the country.

3. Restricting the availability of agro-chemicals by ensuring they are stored safely in locked boxes in rural households, along with all equipment with which these pesticides are used.

4. Ensuring that empty containers are safely and effectively disposed of.

5. Restricting sale of agro-chemicals only to licensed premises and to licensed farmers.

6. Implementing administrative controls to ensure that sales outlets safely store all agro-chemicals.

7. Implementing an ongoing safe use policy to educate people about safe handling, use, storage and disposal. Concurrently, for small-scale farming, non-chemical methods, including organic farming, should be encouraged.

8. Improving medical management of pesticide poisoning: an important facet of control because better management will reduce the number of deaths. Requirements are the better availability of antidotes (both in central referral hospitals and ideally in peripheral health units) and ventilation facilities, better training, and better evidence for interventions.

9. Constantly monitoring all measures to ensure ongoing conformity, including random home visits to check for locked box storage and field visits to ensure that only licensed premises and licensed farmers have access to chemicals and that safe handling, use, storage and disposal are in effect.

Given that in Guyana, the vast majority of suicides result from ingestion of agro-chemicals, it would seem logical for the Ministry of Health, in collaboration with the Ministry of Agriculture (and related other agencies), to implement (with necessary modifications) a suicide reduction model that has been tremendously successful, rather than a measure that is nebulous at best. Besides this innovation should cost less than poison control centers. The most difficult part would be regular enforcement but, given what is at stake, surely the resources should be employed accompanied by political will to ensure success.

 

Abuse Overview

Shot, hacked, beheaded, stabbed, burnt, strangled, drowned.  That’s been the fate of 20 women within the past seven months of 2015, according to the Kaieteur News. While most of the slain women were victims of “crimes of passion,” some were victims of home invasions and sexual assaults.

Although reliable national statistics are not readily available, it is well accepted that Guyanese women continue to be subject to widespread violence that prevents them from enjoying other constitutionally-ensured rights. Guyana’s Second Periodic Report to Committee on the Elimination of All Forms of Violence Against Women  (CEDAW) concludes that “violence against women is widespread in Guyana,” and cites a 1998 survey of 360 women in Greater Georgetown as evidence. The survey found that, “Out of more than 60 percent of women who were involved in a relationship or union, 27.7 percent reported physical abuse, 26.3 percent had experienced verbal abuse and 12.7 percent experienced sexual violence. Approximately half of the surveyed women responded that one of the likely causes of partner’s abuse was jealously (55.4 percent) or “hot temper”. Nearly four of every five respondents perceived violence in the family to be very common in Guyana (76.8 percent). More than one in three knew someone who was currently experiencing domestic violence (35.5 percent).

According to the Stabroek News (Jan 17, 2012) “… domestic violence, and particularly the abuse of women by their male partners, is among the most common and dangerous forms of gender-based violence. Women become targets by virtue of their relationship to the male abuser and the violence is inflicted on them usually, but not exclusively, within the home. Media reports also place the domestic violence rate as anywhere between 50% and 66% but some activists argue that it could even be higher and that a significant percentage of abuse never gets reported. With respect to child abuse, The United States (US) Country Reports on Human Rights Practices for 2007 indicates that in Guyana the "vast majority" of cases of child rape and abuse are not reported.

In effect all of this stacks up to gender inequity premised on gender-based violence and abuse, in which children also often end up being victimized. That corporal punishment in and out of schools is still the practice in Guyana, and considered a necessity in the socialization process, compound the problem. The reality also is that in Guyana, domestic violence continues to be seen as personal, private or a family matter. Its purpose and consequences are often hidden, and domestic violence is frequently portrayed as justified punishment or discipline in what is still a male-centric society and one in which children are still to be seen but not heard.

Tragically too, both spousal abuse and child abuse cut across ethnicity, status, social standing and other ‘divides’ which would seem to suggest that such acts are somewhat normative and thus very few, including some victims, would see anything wrong with abusive behavior, often until it is too late.

 

Drugs & Alcohol Overview

On average, Guyanese consumed more than eight litres (17.5 grams daily) of pure alcohol in 2010 compared to the global figure of 6.2 litres (13.5 grams daily), the World Health Organisation (WHO) said in a new report launched last year.  That is, alcohol consumption in Guyana in 2010 was equal to 8.1 litres of pure alcohol consumed per person aged 15 years or older (15+). However, the average drinker in Guyana consumed more than 3.5 gallons/13.7 litres or 29.76 grams daily.

A one-seventh of this consumption (14 per cent) was unrecorded, ie, homemade alcohol, illegally produced or sold outside normal Government controls. Of total recorded alcohol consumed, 77 per cent was consumed in the form of spirits, while 23 per cent was beer, less than one per cent wine, and less than one per cent other.

About 15.2 per cent of male drinkers (10 per cent of the population aged 15+) engage in heavy episodic drinking, that is, consumed at least 60 grams of pure alcohol at least once per month. Also, 8.6 per cent of males and 5.9 per cent of all Guyanese aged 15 and older are classified as having alcohol use disorder, with 3.9 per cent and 1.9 per cent respectively classified as alcoholics.

The alcohol death rate for Guyana is 1.6 per 100,000.

There are no reliable statistics on the amount of persons engaging in the use of illegal drugs or those described as addicts. However, a Behavioural Surveillance Survey, done by the government in 2003 found that 11% of out of school youth use drugs, as do 8% of in school youth. Other users included 17% of GUYSUCO employees, 45% of female sex workers, 74% of male sex workers and 12% of members of the armed forces. Since then there has been a steady increase in the number of persons observed on the streets coupled with those who engage in the use of illegal drugs in social environment. The illegal drugs of choice in Guyana today are marijuana, crack cocaine, cocaine and to a limited extent ecstasy.

It is also noteworthy that Guyana is increasingly becoming a drug transshipment point and the media is replete with the innovative ways in drugs are shipped out of Guyana (US 5 Mar. 2013; Freedom House 2013; SAS 2012, The US Department of State's 2013 International Narcotics Control Strategy Report) According to OSAC (US Bureau of Diplomatic Security) 2014 report, “Drug trafficking organizations are prevalent and pose the biggest challenge to law enforcement in Georgetown. Airport security and custom officials frequently detail and arrest individuals attempting to smuggle drugs to the USS or other destinations. Apprehension of drug “mules” often US citizens perceived to be able to travel easily with their US passports, have increased this past year.”

This suggests a culture of drugs as an economic activity and quite clearly indicates that drugs are thus easy to access. In fact, empirical and anecdotal evidence gathered by The Caribbean Voice indicate that in almost every community there are well known drug pushers, and that every community has drug addicts who engage in odds and ends work to support their habits.

Also, while there are no statistics available, it has been suggested that a significant percentage of deportees, especially from North America, have developed drug habits.

While reliable statistics are not available, it is a fact that alcohol and drugs have an overall economic cost to all nations and take a toll on workplace productivity. In fact alcoholism has been identified as a major reason for absenteeism in the sugar industry. The Guyana Human Development Report (1996) points out that “there appears to be an association between drug use and mental illness and the transmission of the HIV/AIDS virus,” that prostitution is linked to drug use and that many of the street children are into drug use.

 Other substantial costs to society include property damage, job loss and health service costs. Alcohol and drug abuse have many potential consequences including accidental falls, burns, drowning, brain damage, impaired driving resulting in accidents, deaths and injuries, poor school performance, work productivity loss, sexual assault, truancy, violence, vandalism, homicides, suicides, lower inhibitions, increased impulsivity, risky sexual behavior, early initiation of sexual behavior, multiple sexual partners, pregnancy and STDs.

 

SEXUAL CRIMES OVERVIEW

Sexual violence and crimes against women in Guyana is escalating: a rise of one-third in rape reports (117 to 154) occurred between 2000-2004 and a 16-fold rise in statutory rapes (two to 34). The rape rate in 2010 was 15.5 per 100,000 which would translate into a 124 rapes for that year – an almost four fold increase over 2004 figures. Also, from January to September 2014 there were more than 140 cases of rape reported, while from January to July 2013, there were 179 reported cases. And the Guyana Police Force recorded a 68 percent increase in rape (243 reported cases) during the period January 1 to July 31, 2015 with most of the offences being perpetuated against underage girls. In fact, statistics show that law enforcement officials receive reports of sexual violence almost on a daily basis.

Also, Guyana has the second highest rate of teenage pregnancy in the Caribbean with an estimated 97 teenage girls between the ages of 15-19 out of 1000 becoming pregnant each year. Of the more than 60 percent of women involved in a relationship or union, 12.7 percent experienced sexual violence (media reports, year not given).

A 2007 report by the Guyana Human Rights Association (GHRA) analyzed sexual crimes between 2000 and 2004 and found that 92 per cent of all rape victims were females, 43 per cent were in the 12 to 15 age group, and 26 per cent were in the one to 12 age group. It also found that Amerindian girls between 12 to 16 years were the most vulnerable group nationally. And, over the last three years or so there have been at least eight reported cases of elderly women found murdered, all of them after being raped. Also it should be noted that while these figures are alarming, most rape cases go unreported because of the stigma and discrimination attached to it in Guyana’s society; in Guyana rape is still considered taboo, too shameful to be made publicly known and a significant percentage of rapes is incestuous. Besides the 2007 GHRA report found that more than two-thirds of sexual assault crimes occurred in the homes of the victims while three out of four perpetrators were known to victims and one in every five perpetrators were related to their victims. And, fathers, stepfathers and father-figures are responsible for over 67% of family-related sexual violence. Use of condoms was reported in only 3% of cases.

Against this background of increasing sexual violence and crimes, there has been an average conviction rate of 1.4 per cent in rape cases compared to rape reports originally made to the Police. Additionally, as of last year there were no convictions for sexual offences since 2011. Factors impacting this include lack of rape kits at hospitals, flimsy evidence, an inefficient jury system, shoddy prosecution of such cases, reluctance of victims to give witness and discontinuance of cases owning to unwillingness of victims to pursue.

Amidst all of this, emerge very disturbing trends. The rape/murder of the elderly is one such trend. Another is the rape, resulting in serious injuries, to small children less than 10 years old and as young as a few months old. A third trend is the rape of teenagers, many of who end up pregnant, forever changing their lives and often times putting an end to dreams and aspirations. In most cases sex may have been consensual but the reality is that sex with anyone under 16 is statutory rape.

Empirical and anecdotal evidence indicate that in many cases the victims are bought off, with police often fostering the ‘deal’ for commissions. Sometimes families are also bought off after being intimidated, especially if the rapist is politically connected or comes form a family with status and influence. In effect, in Guyana, issues such as poverty and complicity involving law enforcement officers also impact both the under reporting of rape and the conviction of rapists. Furthermore, the Sexual Offences Act is still to be given teeth and too many police still do not enforce the provisions of that act; in fact sensitivity training with respect to provisions of the Sexual Offences Act, is still to be widely implemented. Given these realities, there is really very little protection against rapists for communities across Guyana.

 

 

 

 

 

SUICIDE SWOT

STRENGTHS

➢ NGOs: TVC, CAR, CADVA, Save Abee, Nirvana, Inspire Inc, CPIC…

➢ Willingness of businesses to help: Cara Hotel, Galaxy 21, Guyenterrpize, Andrews Arts...

➢ General population wants to participate in suicide prevention - TCV polls

➢ Increasing advocacy and education through the media

➢ Increasing resources, training and capacity building by international agencies

➢ Increasing awareness of the issues and needs

➢ Increasing information gathering and anecdotal documentation

 

WEAKNESSES

➢ Lack of  effective/empathetic communication

➢ No concerted planning and implementation among stakeholders

➢ Stigma of and taboo with regards to Mental Illness

➢ Shortage of skilled professional, under the current system of care

➢ Lack of access to needed resources

➢ No standard plan of action to curb the Suicide epidemic

➢ Myths and misinformation abound

➢ Prohibitive costs factors that inhibit activism, advocacy and intervention

➢ Centralization with respect to redress

 

OPPORTUNITIES

➢ Making suicide a public health crisis, facing all Guyanese

➢ Sri Lankan Model

➢ Internet access to free online trainings

➢ Sensitization of students through reports, artwork, projects or workshop

➢ Cross training UG students in all aspect of Human Services

➢ Setting up a crisis network, with referral sites in each region

➢ Collaborative approach - public & private sectors and NGOs & activists

 

THREATS

➢ Lack of funding & training for programs to be implemented nationwide

➢ Inadequate data collections and usage, no consistent approach to data sharing

➢ Increasing suicides which keeps expanding geographically

➢ Maintaining current policy (laws) as regards to suicide.

➢ Resistance to change, due to fear, ignorance and other factors

➢ The interplay of politics and ethnicity

➢ Family dynamics/religious & cultural influences.

➢ No existing mental health program

➢ No network of hotlines, woefully inadequate social workers and counselors

➢ Only five psychologists in the gov't health care system

 

 

 

 

SEXUAL CRIMES SWOT

STRENGTHS

➢ NGOs: TVC, CAR, CADVA, CPIC, GRPA...

➢ Willingness of businesses to help: Cara Hotel, Pegasus Hotel,

➢ Increasing advocacy and education through the media

➢ Increasing awareness of the issues and needs

➢ Increasing information gathering and anecdotal documentation

➢ A seeming desire on the part of government to tackle this issue

 

WEAKNESSES

➢ No concerted planning and implementation among stakeholders

➢ Lack of skilled professional to address the situation

➢ Lack of access to needed resources

➢ No standard plan of action to curb sexual crimes

➢ Legislation without teeth

➢ Justice system leniency coupled with poor investigative techniques

➢ Female powerlessness and dependency on the males in their lives

➢ The social media factor - unstrained access, lack of knowledge about its pros and cons

➢ Insufficient prevention and awareness raising programs

➢ Resigned acceptance by too many victims

➢ Too many cases unreported

 

OPPORTUNITIES

➢ Making sexual crimes a crisis issue

➢ New government ...public utterances point to will and implementable measures

➢ Establish a Registry of Sex offenders and sensitize public to its advantages.

➢ Possibility of sensitivity training for police and health care workers

➢ Internet access to information and resources

➢ Sensitization of students through reports, artwork, projects or workshop

➢ Cross train UG students in all aspect of Human Services

➢ Set up a crisis network, with referral sites in each region

➢ Collaborative approach - public & private sectors and NGOs & activists.

 

THREATS

➢ Lack of funding & training for programs to be implemented nationwide

➢ Increasing sexual crimes with figures indicating a 60% increase in rape this year

➢ Family dynamics/dependency & control influences.

➢ No hotlines, woefully inadequate social workers and counselors

➢ Persistence of silence - shame and stigma

➢ Inadequate data collections and usage, no consistent approach to data sharing

➢ Susceptibility of teenagers to inducements and coercion

➢ The lure of social media 'fame'

➢ Negligible support systems in place

 

 

ABUSE SWOT

STRENGTHS

➢ NGOs: TVC, CADVA, CPIC, HELP & SHELTER...

➢ Willingness of businesses to help: Cara Hotel, Pegasus Hotel…

➢ Increasing advocacy and education through the media

➢ Increasing awareness of the issues and needs

➢ Increasing information gathering and anecdotal documentation

➢ A seeming desire on the part of government to tackle this issue

➢ Increasing activism at the individual level

 

WEAKNESSES

➢ No concerted planning and implementation among stakeholders

➢ Lack of skilled professional to address the situation

➢ Lack of access to needed resources

➢ No standard plan of action to curb abuse

➢ Legislation without teeth

➢ Justice system leniency coupled with poor investigative techniques

➢ Female powerlessness and dependency on the males in their lives

➢ Insufficient prevention and awareness raising programs

➢ Issue of children

 

OPPORTUNITIES

➢ Making abuse a crisis issue

➢ New government ...public utterances point to will and implementable measures

➢ Possibility of sensitivity training for police and health care workers

➢ Internet access to information and resources

➢ Cross train UG students in all aspect of Human Services

➢ Set up a crisis network, with referral sites in each region

➢ Collaborative approach - public & private sectors and NGOs & activists

➢ Involvement of all stakeholders

 

THREATS

➢ Lack of funding & training for programs to be implemented nationwide

➢ Family dynamics/dependency & control influences.

➢ No hotlines, woefully inadequate social workers and counselors

➢ Persistence of silence - shame and stigma

➢ Inadequate data collections and usage, no consistent approach to data sharing

➢ Negligible support systems in place

➢ Resigned acceptance reinforced by normative pressure

 

 

 

 

Drug & Alcohol SWOT

Strengths

• Four local NGO’s staff is extremely knowledgeable in addiction – All staff members have a combined 10-15 years of addiction experience be it personal or professional.

• Three in house treatment centers available in Georgetown – Salvation Army, YMCA and Phoenix Recovery Project (all female) as well as one outpatient center at the public hospital.

• A new form of recovery program – the Catholic Church and other sources.  These programs mostly focus on the client recovery, not the turnover of a client.

• Transportation for clients – Most addicts and alcoholics are either without a driver’s license or cannot afford bus costs. By offering transportation stipend, they are will be able to reach the clients without a vehicle, through Ministry of Health program.

 

Weakness

➢ High financial cost for programs: The YMCA charges each client $40,000 per month to participate in program. The Salvation Army charges $60,000. Phoenix recovery Project charges $50,000.

➢ Only 20 to 25% full recovery rate – Salvation Army

➢ No recovery centers offering any form or extended treatment options within Guyana.

➢ Insufficient professional staff to address the issues of addiction.

➢ Lack of awareness that alcoholism is a disease and that it requires treatment and resources.

➢ Inconsistent and limited application of the law against the sale of alcohol to minors.

➢ No national alcohol anonymous program.

➢ No known national plan to address alcohol abuse and drug addiction.

➢ No secured funding within the ministry of health treatment of addicts.

➢ Poor data collection.

➢ Inconsistent efforts to enforce anti-drinking and driving laws.

➢ Inadequate health promotion and prevention strategies.

 

Opportunities

➢ Create substance abuse-related education, assessment, intervention, treatment and recovery services.

➢ Expand the number of behavioral health provider options in an effort to increase the number of citizens served.

➢ Explore new funding sources from donor communities for behavioral health programs, services, and providers and increase gov’t funding for same.

➢ Partner with NGO’s and churches to implément evidenced-based prevention programs that teach personal responsibility for one’s health.

➢ Maximize the use of social media to educate the public, particularly those under the age of 18.

➢ Improve the internal culture at the Health Department by attracting and engaging high quality staff; ensuring professional excellence by concentrating on ongoing professional development and training, providing training funds and tracking all training; developing leadership competencies; and developing a succession plan and mentorship program.

➢ Leverage technology/infrastructure by implementing an electronic health record (EHR) system; and using social media to its fullest public health potential.

➢ At least one Rehabilitation Treatment Center in each of Guyana’s ten region which was a goal of the previous government.

➢ Re-examination of our laws pertaining to penalties for possession of small amount of marijuana for personal use.

 

Threats

• Lack of established and reputable treatment centers throughout Guyana.

• Increased dysfunctional families:  The impact of drinking on family life can include substantial mental health problems for other family members, such as anxiety, fear and depression.

• Increase domestic violence: Drinking outside the home can mean less time spent at home. The financial costs of alcohol purchase and medical treatment, as well as lost wages can leave other family members destitute. When men drink it often primarily affects their mothers or partners who may need to contribute more to the income of the household and who run an increased risk of violence or HIV infection.

• Communities do not have much communication internally or with each other on the issues of drug use and alcohol.

• The economic consequences of alcohol consumption can be severe, particularly for the poor:  Apart from money spent on drinks, heavy drinkers may suffer other economic problems such as lower wages and lost employment opportunities, increased medical and legal expenses, and decreased ability to manage small resources.

• Increase suicide rates: alcohol plays a role in murder suicides as well as suicide itself.

• Increase in health problems such as respiratory depression, cancer, Fetal Alcohol Syndrome, elevated blood pressure, and, in some case, death.

• Increase in criminal behavior:  Alcohol reduces inhibitions and lead you to behave in a way that you would not consider if you were sober. Incidents that you would deal with rationally when sober, can quickly escalate and get out of hand after a few drinks and may end up involving the police.

• Increase in teenage pregnancy, HIV/AIDS, STD, health and social impacts of underage drinking: Children and young people who misuse alcohol are at greater risk of suffering negative health and social outcomes compared to adults, because they have not yet fully developed their mental and physical faculties. Data and research on underage sexual activity shows evidence that indicates a positive correlation between early regular alcohol consumption and the early onset of risky sexual activity

• Failure of the Criminal Justice system to appreciate rehabilitation as an alternative to incarceration

• Lack of any structured rehabilitation program in our prisons

• The rum culture – sports, entertainment, social and cultural events and social acceptance of drinking

• Benevolent attitude towards drug addicts

• The issue of deportees who are addicts

• Easy availability of drugs in almost every community.

 

 

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