Last Wednesday, three days after he had turned himself into a human torch, Clifford Carter, a father of three, died at the New Amsterdam Hospital. The man, who sustained third degree burns over 70% of his body, said he had taken the action because of domestic problems in his 14-year marriage.
The tragedy of Mr Carter’s suicide reinforces the fact that mental health, a serious problem in Guyana, has been relegated to the bottom of the heap. Mr Carter’s suicide barely caused a blip on the radar of domestic violence and its consequences in Guyana. But it should have.
It is common knowledge that for the most part, local men in Mr Carter’s situation would have first hit the bottle or their substance of choice and then their wives. In way too many cases, the wives do not survive the hitting especially after it becomes chronic or escalates to include the use of knives, cutlasses and other weapons.
Prior to dousing himself with gasoline and scratching that match on Sunday, October 30, Mr Carter, a resident of Corriverton, was a productive citizen, according to reports. He may not have been a model citizen; there was no evidence to suggest that he was or was not, for that matter. He was a painter with a wife and three children who was embroiled in a dispute with his wife that they could not resolve. Frustrated, and with nowhere to turn for help, he, like so many others, chose violence. Only in his case, it physically involved just him. The psychological effect of his action on his family, particularly his children, whom he begged for forgiveness as he lay dying, is bound to be dire.
According to the World Health Organisation, suicide is estimated to be the third-leading cause of death among Guyanese aged 15 to 44 years, accounting for 13% of all deaths. Studies “indicate that there is likely a prevalence of 10% to 15% of the population with a mental disorder at any one time, with 3% to 5% of the population having a severe chronic mental disorder,” the WHO Assessment Instrument for Mental Health Systems (AIMS) 2008 report on Guyana said. “Given a population estimate of 750,000, this would predict that 75,000 to 112,500 Guyanese suffer from mental disorders and require some level of mental health care services,” the report added.
After the report was published in 2008, Minister of Health, Dr Leslie Ramsammy, said at a forum in 2009 that mental health has been sidelined for years because of minimal investments and general neglect. He admitted that the health sector had seriously overlooked the problem, but said it could no longer be ignored given the burden of suicide on public health and its consequent impact on development. He said suicide significantly affects the sector here even though it is a preventable public health problem.
The Ministry of Health’s Strategic Plan 2008-2012, in its preamble noted that the prevalence of completed suicides here – about 24 to 26 per 100,000 population – was more than double the global average. It stated that clinical depression and anxiety could be treated effectively with inexpensive medicines and simple psychosocial interventions and therefore early detection of mental health problems and appropriate treatment was necessary.
The plan listed several interventions, including training, the introduction of modern legislation and the reconstruction of the National Psychiatric Hospital at Fort Canje. There has been some amount of training, mainly for health care workers dealing with substance abusers, but no new legislation. In 2008, a contract for the sum of $44,164,300 was awarded for the remodelling of the Canje Hospital. In January 2009, the conditions at the same hospital sparked a prolonged debate in Parliament. This year, in July, Cabinet green-lighted another contract for $112.7 million for the construction of “an acute care psychiatric hospital at the same Fort Canje facility.” The obvious question is what happened to the $44,164,300 remodelling. Added to which, the primary and community care facilities needed to assist people who might be suicidal, like Mr Carter, are sadly lacking and no doubt still will be, when the health care plan expires next year. What has changed in the mental health arena since Mr Ramsammy’s admission of neglect in 2009? Quite likely, the suicide rate has gone up and there are no doubt other tormented souls contemplating adding themselves to the statistics.
